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Key: (1) language to be deleted (2) new language

CHAPTER 108--H.F.No. 1233

An act

relating to state government; establishing the health and human services budget; modifying provisions related to health care, continuing care, human services licensing, children and family services, program integrity, health-related licensing boards, chemical and mental health services, managed care organizations, waiver provider standards, home care, and the Department of Health; redesigning home and community-based services; establishing payment methodologies for home and community-based services; adjusting provider rates; setting and modifying fees; modifying autism coverage; modifying assistance programs; establishing Northstar care for children; making technical changes; requiring studies; requiring reports; appropriating money;

amending Minnesota Statutes 2012, sections 13.381, subdivisions 2, 10; 13.461, by adding subdivisions; 16A.724, subdivisions 2, 3; 16C.10, subdivision 5; 16C.155, subdivision 1; 43A.23, by adding a subdivision; 62J.692, subdivisions 1, 3, 4, 5, 9, by adding a subdivision; 62Q.19, subdivision 1; 103I.005, by adding a subdivision; 103I.521; 119B.011, by adding a subdivision; 119B.02, by adding a subdivision; 119B.025, subdivision 1; 119B.03, subdivision 4; 119B.05, subdivision 1; 119B.13, subdivisions 1, 1a, 3a, 6, 7, by adding subdivisions; 144.051, by adding subdivisions; 144.0724, subdivisions 4, 6; 144.123, subdivision 1; 144.125, subdivision 1; 144.212; 144.213; 144.215, subdivisions 3, 4; 144.216, subdivision 1; 144.217, subdivision 2; 144.218, subdivision 5; 144.225, subdivisions 1, 4, 7, 8; 144.226; 144.966, subdivisions 2, 3a; 144.98, subdivisions 3, 5, by adding subdivisions; 144.99, subdivision 4; 144A.071, subdivision 4b; 144A.351; 144A.43; 144A.44; 144A.45; 144D.01, subdivision 4; 145.906; 145.986; 145A.17, subdivision 1; 145C.01, subdivision 7; 148B.17, subdivision 2; 148E.065, subdivision 4a; 149A.02, subdivisions 1a, 2, 3, 4, 5, 16, 23, 27, 34, 35, 37, by adding subdivisions; 149A.03; 149A.65, by adding subdivisions; 149A.70, subdivisions 1, 2, 3, 5; 149A.71, subdivisions 2, 4; 149A.72, subdivisions 3, 9, by adding a subdivision; 149A.73, subdivisions 1, 2, 4; 149A.74; 149A.91, subdivision 9; 149A.93, subdivisions 3, 6; 149A.94; 149A.96, subdivision 9; 151.19, subdivisions 1, 3; 151.37, subdivision 4; 151.47, subdivision 1, by adding a subdivision; 151.49; 174.30, subdivision 1; 214.12, by adding a subdivision; 214.40, subdivision 1; 243.166, subdivisions 4b, 7; 245.03, subdivision 1; 245.462, subdivision 20; 245.4661, subdivisions 5, 6; 245.4682, subdivision 2; 245.4871, subdivision 26; 245.4875, subdivision 8; 245.4881, subdivision 1; 245.91, by adding a subdivision; 245.94, subdivisions 2, 2a; 245A.02, subdivisions 1, 9, 10, 14; 245A.03, subdivisions 7, 8, 9; 245A.04, subdivision 13; 245A.042, subdivision 3; 245A.07, subdivisions 2a, 3; 245A.08, subdivision 2a; 245A.10; 245A.11, subdivisions 2a, 7, 7a, 7b, 8; 245A.1435; 245A.144; 245A.1444; 245A.16, subdivision 1; 245A.40, subdivision 5; 245A.50; 245C.04, by adding a subdivision; 245C.08, subdivision 1; 245D.02; 245D.03; 245D.04; 245D.05; 245D.06; 245D.07; 245D.09; 245D.10; 246.18, subdivision 8, by adding a subdivision; 246.54; 252.27, subdivision 2a; 252.291, by adding a subdivision; 252.41, subdivision 3; 252.42; 252.43; 252.44; 252.45; 252.46, subdivision 1a; 253B.10, subdivision 1; 254B.04, subdivision 1; 254B.13; 256.01, subdivisions 2, 24, 34, by adding subdivisions; 256.0112, by adding a subdivision; 256.015, subdivision 1; 256.82, subdivisions 2, 3; 256.9657, subdivisions 3, 3a, 4; 256.969, subdivision 29; 256.975, subdivision 7, by adding subdivisions; 256.9754, subdivision 5, by adding subdivisions; 256.98, subdivision 8; 256B.02, subdivision 17, as added, by adding subdivisions; 256B.021, by adding subdivisions; 256B.04, subdivisions 18, 21, by adding a subdivision; 256B.055, subdivisions 3a, 6, 10, 14, 15, by adding a subdivision; 256B.056, subdivisions 1, 1c, 3, 4, as amended, 5c, 10, by adding a subdivision; 256B.057, subdivisions 1, 8, 10, by adding a subdivision; 256B.06, subdivision 4; 256B.0623, subdivision 2; 256B.0625, subdivisions 9, 13, 13e, 19c, 31, 39, 48, 56, 58, by adding subdivisions; 256B.0631, subdivision 1; 256B.064, subdivisions 1a, 1b, 2; 256B.0659, subdivision 21; 256B.0755, subdivision 3; 256B.0756; 256B.0911, subdivisions 1, 1a, 3a, 4d, 6, 7, by adding a subdivision; 256B.0913, subdivision 4; 256B.0915, subdivisions 3a, 5, by adding a subdivision; 256B.0916, by adding a subdivision; 256B.0917, subdivisions 6, 13, by adding subdivisions; 256B.092, subdivisions 1a, 7, 11, 12, by adding subdivisions; 256B.0943, subdivisions 1, 2, 7, by adding a subdivision; 256B.0946; 256B.095; 256B.0951, subdivisions 1, 4; 256B.0952, subdivisions 1, 5; 256B.0955; 256B.097, subdivisions 1, 3; 256B.196, subdivision 2; 256B.431, subdivision 44; 256B.434, subdivision 4, by adding subdivisions; 256B.437, subdivision 6; 256B.439, subdivisions 1, 2, 3, 4, by adding subdivisions; 256B.441, subdivisions 13, 44, 53, by adding subdivisions; 256B.49, subdivisions 11a, 12, 13, 14, 15, by adding subdivisions; 256B.4912, subdivisions 1, 2, 3, 7, by adding subdivisions; 256B.4913, subdivisions 5, 6, by adding a subdivision; 256B.492; 256B.493, subdivision 2; 256B.501, by adding a subdivision; 256B.5011, subdivision 2; 256B.5012, by adding subdivisions; 256B.69, subdivisions 5c, 5i, 8, 9c, 31, by adding subdivisions; 256B.694; 256B.76, subdivisions 1, 2, 4, by adding a subdivision; 256B.761; 256B.764; 256B.766; 256B.767; 256D.44, subdivision 5; 256I.05, by adding a subdivision; 256J.08, subdivision 24; 256J.21, subdivisions 2, 3; 256J.24, subdivisions 5, 7; 256J.35; 256J.621; 256J.626, subdivision 7; 256K.45; 256L.01, subdivisions 3a, 5, by adding subdivisions; 256L.02, subdivision 2, by adding subdivisions; 256L.03, subdivisions 1, 1a, 3, 5, 6, by adding a subdivision; 256L.04, subdivisions 1, 7, 8, 10, 12, by adding subdivisions; 256L.05, subdivisions 1, 2, 3, 3c; 256L.06, subdivision 3; 256L.07, subdivisions 1, 2, 3; 256L.09, subdivision 2; 256L.11, subdivisions 1, 3; 256L.12, subdivision 1; 256L.15, subdivisions 1, 2; 256M.40, subdivision 1; 257.0755, subdivision 1; 257.75, subdivision 7; 257.85, subdivisions 2, 5, 6; 259A.20, subdivision 4; 260B.007, subdivisions 6, 16; 260C.007, subdivisions 6, 31; 260C.446; 260C.635, subdivision 1; 299C.093; 402A.10; 402A.18; 471.59, subdivision 1; 517.001; 518A.60; 626.556, subdivisions 2, 3, 10d; 626.557, subdivisions 4, 9, 9a, 9e; 626.5572, subdivision 13; Laws 1998, chapter 407, article 6, section 116; Laws 2011, First Special Session chapter 9, article 1, section 3; article 2, section 27; article 10, section 3, subdivision 3, as amended; Laws 2012, chapter 247, article 6, section 4; Laws 2013, chapter 1, section 6; proposing coding for new law in Minnesota Statutes, chapters 62A; 144; 144A; 145; 149A; 151; 214; 245; 245A; 245D; 254B; 256; 256B; 256J; 256L; 259A; 260C; 402A; proposing coding for new law as Minnesota Statutes, chapters 245E; 256N; repealing Minnesota Statutes 2012, sections 62J.693; 103I.005, subdivision 20; 144.123, subdivision 2; 144A.46; 144A.461; 149A.025; 149A.20, subdivision 8; 149A.30, subdivision 2; 149A.40, subdivision 8; 149A.45, subdivision 6; 149A.50, subdivision 6; 149A.51, subdivision 7; 149A.52, subdivision 5a; 149A.53, subdivision 9; 151.19, subdivision 2; 151.25; 151.45; 151.47, subdivision 2; 151.48; 245A.655; 245B.01; 245B.02; 245B.03; 245B.031; 245B.04; 245B.05, subdivisions 1, 2, 3, 5, 6, 7; 245B.055; 245B.06; 245B.07; 245B.08; 245D.08; 252.40; 252.46, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 16, 17, 18, 19, 20, 21; 256.82, subdivision 4; 256B.055, subdivisions 3, 5, 10b; 256B.056, subdivision 5b; 256B.057, subdivisions 1c, 2; 256B.0911, subdivisions 4a, 4b, 4c; 256B.0917, subdivisions 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 14; 256B.096, subdivisions 1, 2, 3, 4; 256B.14, subdivision 3a; 256B.49, subdivision 16a; 256B.4913, subdivisions 1, 2, 3, 4; 256B.501, subdivision 8; 256B.5012, subdivision 13; 256J.24; 256L.01, subdivision 4a; 256L.031; 256L.04, subdivisions 1b, 9, 10a; 256L.05, subdivision 3b; 256L.07, subdivisions 1, 5, 8, 9; 256L.11, subdivisions 5, 6; 256L.17, subdivisions 1, 2, 3, 4, 5; 260C.441; 485.14; 609.093; Laws 2011, First Special Session chapter 9, article 7, section 54, as amended; Minnesota Rules, parts 4668.0002; 4668.0003; 4668.0005; 4668.0008; 4668.0012; 4668.0016; 4668.0017; 4668.0019; 4668.0030; 4668.0035; 4668.0040; 4668.0050; 4668.0060; 4668.0065; 4668.0070; 4668.0075; 4668.0080; 4668.0100; 4668.0110; 4668.0120; 4668.0130; 4668.0140; 4668.0150; 4668.0160; 4668.0170; 4668.0180; 4668.0190; 4668.0200; 4668.0218; 4668.0220; 4668.0230; 4668.0240; 4668.0800; 4668.0805; 4668.0810; 4668.0815; 4668.0820; 4668.0825; 4668.0830; 4668.0835; 4668.0840; 4668.0845; 4668.0855; 4668.0860; 4668.0865; 4668.0870; 4669.0001; 4669.0010; 4669.0020; 4669.0030; 4669.0040; 4669.0050; 9525.1860, subparts 3, items B, C, 4, item D; 9560.0650, subparts 1, 3, 6; 9560.0651; 9560.0655.

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

ARTICLE 1

AFFORDABLE CARE ACT IMPLEMENTATION; BETTER HEALTH CARE FOR MORE MINNESOTANS

Section 1.

Minnesota Statutes 2012, section 16A.724, subdivision 3, is amended to read:

Subd. 3.

MinnesotaCare federal receipts.

deleted text begin Receipts received as a result of federal participation pertaining to administrative costs of the Minnesota health care reform waiver shall be deposited as nondedicated revenue in the health care access fund. Receipts received as a result of federal participation pertaining to grants shall be deposited in the federal fund and shall offset health care access funds for payments to providers. deleted text end new text begin All federal funding received by Minnesota for implementation and administration of MinnesotaCare as a basic health program, as authorized in section 1331 of the Affordable Care Act, Public Law 111-148, as amended by Public Law 111-152, is dedicated to that program and shall be deposited into the health care access fund. Federal funding that is received for implementing and administering MinnesotaCare as a basic health program and deposited in the fund shall be used only for that program to purchase health care coverage for enrollees and reduce enrollee premiums and cost-sharing or provide additional enrollee benefits. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2015. new text end

Sec. 2.

Minnesota Statutes 2012, section 254B.04, subdivision 1, is amended to read:

Subdivision 1.

Eligibility.

(a) Persons eligible for benefits under Code of Federal Regulations, title 25, part 20, persons eligible for medical assistance benefits under sections 256B.055, 256B.056, and 256B.057, subdivisions 1, deleted text begin 2,deleted text end 5, and 6, or who meet the income standards of section 256B.056, subdivision 4, and persons eligible for general assistance medical care under section 256D.03, subdivision 3, are entitled to chemical dependency fund services. State money appropriated for this paragraph must be placed in a separate account established for this purpose.

Persons with dependent children who are determined to be in need of chemical dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the local agency to access needed treatment services. Treatment services must be appropriate for the individual or family, which may include long-term care treatment or treatment in a facility that allows the dependent children to stay in the treatment facility. The county shall pay for out-of-home placement costs, if applicable.

(b) A person not entitled to services under paragraph (a), but with family income that is less than 215 percent of the federal poverty guidelines for the applicable family size, shall be eligible to receive chemical dependency fund services within the limit of funds appropriated for this group for the fiscal year. If notified by the state agency of limited funds, a county must give preferential treatment to persons with dependent children who are in need of chemical dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or a case plan under section 260C.201, subdivision 6, or 260C.212. A county may spend money from its own sources to serve persons under this paragraph. State money appropriated for this paragraph must be placed in a separate account established for this purpose.

(c) Persons whose income is between 215 percent and 412 percent of the federal poverty guidelines for the applicable family size shall be eligible for chemical dependency services on a sliding fee basis, within the limit of funds appropriated for this group for the fiscal year. Persons eligible under this paragraph must contribute to the cost of services according to the sliding fee scale established under subdivision 3. A county may spend money from its own sources to provide services to persons under this paragraph. State money appropriated for this paragraph must be placed in a separate account established for this purpose.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 3.

Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision to read:

new text begin Subd. 35. new text end

new text begin Federal approval. new text end

new text begin (a) The commissioner shall seek federal authority from the U.S. Department of Health and Human Services necessary to operate a health coverage program for Minnesotans with incomes up to 275 percent of the federal poverty guidelines (FPG). The proposal shall seek to secure all federal funding available from at least the following sources: new text end

new text begin (1) all premium tax credits and cost sharing subsidies available under United States Code, title 26, section 36B, and United States Code, title 42, section 18071, for individuals with incomes above 133 percent and at or below 275 percent of the federal poverty guidelines who would otherwise be enrolled in the Minnesota Insurance Marketplace as defined in section 62V.02; new text end

new text begin (2) Medicaid funding; and new text end

new text begin (3) other funding sources identified by the commissioner that support coverage or care redesign in Minnesota. new text end

new text begin (b) Funding received shall be used to design and implement a health coverage program that creates a single streamlined program and meets the needs of Minnesotans with incomes up to 275 percent of the federal poverty guidelines. The program must incorporate: new text end

new text begin (1) payment reform characteristics included in the health care delivery system and accountable care organization payment models; new text end

new text begin (2) flexibility in benefit set design such that benefits can be targeted to meet enrollee needs in different income and health status situations and can provide a more seamless transition from public to private health care coverage; new text end

new text begin (3) flexibility in co-payment or premium structures to incent patients to seek high-quality, low-cost care settings; and new text end

new text begin (4) flexibility in premium structures to ease the transition from public to private health care coverage. new text end

new text begin (c) The commissioner shall develop and submit a proposal consistent with the above criteria and shall seek all federal authority necessary to implement the health coverage program. In developing the request, the commissioner shall consult with appropriate stakeholder groups and consumers. new text end

new text begin (d) The commissioner is authorized to seek any available waivers or federal approvals to accomplish the goals under paragraph (b) prior to 2017. new text end

new text begin (e) The commissioner shall report to the chairs and ranking minority members of the legislative committees with jurisdiction over health and human services policy and financing by January 15, 2015, on the progress of receiving a federal waiver and shall make recommendations on any legislative changes necessary to accomplish the project in this subdivision. Any implementation of the waiver that requires a state financial contribution to operate a health coverage program for Minnesotans with incomes between 200 and 275 percent of the federal poverty guidelines, shall be contingent on legislative action approving the contribution. new text end

new text begin (f) The commissioner is authorized to accept and expend federal funds that support the purposes of this subdivision. new text end

Sec. 4.

Minnesota Statutes 2012, section 256.015, subdivision 1, is amended to read:

Subdivision 1.

State agency has lien.

When the state agency provides, pays for, or becomes liable for medical care or furnishes subsistence or other payments to a person, the agency shall have a lien for the cost of the care and payments on any and all causes of action or recovery rights under any policy, plan, or contract providing benefits for health care or injury which accrue to the person to whom the care or payments were furnished, or to the person's legal representatives, as a result of the occurrence that necessitated the medical care, subsistence, or other payments. For purposes of this section, "state agency" includes prepaid health plans under contract with the commissioner according to sections 256B.69, 256D.03, subdivision 4, paragraph (c), deleted text begin anddeleted text end 256L.12new text begin , 256L.01, subdivision 7, and 256L.03, subdivision 6new text end ; children's mental health collaboratives under section 245.493; demonstration projects for persons with disabilities under section 256B.77; nursing homes under the alternative payment demonstration project under section 256B.434; and county-based purchasing entities under section 256B.692.

Sec. 5.

Minnesota Statutes 2012, section 256B.02, subdivision 17, as added by Laws 2013, chapter 1, section 1, is amended to read:

Subd. 17.

Affordable Care Act deleted text begin or ACAdeleted text end .

"Affordable Care Act" deleted text begin or "ACA" means Public Law 111-148, as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), and any amendments to, or regulations or guidance issued under, those actsdeleted text end new text begin means the federal Patient Protection and Affordable Care Act, Public Law 111-148, as amended, including the federal Health Care and Education Reconciliation Act of 2010, Public Law 111-152, and any amendments to, and any federal guidance or regulations issued under, these actsnew text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013. new text end

Sec. 6.

Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision to read:

new text begin Subd. 18. new text end

new text begin Caretaker relative. new text end

new text begin "Caretaker relative" means a relative, by blood, adoption, or marriage, of a child under age 19 with whom the child is living and who assumes primary responsibility for the child's care. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 7.

Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision to read:

new text begin Subd. 19. new text end

new text begin Insurance affordability program. new text end

new text begin "Insurance affordability program" means one of the following programs: new text end

new text begin (1) medical assistance under this chapter; new text end

new text begin (2) a program that provides advance payments of the premium tax credits established under section 36B of the Internal Revenue Code or cost-sharing reductions established under section 1402 of the Affordable Care Act; new text end

new text begin (3) MinnesotaCare as defined in chapter 256L; and new text end

new text begin (4) a Basic Health Plan as defined in section 1331 of the Affordable Care Act. 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 2012, section 256B.04, subdivision 18, is amended to read:

Subd. 18.

Applications for medical assistance.

(a) The state agency deleted text begin may takedeleted text end new text begin shall acceptnew text end applications for medical assistance deleted text begin and conduct eligibility determinations for MinnesotaCare enrolleesdeleted text end new text begin by telephone, via mail, in-person, online via an Internet Web site, and through other commonly available electronic meansnew text end .

(b) The commissioner of human services shall modify the Minnesota health care programs application form to add a question asking applicants whether they have ever served in the United States military.

new text begin (c) For each individual who submits an application or whose eligibility is subject to renewal or whose eligibility is being redetermined pursuant to a change in circumstances, if the agency determines the individual is not eligible for medical assistance, the agency shall determine potential eligibility for other insurance affordability programs. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 9.

Minnesota Statutes 2012, section 256B.055, subdivision 3a, is amended to read:

Subd. 3a.

Families with children.

deleted text begin Beginning July 1, 2002,deleted text end Medical assistance may be paid for a person who is a child under the age of deleted text begin 18, or age 18 if a full-time student in a secondary school, or in the equivalent level of vocational or technical training, and reasonably expected to complete the program before reaching agedeleted text end 19; the parent new text begin or stepparent new text end of a deleted text begin dependentdeleted text end childnew text begin under the age of 19new text end , including a pregnant woman; or a caretaker relative of a deleted text begin dependentdeleted text end childnew text begin under the age of 19new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 10.

Minnesota Statutes 2012, section 256B.055, subdivision 6, is amended to read:

Subd. 6.

Pregnant women; needy unborn child.

Medical assistance may be paid for a pregnant woman who deleted text begin has written verification of a positive pregnancy test from a physician or licensed registered nurse, whodeleted text end meets the other eligibility criteria of this section and whose unborn child would be eligible as a needy child under subdivision 10 if born and living with the woman. new text begin In accordance with Code of Federal Regulations, title 42, section 435.956, the commissioner must accept self-attestation of pregnancy unless the agency has information that is not reasonably compatible with such attestation. new text end For purposes of this subdivision, a woman is considered pregnant for 60 days postpartum.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 11.

Minnesota Statutes 2012, section 256B.055, subdivision 10, is amended to read:

Subd. 10.

Infants.

Medical assistance may be paid for an infant less than one year of age, whose mother was eligible for and receiving medical assistance at the time of birth or who is new text begin less than two years of age and is new text end in a family with countable income that is equal to or less than the income standard established under section 256B.057, subdivision 1.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 12.

Minnesota Statutes 2012, section 256B.055, subdivision 15, is amended to read:

Subd. 15.

Adults without children.

Medical assistance may be paid for a person who is:

(1) at least age 21 and under age 65;

(2) not pregnant;

(3) not entitled to Medicare Part A or enrolled in Medicare Part B under Title XVIII of the Social Security Act;

(4) deleted text begin not an adult in a family with children as defined in section 256L.01, subdivision 3a; anddeleted text end new text begin not otherwise eligible under subdivision 7 as a person who meets the categorical eligibility requirements of the supplemental security income program;new text end

new text begin (5) not enrolled under subdivision 7 as a person who would meet the categorical eligibility requirements of the supplemental security income program except for excess income or assets; and new text end

deleted text begin (5)deleted text end new text begin (6)new text end not described in another subdivision of this section.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 13.

Minnesota Statutes 2012, section 256B.055, is amended by adding a subdivision to read:

new text begin Subd. 17. new text end

new text begin Adults who were in foster care at the age of 18. new text end

new text begin Medical assistance may be paid for a person under 26 years of age who was in foster care under the commissioner's responsibility on the date of attaining 18 years of age, and who was enrolled in medical assistance under the state plan or a waiver of the plan while in foster care, in accordance with section 2004 of the Affordable Care Act. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 14.

Minnesota Statutes 2012, section 256B.056, subdivision 1, is amended to read:

Subdivision 1.

Residency.

To be eligible for medical assistance, a person must reside in Minnesota, or, if absent from the state, be deemed to be a resident of Minnesotanew text begin ,new text end in accordance with deleted text begin the rules of the state agencydeleted text end new text begin Code of Federal Regulations, title 42, section 435.403new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 15.

Minnesota Statutes 2012, section 256B.056, subdivision 1c, is amended to read:

Subd. 1c.

Families with children income methodology.

(a)deleted text begin (1)deleted text end [Expired, 1Sp2003 c 14 art 12 s 17]

deleted text begin (2) For applications processed within one calendar month prior to July 1, 2003, eligibility shall be determined by applying the income standards and methodologies in effect prior to July 1, 2003, for any months in the six-month budget period before July 1, 2003, and the income standards and methodologies in effect on July 1, 2003, for any deleted text end deleted text begin months in the six-month budget period on or after that date. The income standards for each month shall be added together and compared to the applicant's total countable income for the six-month budget period to determine eligibility. deleted text end

deleted text begin (3) For children ages one through 18 whose eligibility is determined under section 256B.057, subdivision 2, the following deductions shall be applied to income counted toward the child's eligibility as allowed under the state's AFDC plan in effect as of July 16, 1996: $90 work expense, dependent care, and child support paid under court order. This clause is effective October 1, 2003. deleted text end

deleted text begin (b) For families with children whose eligibility is determined using the standard specified in section 256B.056, subdivision 4, paragraph (c), 17 percent of countable earned income shall be disregarded for up to four months and the following deductions shall be applied to each individual's income counted toward eligibility as allowed under the state's AFDC plan in effect as of July 16, 1996: dependent care and child support paid under court order. deleted text end

deleted text begin (c) If the four-month disregard in paragraph (b) has been applied to the wage earner's income for four months, the disregard shall not be applied again until the wage earner's income has not been considered in determining medical assistance eligibility for 12 consecutive months. deleted text end

deleted text begin (d)deleted text end new text begin (b)new text end The commissioner shall adjust the income standards under this section each July 1 by the annual update of the federal poverty guidelines following publication by the United States Department of Health and Human Services except that the income standards shall not go below those in effect on July 1, 2009.

deleted text begin (e)deleted text end new text begin (c)new text end For children age 18 or under, annual gifts of $2,000 or less by a tax-exempt organization to or for the benefit of the child with a life-threatening illness must be disregarded from income.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 16.

Minnesota Statutes 2012, section 256B.056, subdivision 3, is amended to read:

Subd. 3.

Asset limitations for new text begin certain new text end individuals deleted text begin and familiesdeleted text end .

(a) To be eligible for medical assistance, a person must not individually own more than $3,000 in assets, or if a member of a household with two family members, husband and wife, or parent and child, the household must not own more than $6,000 in assets, plus $200 for each additional legal dependent. In addition to these maximum amounts, an eligible individual or family may accrue interest on these amounts, but they must be reduced to the maximum at the time of an eligibility redetermination. The accumulation of the clothing and personal needs allowance according to section 256B.35 must also be reduced to the maximum at the time of the eligibility redetermination. The value of assets that are not considered in determining eligibility for medical assistance is the value of those assets excluded under the supplemental security income program for aged, blind, and disabled persons, with the following exceptions:

(1) household goods and personal effects are not considered;

(2) capital and operating assets of a trade or business that the local agency determines are necessary to the person's ability to earn an income are not considered;

(3) motor vehicles are excluded to the same extent excluded by the supplemental security income program;

(4) assets designated as burial expenses are excluded to the same extent excluded by the supplemental security income program. Burial expenses funded by annuity contracts or life insurance policies must irrevocably designate the individual's estate as contingent beneficiary to the extent proceeds are not used for payment of selected burial expenses;

(5) for a person who no longer qualifies as an employed person with a disability due to loss of earnings, assets allowed while eligible for medical assistance under section 256B.057, subdivision 9, are not considered for 12 months, beginning with the first month of ineligibility as an employed person with a disability, to the extent that the person's total assets remain within the allowed limits of section 256B.057, subdivision 9, paragraph (d);

(6) when a person enrolled in medical assistance under section 256B.057, subdivision 9, is age 65 or older and has been enrolled during each of the 24 consecutive months before the person's 65th birthday, the assets owned by the person and the person's spouse must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d), when determining eligibility for medical assistance under section 256B.055, subdivision 7. The income of a spouse of a person enrolled in medical assistance under section 256B.057, subdivision 9, during each of the 24 consecutive months before the person's 65th birthday must be disregarded when determining eligibility for medical assistance under section 256B.055, subdivision 7. Persons eligible under this clause are not subject to the provisions in section 256B.059. A person whose 65th birthday occurs in 2012 or 2013 is required to have qualified for medical assistance under section 256B.057, subdivision 9, prior to age 65 for at least 20 months in the 24 months prior to reaching age 65; and

(7) effective July 1, 2009, certain assets owned by American Indians are excluded as required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5. For purposes of this clause, an American Indian is any person who meets the definition of Indian according to Code of Federal Regulations, title 42, section 447.50.

(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision 15.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 17.

Minnesota Statutes 2012, section 256B.056, subdivision 4, as amended by Laws 2013, chapter 1, section 5, is amended to read:

Subd. 4.

Income.

(a) To be eligible for medical assistance, a person eligible under section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of the federal poverty guidelines. Effective January 1, 2000, and each successive January, recipients of supplemental security income may have an income up to the supplemental security income standard in effect on that date.

deleted text begin (b) To be eligible for medical assistance, families and children may have an income up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996, AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16, 1996, shall be increased by three percent. deleted text end

deleted text begin (c)deleted text end new text begin (b)new text end Effective January 1, 2014, to be eligible for medical assistance, under section 256B.055, subdivision 3a, a parent or caretaker relative may have an income up to 133 percent of the federal poverty guidelines for the household size.

deleted text begin (d)deleted text end new text begin (c)new text end To be eligible for medical assistance under section 256B.055, subdivision 15, a person may have an income up to 133 percent of federal poverty guidelines for the household size.

deleted text begin (e)deleted text end new text begin (d)new text end To be eligible for medical assistance under section 256B.055, subdivision 16, a child new text begin age 19 to 20 new text end may have an income up to 133 percent of the federal poverty guidelines for the household size.

deleted text begin (f) deleted text end new text begin (e) To be eligible for medical assistance under section 256B.055, subdivision 3a, a child under age 19 may have income up to 275 percent of the federal poverty guidelines for the household size or an equivalent standard when converted using modified adjusted gross income methodology as required under the Affordable Care Act. Children who are enrolled in medical assistance as of December 31, 2013, and are determined ineligible for medical assistance because of the elimination of income disregards under modified adjusted gross income methodology as defined in subdivision 1a remain eligible for medical assistance under the Children's Health Insurance Program Reauthorization Act of 2009, Public Law 111-3, until the date of their next regularly scheduled eligibility redetermination as required in section 256B.056, subdivision 7a. new text end

new text begin (f)new text end In computing income to determine eligibility of persons under paragraphs (a) to (e) who are not residents of long-term care facilities, the commissioner shall disregard increases in income as required by Public Laws 94-566, section 503; 99-272; and 99-509. For persons eligible under paragraph (a), veteran aid and attendance benefits and Veterans Administration unusual medical expense payments are considered income to the recipient.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 18.

Minnesota Statutes 2012, section 256B.056, subdivision 5c, is amended to read:

Subd. 5c.

Excess income standard.

(a) The excess income standard for deleted text begin families with childrendeleted text end new text begin parents and caretaker relatives, pregnant women, infants, and children ages two through 20new text end is the standard specified in subdivision 4new text begin , paragraph (b)new text end .

(b) The excess income standard for a person whose eligibility is based on blindness, disability, or age of 65 or more years deleted text begin is 70 percent of the federal poverty guidelines for the family size. Effective July 1, 2002, the excess income standard for this paragraphdeleted text end shall equal 75 percent of the federal poverty guidelines.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 19.

Minnesota Statutes 2012, section 256B.056, is amended by adding a subdivision to read:

new text begin Subd. 7a. new text end

new text begin Periodic renewal of eligibility. new text end

new text begin (a) The commissioner shall make an annual redetermination of eligibility based on information contained in the enrollee's case file and other information available to the agency, including but not limited to information accessed through an electronic database, without requiring the enrollee to submit any information when sufficient data is available for the agency to renew eligibility. new text end

new text begin (b) If the commissioner cannot renew eligibility in accordance with paragraph (a), the commissioner must provide the enrollee with a prepopulated renewal form containing eligibility information available to the agency and permit the enrollee to submit the form with any corrections or additional information to the agency and sign the renewal form via any of the modes of submission specified in section 256B.04, subdivision 18. new text end

new text begin (c) An enrollee who is terminated for failure to complete the renewal process may subsequently submit the renewal form and required information within four months after the date of termination and have coverage reinstated without a lapse, if otherwise eligible under this chapter. new text end

new text begin (d) Notwithstanding paragraph (a), individuals eligible under subdivision 5 shall be required to renew eligibility every six months. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 20.

Minnesota Statutes 2012, section 256B.056, subdivision 10, is amended to read:

Subd. 10.

Eligibility verification.

(a) The commissioner shall require women who are applying for the continuation of medical assistance coverage following the end of the 60-day postpartum period to update their income and asset information and to submit any required income or asset verification.

(b) The commissioner shall determine the eligibility of private-sector health care coverage for infants less than one year of age eligible under section 256B.055, subdivision 10, or 256B.057, subdivision 1, paragraph (d), and shall pay for private-sector coverage if this is determined to be cost-effective.

(c) The commissioner shall verify assets and income for all applicants, and for all recipients upon renewal.

new text begin (d) The commissioner shall utilize information obtained through the electronic service established by the secretary of the United States Department of Health and Human Services and other available electronic data sources in Code of Federal Regulations, title 42, sections 435.940 to 435.956, to verify eligibility requirements. The commissioner shall establish standards to define when information obtained electronically is reasonably compatible with information provided by applicants and enrollees, including use of self-attestation, to accomplish real-time eligibility determinations and maintain program integrity. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 21.

Minnesota Statutes 2012, section 256B.057, subdivision 1, is amended to read:

Subdivision 1.

Infants and pregnant women.

(a)deleted text begin (1)deleted text end An infant less than deleted text begin one yeardeleted text end new text begin two yearsnew text end of age or a pregnant woman deleted text begin who has written verification of a positive pregnancy test from a physician or licensed registered nursedeleted text end is eligible for medical assistance ifnew text begin the individual'snew text end countable deleted text begin familydeleted text end new text begin householdnew text end income is equal to or less than 275 percent of the federal poverty guideline for the same deleted text begin familydeleted text end new text begin householdnew text end sizenew text begin or an equivalent standard when converted using modified adjusted gross income methodology as required under the Affordable Care Actnew text end . deleted text begin For purposes of this subdivision, "countable family income" means the amount of income considered available using the methodology of the AFDC program under the state's AFDC plan as of July 16, 1996, as required by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 104-193, except for the earned income disregard and employment deductions.deleted text end

deleted text begin (2) For applications processed within one calendar month prior to the effective date, eligibility shall be determined by applying the income standards and methodologies in effect prior to the effective date for any months in the six-month budget period before that date and the income standards and methodologies in effect on the effective date for any months in the six-month budget period on or after that date. The income standards for each month shall be added together and compared to the applicant's total countable income for the six-month budget period to determine eligibility. deleted text end

deleted text begin (b)(1) [Expired, 1Sp2003 c 14 art 12 s 19] deleted text end

deleted text begin (2) For applications processed within one calendar month prior to July 1, 2003, eligibility shall be determined by applying the income standards and methodologies in effect prior to July 1, 2003, for any months in the six-month budget period before July 1, 2003, and the income standards and methodologies in effect on the expiration date for any months in the six-month budget period on or after July 1, 2003. The income standards for each month shall be added together and compared to the applicant's total countable income for the six-month budget period to determine eligibility. deleted text end

deleted text begin (3) An amount equal to the amount of earned income exceeding 275 percent of the federal poverty guideline, up to a maximum of the amount by which the combined total of 185 percent of the federal poverty guideline plus the earned income disregards and deductions allowed under the state's AFDC plan as of July 16, 1996, as required by the Personal Responsibility and Work Opportunity Act of 1996 (PRWORA), Public Law 104-193, exceeds 275 percent of the federal poverty guideline will be deducted for pregnant women and infants less than one year of age. deleted text end

deleted text begin (c) Dependent care and child support paid under court order shall be deducted from the countable income of pregnant women. deleted text end

deleted text begin (d)deleted text end new text begin (b)new text end An infant born to a woman who was eligible for and receiving medical assistance on the date of the child's birth shall continue to be eligible for medical assistance without redetermination until the child's first birthday.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 22.

Minnesota Statutes 2012, section 256B.057, subdivision 8, is amended to read:

Subd. 8.

Children under age two.

Medical assistance may be paid for a child under two years of age whose countable family income is above 275 percent of the federal poverty guidelines for the same size family but less than or equal to 280 percent of the federal poverty guidelines for the same size familynew text begin or an equivalent standard when converted using modified adjusted gross income methodology as required under the Affordable Care Actnew text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 23.

Minnesota Statutes 2012, section 256B.057, subdivision 10, is amended to read:

Subd. 10.

Certain persons needing treatment for breast or cervical cancer.

(a) Medical assistance may be paid for a person who:

(1) has been screened for breast or cervical cancer by the Minnesota breast and cervical cancer control program, and program funds have been used to pay for the person's screening;

(2) according to the person's treating health professional, needs treatment, including diagnostic services necessary to determine the extent and proper course of treatment, for breast or cervical cancer, including precancerous conditions and early stage cancer;

(3) meets the income eligibility guidelines for the Minnesota breast and cervical cancer control program;

(4) is under age 65;

(5) is not otherwise eligible for medical assistance under United States Code, title 42, section 1396a(a)(10)(A)(i); and

(6) is not otherwise covered under creditable coverage, as defined under United States Code, title 42, section 1396a(aa).

(b) Medical assistance provided for an eligible person under this subdivision shall be limited to services provided during the period that the person receives treatment for breast or cervical cancer.

(c) A person meeting the criteria in paragraph (a) is eligible for medical assistance without meeting the eligibility criteria relating to income and assets in section 256B.056, subdivisions 1a to deleted text begin 5bdeleted text end new text begin 5anew text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 24.

Minnesota Statutes 2012, section 256B.057, is amended by adding a subdivision to read:

new text begin Subd. 12. new text end

new text begin Presumptive eligibility determinations made by qualified hospitals. new text end

new text begin The commissioner shall establish a process to qualify hospitals that are participating providers under the medical assistance program to determine presumptive eligibility for medical assistance for applicants who may have a basis of eligibility using the modified adjusted gross income methodology as defined in section 256B.056, subdivision 1a, paragraph (b), clause (1). new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 25.

Minnesota Statutes 2012, section 256B.06, subdivision 4, is amended to read:

Subd. 4.

Citizenship requirements.

(a) Eligibility for medical assistance is limited to citizens of the United States, qualified noncitizens as defined in this subdivision, and other persons residing lawfully in the United States. Citizens or nationals of the United States must cooperate in obtaining satisfactory documentary evidence of citizenship or nationality according to the requirements of the federal Deficit Reduction Act of 2005, Public Law 109-171.

(b) "Qualified noncitizen" means a person who meets one of the following immigration criteria:

(1) admitted for lawful permanent residence according to United States Code, title 8;

(2) admitted to the United States as a refugee according to United States Code, title 8, section 1157;

(3) granted asylum according to United States Code, title 8, section 1158;

(4) granted withholding of deportation according to United States Code, title 8, section 1253(h);

(5) paroled for a period of at least one year according to United States Code, title 8, section 1182(d)(5);

(6) granted conditional entrant status according to United States Code, title 8, section 1153(a)(7);

(7) determined to be a battered noncitizen by the United States Attorney General according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;

(8) is a child of a noncitizen determined to be a battered noncitizen by the United States Attorney General according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, Public Law 104-200; or

(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public Law 96-422, the Refugee Education Assistance Act of 1980.

(c) All qualified noncitizens who were residing in the United States before August 22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for medical assistance with federal financial participation.

(d) Beginning December 1, 1996, qualified noncitizens who entered the United States on or after August 22, 1996, and who otherwise meet the eligibility requirements of this chapter are eligible for medical assistance with federal participation for five years if they meet one of the following criteria:

(1) refugees admitted to the United States according to United States Code, title 8, section 1157;

(2) persons granted asylum according to United States Code, title 8, section 1158;

(3) persons granted withholding of deportation according to United States Code, title 8, section 1253(h);

(4) veterans of the United States armed forces with an honorable discharge for a reason other than noncitizen status, their spouses and unmarried minor dependent children; or

(5) persons on active duty in the United States armed forces, other than for training, their spouses and unmarried minor dependent children.

Beginning July 1, 2010, children and pregnant women who are noncitizens described in paragraph (b) or who are lawfully present in the United States as defined in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet eligibility requirements of this chapter, are eligible for medical assistance with federal financial participation as provided by the federal Children's Health Insurance Program Reauthorization Act of 2009, Public Law 111-3.

(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this subdivision, a "nonimmigrant" is a person in one of the classes listed in United States Code, title 8, section 1101(a)(15).

(f) Payment shall also be made for care and services that are furnished to noncitizens, regardless of immigration status, who otherwise meet the eligibility requirements of this chapter, if such care and services are necessary for the treatment of an emergency medical condition.

(g) For purposes of this subdivision, the term "emergency medical condition" means a medical condition that meets the requirements of United States Code, title 42, section 1396b(v).

(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment of an emergency medical condition are limited to the following:

(i) services delivered in an emergency room or by an ambulance service licensed under chapter 144E that are directly related to the treatment of an emergency medical condition;

(ii) services delivered in an inpatient hospital setting following admission from an emergency room or clinic for an acute emergency condition; and

(iii) follow-up services that are directly related to the original service provided to treat the emergency medical condition and are covered by the global payment made to the provider.

(2) Services for the treatment of emergency medical conditions do not include:

(i) services delivered in an emergency room or inpatient setting to treat a nonemergency condition;

(ii) organ transplants, stem cell transplants, and related care;

(iii) services for routine prenatal care;

(iv) continuing care, including long-term care, nursing facility services, home health care, adult day care, day training, or supportive living services;

(v) elective surgery;

(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as part of an emergency room visit;

(vii) preventative health care and family planning services;

(viii) dialysis;

(ix) chemotherapy or therapeutic radiation services;

(x) rehabilitation services;

(xi) physical, occupational, or speech therapy;

(xii) transportation services;

(xiii) case management;

(xiv) prosthetics, orthotics, durable medical equipment, or medical supplies;

(xv) dental services;

(xvi) hospice care;

(xvii) audiology services and hearing aids;

(xviii) podiatry services;

(xix) chiropractic services;

(xx) immunizations;

(xxi) vision services and eyeglasses;

(xxii) waiver services;

(xxiii) individualized education programs; or

(xxiv) chemical dependency treatment.

(i) deleted text begin Beginning July 1, 2009,deleted text end Pregnant noncitizens who are deleted text begin undocumented, nonimmigrants, or lawfully present in the United States as defined in Code of Federal Regulations, title 8, section 103.12,deleted text end new text begin ineligible for federally funded medical assistance because of immigration status,new text end are not covered by a group health plan or health insurance coverage according to Code of Federal Regulations, title 42, section 457.310, and deleted text begin whodeleted text end otherwise meet the eligibility requirements of this chapter, are eligible for medical assistance through the period of pregnancy, including labor and delivery, and 60 days postpartum, to the extent federal funds are available under title XXI of the Social Security Act, and the state children's health insurance program.

(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation services from a nonprofit center established to serve victims of torture and are otherwise ineligible for medical assistance under this chapter are eligible for medical assistance without federal financial participation. These individuals are eligible only for the period during which they are receiving services from the center. Individuals eligible under this paragraph shall not be required to participate in prepaid medical assistance.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 26.

Minnesota Statutes 2012, section 256B.0755, subdivision 3, is amended to read:

Subd. 3.

Accountability.

(a) Health care delivery systems must accept responsibility for the quality of care based on standards established under subdivision 1, paragraph (b), clause (10), and the cost of care or utilization of services provided to its enrollees under subdivision 1, paragraph (b), clause (1).

(b) A health care delivery system may contract and coordinate with providers and clinics for the delivery of services and shall contract with community health clinics, federally qualified health centers, community mental health centers or programs, new text begin county agencies, new text end and rural clinics to the extent practicable.

new text begin (c) A health care delivery system must indicate how it will coordinate with other services affecting its patients' health, quality of care, and cost of care that are provided by other providers, county agencies, and other organizations in the local service area. The health care delivery system must indicate how it will engage other providers, counties, and organizations, including county-based purchasing plans, that provide services to patients of the health care delivery system on issues related to local population health, including applicable local needs, priorities, and public health goals. The health care delivery system must describe how local providers, counties, organizations, including county-based purchasing plans, and other relevant purchasers were consulted in developing the application to participate in the demonstration project. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013, and applies to health care delivery system contracts entered into on or after that date. new text end

Sec. 27.

Minnesota Statutes 2012, section 256B.694, is amended to read:

256B.694 SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE CONTRACT.

(a) MS 2010 [Expired, 2008 c 364 s 10]

(b) The commissioner shall consider, and may approve, contracting on a single-health plan basis with deleted text begin otherdeleted text end county-based purchasing plans, or with other qualified health plans that have coordination arrangements with counties, to serve persons deleted text begin with a disability who voluntarily enrolldeleted text end new text begin enrolled in state public health care programsnew text end , in order to promote better coordination or integration of health care services, social services and other community-based services, provided that all requirements applicable to health plan purchasing, including those in deleted text begin section 256B.69, subdivision 23deleted text end new text begin sections 256B.69 and 256B.692new text end , are satisfied. deleted text begin Nothing in this paragraph supersedes or modifies the requirements in paragraph (a).deleted text end

Sec. 28.

Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision to read:

new text begin Subd. 1b. new text end

new text begin Affordable Care Act. new text end

new text begin "Affordable Care Act" means the federal Patient Protection and Affordable Care Act, Public Law 111-148, as amended, including the federal Health Care and Education Reconciliation Act of 2010, Public Law 111-152, and any amendments to, and any federal guidance or regulations issued under, these acts. new text end

Sec. 29.

Minnesota Statutes 2012, section 256L.01, subdivision 3a, is amended to read:

Subd. 3a.

Family deleted text begin with childrendeleted text end .

(a) deleted text begin "Family with children" means:deleted text end

deleted text begin (1) parents and their children residing in the same household; or deleted text end

deleted text begin (2) grandparents, foster parents, relative caretakers as defined in the medical assistance program, or legal guardians; and their wards who are children residing in the same household. deleted text end new text begin "Family" has the meaning given for family and family size as defined in Code of Federal Regulations, title 26, section 1.36B-1. new text end

(b) The term includes children who are temporarily absent from the household in settings such as schools, camps, or parenting time with noncustodial parents.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 30.

Minnesota Statutes 2012, section 256L.01, subdivision 5, is amended to read:

Subd. 5.

Income.

deleted text begin (a)deleted text end "Income" has the meaning given for deleted text begin earned and unearned income for families and children in the medical assistance program, according to the state's aid to families with dependent children plan in effect as of July 16, 1996. The definition does not include medical assistance income methodologies and deeming requirements. The earned income of full-time and part-time students under age 19 is not counted as income. Public assistance payments and supplemental security income are not excluded incomedeleted text end new text begin modified adjusted gross income, as defined in Code of Federal Regulations, title 26, section 1.36B-1new text end .

deleted text begin (b) For purposes of this subdivision, and unless otherwise specified in this section, the commissioner shall use reasonable methods to calculate gross earned and unearned income including, but not limited to, projecting income based on income received within the past 30 days, the last 90 days, or the last 12 months. deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 31.

Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision to read:

new text begin Subd. 6. new text end

new text begin Minnesota Insurance Marketplace. new text end

new text begin "Minnesota Insurance Marketplace" means the Minnesota Insurance Marketplace as defined in section 62V.02. new text end

Sec. 32.

Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision to read:

new text begin Subd. 7. new text end

new text begin Participating entity. new text end

new text begin "Participating entity" means a health carrier as defined in section 62A.01, subdivision 2; a county-based purchasing plan established under section 256B.692; an accountable care organization or other entity operating a health care delivery systems demonstration project authorized under section 256B.0755; an entity operating a county integrated health care delivery network pilot project authorized under section 256B.0756; or a network of health care providers established to offer services under MinnesotaCare. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2015. new text end

Sec. 33.

Minnesota Statutes 2012, section 256L.02, subdivision 2, is amended to read:

Subd. 2.

Commissioner's duties.

new text begin (a) new text end The commissioner shall establish an office for the state administration of this plan. The plan shall be used to provide covered health services for eligible persons. Payment for these services shall be made to all deleted text begin eligible providersdeleted text end new text begin participating entities under contract with the commissionernew text end . The commissioner shall adopt rules to administer the MinnesotaCare program. The commissioner shall establish marketing efforts to encourage potentially eligible persons to receive information about the program and about other medical care programs administered or supervised by the Department of Human Services.

new text begin (b)new text end A toll-free telephone number new text begin and Web site new text end must be used to provide information about medical programs and to promote access to the covered services.

new text begin EFFECTIVE DATE. new text end

new text begin Paragraph (a) is effective January 1, 2015. Paragraph (b) is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 34.

Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision to read:

new text begin Subd. 5. new text end

new text begin Federal approval. new text end

new text begin (a) The commissioner of human services shall seek federal approval to implement the MinnesotaCare program under this chapter as a basic health program. In any agreement with the Centers for Medicare and Medicaid Services to operate MinnesotaCare as a basic health program, the commissioner shall seek to include procedures to ensure that federal funding is predictable, stable, and sufficient to sustain ongoing operation of MinnesotaCare. These procedures must address issues related to the timing of federal payments, payment reconciliation, enrollee risk adjustment, and minimization of state financial risk. The commissioner shall consult with the commissioner of management and budget, when developing the proposal for establishing MinnesotaCare as a basic health program to be submitted to the Centers for Medicare and Medicaid Services. new text end

new text begin (b) The commissioner of human services, in consultation with the commissioner of management and budget, shall work with the Centers for Medicare and Medicaid Services to establish a process for reconciliation and adjustment of federal payments that balances state and federal liability over time. The commissioner of human services shall request that the secretary of health and human services hold the state, and enrollees, harmless in the reconciliation process for the first three years, to allow the state to develop a statistically valid methodology for predicting enrollment trends and their net effect on federal payments. 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. 35.

Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision to read:

new text begin Subd. 6. new text end

new text begin Coordination with Minnesota Insurance Marketplace. new text end

new text begin MinnesotaCare shall be considered a public health care program for purposes of chapter 62V. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 36.

Minnesota Statutes 2012, section 256L.03, subdivision 1, is amended to read:

Subdivision 1.

Covered health services.

(a) "Covered health services" means the health services reimbursed under chapter 256B, with the exception of deleted text begin inpatient hospital services,deleted text end special education services, private duty nursing services, adult dental care services other than services covered under section 256B.0625, subdivision 9, orthodontic services, nonemergency medical transportation services, personal care assistance and case management services, new text begin and new text end nursing home or intermediate care facilities servicesdeleted text begin , inpatient mental health services, and chemical dependency servicesdeleted text end .

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

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 37.

Minnesota Statutes 2012, section 256L.03, subdivision 1a, is amended to read:

Subd. 1a.

deleted text begin Pregnant women anddeleted text end Children; MinnesotaCare health care reform waiver.

deleted text begin Beginning January 1, 1999,deleted text end Children deleted text begin and pregnant womendeleted text end are eligible for coverage of all services that are eligible for reimbursement under the medical assistance program according to chapter 256B, except that abortion services under MinnesotaCare shall be limited as provided under subdivision 1. deleted text begin Pregnant women anddeleted text end Children are exempt from the provisions of subdivision 5, regarding co-payments. deleted text begin Pregnant women anddeleted text end Children who are lawfully residing in the United States but who are not "qualified noncitizens" under title IV of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Public Law 104-193, Statutes at Large, volume 110, page 2105, are eligible for coverage of all services provided under the medical assistance program according to chapter 256B.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 38.

Minnesota Statutes 2012, section 256L.03, subdivision 3, is amended to read:

Subd. 3.

Inpatient hospital services.

(a) Covered health services shall include inpatient hospital services, including inpatient hospital mental health services and inpatient hospital and residential chemical dependency treatment, subject to those limitations necessary to coordinate the provision of these services with eligibility under the medical assistance spenddown. deleted text begin The inpatient hospital benefit for adult enrollees who qualify under section 256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and 2, with family gross income that exceeds 200 percent of the federal poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not pregnant, is subject to an annual limit of $10,000.deleted text end

(b) Admissions for inpatient hospital services paid for under section 256L.11, subdivision 3, must be certified as medically necessary in accordance with Minnesota Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2):

(1) all admissions must be certified, except those authorized under rules established under section 254A.03, subdivision 3, or approved under Medicare; and

(2) payment under section 256L.11, subdivision 3, shall be reduced by five percent for admissions for which certification is requested more than 30 days after the day of admission. The hospital may not seek payment from the enrollee for the amount of the payment reduction under this clause.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 39.

Minnesota Statutes 2012, section 256L.03, is amended by adding a subdivision to read:

new text begin Subd. 4a. new text end

new text begin Loss ratio. new text end

new text begin Health coverage provided through the MinnesotaCare program must have a medical loss ratio of at least 85 percent, as defined using the loss ratio methodology described in section 1001 of the Affordable Care Act. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2015. new text end

Sec. 40.

Minnesota Statutes 2012, section 256L.03, subdivision 5, is amended to read:

Subd. 5.

Cost-sharing.

(a) Except as new text begin otherwise new text end provided in deleted text begin paragraphs (b) and (c)deleted text end new text begin this subdivisionnew text end , the MinnesotaCare benefit plan shall include the following cost-sharing requirements for all enrollees:

deleted text begin (1) ten percent of the paid charges for inpatient hospital services for adult enrollees, subject to an annual inpatient out-of-pocket maximum of $1,000 per individual; deleted text end

deleted text begin (2)deleted text end new text begin (1)new text end $3 per prescription for adult enrollees;

deleted text begin (3)deleted text end new text begin (2)new text end $25 for eyeglasses for adult enrollees;

deleted text begin (4)deleted text end new text begin (3)new text end $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an episode of service which is required because of a recipient's symptoms, diagnosis, or established illness, and which is delivered in an ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, audiologist, optician, or optometrist;

deleted text begin (5)deleted text end new text begin (4)new text end $6 for nonemergency visits to a hospital-based emergency room for services provided through December 31, 2010, and $3.50 effective January 1, 2011; and

deleted text begin (6)deleted text end new text begin (5)new text end a family deductible equal to the maximum amount allowed under Code of Federal Regulations, title 42, part 447.54.

deleted text begin (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of children under the age of 21. deleted text end

deleted text begin (c)deleted text end new text begin (b)new text end Paragraph (a) does not apply to deleted text begin pregnant women anddeleted text end children under the age of 21.

deleted text begin (d)deleted text end new text begin (c)new text end Paragraph (a), clause deleted text begin (4)deleted text end new text begin (3)new text end , does not apply to mental health services.

deleted text begin (e) Adult enrollees with family gross income that exceeds 200 percent of the federal poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not pregnant shall be financially responsible for the coinsurance amount, if applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit. deleted text end

deleted text begin (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan, or changes from one prepaid health plan to another during a calendar year, any charges submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket expenses incurred by the enrollee for inpatient services, that were submitted or incurred prior to enrollment, or prior to the change in health plans, shall be disregarded. deleted text end

deleted text begin (g)deleted text end new text begin (d)new text end MinnesotaCare reimbursements to fee-for-service providers and payments to managed care plans or county-based purchasing plans shall not be increased as a result of the reduction of the co-payments in paragraph (a), clause deleted text begin (5)deleted text end new text begin (4)new text end , effective January 1, 2011.

deleted text begin (h)deleted text end new text begin (e)new text end The commissioner, through the contracting process under section 256L.12, may allow managed care plans and county-based purchasing plans to waive the family deductible under paragraph (a), clause deleted text begin (6)deleted text end new text begin (5)new text end . The value of the family deductible shall not be included in the capitation payment to managed care plans and county-based purchasing plans. Managed care plans and county-based purchasing plans shall certify annually to the commissioner the dollar value of the family deductible.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 41.

Minnesota Statutes 2012, section 256L.03, subdivision 6, is amended to read:

Subd. 6.

Lien.

When the state agency provides, pays for, or becomes liable for covered health services, the agency shall have a lien for the cost of the covered health services upon any and all causes of action accruing to the enrollee, or to the enrollee's legal representatives, as a result of the occurrence that necessitated the payment for the covered health services. All liens under this section shall be subject to the provisions of section 256.015. For purposes of this subdivision, "state agency" includes deleted text begin prepaid health plansdeleted text end new text begin participating entities,new text end under contract with the commissioner according to deleted text begin sections 256B.69, 256D.03, subdivision 4, paragraph (c), and 256L.12; and county-based purchasing entities under section 256B.692deleted text end new text begin section 256L.121new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2015. new text end

Sec. 42.

Minnesota Statutes 2012, section 256L.04, subdivision 1, is amended to read:

Subdivision 1.

Families with children.

deleted text begin (a)deleted text end Families with children with family incomenew text begin above 133 percent of the federal poverty guidelines andnew text end equal to or less than deleted text begin 275deleted text end new text begin 200new text end percent of the federal poverty guidelines for the applicable family size shall be eligible for MinnesotaCare according to this section. All other provisions of sections 256L.01 to 256L.18deleted text begin , including the insurance-related barriers to enrollment under section 256L.07,deleted text end shall apply unless otherwise specified.new text begin Children under age 19 with family income at or below 200 percent of the federal poverty guidelines and who are ineligible for medical assistance by sole reason of the application of federal household composition rules for medical assistance are eligible for MinnesotaCare.new text end

deleted text begin (b) Parents who enroll in the MinnesotaCare program must also enroll their children, if the children are eligible. Children may be enrolled separately without enrollment by parents. However, if one parent in the household enrolls, both parents must enroll, unless other insurance is available. If one child from a family is enrolled, all children must be enrolled, unless other insurance is available. If one spouse in a household enrolls, the other spouse in the household must also enroll, unless other insurance is available. Families cannot choose to enroll only certain uninsured members. deleted text end

deleted text begin (c) Beginning October 1, 2003, the dependent sibling definition no longer applies to the MinnesotaCare program. These persons are no longer counted in the parental household and may apply as a separate household. deleted text end

deleted text begin (d) Parents are not eligible for MinnesotaCare if their gross income exceeds $57,500. deleted text end

deleted text begin (e) Children deemed eligible for MinnesotaCare under section 256L.07, subdivision 8, are exempt from the eligibility requirements of this subdivision. deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 43.

Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision to read:

new text begin Subd. 1c. new text end

new text begin General requirements. new text end

new text begin To be eligible for coverage under MinnesotaCare, a person must meet the eligibility requirements of this section. A person eligible for MinnesotaCare shall not be considered a qualified individual under section 1312 of the Affordable Care Act, and is not eligible for enrollment in a qualified health plan offered through the Minnesota Insurance Marketplace under chapter 62V. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 44.

Minnesota Statutes 2012, section 256L.04, subdivision 7, is amended to read:

Subd. 7.

Single adults and households with no children.

deleted text begin (a)deleted text end The definition of eligible persons includes all individuals and deleted text begin householdsdeleted text end new text begin familiesnew text end with no children who have deleted text begin gross familydeleted text end incomes that are new text begin above 133 percent and new text end equal to or less than 200 percent of the federal poverty guidelinesnew text begin for the applicable family sizenew text end .

deleted text begin (b) Effective July 1, 2009, the definition of eligible persons includes all individuals and households with no children who have gross family incomes that are equal to or less than 250 percent of the federal poverty guidelines. deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 45.

Minnesota Statutes 2012, section 256L.04, subdivision 8, is amended to read:

Subd. 8.

Applicants potentially eligible for medical assistance.

(a) Individuals who receive supplemental security income or retirement, survivors, or disability benefits due to a disability, or other disability-based pension, who qualify under subdivision 7, but who are potentially eligible for medical assistance without a spenddown shall be allowed to enroll in MinnesotaCare deleted text begin for a period of 60 daysdeleted text end , so long as the applicant meets all other conditions of eligibility. The commissioner shall identify and refer the applications of such individuals to their county social service agency. The county and the commissioner shall cooperate to ensure that the individuals obtain medical assistance coverage for any months for which they are eligible.

(b) The enrollee must cooperate with the county social service agency in determining medical assistance eligibility deleted text begin within the 60-day enrollment perioddeleted text end . Enrollees who do not cooperate with medical assistance deleted text begin within the 60-day enrollment perioddeleted text end shall be disenrolled from the plan within one calendar month. Persons disenrolled for nonapplication for medical assistance may not reenroll until they have obtained a medical assistance eligibility determination. Persons disenrolled for noncooperation with medical assistance may not reenroll until they have cooperated with the county agency and have obtained a medical assistance eligibility determination.

(c) deleted text begin Beginning January 1, 2000,deleted text end Counties that choose to become MinnesotaCare enrollment sites shall consider MinnesotaCare applications to also be applications for medical assistance. deleted text begin Applicants who are potentially eligible for medical assistance, except for those described in paragraph (a), may choose to enroll in either MinnesotaCare or medical assistance.deleted text end

(d) The commissioner shall redetermine provider payments made under MinnesotaCare to the appropriate medical assistance payments for those enrollees who subsequently become eligible for medical assistance.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 46.

Minnesota Statutes 2012, section 256L.04, subdivision 10, is amended to read:

Subd. 10.

Citizenship requirements.

new text begin (a) new text end Eligibility for MinnesotaCare is limited to citizens or nationals of the United Statesdeleted text begin , qualified noncitizens, and other persons residingdeleted text end new text begin andnew text end lawfully deleted text begin in the United Statesdeleted text end new text begin present noncitizensnew text end as defined in Code of Federal Regulations, title 8, section 103.12. Undocumented noncitizens deleted text begin and nonimmigrantsdeleted text end are ineligible for MinnesotaCare. For purposes of this subdivision, deleted text begin a nonimmigrant is an individual in one or more of the classes listed in United States Code, title 8, section 1101(a)(15), anddeleted text end an undocumented noncitizen is an individual who resides in the United States without the approval or acquiescence of the United States Citizenship and Immigration Services. Families with children who are citizens or nationals of the United States must cooperate in obtaining satisfactory documentary evidence of citizenship or nationality according to the requirements of the federal Deficit Reduction Act of 2005, Public Law 109-171.

new text begin (b) Notwithstanding subdivisions 1 and 7, eligible persons include families and individuals who are lawfully present and ineligible for medical assistance by reason of immigration status and who have incomes equal to or less than 200 percent of federal poverty guidelines. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 47.

Minnesota Statutes 2012, section 256L.04, subdivision 12, is amended to read:

Subd. 12.

Persons in detention.

deleted text begin Beginning January 1, 1999,deleted text end An applicantnew text begin or enrolleenew text end residing in a correctional or detention facility is not eligible for MinnesotaCarenew text begin , unless the applicant or enrollee is awaiting disposition of chargesnew text end . deleted text begin An enrollee residing in a correctional or detention facility is not eligible at renewal of eligibility under section 256L.05, subdivision 3a.deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 48.

Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision to read:

new text begin Subd. 14. new text end

new text begin Coordination with medical assistance. new text end

new text begin (a) Individuals eligible for medical assistance under chapter 256B are not eligible for MinnesotaCare under this section. new text end

new text begin (b) The commissioner shall coordinate eligibility and coverage to ensure that individuals transitioning between medical assistance and MinnesotaCare have seamless eligibility and access to health care services. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 49.

Minnesota Statutes 2012, section 256L.05, subdivision 1, is amended to read:

Subdivision 1.

Application assistance and information availability.

(a)new text begin Applicants may submit applications online, in person, by mail, or by phone in accordance with the Affordable Care Act, and by any other means by which medical assistance applications may be submitted. Applicants may submit applications through the Minnesota Insurance Marketplace or through the MinnesotaCare program.new text end Applications and application assistance must be made available at provider offices, local human services agencies, school districts, public and private elementary schools in which 25 percent or more of the students receive free or reduced price lunches, community health offices, Women, Infants and Children (WIC) program sites, Head Start program sites, public housing councils, crisis nurseries, child care centers, early childhood education and preschool program sites, legal aid offices, and librariesnew text begin , and at any other locations at which medical assistance applications must be made availablenew text end . These sites may accept applications and forward the forms to the commissioner or local county human services agencies that choose to participate as an enrollment site. Otherwise, applicants may apply directly to the commissioner or to participating local county human services agencies.

(b) Application assistance must be available for applicants choosing to file an online applicationnew text begin through the Minnesota Insurance Marketplacenew text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 50.

Minnesota Statutes 2012, section 256L.05, subdivision 2, is amended to read:

Subd. 2.

Commissioner's duties.

The commissioner or county agency shall use electronic verificationnew text begin through the Minnesota Insurance Marketplacenew text end as the primary method of income verification. If there is a discrepancy between reported income and electronically verified income, an individual may be required to submit additional verificationnew text begin to the extent permitted under the Affordable Care Actnew text end . In addition, the commissioner shall perform random audits to verify reported income and eligibility. The commissioner may execute data sharing arrangements with the Department of Revenue and any other governmental agency in order to perform income verification related to eligibility and premium payment under the MinnesotaCare program.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 51.

Minnesota Statutes 2012, section 256L.05, subdivision 3, is amended to read:

Subd. 3.

Effective date of coverage.

(a) The effective date of coverage is the first day of the month following the month in which eligibility is approved and the first premium payment has been received. deleted text begin As provided in section 256B.057, coverage for newborns is automatic from the date of birth and must be coordinated with other health coverage. The effective date of coverage for eligible newly adoptive children added to a family receiving covered health services is the month of placement.deleted text end The effective date of coverage for deleted text begin otherdeleted text end new members added to the family is the first day of the month following the month in which the change is reported. All eligibility criteria must be met by the family at the time the new family member is added. The income of the new family member is included with the family'snew text begin modified adjustednew text end gross income and the adjusted premium begins in the month the new family member is added.

(b) The initial premium must be received by the last working day of the month for coverage to begin the first day of the following month.

deleted text begin (c) Benefits are not available until the day following discharge if an enrollee is hospitalized on the first day of coverage. deleted text end

deleted text begin (d)deleted text end new text begin (c)new text end Notwithstanding any other law to the contrary, benefits under sections 256L.01 to 256L.18 are secondary to a plan of insurance or benefit program under which an eligible person may have coverage and the commissioner shall use cost avoidance techniques to ensure coordination of any other health coverage for eligible persons. The commissioner shall identify eligible persons who may have coverage or benefits under other plans of insurance or who become eligible for medical assistance.

deleted text begin (e)deleted text end new text begin (d)new text end The effective date of coverage for individuals or families who are exempt from paying premiums under section 256L.15, subdivision 1, paragraph (d), is the first day of the month following the month in which verification of American Indian status is received or eligibility is approved, whichever is later.

deleted text begin (f) The effective date of coverage for children eligible under section 256L.07, subdivision 8, is the first day of the month following the date of termination from foster care or release from a juvenile residential correctional facility. deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 52.

Minnesota Statutes 2012, section 256L.05, subdivision 3c, is amended to read:

Subd. 3c.

Retroactive coverage.

Notwithstanding subdivision 3, the effective date of coverage shall be the first day of the month following termination from medical assistance for families and individuals who are eligible for MinnesotaCare and who submitted a written request for retroactive MinnesotaCare coverage with a completed application within 30 days of the mailing of notification of termination from medical assistance. The applicant must provide all required verifications within 30 days of the written request for verification. For retroactive coverage, premiums must be paid in full for any retroactive month, current month, and next month within 30 days of the premium billing. deleted text begin General assistance medical care recipients may qualify for retroactive coverage under this subdivision at six-month renewal.deleted text end new text begin This subdivision does not apply, and shall not be implemented by the commissioner, once eligibility determination for MinnesotaCare is conducted by the Minnesota Insurance Marketplace eligibility determination system.new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 53.

Minnesota Statutes 2012, section 256L.06, subdivision 3, is amended to read:

Subd. 3.

Commissioner's duties and payment.

(a) Premiums are dedicated to the commissioner for MinnesotaCare.

(b) The commissioner shall develop and implement procedures to: (1) require enrollees to report changes in income; (2) adjust sliding scale premium payments, based upon both increases and decreases in enrollee income, at the time the change in income is reported; and (3) disenroll enrollees from MinnesotaCare for failure to pay required premiums. Failure to pay includes payment with a dishonored check, a returned automatic bank withdrawal, or a refused credit card or debit card payment. The commissioner may demand a guaranteed form of payment, including a cashier's check or a money order, as the only means to replace a dishonored, returned, or refused payment.

(c) Premiums are calculated on a calendar month basis and may be paid on a monthly, quarterly, or semiannual basis, with the first payment due upon notice from the commissioner of the premium amount required. The commissioner shall inform applicants and enrollees of these premium payment options. Premium payment is required before enrollment is complete and to maintain eligibility in MinnesotaCare. Premium payments received before noon are credited the same day. Premium payments received after noon are credited on the next working day.

(d) Nonpayment of the premium will result in disenrollment from the plan effective for the calendar month for which the premium was due. deleted text begin Persons disenrolled for nonpayment or who voluntarily terminate coverage from the program may not reenroll until four calendar months have elapsed.deleted text end Persons disenrolled for nonpayment who pay all past due premiums as well as current premiums due, including premiums due for the period of disenrollment, within 20 days of disenrollment, shall be reenrolled retroactively to the first day of disenrollment. deleted text begin Persons disenrolled for nonpayment or who voluntarily terminate coverage from the program may not reenroll for four calendar months unless the person demonstrates good cause for nonpayment. Good cause does not exist if a person chooses to pay other family expenses instead of the premium. The commissioner shall define good cause in rule.deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 54.

Minnesota Statutes 2012, section 256L.07, subdivision 1, is amended to read:

Subdivision 1.

General requirements.

deleted text begin (a) Children enrolled in the original children's health plan as of September 30, 1992, children who enrolled in the MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549, article 4, section 17, and children who have family gross incomes that are equal to or less than 200 percent of the federal poverty guidelines are eligible without meeting the requirements of subdivision 2 and the four-month requirement in subdivision 3, as long as they maintain continuous coverage in the MinnesotaCare program or medical assistance. deleted text end

deleted text begin Parentsdeleted text end new text begin Individualsnew text end enrolled in MinnesotaCare under section 256L.04, subdivision 1new text begin , and individuals enrolled in MinnesotaCare under section 256L.04, subdivision 7new text end , whose income increases above deleted text begin 275deleted text end new text begin 200new text end percent of the federal poverty guidelines, are no longer eligible for the program and shall be disenrolled by the commissioner. deleted text begin Beginning January 1, 2008, individuals enrolled in MinnesotaCare under section 256L.04, subdivision 7, whose income increases above 200 percent of the federal poverty guidelines or 250 percent of the federal poverty guidelines on or after July 1, 2009, are no longer eligible for the program and shall be disenrolled by the commissioner.deleted text end For persons disenrolled under this subdivision, MinnesotaCare coverage terminates the last day of the calendar month following the month in which the commissioner determines that the income of a family or individual exceeds program income limits.

deleted text begin (b) Children may remain enrolled in MinnesotaCare if their gross family income as defined in section 256L.01, subdivision 4, is greater than 275 percent of federal poverty guidelines. The premium for children remaining eligible under this paragraph shall be the maximum premium determined under section 256L.15, subdivision 2, paragraph (b). deleted text end

deleted text begin (c) Notwithstanding paragraph (a), parents are not eligible for MinnesotaCare if gross household income exceeds $57,500 for the 12-month period of eligibility. deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 55.

Minnesota Statutes 2012, section 256L.07, subdivision 2, is amended to read:

Subd. 2.

Must not have access to employer-subsidizednew text begin minimum essentialnew text end coverage.

(a) To be eligible, a family or individual must not have access to subsidized health coverage deleted text begin through an employer and must not have had access to employer-subsidized coverage through a current employer for 18 months prior to application or reapplication. A family or individual whose employer-subsidized coverage is lost due to an employer terminating health care coverage as an employee benefit during the previous 18 months is not eligibledeleted text end new text begin that is affordable and provides minimum value as defined in Code of Federal Regulations, title 26, section 1.36B-2new text end .

(b) This subdivision does not apply to a family or individual deleted text begin who was enrolled in MinnesotaCare within six months or less of reapplication anddeleted text end who no longer has employer-subsidized coverage due to the employer terminating health care coverage as an employee benefit. deleted text begin This subdivision does not apply to children with family gross incomes that are equal to or less than 200 percent of federal poverty guidelines.deleted text end

deleted text begin (c) For purposes of this requirement, subsidized health coverage means health coverage for which the employer pays at least 50 percent of the cost of coverage for the employee or dependent, or a higher percentage as specified by the commissioner. Children are eligible for employer-subsidized coverage through either parent, including the noncustodial parent. The commissioner must treat employer contributions to Internal Revenue Code Section 125 plans and any other employer benefits intended to pay health care costs as qualified employer subsidies toward the cost of health coverage for employees for purposes of this subdivision. deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 56.

Minnesota Statutes 2012, section 256L.07, subdivision 3, is amended to read:

Subd. 3.

Other health coverage.

(a) deleted text begin Families and individuals enrolled in the MinnesotaCare program must have nodeleted text end new text begin To be eligible, a family or individual must not have minimum essentialnew text end health coverage deleted text begin while enrolleddeleted text end new text begin , as defined by section 5000A of the Internal Revenue Codenew text end . deleted text begin Children with family gross incomes equal to or greater than 200 percent of federal poverty guidelines, and adults, must have had no health coverage for at least four months prior to application and renewal. Children enrolled in the original children's health plan and children in families with income equal to or less than 200 percent of the federal poverty guidelines, who have other health insurance, are eligible if the coverage:deleted text end

deleted text begin (1) lacks two or more of the following: deleted text end

deleted text begin (i) basic hospital insurance; deleted text end

deleted text begin (ii) medical-surgical insurance; deleted text end

deleted text begin (iii) prescription drug coverage; deleted text end

deleted text begin (iv) dental coverage; or deleted text end

deleted text begin (v) vision coverage; deleted text end

deleted text begin (2) requires a deductible of $100 or more per person per year; or deleted text end

deleted text begin (3) lacks coverage because the child has exceeded the maximum coverage for a particular diagnosis or the policy excludes a particular diagnosis. deleted text end

deleted text begin The commissioner may change this eligibility criterion for sliding scale premiums in order to remain within the limits of available appropriations. The requirement of no health coverage does not apply to newborns. deleted text end

deleted text begin (b) Coverage purchased as provided under section 256L.031, subdivision 2, medical assistance, and the Civilian Health and Medical Program of the Uniformed Service, CHAMPUS, or other coverage provided under United States Code, title 10, subtitle A, part II, chapter 55, are not considered insurance or health coverage for purposes of the four-month requirement described in this subdivision. deleted text end

deleted text begin (c)deleted text end new text begin (b)new text end For purposes of this subdivision, an applicant or enrollee who is entitled to Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered to havenew text begin minimum essentialnew text end health coverage. An applicant or enrollee who is entitled to premium-free Medicare Part A may not refuse to apply for or enroll in Medicare coverage to establish eligibility for MinnesotaCare.

deleted text begin (d) Applicants who were recipients of medical assistance within one month of application must meet the provisions of this subdivision and subdivision 2. deleted text end

deleted text begin (e) Cost-effective health insurance that was paid for by medical assistance is not considered health coverage for purposes of the four-month requirement under this section, except if the insurance continued after medical assistance no longer considered it cost-effective or after medical assistance closed. deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 57.

Minnesota Statutes 2012, section 256L.09, subdivision 2, is amended to read:

Subd. 2.

Residency requirement.

To be eligible for health coverage under the MinnesotaCare program, deleted text begin pregnant women,deleted text end individuals, and families with children must meet the residency requirements as provided by Code of Federal Regulations, title 42, section 435.403deleted text begin , except that the provisions of section 256B.056, subdivision 1, shall apply upon receipt of federal approvaldeleted text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 58.

Minnesota Statutes 2012, section 256L.11, subdivision 1, is amended to read:

Subdivision 1.

Medical assistance rate to be used.

deleted text begin (a)deleted text end Payment to providers under deleted text begin sections 256L.01 to 256L.11deleted text end new text begin this chapternew text end shall be at the same rates and conditions established for medical assistance, except as provided in deleted text begin subdivisions 2 to 6deleted text end new text begin this sectionnew text end .

deleted text begin (b) Effective for services provided on or after July 1, 2009, total payments for basic care services shall be reduced by three percent, in accordance with section 256B.766. Payments made to managed care and county-based purchasing plans shall be reduced for services provided on or after October 1, 2009, to reflect this reduction. deleted text end

deleted text begin (c) Effective for services provided on or after July 1, 2009, payment rates for physician and professional services shall be reduced as described under section 256B.76, subdivision 1, paragraph (c). Payments made to managed care and county-based deleted text end deleted text begin purchasing plans shall be reduced for services provided on or after October 1, 2009, to reflect this reduction. deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 59.

Minnesota Statutes 2012, section 256L.11, subdivision 3, is amended to read:

Subd. 3.

Inpatient hospital services.

Inpatient hospital services provided under section 256L.03, subdivision 3, shall be deleted text begin paid for as provided in subdivisions 4 to 6deleted text end new text begin at the medical assistance ratenew text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 60.

Minnesota Statutes 2012, section 256L.12, subdivision 1, is amended to read:

Subdivision 1.

Selection of vendors.

In order to contain costs, the commissioner of human services shall select vendors of medical care who can provide the most economical care consistent with high medical standards and shall, where possible, contract with organizations on a prepaid capitation basis to provide these services. The commissioner shall consider proposals by counties and vendors for managed care plans new text begin and managed care-like entities as defined by the final regulation implementing section 1331 of the Affordable Care Act regarding basic health plans, new text end which may include: prepaid capitation programs, competitive bidding programs, or other vendor payment mechanisms designed to provide services in an economical manner or to control utilization, with safeguards to ensure that necessary services are provided.

Sec. 61.

new text begin [256L.121] SERVICE DELIVERY. new text end

new text begin Subdivision 1. new text end

new text begin Competitive process. new text end

new text begin The commissioner of human services shall establish a competitive process for entering into contracts with participating entities for the offering of standard health plans through MinnesotaCare. Coverage through standard health plans must be available to enrollees beginning January 1, 2015. Each standard health plan must cover the health services listed in and meet the requirements of section 256L.03. The competitive process must meet the requirements of section 1331 of the Affordable Care Act and be designed to ensure enrollee access to high-quality health care coverage options. The commissioner, to the extent feasible, shall seek to ensure that enrollees have a choice of coverage from more than one participating entity within a geographic area. In counties that were part of a county-based purchasing plan on January 1, 2013, the commissioner shall use the medical assistance competitive procurement process under section 256B.69, subdivisions 1 to 32, under which selection of entities is based on criteria related to provider network access, coordination of health care with other local services, alignment with local public health goals, and other factors. new text end

new text begin Subd. 2. new text end

new text begin Other requirements for participating entities. new text end

new text begin The commissioner shall require participating entities, as a condition of contract, to document to the commissioner: new text end

new text begin (1) the provision of culturally and linguistically appropriate services, including marketing materials, to MinnesotaCare enrollees; and new text end

new text begin (2) the inclusion in provider networks of providers designated as essential community providers under section 62Q.19. new text end

new text begin Subd. 3. new text end

new text begin Coordination with state-administered health programs. new text end

new text begin The commissioner shall coordinate the administration of the MinnesotaCare program with medical assistance to maximize efficiency and improve the continuity of care. This includes, but is not limited to: new text end

new text begin (1) establishing geographic areas for MinnesotaCare that are consistent with the geographic areas of the medical assistance program, within which participating entities may offer health plans; new text end

new text begin (2) requiring, as a condition of participation in MinnesotaCare, participating entities to also participate in the medical assistance program; new text end

new text begin (3) complying with sections 256B.69, subdivision 3a; 256B.692, subdivision 1; and 256B.694, when contracting with MinnesotaCare participating entities; new text end

new text begin (4) providing MinnesotaCare enrollees, to the extent possible, with the option to remain in the same health plan and provider network, if they later become eligible for medical assistance or coverage through the Minnesota health benefit exchange and if, in the case of becoming eligible for medical assistance, the enrollee's MinnesotaCare health plan is also a medical assistance health plan in the enrollee's county of residence; and new text end

new text begin (5) establishing requirements and criteria for selection that ensure that covered health care services will be coordinated with local public health services, social services, long-term care services, mental health services, and other local services affecting enrollees' health, access, and quality of care. 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. 62.

Minnesota Statutes 2012, section 256L.15, subdivision 1, is amended to read:

Subdivision 1.

Premium determination.

(a) Families with children and individuals shall pay a premium determined according to subdivision 2.

deleted text begin (b) Pregnant women and children under age two are exempt from the provisions of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment for failure to pay premiums. For pregnant women, this exemption continues until the first day of the month following the 60th day postpartum. Women who remain enrolled during pregnancy or the postpartum period, despite nonpayment of premiums, shall be disenrolled on the first of the month following the 60th day postpartum for the penalty period that otherwise applies under section 256L.06, unless they begin paying premiums. deleted text end

deleted text begin (c)deleted text end new text begin (b)new text end Members of the military and their families who meet the eligibility criteria for MinnesotaCare upon eligibility approval made within 24 months following the end of the member's tour of active duty shall have their premiums paid by the commissioner. The effective date of coverage for an individual or family who meets the criteria of this paragraph shall be the first day of the month following the month in which eligibility is approved. This exemption applies for 12 months.

deleted text begin (d)deleted text end new text begin (c) new text end Beginning July 1, 2009, American Indians enrolled in MinnesotaCare and their families shall have their premiums waived by the commissioner in accordance with section 5006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5. An individual must document status as an American Indian, as defined under Code of Federal Regulations, title 42, section 447.50, to qualify for the waiver of premiums.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 63.

Minnesota Statutes 2012, section 256L.15, subdivision 2, is amended to read:

Subd. 2.

Sliding fee scale; monthly deleted text begin grossdeleted text end individual or family income.

(a) The commissioner shall establish a sliding fee scale to determine the percentage of monthly deleted text begin grossdeleted text end individual or family income that households at different income levels must pay to obtain coverage through the MinnesotaCare program. The sliding fee scale must be based on the enrollee's monthly deleted text begin grossdeleted text end individual or family income. deleted text begin The sliding fee scale must contain separate tables based on enrollment of one, two, or three or more persons. Until June 30, 2009, the sliding fee scale begins with a premium of 1.5 percent of monthly gross individual or family income for individuals or families with incomes below the limits for the medical assistance program for families and children in effect on January 1, 1999, and proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 percent. These percentages are matched to evenly spaced income steps ranging from the medical assistance income limit for families and children in effect on January 1, 1999, to 275 percent of the federal poverty guidelines for the applicable family size, up to a family size of five. The sliding fee scale for a family of five must be used for families of more than five. The sliding fee scale and percentages are not subject to the provisions of chapter 14. If a family or individual reports increased income after enrollment, premiums shall be adjusted at the time the change in income is reported.deleted text end

(b) deleted text begin Children in families whose gross income is above 275 percent of the federal poverty guidelines shall pay the maximum premium. The maximum premium is defined as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare cases paid the maximum premium, the total revenue would equal the total cost of MinnesotaCare medical coverage and administration. In this calculation, administrative costs shall be assumed to equal ten percent of the total. The costs of medical coverage for pregnant women and children under age two and the enrollees in these groups shall be excluded from the total. The maximum premium for two enrollees shall be twice the maximum premium for one, and the maximum premium for three or more enrollees shall be three times the maximum premium for one.deleted text end

deleted text begin (c)deleted text end Beginning deleted text begin July 1, 2009deleted text end new text begin January 1, 2014new text end , MinnesotaCare enrollees shall pay premiums according to the premium scale specified in paragraph deleted text begin (d)deleted text end new text begin (c) new text end with the exception that children new text begin 20 years of age and younger new text end in families with income at or below 200 percent of the federal poverty guidelines shall pay no premiums. deleted text begin For purposes of paragraph (d), "minimum" means a monthly premium of $4.deleted text end

deleted text begin (d)deleted text end new text begin (c) new text end The following premium scale is established for deleted text begin individuals and families with gross family incomes of 275 percent of the federal poverty guidelines or lessdeleted text end new text begin each individual in the household who is 21 years of age or older and enrolled in MinnesotaCarenew text end :

deleted text begin Federal Poverty Guideline Range deleted text end deleted text begin Percent of Average Gross Monthly Income deleted text end
deleted text begin 0-45% deleted text end deleted text begin minimum deleted text end
deleted text begin 46-54% deleted text end deleted text begin $4 or 1.1% of family income, whichever is greater deleted text end
deleted text begin 55-81% deleted text end deleted text begin 1.6% deleted text end
deleted text begin 82-109% deleted text end deleted text begin 2.2% deleted text end
deleted text begin 110-136% deleted text end deleted text begin 2.9% deleted text end
deleted text begin 137-164% deleted text end deleted text begin 3.6% deleted text end
deleted text begin 165-191% deleted text end deleted text begin 4.6% deleted text end
deleted text begin 192-219% deleted text end deleted text begin 5.6% deleted text end
deleted text begin 220-248% deleted text end deleted text begin 6.5% deleted text end
deleted text begin 249-275% deleted text end deleted text begin 7.2% deleted text end
new text begin Federal Poverty Guideline Greater than or Equal to new text end new text begin Less than new text end new text begin Individual Premium Amount new text end
new text begin 0% new text end new text begin 55% new text end new text begin $4 new text end
new text begin 55% new text end new text begin 80% new text end new text begin $6 new text end
new text begin 80% new text end new text begin 90% new text end new text begin $8 new text end
new text begin 90% new text end new text begin 100% new text end new text begin $10 new text end
new text begin 100% new text end new text begin 110% new text end new text begin $12 new text end
new text begin 110% new text end new text begin 120% new text end new text begin $15 new text end
new text begin 120% new text end new text begin 130% new text end new text begin $18 new text end
new text begin 130% new text end new text begin 140% new text end new text begin $21 new text end
new text begin 140% new text end new text begin 150% new text end new text begin $25 new text end
new text begin 150% new text end new text begin 160% new text end new text begin $29 new text end
new text begin 160% new text end new text begin 170% new text end new text begin $33 new text end
new text begin 170% new text end new text begin 180% new text end new text begin $38 new text end
new text begin 180% new text end new text begin 190% new text end new text begin $43 new text end
new text begin 190% new text end new text begin $50 new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when federal approval is obtained. new text end

Sec. 64.

new text begin DETERMINATION OF FUNDING ADEQUACY FOR MINNESOTACARE. new text end

new text begin The commissioners of revenue and management and budget, in consultation with the commissioner of human services, shall conduct an assessment of health care taxes, including the gross premiums tax, the provider tax, and Medicaid surcharges, and their relationship to the long-term solvency of the health care access fund, as part of the state revenue and expenditure forecast in November 2013. The commissioners shall determine the amount of state funding that will be required after December 31, 2019, in addition to the federal payments made available under section 1331 of the Affordable Care Act, for the MinnesotaCare program. The commissioners shall evaluate the stability and likelihood of long-term federal funding for the MinnesotaCare program under section 1331. The commissioners shall report the results of this assessment to the chairs and ranking minority members of the legislative committees with jurisdiction over human services, finances, and taxes by January 15, 2014, along with recommendations for changes to state revenue for the health care access fund, if state funding continues to be required beyond December 31, 2019. new text end

Sec. 65.

new text begin STATE-BASED RISK ADJUSTMENT SYSTEM ASSESSMENT. new text end

new text begin (a) Notwithstanding Minnesota Rules, chapter 4653, the commissioner of health, as part of the commissioner's responsibilities under Minnesota Statutes, section 62U.04, subdivision 4, paragraph (b), shall collect from health carriers in the individual and small group health insurance market, beginning on January 1, 2014, for service dates beginning October 1, 2013, through December 31, 2014, all data required for conducting risk adjustment with standard risk adjusters such as the Adjusted Clinical Groups or the Hierarchical Condition Category System, including, but not limited to: new text end

new text begin (1) an indicator identifying the health plan product under which an enrollee is covered; new text end

new text begin (2) an indicator identifying whether an enrollee's policy is an individual or small group market policy; new text end

new text begin (3) an indicator identifying, if applicable, the metal level of an enrollee's health plan product, and whether the policy is a catastrophic policy; and new text end

new text begin (4) additional identified demographic data necessary to link individuals' data across health carriers and insurance affordability programs with 95 percent accuracy. The commissioner shall not collect more than the last four digits of an individual's Social Security number. new text end

new text begin (b) The commissioner of health shall assess the extent to which data collected under paragraph (a) and under Minnesota Statutes, section 62U.04, subdivision 4, paragraph (a), are sufficient for developing and operating a state alternative risk adjustment methodology consistent with applicable federal rules by evaluating: new text end

new text begin (1) if the data submitted are adequately complete, accurate, and timely; new text end

new text begin (2) if the data should be further enriched by nontraditional risk adjusters that help in better explaining variation in health care costs of a given population and account for risk selection across metal levels; new text end

new text begin (3) whether additional data or identifiers have the potential to strengthen a Minnesota-based risk adjustment approach; and new text end

new text begin (4) what, if any, changes to the technical infrastructure will be necessary to effectively perform state-based risk adjustment. new text end

new text begin (c) For purposes of paragraph (b), the commissioner of health shall have the authority to use identified data to validate and audit a statistically valid sample of data for each health carrier in the individual and small group health insurance market. new text end

new text begin (d) If the assessment conducted in paragraph (b) finds that the data collected under Minnesota Statutes, section 62U.04, subdivision 4, are sufficient for developing and operating a state alternative risk adjustment methodology consistent with applicable federal rules, the commissioners of health and human services, in consultation with the commissioner of commerce and the Board of MNsure, shall study whether Minnesota-based risk adjustment of the individual and small group health insurance market, using either the federal risk adjustment model or a state-based alternative, can be more cost-effective and perform better than risk adjustment conducted by federal agencies. The study shall assess the policies, infrastructure, and resources necessary to satisfy the requirements of Code of Federal Regulations, title 45, section 153, subpart D. The study shall also evaluate the extent to which Minnesota-based risk adjustment could meet requirements established in Code of Federal Regulations, title 45, section 153.330, including: new text end

new text begin (1) explaining the variation in health care costs of a given population; new text end

new text begin (2) linking risk factors to daily clinical practices and that which is clinically meaningful to providers; new text end

new text begin (3) encouraging favorable behavior among health care market participants and discouraging unfavorable behavior; new text end

new text begin (4) whether risk adjustment factors are relatively easy for stakeholders to understand and participate in; new text end

new text begin (5) providing stable risk scores over time and across health plan products; new text end

new text begin (6) minimizing administrative costs; new text end

new text begin (7) accounting for risk selection across metal levels; new text end

new text begin (8) aligning each of the elements of the methodology; and new text end

new text begin (9) can be conducted at per-member cost equal to or lower than the projected cost of the federal risk adjustment model. new text end

new text begin (e) In conducting the study described in paragraph (d), the commissioner of health shall contract with entities that do not have an economic interest in the outcome of Minnesota-based risk adjustment, but have demonstrated expertise in actuarial science or health economics and demonstrated experience with designing and implementing risk adjustment models. The commissioner of human services shall evaluate opportunities to maximize federal funding under section 1331 of the Affordable Care Act. The commissioner of human services shall make recommendations on risk adjustment strategies to maximize federal funding to the state of Minnesota. new text end

new text begin (f) The commissioner of health shall submit an interim report to the legislature by March 15, 2014, with preliminary findings from the assessment conducted in paragraph (b). The interim report shall include legislative recommendations for any necessary changes to Minnesota Statutes, section 62Q.03. The commissioners of health and human services shall submit a final report to the legislature by October 1, 2015. The final report must include findings from the overall assessment conducted under paragraph (e), and a recommendation on whether to conduct state-based risk adjustment. new text end

new text begin (g) The Board of MNsure shall apply for federal funding under section 1311 or 1321 of the Affordable Care Act, to fund the work under paragraphs (a), (b), (d), and (e). Federal funding awarded to MNsure for this purpose is approved and appropriated for this purpose. The commissioners of health and human services may only proceed with activities under paragraphs (a) to (e) if funding has been made available for this purpose. new text end

new text begin (h) For purposes of this section, the Board of MNsure means the board established under Minnesota Statutes, section 62V.03, and the Affordable Care Act has the meaning given in Minnesota Statutes, section 256B.02, subdivision 17. new text end

Sec. 66.

new text begin REQUEST FOR FEDERAL AUTHORITY. new text end

new text begin The commissioner of human services shall seek authority from the federal Centers for Medicare and Medicaid Services to allow persons under age 65, participating in a home and community-based services waiver under section 1915(c) of the Social Security Act, to continue to disregard spousal income and assets, in place of the spousal impoverishment provisions under the federal Patient Protection and Affordable Care Act, Public Law 111-148, section 2404, as amended by the federal Health Care and Education Reconciliation Act of 2010, Public Law 111-152, and any amendments to, or regulations and guidance issued under, those acts. new text end

Sec. 67.

new text begin REVISOR'S INSTRUCTION. new text end

new text begin The revisor of statutes shall: (1) remove cross-references to the sections repealed in this article wherever they appear in Minnesota Statutes and Minnesota Rules; (2) change the term "Minnesota Insurance Marketplace" to "MNsure" wherever it appears in this article and in Minnesota Statutes; and (3) make changes necessary to correct the punctuation, grammar, or structure of the remaining text and preserve its meaning. new text end

Sec. 68.

new text begin REPEALER. new text end

new text begin (a) new text end new text begin Minnesota Statutes 2012, sections 256L.01, subdivision 4a; 256L.031; 256L.04, subdivisions 1b, 9, and 10a; 256L.05, subdivision 3b; 256L.07, subdivisions 1, 5, 8, and 9; 256L.11, subdivisions 5 and 6; and 256L.17, subdivisions 1, 2, 3, 4, and 5, new text end new text begin are repealed effective January 1, 2014. new text end

new text begin (b) new text end new text begin Minnesota Statutes 2012, sections 256B.055, subdivisions 3, 5, and 10b; 256B.056, subdivision 5b; and 256B.057, subdivisions 1c and 2, new text end new text begin are repealed effective January 1, 2014. new text end

ARTICLE 2

CONTINGENT REFORM 2020; REDESIGNING HOME AND COMMUNITY-BASED SERVICES

Section 1.

Minnesota Statutes 2012, section 144.0724, subdivision 4, is amended to read:

Subd. 4.

Resident assessment schedule.

(a) A facility must conduct and electronically submit to the commissioner of health case mix assessments that conform with the assessment schedule defined by Code of Federal Regulations, title 42, section 483.20, and published by the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services, in the Long Term Care Assessment Instrument User's Manual, version 3.0, and subsequent updates when issued by the Centers for Medicare and Medicaid Services. The commissioner of health may substitute successor manuals or question and answer documents published by the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services, to replace or supplement the current version of the manual or document.

(b) The assessments used to determine a case mix classification for reimbursement include the following:

(1) a new admission assessment must be completed by day 14 following admission;

(2) an annual assessment which must have an assessment reference date (ARD) within 366 days of the ARD of the last comprehensive assessment;

(3) a significant change assessment must be completed within 14 days of the identification of a significant change; and

(4) all quarterly assessments must have an assessment reference date (ARD) within 92 days of the ARD of the previous assessment.

(c) In addition to the assessments listed in paragraph (b), the assessments used to determine nursing facility level of care include the following:

(1) preadmission screening completed under section deleted text begin 256B.0911, subdivision 4a, by a county, tribe, or managed care organization under contract with the Department of Human Servicesdeleted text end new text begin 256.975, subdivision 7a, by the Senior LinkAge Line or other organization under contract with the Minnesota Board on Agingnew text end ; and

(2) new text begin a nursing facility level of care determination as provided for under section 256B.0911, subdivision 4e, as part of new text end a face-to-face long-term care consultation assessment completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care organization under contract with the Department of Human Services.

Sec. 2.

Minnesota Statutes 2012, section 144A.351, is amended to read:

144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS: REPORT new text begin AND STUDY new text end REQUIRED.

new text begin Subdivision 1. new text end

new text begin Report requirements. new text end

The commissioners of health and human services, with the cooperation of counties and in consultation with stakeholders, including persons who need or are using long-term care services and supports, lead agencies, regional entities, senior, disability, and mental health organization representatives, service providers, and community members shall prepare a report to the legislature by August 15, 2013, and biennially thereafter, regarding the status of the full range of long-term care services and supports for the elderly and children and adults with disabilities and mental illnesses in Minnesota. The report shall address:

(1) demographics and need for long-term care services and supports in Minnesota;

(2) summary of county and regional reports on long-term care gaps, surpluses, imbalances, and corrective action plans;

(3) status of long-term care services and related mental health services, housing options, and supports by county and region including:

(i) changes in availability of the range of long-term care services and housing options;

(ii) access problems, including access to the least restrictive and most integrated services and settings, regarding long-term care services; and

(iii) comparative measures of long-term care services availability, including serving people in their home areas near family, and changes over time; and

(4) recommendations regarding goals for the future of long-term care services and supports, policy and fiscal changes, and resource development and transition needs.

new text begin Subd. 2. new text end

new text begin Critical access study. new text end

new text begin The commissioner of human services shall conduct a onetime study to assess local capacity and availability of home and community-based services for older adults, people with disabilities, and people with mental illnesses. The study must assess critical access at the community level and identify potential strategies to build home and community-based service capacity in critical access areas. The report shall be submitted to the legislature no later than August 15, 2015. new text end

Sec. 3.

Minnesota Statutes 2012, section 148E.065, subdivision 4a, is amended to read:

Subd. 4a.

City, county, and state social workers.

(a) Beginning July 1, 2016, the licensure of city, county, and state agency social workers is voluntary, except an individual who is newly employed by a city or state agency after July 1, 2016, must be licensed if the individual who provides social work services, as those services are defined in section 148E.010, subdivision 11, paragraph (b), is presented to the public by any title incorporating the words "social work" or "social worker."

(b) City, county, and state agencies employing social workers new text begin and staff who are designated to perform mandated duties under sections 256.975, subdivisions 7 to 7c and 256.01, subdivision 24, new text end are not required to employ licensed social workers.

Sec. 4.

Minnesota Statutes 2012, section 256.01, subdivision 2, is amended to read:

Subd. 2.

Specific powers.

Subject to the provisions of section 241.021, subdivision 2, the commissioner of human services shall carry out the specific duties in paragraphs (a) through deleted text begin (cc)deleted text end new text begin (dd)new text end :

(a) Administer and supervise all forms of public assistance provided for by state law and other welfare activities or services as are vested in the commissioner. Administration and supervision of human services activities or services includes, but is not limited to, assuring timely and accurate distribution of benefits, completeness of service, and quality program management. In addition to administering and supervising human services activities vested by law in the department, the commissioner shall have the authority to:

(1) require county agency participation in training and technical assistance programs to promote compliance with statutes, rules, federal laws, regulations, and policies governing human services;

(2) monitor, on an ongoing basis, the performance of county agencies in the operation and administration of human services, enforce compliance with statutes, rules, federal laws, regulations, and policies governing welfare services and promote excellence of administration and program operation;

(3) develop a quality control program or other monitoring program to review county performance and accuracy of benefit determinations;

(4) require county agencies to make an adjustment to the public assistance benefits issued to any individual consistent with federal law and regulation and state law and rule and to issue or recover benefits as appropriate;

(5) delay or deny payment of all or part of the state and federal share of benefits and administrative reimbursement according to the procedures set forth in section 256.017;

(6) make contracts with and grants to public and private agencies and organizations, both profit and nonprofit, and individuals, using appropriated funds; and

(7) enter into contractual agreements with federally recognized Indian tribes with a reservation in Minnesota to the extent necessary for the tribe to operate a federally approved family assistance program or any other program under the supervision of the commissioner. The commissioner shall consult with the affected county or counties in the contractual agreement negotiations, if the county or counties wish to be included, in order to avoid the duplication of county and tribal assistance program services. The commissioner may establish necessary accounts for the purposes of receiving and disbursing funds as necessary for the operation of the programs.

(b) Inform county agencies, on a timely basis, of changes in statute, rule, federal law, regulation, and policy necessary to county agency administration of the programs.

(c) Administer and supervise all child welfare activities; promote the enforcement of laws protecting disabled, dependent, neglected and delinquent children, and children born to mothers who were not married to the children's fathers at the times of the conception nor at the births of the children; license and supervise child-caring and child-placing agencies and institutions; supervise the care of children in boarding and foster homes or in private institutions; and generally perform all functions relating to the field of child welfare now vested in the State Board of Control.

(d) Administer and supervise all noninstitutional service to disabled persons, including those who are visually impaired, hearing impaired, or physically impaired or otherwise disabled. The commissioner may provide and contract for the care and treatment of qualified indigent children in facilities other than those located and available at state hospitals when it is not feasible to provide the service in state hospitals.

(e) Assist and actively cooperate with other departments, agencies and institutions, local, state, and federal, by performing services in conformity with the purposes of Laws 1939, chapter 431.

(f) Act as the agent of and cooperate with the federal government in matters of mutual concern relative to and in conformity with the provisions of Laws 1939, chapter 431, including the administration of any federal funds granted to the state to aid in the performance of any functions of the commissioner as specified in Laws 1939, chapter 431, and including the promulgation of rules making uniformly available medical care benefits to all recipients of public assistance, at such times as the federal government increases its participation in assistance expenditures for medical care to recipients of public assistance, the cost thereof to be borne in the same proportion as are grants of aid to said recipients.

(g) Establish and maintain any administrative units reasonably necessary for the performance of administrative functions common to all divisions of the department.

(h) Act as designated guardian of both the estate and the person of all the wards of the state of Minnesota, whether by operation of law or by an order of court, without any further act or proceeding whatever, except as to persons committed as developmentally disabled. For children under the guardianship of the commissioner or a tribe in Minnesota recognized by the Secretary of the Interior whose interests would be best served by adoptive placement, the commissioner may contract with a licensed child-placing agency or a Minnesota tribal social services agency to provide adoption services. A contract with a licensed child-placing agency must be designed to supplement existing county efforts and may not replace existing county programs or tribal social services, unless the replacement is agreed to by the county board and the appropriate exclusive bargaining representative, tribal governing body, or the commissioner has evidence that child placements of the county continue to be substantially below that of other counties. Funds encumbered and obligated under an agreement for a specific child shall remain available until the terms of the agreement are fulfilled or the agreement is terminated.

(i) Act as coordinating referral and informational center on requests for service for newly arrived immigrants coming to Minnesota.

(j) The specific enumeration of powers and duties as hereinabove set forth shall in no way be construed to be a limitation upon the general transfer of powers herein contained.

(k) Establish county, regional, or statewide schedules of maximum fees and charges which may be paid by county agencies for medical, dental, surgical, hospital, nursing and nursing home care and medicine and medical supplies under all programs of medical care provided by the state and for congregate living care under the income maintenance programs.

(l) Have the authority to conduct and administer experimental projects to test methods and procedures of administering assistance and services to recipients or potential recipients of public welfare. To carry out such experimental projects, it is further provided that the commissioner of human services is authorized to waive the enforcement of existing specific statutory program requirements, rules, and standards in one or more counties. The order establishing the waiver shall provide alternative methods and procedures of administration, shall not be in conflict with the basic purposes, coverage, or benefits provided by law, and in no event shall the duration of a project exceed four years. It is further provided that no order establishing an experimental project as authorized by the provisions of this section shall become effective until the following conditions have been met:

(1) the secretary of health and human services of the United States has agreed, for the same project, to waive state plan requirements relative to statewide uniformity; and

(2) a comprehensive plan, including estimated project costs, shall be approved by the Legislative Advisory Commission and filed with the commissioner of administration.

(m) According to federal requirements, establish procedures to be followed by local welfare boards in creating citizen advisory committees, including procedures for selection of committee members.

(n) Allocate federal fiscal disallowances or sanctions which are based on quality control error rates for the aid to families with dependent children program formerly codified in sections 256.72 to 256.87, medical assistance, or food stamp program in the following manner:

(1) one-half of the total amount of the disallowance shall be borne by the county boards responsible for administering the programs. For the medical assistance and the AFDC program formerly codified in sections 256.72 to 256.87, disallowances shall be shared by each county board in the same proportion as that county's expenditures for the sanctioned program are to the total of all counties' expenditures for the AFDC program formerly codified in sections 256.72 to 256.87, and medical assistance programs. For the food stamp program, sanctions shall be shared by each county board, with 50 percent of the sanction being distributed to each county in the same proportion as that county's administrative costs for food stamps are to the total of all food stamp administrative costs for all counties, and 50 percent of the sanctions being distributed to each county in the same proportion as that county's value of food stamp benefits issued are to the total of all benefits issued for all counties. Each county shall pay its share of the disallowance to the state of Minnesota. When a county fails to pay the amount due hereunder, the commissioner may deduct the amount from reimbursement otherwise due the county, or the attorney general, upon the request of the commissioner, may institute civil action to recover the amount due; and

(2) notwithstanding the provisions of clause (1), if the disallowance results from knowing noncompliance by one or more counties with a specific program instruction, and that knowing noncompliance is a matter of official county board record, the commissioner may require payment or recover from the county or counties, in the manner prescribed in clause (1), an amount equal to the portion of the total disallowance which resulted from the noncompliance, and may distribute the balance of the disallowance according to clause (1).

(o) Develop and implement special projects that maximize reimbursements and result in the recovery of money to the state. For the purpose of recovering state money, the commissioner may enter into contracts with third parties. Any recoveries that result from projects or contracts entered into under this paragraph shall be deposited in the state treasury and credited to a special account until the balance in the account reaches $1,000,000. When the balance in the account exceeds $1,000,000, the excess shall be transferred and credited to the general fund. All money in the account is appropriated to the commissioner for the purposes of this paragraph.

(p) Have the authority to make direct payments to facilities providing shelter to women and their children according to section 256D.05, subdivision 3. Upon the written request of a shelter facility that has been denied payments under section 256D.05, subdivision 3, the commissioner shall review all relevant evidence and make a determination within 30 days of the request for review regarding issuance of direct payments to the shelter facility. Failure to act within 30 days shall be considered a determination not to issue direct payments.

(q) Have the authority to establish and enforce the following county reporting requirements:

(1) the commissioner shall establish fiscal and statistical reporting requirements necessary to account for the expenditure of funds allocated to counties for human services programs. When establishing financial and statistical reporting requirements, the commissioner shall evaluate all reports, in consultation with the counties, to determine if the reports can be simplified or the number of reports can be reduced;

(2) the county board shall submit monthly or quarterly reports to the department as required by the commissioner. Monthly reports are due no later than 15 working days after the end of the month. Quarterly reports are due no later than 30 calendar days after the end of the quarter, unless the commissioner determines that the deadline must be shortened to 20 calendar days to avoid jeopardizing compliance with federal deadlines or risking a loss of federal funding. Only reports that are complete, legible, and in the required format shall be accepted by the commissioner;

(3) if the required reports are not received by the deadlines established in clause (2), the commissioner may delay payments and withhold funds from the county board until the next reporting period. When the report is needed to account for the use of federal funds and the late report results in a reduction in federal funding, the commissioner shall withhold from the county boards with late reports an amount equal to the reduction in federal funding until full federal funding is received;

(4) a county board that submits reports that are late, illegible, incomplete, or not in the required format for two out of three consecutive reporting periods is considered noncompliant. When a county board is found to be noncompliant, the commissioner shall notify the county board of the reason the county board is considered noncompliant and request that the county board develop a corrective action plan stating how the county board plans to correct the problem. The corrective action plan must be submitted to the commissioner within 45 days after the date the county board received notice of noncompliance;

(5) the final deadline for fiscal reports or amendments to fiscal reports is one year after the date the report was originally due. If the commissioner does not receive a report by the final deadline, the county board forfeits the funding associated with the report for that reporting period and the county board must repay any funds associated with the report received for that reporting period;

(6) the commissioner may not delay payments, withhold funds, or require repayment under clause (3) or (5) if the county demonstrates that the commissioner failed to provide appropriate forms, guidelines, and technical assistance to enable the county to comply with the requirements. If the county board disagrees with an action taken by the commissioner under clause (3) or (5), the county board may appeal the action according to sections 14.57 to 14.69; and

(7) counties subject to withholding of funds under clause (3) or forfeiture or repayment of funds under clause (5) shall not reduce or withhold benefits or services to clients to cover costs incurred due to actions taken by the commissioner under clause (3) or (5).

(r) Allocate federal fiscal disallowances or sanctions for audit exceptions when federal fiscal disallowances or sanctions are based on a statewide random sample in direct proportion to each county's claim for that period.

(s) Be responsible for ensuring the detection, prevention, investigation, and resolution of fraudulent activities or behavior by applicants, recipients, and other participants in the human services programs administered by the department.

(t) Require county agencies to identify overpayments, establish claims, and utilize all available and cost-beneficial methodologies to collect and recover these overpayments in the human services programs administered by the department.

(u) Have the authority to administer a drug rebate program for drugs purchased pursuant to the prescription drug program established under section 256.955 after the beneficiary's satisfaction of any deductible established in the program. The commissioner shall require a rebate agreement from all manufacturers of covered drugs as defined in section 256B.0625, subdivision 13. Rebate agreements for prescription drugs delivered on or after July 1, 2002, must include rebates for individuals covered under the prescription drug program who are under 65 years of age. For each drug, the amount of the rebate shall be equal to the rebate as defined for purposes of the federal rebate program in United States Code, title 42, section 1396r-8. The manufacturers must provide full payment within 30 days of receipt of the state invoice for the rebate within the terms and conditions used for the federal rebate program established pursuant to section 1927 of title XIX of the Social Security Act. The manufacturers must provide the commissioner with any information necessary to verify the rebate determined per drug. The rebate program shall utilize the terms and conditions used for the federal rebate program established pursuant to section 1927 of title XIX of the Social Security Act.

(v) Have the authority to administer the federal drug rebate program for drugs purchased under the medical assistance program as allowed by section 1927 of title XIX of the Social Security Act and according to the terms and conditions of section 1927. Rebates shall be collected for all drugs that have been dispensed or administered in an outpatient setting and that are from manufacturers who have signed a rebate agreement with the United States Department of Health and Human Services.

(w) Have the authority to administer a supplemental drug rebate program for drugs purchased under the medical assistance program. The commissioner may enter into supplemental rebate contracts with pharmaceutical manufacturers and may require prior authorization for drugs that are from manufacturers that have not signed a supplemental rebate contract. Prior authorization of drugs shall be subject to the provisions of section 256B.0625, subdivision 13.

(x) Operate the department's communication systems account established in Laws 1993, First Special Session chapter 1, article 1, section 2, subdivision 2, to manage shared communication costs necessary for the operation of the programs the commissioner supervises. A communications account may also be established for each regional treatment center which operates communications systems. Each account must be used to manage shared communication costs necessary for the operations of the programs the commissioner supervises. The commissioner may distribute the costs of operating and maintaining communication systems to participants in a manner that reflects actual usage. Costs may include acquisition, licensing, insurance, maintenance, repair, staff time and other costs as determined by the commissioner. Nonprofit organizations and state, county, and local government agencies involved in the operation of programs the commissioner supervises may participate in the use of the department's communications technology and share in the cost of operation. The commissioner may accept on behalf of the state any gift, bequest, devise or personal property of any kind, or money tendered to the state for any lawful purpose pertaining to the communication activities of the department. Any money received for this purpose must be deposited in the department's communication systems accounts. Money collected by the commissioner for the use of communication systems must be deposited in the state communication systems account and is appropriated to the commissioner for purposes of this section.

(y) Receive any federal matching money that is made available through the medical assistance program for the consumer satisfaction survey. Any federal money received for the survey is appropriated to the commissioner for this purpose. The commissioner may expend the federal money received for the consumer satisfaction survey in either year of the biennium.

(z) Designate community information and referral call centers and incorporate cost reimbursement claims from the designated community information and referral call centers into the federal cost reimbursement claiming processes of the department according to federal law, rule, and regulations. Existing information and referral centers provided by Greater Twin Cities United Way or existing call centers for which Greater Twin Cities United Way has legal authority to represent, shall be included in these designations upon review by the commissioner and assurance that these services are accredited and in compliance with national standards. Any reimbursement is appropriated to the commissioner and all designated information and referral centers shall receive payments according to normal department schedules established by the commissioner upon final approval of allocation methodologies from the United States Department of Health and Human Services Division of Cost Allocation or other appropriate authorities.

(aa) Develop recommended standards for foster care homes that address the components of specialized therapeutic services to be provided by foster care homes with those services.

(bb) Authorize the method of payment to or from the department as part of the human services programs administered by the department. This authorization includes the receipt or disbursement of funds held by the department in a fiduciary capacity as part of the human services programs administered by the department.

(cc) Have the authority to administer a drug rebate program for drugs purchased for persons eligible for general assistance medical care under section 256D.03, subdivision 3. For manufacturers that agree to participate in the general assistance medical care rebate program, the commissioner shall enter into a rebate agreement for covered drugs as defined in section 256B.0625, subdivisions 13 and 13d. For each drug, the amount of the rebate shall be equal to the rebate as defined for purposes of the federal rebate program in United States Code, title 42, section 1396r-8. The manufacturers must provide payment within the terms and conditions used for the federal rebate program established under section 1927 of title XIX of the Social Security Act. The rebate program shall utilize the terms and conditions used for the federal rebate program established under section 1927 of title XIX of the Social Security Act.

Effective January 1, 2006, drug coverage under general assistance medical care shall be limited to those prescription drugs that:

(1) are covered under the medical assistance program as described in section 256B.0625, subdivisions 13 and 13d; and

(2) are provided by manufacturers that have fully executed general assistance medical care rebate agreements with the commissioner and comply with such agreements. Prescription drug coverage under general assistance medical care shall conform to coverage under the medical assistance program according to section 256B.0625, subdivisions 13 to 13g.

The rebate revenues collected under the drug rebate program are deposited in the general fund.

new text begin (dd) Designate the agencies that operate the Senior LinkAge Line under section 256.975, subdivision 7, and the Disability Linkage Line under subdivision 24 as the state of Minnesota Aging and Disability Resource Center under United States Code, title 42, section 3001, the Older Americans Act Amendments of 2006, and incorporate cost reimbursement claims from the designated centers into the federal cost reimbursement claiming processes of the department according to federal law, rule, and regulations. Any reimbursement must be appropriated to the commissioner and treated consistent with section 256.011. All Aging and Disability Resource Center designated agencies shall receive payments of grant funding that supports the activity and generates the federal financial participation according to Board on Aging administrative granting mechanisms. new text end

Sec. 5.

Minnesota Statutes 2012, section 256.01, subdivision 24, is amended to read:

Subd. 24.

Disability Linkage Line.

The commissioner shall establish the Disability Linkage Line, deleted text begin todeleted text end new text begin which shall serve people with disabilities as the designated Aging and Disability Resource Center under United States Code, title 42, section 3001, the Older Americans Act Amendments of 2006, in partnership with the Senior LinkAge Line and shall new text end serve as Minnesota's neutral access point for statewide disability information and assistancenew text begin and must be available during business hours through a statewide toll-free number and the Internetnew text end . The Disability Linkage Line shall:

(1) deliver information and assistance based on national and state standards;

(2) provide information about state and federal eligibility requirements, benefits, and service options;

(3) provide benefits and options counseling;

(4) make referrals to appropriate support entities;

(5) educate people on their options so they can make well-informed choicesnew text begin and link them to quality profilesnew text end ;

(6) help support the timely resolution of service access and benefit issues;

(7) inform people of their long-term community services and supports;

(8) provide necessary resources and supports that can lead to employment and increased economic stability of people with disabilities; and

(9) serve as the technical assistance and help center for the Web-based tool, Minnesota's Disability Benefits 101.org.

Sec. 6.

Minnesota Statutes 2012, section 256.975, subdivision 7, is amended to read:

Subd. 7.

Consumer information and assistance and long-term care options counseling; Senior LinkAge Line.

(a) The Minnesota Board on Aging shall operate a statewide service to aid older Minnesotans and their families in making informed choices about long-term care options and health care benefits. Language services to persons with limited English language skills may be made available. The service, known as Senior LinkAge Line, new text begin shall serve older adults as the designated Aging and Disability Resource Center under United States Code, title 42, section 3001, the Older Americans Act Amendments of 2006 in partnership with the Disability Linkage Line under section 256.01, subdivision 24, and new text end must be available during business hours through a statewide toll-free number and deleted text begin must also be available throughdeleted text end the Internet.new text begin The Minnesota Board on Aging shall consult with, and when appropriate work through, the area agencies on aging counties, and other entities that serve aging and disabled populations of all ages, to provide and maintain the telephone infrastructure and related support for the Aging and Disability Resource Center partners which agree by memorandum to access the infrastructure, including the designated providers of the Senior LinkAge Line and the Disability Linkage Line.new text end

(b) The service must provide long-term care options counseling by assisting older adults, caregivers, and providers in accessing information and options counseling about choices in long-term care services that are purchased through private providers or available through public options. The service must:

(1) develop new text begin and provide for regular updating ofnew text end a comprehensive database that includes detailed listings in both consumer- and provider-oriented formatsnew text begin that can provide search results down to the neighborhood levelnew text end ;

(2) make the database accessible on the Internet and through other telecommunication and media-related tools;

(3) link callers to interactive long-term care screening tools and make these tools available through the Internet by integrating the tools with the database;

(4) develop community education materials with a focus on planning for long-term care and evaluating independent living, housing, and service options;

(5) conduct an outreach campaign to assist older adults and their caregivers in finding information on the Internet and through other means of communication;

(6) implement a messaging system for overflow callers and respond to these callers by the next business day;

(7) link callers with county human services and other providers to receive more in-depth assistance and consultation related to long-term care options;

(8) link callers with quality profiles for nursing facilities and other new text begin home and community-based services new text end providers developed by the deleted text begin commissionerdeleted text end new text begin commissionersnew text end of healthnew text begin and human servicesnew text end ;

new text begin (9) develop an outreach plan to seniors and their caregivers with a particular focus on establishing a clear presence in places that seniors recognize and: new text end

new text begin (i) place a significant emphasis on improved outreach and service to seniors and their caregivers by establishing annual plans by neighborhood, city, and county, as necessary, to address the unique needs of geographic areas in the state where there are dense populations of seniors; new text end

new text begin (ii) establish an efficient workforce management approach and assign community living specialist staff and volunteers to geographic areas as well as aging and disability resource center sites so that seniors and their caregivers and professionals recognize the Senior LinkAge Line as the place to call for aging services and information; new text end

new text begin (iii) recognize the size and complexity of the metropolitan area service system by working with metropolitan counties to establish a clear partnership with them, including seeking county advice on the establishment of local aging and disabilities resource center sites; and new text end

new text begin (iv) maintain dashboards with metrics that demonstrate how the service is expanding and extending or enhancing its outreach efforts in dispersed or hard to reach locations in varied population centers; new text end

deleted text begin (9)deleted text end new text begin (10)new text end incorporate information about the availability of housing options, as well as registered housing with services and consumer rights within the MinnesotaHelp.info network long-term care database to facilitate consumer comparison of services and costs among housing with services establishments and with other in-home services and to support financial self-sufficiency as long as possible. Housing with services establishments and their arranged home care providers shall provide information that will facilitate price comparisons, including delineation of charges for rent and for services available. The commissioners of health and human services shall align the data elements required by section 144G.06, the Uniform Consumer Information Guide, and this section to provide consumers standardized information and ease of comparison of long-term care options. The commissioner of human services shall provide the data to the Minnesota Board on Aging for inclusion in the MinnesotaHelp.info network long-term care database;

deleted text begin (10)deleted text end new text begin (11)new text end provide long-term care options counseling. Long-term care options counselors shall:

(i) for individuals not eligible for case management under a public program or public funding source, provide interactive decision support under which consumers, family members, or other helpers are supported in their deliberations to determine appropriate long-term care choices in the context of the consumer's needs, preferences, values, and individual circumstances, including implementing a community support plan;

(ii) provide Web-based educational information and collateral written materials to familiarize consumers, family members, or other helpers with the long-term care basics, issues to be considered, and the range of options available in the community;

(iii) provide long-term care futures planning, which means providing assistance to individuals who anticipate having long-term care needs to develop a plan for the more distant future; and

(iv) provide expertise in benefits and financing options for long-term care, including Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages, private pay options, and ways to access low or no-cost services or benefits through volunteer-based or charitable programs;

deleted text begin (11)deleted text end new text begin (12)new text end using risk management and support planning protocols, provide long-term care options counseling to current residents of nursing homes deemed appropriate for discharge by the commissionernew text begin and older adults who request service after consultation with the Senior LinkAge Line under clause (12)new text end . deleted text begin In order to meet this requirement,deleted text end new text begin The Senior LinkAge Line shall also receive referrals from the residents or staff of nursing homes. The Senior LinkAge Line shall identify and contact residents deemed appropriate for discharge by developing targeting criteria in consultation withnew text end the commissioner new text begin who new text end shall provide designated Senior LinkAge Line contact centers with a list of nursing home residents new text begin that meet the criteria as being new text end appropriate for discharge planning via a secure Web portal. Senior LinkAge Line shall provide these residents, if they indicate a preference to receive long-term care options counseling, with initial assessmentdeleted text begin , review of risk factors, independent living support consultation, ordeleted text end new text begin and, if appropriate, anew text end referral to:

(i) long-term care consultation services under section 256B.0911;

(ii) designated care coordinators of contracted entities under section 256B.035 for persons who are enrolled in a managed care plan; or

(iii) the long-term care consultation team for those who are deleted text begin appropriatedeleted text end new text begin eligiblenew text end for relocation service coordination due to high-risk factors or psychological or physical disability; and

deleted text begin (12)deleted text end new text begin (13)new text end develop referral protocols and processes that will assist certified health care homes and hospitals to identify at-risk older adults and determine when to refer these individuals to the Senior LinkAge Line for long-term care options counseling under this section. The commissioner is directed to work with the commissioner of health to develop protocols that would comply with the health care home designation criteria and protocols available at the time of hospital discharge. The commissioner shall keep a record of the number of people who choose long-term care options counseling as a result of this section.

Sec. 7.

Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision to read:

new text begin Subd. 7a. new text end

new text begin Preadmission screening activities related to nursing facility admissions. new text end

new text begin (a) All individuals seeking admission to Medicaid certified nursing facilities, including certified boarding care facilities, must be screened prior to admission regardless of income, assets, or funding sources for nursing facility care, except as described in subdivision 7b, paragraphs (a) and (b). The purpose of the screening is to determine the need for nursing facility level of care as described in section 256B.0911, subdivision 4e, and to complete activities required under federal law related to mental illness and developmental disability as outlined in paragraph (b). new text end

new text begin (b) A person who has a diagnosis or possible diagnosis of mental illness or developmental disability must receive a preadmission screening before admission regardless of the exemptions outlined in subdivision 7b, paragraphs (a) and (b), to identify the need for further evaluation and specialized services, unless the admission prior to screening is authorized by the local mental health authority or the local developmental disabilities case manager, or unless authorized by the county agency according to Public Law 101-508. new text end

new text begin (c) The following criteria apply to the preadmission screening: new text end

new text begin (1) requests for preadmission screenings must be submitted via an online form developed by the commissioner; new text end

new text begin (2) the Senior LinkAge Line must use forms and criteria developed by the commissioner to identify persons who require referral for further evaluation and determination of the need for specialized services; and new text end

new text begin (3) the evaluation and determination of the need for specialized services must be done by: new text end

new text begin (i) a qualified independent mental health professional, for persons with a primary or secondary diagnosis of a serious mental illness; or new text end

new text begin (ii) a qualified developmental disability professional, for persons with a primary or secondary diagnosis of developmental disability. For purposes of this requirement, a qualified developmental disability professional must meet the standards for a qualified developmental disability professional under Code of Federal Regulations, title 42, section 483.430. new text end

new text begin (d) The local county mental health authority or the state developmental disability authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a nursing facility if the individual does not meet the nursing facility level of care criteria or needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For purposes of this section, "specialized services" for a person with developmental disability means active treatment as that term is defined under Code of Federal Regulations, title 42, section 483.440(a)(1). new text end

new text begin (e) In assessing a person's needs, the screener shall: new text end

new text begin (1) use an automated system designated by the commissioner; new text end

new text begin (2) consult with care transitions coordinators or physician; and new text end

new text begin (3) consider the assessment of the individual's physician. new text end

new text begin Other personnel may be included in the level of care determination as deemed necessary by the screener. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2013. new text end

Sec. 8.

Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision to read:

new text begin Subd. 7b. new text end

new text begin Exemptions and emergency admissions. new text end

new text begin (a) Exemptions from the federal screening requirements outlined in subdivision 7a, paragraphs (b) and (c), are limited to: new text end

new text begin (1) a person who, having entered an acute care facility from a certified nursing facility, is returning to a certified nursing facility; or new text end

new text begin (2) a person transferring from one certified nursing facility in Minnesota to another certified nursing facility in Minnesota. new text end

new text begin (b) Persons who are exempt from preadmission screening for purposes of level of care determination include: new text end

new text begin (1) persons described in paragraph (a); new text end

new text begin (2) an individual who has a contractual right to have nursing facility care paid for indefinitely by the Veterans' Administration; new text end

new text begin (3) an individual enrolled in a demonstration project under section 256B.69, subdivision 8, at the time of application to a nursing facility; and new text end

new text begin (4) an individual currently being served under the alternative care program or under a home and community-based services waiver authorized under section 1915(c) of the federal Social Security Act. new text end

new text begin (c) Persons admitted to a Medicaid-certified nursing facility from the community on an emergency basis as described in paragraph (d) or from an acute care facility on a nonworking day must be screened the first working day after admission. new text end

new text begin (d) Emergency admission to a nursing facility prior to screening is permitted when all of the following conditions are met: new text end

new text begin (1) a person is admitted from the community to a certified nursing or certified boarding care facility during Senior LinkAge Line nonworking hours; new text end

new text begin (2) a physician has determined that delaying admission until preadmission screening is completed would adversely affect the person's health and safety; new text end

new text begin (3) there is a recent precipitating event that precludes the client from living safely in the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's inability to continue to provide care; new text end

new text begin (4) the attending physician has authorized the emergency placement and has documented the reason that the emergency placement is recommended; and new text end

new text begin (5) the Senior LinkAge Line is contacted on the first working day following the emergency admission. new text end

new text begin Transfer of a patient from an acute care hospital to a nursing facility is not considered an emergency except for a person who has received hospital services in the following situations: hospital admission for observation, care in an emergency room without hospital admission, or following hospital 24-hour bed care and from whom admission is being sought on a nonworking day. new text end

new text begin (e) A nursing facility must provide written information to all persons admitted regarding the person's right to request and receive long-term care consultation services as defined in section 256B.0911, subdivision 1a. The information must be provided prior to the person's discharge from the facility and in a format specified by the commissioner. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2013. new text end

Sec. 9.

Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision to read:

new text begin Subd. 7c. new text end

new text begin Screening requirements. new text end

new text begin (a) A person may be screened for nursing facility admission by telephone or in a face-to-face screening interview. The Senior LinkAge Line shall identify each individual's needs using the following categories: new text end

new text begin (1) the person needs no face-to-face long-term care consultation assessment completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care organization under contract with the Department of Human Services to determine the need for nursing facility level of care based on information obtained from other health care professionals; new text end

new text begin (2) the person needs an immediate face-to-face long-term care consultation assessment completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care organization under contract with the Department of Human Services to determine the need for nursing facility level of care and complete activities required under subdivision 7a; or new text end

new text begin (3) the person may be exempt from screening requirements as outlined in subdivision 7b, but will need transitional assistance after admission or in-person follow-along after a return home. new text end

new text begin (b) Individuals under 65 years of age who are admitted to nursing facilities with only a telephone screening must receive a face-to-face assessment from the long-term care consultation team member of the county in which the facility is located or from the recipient's county case manager within 40 calendar days of admission as described in section 256B.0911, subdivision 4d, paragraph (c). new text end

new text begin (c) Persons admitted on a nonemergency basis to a Medicaid-certified nursing facility must be screened prior to admission. new text end

new text begin (d) Screenings provided by the Senior LinkAge Line must include processes to identify persons who may require transition assistance described in subdivision 7, paragraph (b), clause (12), and section 256B.0911, subdivision 3b. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2013. new text end

Sec. 10.

Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision to read:

new text begin Subd. 7d. new text end

new text begin Payment for preadmission screening. new text end

new text begin Funding for preadmission screening shall be provided to the Minnesota Board on Aging by the Department of Human Services to cover screener salaries and expenses to provide the services described in subdivisions 7a to 7c. The Minnesota Board on Aging shall employ, or contract with other agencies to employ, within the limits of available funding, sufficient personnel to provide preadmission screening and level of care determination services and shall seek to maximize federal funding for the service as provided under section 256.01, subdivision 2, paragraph (dd). new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2013. new text end

Sec. 11.

Minnesota Statutes 2012, section 256.9754, is amended by adding a subdivision to read:

new text begin Subd. 3a. new text end

new text begin Priority for other grants. new text end

new text begin The commissioner of health shall give priority to a grantee selected under subdivision 3 when awarding technology-related grants, if the grantee is using technology as part of the proposal unless that priority conflicts with existing state or federal guidance related to grant awards by the Department of Health. The commissioner of transportation shall give priority to a grantee under subdivision 3 when distributing transportation-related funds to create transportation options for older adults unless that preference conflicts with existing state or federal guidance related to grant awards by the Department of Transportation. new text end

Sec. 12.

Minnesota Statutes 2012, section 256.9754, is amended by adding a subdivision to read:

new text begin Subd. 3b. new text end

new text begin State waivers. new text end

new text begin The commissioner of health may waive applicable state laws and rules on a time-limited basis if the commissioner of health determines that a participating grantee requires a waiver in order to achieve demonstration project goals. new text end

Sec. 13.

Minnesota Statutes 2012, section 256.9754, subdivision 5, is amended to read:

Subd. 5.

Grant preference.

The commissioner of human services shall give preference when awarding grants under this section to areas where nursing facility closures have occurred or are occurringnew text begin or areas with service needs identified by section 144A.351new text end . The commissioner may award grants to the extent grant funds are available and to the extent applications are approved by the commissioner. Denial of approval of an application in one year does not preclude submission of an application in a subsequent year. The maximum grant amount is limited to $750,000.

Sec. 14.

Minnesota Statutes 2012, section 256B.021, is amended by adding a subdivision to read:

new text begin Subd. 4a. new text end

new text begin Evaluation. new text end

new text begin The commissioner shall evaluate the projects contained in subdivision 4, paragraphs (f), clauses (2) and (12), and (h). The evaluation must include: new text end

new text begin (1) an impact assessment focusing on program outcomes, especially those experienced directly by the person receiving services; new text end

new text begin (2) study samples drawn from the population of interest for each project; and new text end

new text begin (3) a time series analysis to examine aggregate trends in average monthly utilization, expenditures, and other outcomes in the targeted populations before and after implementation of the initiatives. new text end

Sec. 15.

Minnesota Statutes 2012, section 256B.021, is amended by adding a subdivision to read:

new text begin Subd. 6. new text end

new text begin Work, empower, and encourage independence. new text end

new text begin As provided under subdivision 4, paragraph (e), upon federal approval, the commissioner shall establish a demonstration project to provide navigation, employment supports, and benefits planning services to a targeted group of federally funded Medicaid recipients to begin July 1, 2014. This demonstration shall promote economic stability, increase independence, and reduce applications for disability benefits while providing a positive impact on the health and future of participants. new text end

Sec. 16.

Minnesota Statutes 2012, section 256B.021, is amended by adding a subdivision to read:

new text begin Subd. 7. new text end

new text begin Housing stabilization. new text end

new text begin As provided under subdivision 4, paragraph (e), upon federal approval, the commissioner shall establish a demonstration project to provide service coordination, outreach, in-reach, tenancy support, and community living assistance to a targeted group of federally funded Medicaid recipients to begin January 1, 2014. This demonstration shall promote housing stability, reduce costly medical interventions, and increase opportunities for independent community living. new text end

Sec. 17.

Minnesota Statutes 2012, section 256B.0911, subdivision 1, is amended to read:

Subdivision 1.

Purpose and goal.

(a) The purpose of long-term care consultation services is to assist persons with long-term or chronic care needs in making care decisions and selecting support and service options that meet their needs and reflect their preferences. The availability of, and access to, information and other types of assistance, including assessment and support planning, is also intended to prevent or delay institutional placements and to provide access to transition assistance after admission. Further, the goal of these services is to contain costs associated with unnecessary institutional admissions. Long-term consultation services must be available to any person regardless of public program eligibility. The commissioner of human services shall seek to maximize use of available federal and state funds and establish the broadest program possible within the funding available.

(b) These services must be coordinated with long-term care options counseling provided under new text begin subdivision 4d, new text end section 256.975, deleted text begin subdivisiondeleted text end new text begin subdivisionsnew text end 7new text begin to 7cnew text end , and section 256.01, subdivision 24. The lead agency providing long-term care consultation services shall encourage the use of volunteers from families, religious organizations, social clubs, and similar civic and service organizations to provide community-based services.

Sec. 18.

Minnesota Statutes 2012, section 256B.0911, subdivision 1a, is amended to read:

Subd. 1a.

Definitions.

For purposes of this section, the following definitions apply:

(a) Until additional requirements apply under paragraph (b), "long-term care consultation services" means:

(1) intake for and access to assistance in identifying services needed to maintain an individual in the most inclusive environment;

(2) providing recommendations for and referrals to cost-effective community services that are available to the individual;

(3) development of an individual's person-centered community support plan;

(4) providing information regarding eligibility for Minnesota health care programs;

(5) face-to-face long-term care consultation assessments, which may be completed in a hospital, nursing facility, intermediate care facility for persons with developmental disabilities (ICF/DDs), regional treatment centers, or the person's current or planned residence;

deleted text begin (6) federally mandated preadmission screening activities described under subdivisions 4a and 4b; deleted text end

deleted text begin (7)deleted text end new text begin (6)new text end determination of home and community-based waiver and other service eligibility as required under sections 256B.0913, 256B.0915, and 256B.49, including level of care determination for individuals who need an institutional level of care as determined under section 256B.0911, subdivision deleted text begin 4a, paragraph (d)deleted text end new text begin 4enew text end , based on assessment and community support plan development, appropriate referrals to obtain necessary diagnostic information, and including an eligibility determination for consumer-directed community supports;

deleted text begin (8)deleted text end new text begin (7)new text end providing recommendations for institutional placement when there are no cost-effective community services available;

deleted text begin (9)deleted text end new text begin (8)new text end providing access to assistance to transition people back to community settings after institutional admission; and

deleted text begin (10)deleted text end new text begin (9)new text end providing information about competitive employment, with or without supports, for school-age youth and working-age adults and referrals to the Disability Linkage Line and Disability Benefits 101 to ensure that an informed choice about competitive employment can be made. For the purposes of this subdivision, "competitive employment" means work in the competitive labor market that is performed on a full-time or part-time basis in an integrated setting, and for which an individual is compensated at or above the minimum wage, but not less than the customary wage and level of benefits paid by the employer for the same or similar work performed by individuals without disabilities.

(b) Upon statewide implementation of lead agency requirements in subdivisions 2b, 2c, and 3a, "long-term care consultation services" also means:

(1) service eligibility determination for state plan home care services identified in:

(i) section 256B.0625, subdivisions 7, 19a, and 19c;

(ii) section 256B.0657; or

(iii) consumer support grants under section 256.476;

(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024, determination of eligibility for case management services available under sections 256B.0621, subdivision 2, paragraph (4), and 256B.0924 and Minnesota Rules, part 9525.0016;

(3) determination of institutional level of care, home and community-based service waiver, and other service eligibility as required under section 256B.092, determination of eligibility for family support grants under section 252.32, semi-independent living services under section 252.275, and day training and habilitation services under section 256B.092; and

(4) obtaining necessary diagnostic information to determine eligibility under clauses (2) and (3).

(c) "Long-term care options counseling" means the services provided by the linkage lines as mandated by sections 256.01new text begin , subdivision 24,new text end and 256.975, subdivision 7, and also includes telephone assistance and follow up once a long-term care consultation assessment has been completed.

(d) "Minnesota health care programs" means the medical assistance program under chapter 256B and the alternative care program under section 256B.0913.

(e) "Lead agencies" means counties administering or tribes and health plans under contract with the commissioner to administer long-term care consultation assessment and support planning services.

Sec. 19.

Minnesota Statutes 2012, 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 private duty 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) The lead agency may utilize a team of either the social worker or public health nurse, or both. Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified assessors to conduct the assessment. The consultation team members must confer regarding the most appropriate care for each individual screened or assessed. For a person with complex health care needs, a public health or registered nurse from the team must be consulted.

(c) The assessment must be comprehensive and include a person-centered assessment of the health, psychological, functional, environmental, and social needs of referred individuals and provide information necessary to develop a community support plan that meets the consumers needs, using an assessment form provided by the commissioner.

(d) The assessment must be conducted in a face-to-face interview with the person being assessed and the person's legal representative, and other individuals as requested by the person, who can 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, but who is not a provider of service or has 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 will 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.

(e) If the person chooses to use community-based services, 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 providers;

(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 new text begin section 256.975, new text end subdivision deleted text begin 4a, paragraph (c)deleted text end new text begin 7a, paragraph (d)new text end .

(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 new text begin conducted by long-term care options counselors according to section 256.975, subdivisions 7a to 7c, new text end if the person selects nursing facility placementnew text begin . 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 commissionernew text end ;

(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 (7), 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 section 256B.0911, subdivision deleted text begin 4a, paragraph (d)deleted text end new text begin 4enew text end , and the certified assessor's decision regarding eligibility for all services and programs as defined in subdivision 1a, paragraphs (a), clause (7), 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), clause (7), 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 alternatives for disabled individuals, 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 in a face-to-face visit 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.

Sec. 20.

Minnesota Statutes 2012, section 256B.0911, subdivision 4d, is amended to read:

Subd. 4d.

Preadmission screening of individuals under 65 years of age.

(a) It is the policy of the state of Minnesota to ensure that individuals with disabilities or chronic illness are served in the most integrated setting appropriate to their needs and have the necessary information to make informed choices about home and community-based service options.

(b) Individuals under 65 years of age who are admitted to a new text begin Medicaid-certifiednew text end nursing facility deleted text begin from a hospitaldeleted text end must be screened prior to admission deleted text begin as outlined in subdivisions 4a through 4cdeleted text end new text begin according to the requirements outlined in section 256.975, subdivisions 7a to 7c. This shall be provided by the Senior LinkAge Line as required under section 256.975, subdivision 7new text end .

(c) Individuals under 65 years of age who are admitted to nursing facilities with only a telephone screening must receive a face-to-face assessment from the long-term care consultation team member of the county in which the facility is located or from the recipient's county case manager within 40 calendar days of admission.

deleted text begin (d) Individuals under 65 years of age who are admitted to a nursing facility without preadmission screening according to the exemption described in subdivision 4b, paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive a face-to-face assessment within 40 days of admission. deleted text end

deleted text begin (e)deleted text end new text begin (d)new text end At the face-to-face assessment, the long-term care consultation team member or county case manager must perform the activities required under subdivision 3b.

deleted text begin (f)deleted text end new text begin (e)new text end For individuals under 21 years of age, a screening interview which recommends nursing facility admission must be face-to-face and approved by the commissioner before the individual is admitted to the nursing facility.

deleted text begin (g)deleted text end new text begin (f)new text end In the event that an individual under 65 years of age is admitted to a nursing facility on an emergency basis, the deleted text begin countydeleted text end new text begin Senior LinkAge Linenew text end must be notified of the admission on the next working day, and a face-to-face assessment as described in paragraph (c) must be conducted within 40 calendar days of admission.

deleted text begin (h)deleted text end new text begin (g)new text end At the face-to-face assessment, the long-term care consultation team member or the case manager must present information about home and community-based options, including consumer-directed options, so the individual can make informed choices. If the individual chooses home and community-based services, the long-term care consultation team member or case manager must complete a written relocation plan within 20 working days of the visit. The plan shall describe the services needed to move out of the facility and a time line for the move which is designed to ensure a smooth transition to the individual's home and community.

deleted text begin (i)deleted text end new text begin (h)new text end An individual under 65 years of age residing in a nursing facility shall receive a face-to-face assessment at least every 12 months to review the person's service choices and available alternatives unless the individual indicates, in writing, that annual visits are not desired. In this case, the individual must receive a face-to-face assessment at least once every 36 months for the same purposes.

deleted text begin (j)deleted text end new text begin (i)new text end Notwithstanding the provisions of subdivision 6, the commissioner may pay county agencies directly for face-to-face assessments for individuals under 65 years of age who are being considered for placement or residing in a nursing facility.

new text begin (j) Funding for preadmission screening follow-up shall be provided to the Disability Linkage Line for the under 60 population by the Department of Human Services to cover options counseling salaries and expenses to provide the services described in subdivisions 7a to 7c. The Disability Linkage Line shall employ, or contract with other agencies to employ, within the limits of available funding, sufficient personnel to provide preadmission screening follow-up services and shall seek to maximize federal funding for the service as provided under section 256.01, subdivision 2, paragraph (dd). new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2013. new text end

Sec. 21.

Minnesota Statutes 2012, section 256B.0911, is amended by adding a subdivision to read:

new text begin Subd. 4e. new text end

new text begin Determination of institutional level of care. new text end

new text begin The determination of the need for nursing facility, hospital, and intermediate care facility levels of care must be made according to criteria developed by the commissioner, and in section 256B.092, using forms developed by the commissioner. Effective January 1, 2014, for individuals age 21 and older, the determination of need for nursing facility level of care shall be based on criteria in section 144.0724, subdivision 11. For individuals under age 21, the determination of the need for nursing facility level of care must be made according to criteria developed by the commissioner until criteria in section 144.0724, subdivision 11, becomes effective on or after October 1, 2019. new text end

Sec. 22.

Minnesota Statutes 2012, section 256B.0911, subdivision 6, is amended to read:

Subd. 6.

Payment for long-term care consultation services.

(a) new text begin Until September 30, 2013, payment for long-term care consultation face-to-face assessment shall be made as described in this subdivision.new text end

new text begin (b) new text end The total payment for each county must be paid monthly by certified nursing facilities in the county. The monthly amount to be paid by each nursing facility for each fiscal year must be determined by dividing the county's annual allocation for long-term care consultation services by 12 to determine the monthly payment and allocating the monthly payment to each nursing facility based on the number of licensed beds in the nursing facility. Payments to counties in which there is no certified nursing facility must be made by increasing the payment rate of the two facilities located nearest to the county seat.

deleted text begin (b)deleted text end new text begin (c)new text end The commissioner shall include the total annual payment determined under paragraph (a) for each nursing facility reimbursed under section 256B.431, 256B.434, or 256B.441.

deleted text begin (c)deleted text end new text begin (d)new text end In the event of the layaway, delicensure and decertification, or removal from layaway of 25 percent or more of the beds in a facility, the commissioner may adjust the per diem payment amount in paragraph deleted text begin (b)deleted text end new text begin (c)new text end and may adjust the monthly payment amount in paragraph deleted text begin (a)deleted text end new text begin (b)new text end . The effective date of an adjustment made under this paragraph shall be on or after the first day of the month following the effective date of the layaway, delicensure and decertification, or removal from layaway.

deleted text begin (d)deleted text end new text begin (e)new text end Payments for long-term care consultation services are available to the county or counties to cover staff salaries and expenses to provide the services described in subdivision 1a. The county shall employ, or contract with other agencies to employ, within the limits of available funding, sufficient personnel to provide long-term care consultation services while meeting the state's long-term care outcomes and objectives as defined in subdivision 1. The county shall be accountable for meeting local objectives as approved by the commissioner in the biennial home and community-based services quality assurance plan on a form provided by the commissioner.

deleted text begin (e)deleted text end new text begin (f)new text end Notwithstanding section 256B.0641, overpayments attributable to payment of the screening costs under the medical assistance program may not be recovered from a facility.

deleted text begin (f)deleted text end new text begin (g)new text end The commissioner of human services shall amend the Minnesota medical assistance plan to include reimbursement for the local consultation teams.

deleted text begin (g)deleted text end new text begin (h)new text end Until the alternative payment methodology in paragraph deleted text begin (h)deleted text end new text begin (i)new text end is implemented, the county may bill, as case management services, assessments, support planning, and follow-along provided to persons determined to be eligible for case management under Minnesota health care programs. No individual or family member shall be charged for an initial assessment or initial support plan development provided under subdivision 3a or 3b.

deleted text begin (h)deleted text end new text begin (i)new text end The commissioner shall develop an alternative payment methodologynew text begin , effective on October 1, 2013,new text end for long-term care consultation services that includes the funding available under this subdivision, and new text begin for assessments authorized under new text end sections 256B.092 and 256B.0659. In developing the new payment methodology, the commissioner shall consider the maximization of other funding sources, including federal new text begin administrative reimbursement through federal financial participation new text end funding, for all long-term care consultation deleted text begin and preadmission screeningdeleted text end activity.new text begin The alternative payment methodology shall include the use of the appropriate time studies and the state financing of nonfederal share as part of the state's medical assistance program.new text end

Sec. 23.

Minnesota Statutes 2012, section 256B.0911, subdivision 7, is amended to read:

Subd. 7.

Reimbursement for certified nursing facilities.

(a) Medical assistance reimbursement for nursing facilities shall be authorized for a medical assistance recipient only if a preadmission screening has been conducted prior to admission or the county has authorized an exemption. Medical assistance reimbursement for nursing facilities shall not be provided for any recipient who the local screener has determined does not meet the level of care criteria for nursing facility placement in section 144.0724, subdivision 11, or, if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus Budget Reconciliation Act of 1987 completed unless an admission for a recipient with mental illness is approved by the local mental health authority or an admission for a recipient with developmental disability is approved by the state developmental disability authority.

(b) The nursing facility must not bill a person who is not a medical assistance recipient for resident days that preceded the date of completion of screening activities as required under new text begin section 256.975, new text end subdivisions deleted text begin 4a, 4b, and 4cdeleted text end new text begin 7a to 7cnew text end . The nursing facility must include unreimbursed resident days in the nursing facility resident day totals reported to the commissioner.

Sec. 24.

Minnesota Statutes 2012, section 256B.0913, subdivision 4, is amended to read:

Subd. 4.

Eligibility for funding for services for nonmedical assistance recipients.

(a) Funding for services under the alternative care program is available to persons who meet the following criteria:

(1) the person has been determined by a community assessment under section 256B.0911 to be a person who would require the level of care provided in a nursing facility, as determined under section 256B.0911, subdivision deleted text begin 4a, paragraph (d)deleted text end new text begin 4enew text end , but for the provision of services under the alternative care program;

(2) the person is age 65 or older;

(3) the person would be eligible for medical assistance within 135 days of admission to a nursing facility;

(4) the person is not ineligible for the payment of long-term care services by the medical assistance program due to an asset transfer penalty under section 256B.0595 or equity interest in the home exceeding $500,000 as stated in section 256B.056;

(5) the person needs long-term care services that are not funded through other state or federal funding, or other health insurance or other third-party insurance such as long-term care insurance;

(6) except for individuals described in clause (7), the monthly cost of the alternative care services funded by the program for this person does not exceed 75 percent of the monthly limit described under section 256B.0915, subdivision 3a. This monthly limit does not prohibit the alternative care client from payment for additional services, but in no case may the cost of additional services purchased under this section exceed the difference between the client's monthly service limit defined under section 256B.0915, subdivision 3, and the alternative care program monthly service limit defined in this paragraph. If care-related supplies and equipment or environmental modifications and adaptations are or will be purchased for an alternative care services recipient, the costs may be prorated on a monthly basis for up to 12 consecutive months beginning with the month of purchase. If the monthly cost of a recipient's other alternative care services exceeds the monthly limit established in this paragraph, the annual cost of the alternative care services shall be determined. In this event, the annual cost of alternative care services shall not exceed 12 times the monthly limit described in this paragraph;

(7) for individuals assigned a case mix classification A as described under section 256B.0915, subdivision 3a, paragraph (a), with (i) no dependencies in activities of daily living, or (ii) up to two dependencies in bathing, dressing, grooming, walking, and eating when the dependency score in eating is three or greater as determined by an assessment performed under section 256B.0911, the monthly cost of alternative care services funded by the program cannot exceed $593 per month for all new participants enrolled in the program on or after July 1, 2011. This monthly limit shall be applied to all other participants who meet this criteria at reassessment. This monthly limit shall be increased annually as described in section 256B.0915, subdivision 3a, paragraph (a). This monthly limit does not prohibit the alternative care client from payment for additional services, but in no case may the cost of additional services purchased exceed the difference between the client's monthly service limit defined in this clause and the limit described in clause (6) for case mix classification A; and

(8) the person is making timely payments of the assessed monthly fee.

A person is ineligible if payment of the fee is over 60 days past due, unless the person agrees to:

(i) the appointment of a representative payee;

(ii) automatic payment from a financial account;

(iii) the establishment of greater family involvement in the financial management of payments; or

(iv) another method acceptable to the lead agency to ensure prompt fee payments.

The lead agency may extend the client's eligibility as necessary while making arrangements to facilitate payment of past-due amounts and future premium payments. Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be reinstated for a period of 30 days.

(b) Alternative care funding under this subdivision is not available for a person who is a medical assistance recipient or who would be eligible for medical assistance without a spenddown or waiver obligation. A person whose initial application for medical assistance and the elderly waiver program is being processed may be served under the alternative care program for a period up to 60 days. If the individual is found to be eligible for medical assistance, medical assistance must be billed for services payable under the federally approved elderly waiver plan and delivered from the date the individual was found eligible for the federally approved elderly waiver plan. Notwithstanding this provision, alternative care funds may not be used to pay for any service the cost of which: (i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to pay a medical assistance income spenddown for a person who is eligible to participate in the federally approved elderly waiver program under the special income standard provision.

(c) Alternative care funding is not available for a person who resides in a licensed nursing home, certified boarding care home, hospital, or intermediate care facility, except for case management services which are provided in support of the discharge planning process for a nursing home resident or certified boarding care home resident to assist with a relocation process to a community-based setting.

(d) Alternative care funding is not available for a person whose income is greater than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal year for which alternative care eligibility is determined, who would be eligible for the elderly waiver with a waiver obligation.

Sec. 25.

Minnesota Statutes 2012, section 256B.0915, subdivision 5, is amended to read:

Subd. 5.

Assessments and reassessments for waiver clients.

(a) Each client shall receive an initial assessment of strengths, informal supports, and need for services in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a client served under the elderly waiver must be conducted at least every 12 months and at other times when the case manager determines that there has been significant change in the client's functioning. This may include instances where the client is discharged from the hospital. There must be a determination that the client requires nursing facility level of care as defined in section 256B.0911, subdivision deleted text begin 4a, paragraph (d)deleted text end new text begin 4enew text end , at initial and subsequent assessments to initiate and maintain participation in the waiver program.

(b) Regardless of other assessments identified in section 144.0724, subdivision 4, as appropriate to determine nursing facility level of care for purposes of medical assistance payment for nursing facility services, only face-to-face assessments conducted according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility level of care determination will be accepted for purposes of initial and ongoing access to waiver service payment.

Sec. 26.

Minnesota Statutes 2012, section 256B.0917, is amended by adding a subdivision to read:

new text begin Subd. 1a. new text end

new text begin Home and community-based services for older adults. new text end

new text begin (a) The purpose of projects selected by the commissioner of human services under this section is to make strategic changes in the long-term services and supports system for older adults including statewide capacity for local service development and technical assistance, and statewide availability of home and community-based services for older adult services, caregiver support and respite care services, and other supports in the state of Minnesota. These projects are intended to create incentives for new and expanded home and community-based services in Minnesota in order to: new text end

new text begin (1) reach older adults early in the progression of their need for long-term services and supports, providing them with low-cost, high-impact services that will prevent or delay the use of more costly services; new text end

new text begin (2) support older adults to live in the most integrated, least restrictive community setting; new text end

new text begin (3) support the informal caregivers of older adults; new text end

new text begin (4) develop and implement strategies to integrate long-term services and supports with health care services, in order to improve the quality of care and enhance the quality of life of older adults and their informal caregivers; new text end

new text begin (5) ensure cost-effective use of financial and human resources; new text end

new text begin (6) build community-based approaches and community commitment to delivering long-term services and supports for older adults in their own homes; new text end

new text begin (7) achieve a broad awareness and use of lower-cost in-home services as an alternative to nursing homes and other residential services; new text end

new text begin (8) strengthen and develop additional home and community-based services and alternatives to nursing homes and other residential services; and new text end

new text begin (9) strengthen programs that use volunteers. new text end

new text begin (b) The services provided by these projects are available to older adults who are eligible for medical assistance and the elderly waiver under section 256B.0915, the alternative care program under section 256B.0913, or essential community supports grant under subdivision 14, paragraph (b), and to persons who have their own funds to pay for services. new text end

Sec. 27.

Minnesota Statutes 2012, section 256B.0917, is amended by adding a subdivision to read:

new text begin Subd. 1b. new text end

new text begin Definitions. new text end

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

new text begin (b) "Community" means a town; township; city; or targeted neighborhood within a city; or a consortium of towns, townships, cities, or specific neighborhoods within a city. new text end

new text begin (c) "Core home and community-based services provider" means a Faith in Action, Living at Home Block Nurse, Congregational Nurse, or similar community-based program governed by a board, the majority of whose members reside within the program's service area, that organizes and uses volunteers and paid staff to deliver nonmedical services intended to assist older adults to identify and manage risks and to maintain their community living and integration in the community. new text end

new text begin (d) "Eldercare development partnership" means a team of representatives of county social service and public health agencies, the area agency on aging, local nursing home providers, local home care providers, and other appropriate home and community-based providers in the area agency's planning and service area. new text end

new text begin (e) "Long-term services and supports" means any service available under the elderly waiver program or alternative care grant programs, nursing facility services, transportation services, caregiver support and respite care services, and other home and community-based services identified as necessary either to maintain lifestyle choices for older adults or to support them to remain in their own home. new text end

new text begin (f) "Older adult" refers to an individual who is 65 years of age or older. new text end

Sec. 28.

Minnesota Statutes 2012, section 256B.0917, is amended by adding a subdivision to read:

new text begin Subd. 1c. new text end

new text begin Eldercare development partnerships. new text end

new text begin The commissioner of human services shall select and contract with eldercare development partnerships sufficient to provide statewide availability of service development and technical assistance using a request for proposals process. Eldercare development partnerships shall: new text end

new text begin (1) develop a local long-term services and supports strategy consistent with state goals and objectives; new text end

new text begin (2) identify and use existing local skills, knowledge, and relationships, and build on these assets; new text end

new text begin (3) coordinate planning for funds to provide services to older adults, including funds received under Title III of the Older Americans Act, Title XX of the Social Security Act, and the Local Public Health Act; new text end

new text begin (4) target service development and technical assistance where nursing facility closures have occurred or are occurring or in areas where service needs have been identified through activities under section 144A.351; new text end

new text begin (5) provide sufficient staff for development and technical support in its designated area; and new text end

new text begin (6) designate a single public or nonprofit member of the eldercare development partnerships to apply grant funding and manage the project. new text end

Sec. 29.

Minnesota Statutes 2012, section 256B.0917, subdivision 6, is amended to read:

Subd. 6.

Caregiver support and respite care projects.

(a) The commissioner shall establish deleted text begin up to 36deleted text end projects to expand the deleted text begin respite care network in the state and to support caregivers in their responsibilities for care. The purpose of each project shall be todeleted text end new text begin availability of caregiver support and respite care services for family and other caregivers. The commissioner shall use a request for proposals to select nonprofit entities to administer the projects. Projects shallnew text end :

(1) establish a local coordinated network of volunteer and paid respite workers;

(2) coordinate assignment of respite deleted text begin workersdeleted text end new text begin care servicesnew text end to deleted text begin clients and care receivers and assure the health and safety of the client; anddeleted text end new text begin caregivers of older adults;new text end

deleted text begin (3) provide training for caregivers and ensure that support groups are available in the community. deleted text end

deleted text begin (b) The caregiver support and respite care funds shall be available to the four to six local long-term care strategy projects designated in subdivisions 1 to 5. deleted text end

deleted text begin (c) The commissioner shall publish a notice in the State Register to solicit proposals from public or private nonprofit agencies for the projects not included in the four to six local long-term care strategy projects defined in subdivision 2. A county agency may, alone or in combination with other county agencies, apply for caregiver support and respite care project funds. A public or nonprofit agency within a designated SAIL project area may apply for project funds if the agency has a letter of agreement with the county or counties in which services will be developed, stating the intention of the county or counties to coordinate their activities with the agency requesting a grant. deleted text end

deleted text begin (d) The commissioner shall select grantees based on the following criteriadeleted text end :

deleted text begin (1) the ability of the proposal to demonstrate need in the area served, as evidenced by a community needs assessment or other demographic data; deleted text end

deleted text begin (2) the ability of the proposal to clearly describe how the project deleted text end

new text begin (3) assure the health and safety of the older adults; new text end

new text begin (4) identify at-risk caregivers; new text end

new text begin (5) provide information, education, and training for caregivers in the designated community; and new text end

new text begin (6) demonstrate the need in the proposed service area particularly where nursing facility closures have occurred or are occurring or areas with service needs identified by section 144A.351. Preference must be given for projects that reach underserved populations. new text end

new text begin (b) Projects must clearly describe: new text end

new text begin (1) how theynew text end will achieve deleted text begin thedeleted text end new text begin theirnew text end purpose deleted text begin defined in paragraph (b)deleted text end ;

deleted text begin (3) the ability of the proposal to reach underserved populations; deleted text end

deleted text begin (4) the ability of the proposal to demonstrate community commitment to the project, as evidenced by letters of support and cooperation as well as formation of a community task force; deleted text end

deleted text begin (5) the ability of the proposal to clearly describedeleted text end new text begin (2)new text end the process for recruiting, training, and retraining volunteers; and

deleted text begin (6) the inclusion in the proposal of thedeleted text end new text begin (3) anew text end plan to promote the project in the new text begin designated new text end community, including outreach to persons needing the services.

deleted text begin (e)deleted text end new text begin (c)new text end Funds for all projects under this subdivision may be used to:

(1) hire a coordinator to develop a coordinated network of volunteer and paid respite care services and assign workers to clients;

(2) recruit and train volunteer providers;

(3) deleted text begin traindeleted text end new text begin provide information, training, and education tonew text end caregivers;

deleted text begin (4) ensure the development of support groups for caregivers; deleted text end

deleted text begin (5)deleted text end new text begin (4)new text end advertise the availability of the caregiver support and respite care project; and

deleted text begin (6)deleted text end new text begin (5)new text end purchase equipment to maintain a system of assigning workers to clients.

deleted text begin (f)deleted text end new text begin (d)new text end Project funds may not be used to supplant existing funding sources.

Sec. 30.

Minnesota Statutes 2012, section 256B.0917, is amended by adding a subdivision to read:

new text begin Subd. 7a. new text end

new text begin Core home and community-based services. new text end

new text begin The commissioner shall select and contract with core home and community-based services providers for projects to provide services and supports to older adults both with and without family and other informal caregivers using a request for proposals process. Projects must: new text end

new text begin (1) have a credible, public, or private nonprofit sponsor providing ongoing financial support; new text end

new text begin (2) have a specific, clearly defined geographic service area; new text end

new text begin (3) use a practice framework designed to identify high-risk older adults and help them take action to better manage their chronic conditions and maintain their community living; new text end

new text begin (4) have a team approach to coordination and care, ensuring that the older adult participants, their families, and the formal and informal providers are all part of planning and providing services; new text end

new text begin (5) provide information, support services, homemaking services, counseling, and training for the older adults and family caregivers; new text end

new text begin (6) encourage service area or neighborhood residents and local organizations to collaborate in meeting the needs of older adults in their geographic service areas; new text end

new text begin (7) recruit, train, and direct the use of volunteers to provide informal services and other appropriate support to older adults and their caregivers; and new text end

new text begin (8) provide coordination and management of formal and informal services to older adults and their families using less expensive alternatives. new text end

Sec. 31.

Minnesota Statutes 2012, section 256B.0917, subdivision 13, is amended to read:

Subd. 13.

Community service grants.

The commissioner shall award contracts for grants to public and private nonprofit agencies to establish services that strengthen a community's ability to provide a system of home and community-based services for elderly persons. The commissioner shall use a request for proposal process. The commissioner shall give preference when awarding grants under this section to areas where nursing facility closures have occurred or are occurringnew text begin or to areas with service needs identified under section 144A.351new text end . deleted text begin The commissioner shall consider grants for:deleted text end

deleted text begin (1) caregiver support and respite care projects under subdivision 6; deleted text end

deleted text begin (2) the living-at-home/block nurse grant under subdivisions 7 to 10; and deleted text end

deleted text begin (3) services identified as needed for community transition. deleted text end

Sec. 32.

Minnesota Statutes 2012, section 256B.439, subdivision 3, is amended to read:

Subd. 3.

Consumer surveysnew text begin of nursing facilities residentsnew text end .

Following identification of the quality measurement tool, the commissioners shall conduct surveys of long-term care service consumers new text begin of nursing facilities new text end to develop quality profiles of providers. To the extent possible, surveys must be conducted face-to-face by state employees or contractors. At the discretion of the commissioners, surveys may be conducted by telephone or by provider staff. Surveys must be conducted periodically to update quality profiles of individual deleted text begin servicedeleted text end new text begin nursing facilitiesnew text end providers.

Sec. 33.

Minnesota Statutes 2012, section 256B.439, is amended by adding a subdivision to read:

new text begin Subd. 3b. new text end

new text begin Home and community-based services report card in cooperation with the commissioner of health. new text end

new text begin The commissioner shall work with existing Department of Human Services advisory groups to develop recommendations for a home and community-based services report card. Health and human services staff that regulate home and community-based services as provided in chapter 245D and licensed home care as provided in chapter 144A shall be consulted. The advisory groups shall consider the requirements from the Minnesota consumer information guide under section 144G.06 as a base for development of the home and community-based services report card to compare the housing options available to consumers. Other items to be considered by the advisory groups in developing recommendations include: new text end

new text begin (1) defining the goals of the report card, including measuring outcomes, providing consumer information, and defining vehicle-for-pay performance; new text end

new text begin (2) developing separate measures for programs for the elderly population and for persons with disabilities; new text end

new text begin (3) the sources of information needed that are standardized and contain sufficient data; new text end

new text begin (4) the financial support needed for creating and publicizing the housing information guide, and ongoing funding for data collection and staffing to monitor, report, and analyze; new text end

new text begin (5) a recognition that home and community-based services settings exist with significant variations in size, settings, and services available; new text end

new text begin (6) ensuring that consumer choice and consumer information is retained and valued; new text end

new text begin (7) the applicability of these measures to providers based on payor source, size, and population served; and new text end

new text begin (8) dissemination of quality profiles. new text end

new text begin The advisory groups shall discuss whether there are additional funding, resources, and research needed. The commissioner shall report recommendations to the chairs and ranking minority members of the legislative committees and divisions with jurisdiction over health and human services issues by August 1, 2014. The report card shall be available on July 1, 2015. new text end

Sec. 34.

Minnesota Statutes 2012, section 256B.439, subdivision 4, is amended to read:

Subd. 4.

Dissemination of quality profiles.

By July 1, deleted text begin 2003deleted text end new text begin 2014new text end , the commissioners shall implement a deleted text begin systemdeleted text end new text begin public awareness effortnew text end to disseminate the quality profiles deleted text begin developed from consumer surveys using the quality measurement tooldeleted text end . Profiles may be disseminated deleted text begin todeleted text end new text begin throughnew text end the Senior LinkAge Linenew text begin and Disability Linkage Linenew text end and to consumers, providers, and purchasers of long-term care services deleted text begin through all feasible printed and electronic outlets. The commissioners may conduct a public awareness campaign to inform potential users regarding profile contents and potential usesdeleted text end .

Sec. 35.

Minnesota Statutes 2012, section 256B.441, subdivision 13, is amended to read:

Subd. 13.

External fixed costs.

"External fixed costs" means costs related to the nursing home surcharge under section 256.9657, subdivision 1; licensure fees under section 144.122; new text begin until September 30, 2013, new text end long-term care consultation fees under section 256B.0911, subdivision 6; family advisory council fee under section 144A.33; scholarships under section 256B.431, subdivision 36; planned closure rate adjustments under section 256B.437; or single bed room incentives under section 256B.431, subdivision 42; property taxes and property insurance; and PERA.

Sec. 36.

Minnesota Statutes 2012, section 256B.441, subdivision 53, is amended to read:

Subd. 53.

Calculation of payment rate for external fixed costs.

The commissioner shall calculate a payment rate for external fixed costs.

(a) For a facility licensed as a nursing home, the portion related to section 256.9657 shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the result of its number of nursing home beds divided by its total number of licensed beds.

(b) The portion related to the licensure fee under section 144.122, paragraph (d), shall be the amount of the fee divided by actual resident days.

(c) The portion related to scholarships shall be determined under section 256B.431, subdivision 36.

(d) new text begin Until September 30, 2013, new text end the portion related to long-term care consultation shall be determined according to section 256B.0911, subdivision 6.

(e) The portion related to development and education of resident and family advisory councils under section 144A.33 shall be $5 divided by 365.

(f) The portion related to planned closure rate adjustments shall be as determined under section 256B.437, subdivision 6, and Minnesota Statutes 2010, section 256B.436. Planned closure rate adjustments that take effect before October 1, 2014, shall no longer be included in the payment rate for external fixed costs beginning October 1, 2016. Planned closure rate adjustments that take effect on or after October 1, 2014, shall no longer be included in the payment rate for external fixed costs beginning on October 1 of the first year not less than two years after their effective date.

(g) The portions related to property insurance, real estate taxes, special assessments, and payments made in lieu of real estate taxes directly identified or allocated to the nursing facility shall be the actual amounts divided by actual resident days.

(h) The portion related to the Public Employees Retirement Association shall be actual costs divided by resident days.

(i) The single bed room incentives shall be as determined under section 256B.431, subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall no longer be included in the payment rate for external fixed costs beginning October 1, 2016. Single bed room incentives that take effect on or after October 1, 2014, shall no longer be included in the payment rate for external fixed costs beginning on October 1 of the first year not less than two years after their effective date.

(j) The payment rate for external fixed costs shall be the sum of the amounts in paragraphs (a) to (i).

Sec. 37.

Minnesota Statutes 2012, section 256B.49, subdivision 12, is amended to read:

Subd. 12.

Informed choice.

Persons who are determined likely to require the level of care provided in a nursing facility as determined under section 256B.0911new text begin , subdivision 4e,new text end or a hospital shall be informed of the home and community-based support alternatives to the provision of inpatient hospital services or nursing facility services. Each person must be given the choice of either institutional or home and community-based services using the provisions described in section 256B.77, subdivision 2, paragraph (p).

Sec. 38.

Minnesota Statutes 2012, section 256B.49, subdivision 14, is amended to read:

Subd. 14.

Assessment and reassessment.

(a) Assessments and reassessments shall be conducted by certified assessors according to section 256B.0911, subdivision 2b. With the permission of the recipient or the recipient's designated legal representative, the recipient's current provider of services may submit a written report outlining their recommendations regarding the recipient'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.

(b) There must be a determination that the client requires a hospital level of care or a nursing facility level of care as defined in section 256B.0911, subdivision deleted text begin 4a, paragraph (d)deleted text end new text begin 4enew text end , at initial and subsequent assessments to initiate and maintain participation in the waiver program.

(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as appropriate to determine nursing facility level of care for purposes of medical assistance payment for nursing facility services, only face-to-face assessments conducted according to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care determination or a nursing facility level of care determination must be accepted for purposes of initial and ongoing access to waiver services payment.

(d) Recipients who are found eligible for home and community-based services under this section before their 65th birthday may remain eligible for these services after their 65th birthday if they continue to meet all other eligibility factors.

(e) The commissioner shall develop criteria to identify recipients whose level of functioning is reasonably expected to improve and reassess these recipients to establish a baseline assessment. Recipients who meet these criteria must have a comprehensive transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be reassessed every six months until there has been no significant change in the recipient's functioning for at least 12 months. After there has been no significant change in the recipient's functioning for at least 12 months, reassessments of the recipient's strengths, informal support systems, and need for services shall be conducted at least every 12 months and at other times when there has been a significant change in the recipient's functioning. Counties, case managers, and service providers are responsible for conducting these reassessments and shall complete the reassessments out of existing funds.

Sec. 39.

Minnesota Statutes 2012, section 256B.69, subdivision 8, is amended to read:

Subd. 8.

Preadmission screening waiver.

Except as applicable to the project's operation, the provisions of deleted text begin sectiondeleted text end new text begin sections 256.975 andnew text end 256B.0911 are waived for the purposes of this section for recipients enrolled with demonstration providers or in the prepaid medical assistance program for seniors.

Sec. 40.

Minnesota Statutes 2012, section 256I.05, is amended by adding a subdivision to read:

new text begin Subd. 1o. new text end

new text begin Supplementary service rate; exemptions. new text end

new text begin A county agency shall not negotiate a supplementary service rate under this section for any individual that has been determined to be eligible for Housing Stability Services as approved by the Centers for Medicare and Medicaid Services, and who resides in an establishment voluntarily registered under section 144D.025, as a supportive housing establishment or participates in the Minnesota supportive housing demonstration program under section 256I.04, subdivision 3, paragraph (a), clause (4). new text end

Sec. 41.

Minnesota Statutes 2012, section 626.557, subdivision 4, is amended to read:

Subd. 4.

Reporting.

(a) Except as provided in paragraph (b), a mandated reporter shall immediately make an oral report to the common entry point. new text begin The common entry point may accept electronic reports submitted through a Web-based reporting system established by the commissioner. new text end Use of a telecommunications device for the deaf or other similar device shall be considered an oral report. The common entry point may not require written reports. To the extent possible, the report must be of sufficient content to identify the vulnerable adult, the caregiver, the nature and extent of the suspected maltreatment, any evidence of previous maltreatment, the name and address of the reporter, the time, date, and location of the incident, and any other information that the reporter believes might be helpful in investigating the suspected maltreatment. A mandated reporter may disclose not public data, as defined in section 13.02, and medical records under sections 144.291 to 144.298, to the extent necessary to comply with this subdivision.

(b) A boarding care home that is licensed under sections 144.50 to 144.58 and certified under Title 19 of the Social Security Act, a nursing home that is licensed under section 144A.02 and certified under Title 18 or Title 19 of the Social Security Act, or a hospital that is licensed under sections 144.50 to 144.58 and has swing beds certified under Code of Federal Regulations, title 42, section 482.66, may submit a report electronically to the common entry point instead of submitting an oral report. The report may be a duplicate of the initial report the facility submits electronically to the commissioner of health to comply with the reporting requirements under Code of Federal Regulations, title 42, section 483.13. The commissioner of health may modify these reporting requirements to include items required under paragraph (a) that are not currently included in the electronic reporting form.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2014. new text end

Sec. 42.

Minnesota Statutes 2012, section 626.557, subdivision 9, is amended to read:

Subd. 9.

Common entry point designation.

(a) deleted text begin Each county board shall designate a common entry point for reports of suspected maltreatment. Two or more county boards may jointly designate a singledeleted text end new text begin The commissioner of human services shall establish anew text end common entry pointnew text begin effective July 1, 2014new text end . The common entry point is the unit responsible for receiving the report of suspected maltreatment under this section.

(b) The common entry point must be available 24 hours per day to take calls from reporters of suspected maltreatment. The common entry point shall use a standard intake form that includes:

(1) the time and date of the report;

(2) the name, address, and telephone number of the person reporting;

(3) the time, date, and location of the incident;

(4) the names of the persons involved, including but not limited to, perpetrators, alleged victims, and witnesses;

(5) whether there was a risk of imminent danger to the alleged victim;

(6) a description of the suspected maltreatment;

(7) the disability, if any, of the alleged victim;

(8) the relationship of the alleged perpetrator to the alleged victim;

(9) whether a facility was involved and, if so, which agency licenses the facility;

(10) any action taken by the common entry point;

(11) whether law enforcement has been notified;

(12) whether the reporter wishes to receive notification of the initial and final reports; and

(13) if the report is from a facility with an internal reporting procedure, the name, mailing address, and telephone number of the person who initiated the report internally.

(c) The common entry point is not required to complete each item on the form prior to dispatching the report to the appropriate lead investigative agency.

(d) The common entry point shall immediately report to a law enforcement agency any incident in which there is reason to believe a crime has been committed.

(e) If a report is initially made to a law enforcement agency or a lead investigative agency, those agencies shall take the report on the appropriate common entry point intake forms and immediately forward a copy to the common entry point.

(f) The common entry point staff must receive training on how to screen and dispatch reports efficiently and in accordance with this section.

(g) The commissioner of human services shall maintain a centralized database for the collection of common entry point data, lead investigative agency data including maltreatment report disposition, and appeals data.new text begin The common entry point shall have access to the centralized database and must log the reports into the database and immediately identify and locate prior reports of abuse, neglect, or exploitation.new text end

new text begin (h) When appropriate, the common entry point staff must refer calls that do not allege the abuse, neglect, or exploitation of a vulnerable adult to other organizations that might resolve the reporter's concerns. new text end

new text begin (i) A common entry point must be operated in a manner that enables the commissioner of human services to: new text end

new text begin (1) track critical steps in the reporting, evaluation, referral, response, disposition, and investigative process to ensure compliance with all requirements for all reports; new text end

new text begin (2) maintain data to facilitate the production of aggregate statistical reports for monitoring patterns of abuse, neglect, or exploitation; new text end

new text begin (3) serve as a resource for the evaluation, management, and planning of preventative and remedial services for vulnerable adults who have been subject to abuse, neglect, or exploitation; new text end

new text begin (4) set standards, priorities, and policies to maximize the efficiency and effectiveness of the common entry point; and new text end

new text begin (5) track and manage consumer complaints related to the common entry point. new text end

new text begin (j) The commissioners of human services and health shall collaborate on the creation of a system for referring reports to the lead investigative agencies. This system shall enable the commissioner of human services to track critical steps in the reporting, evaluation, referral, response, disposition, investigation, notification, determination, and appeal processes. new text end

Sec. 43.

Minnesota Statutes 2012, section 626.557, subdivision 9e, is amended to read:

Subd. 9e.

Education requirements.

(a) The commissioners of health, human services, and public safety shall cooperate in the development of a joint program for education of lead investigative agency investigators in the appropriate techniques for investigation of complaints of maltreatment. This program must be developed by July 1, 1996. The program must include but need not be limited to the following areas: (1) information collection and preservation; (2) analysis of facts; (3) levels of evidence; (4) conclusions based on evidence; (5) interviewing skills, including specialized training to interview people with unique needs; (6) report writing; (7) coordination and referral to other necessary agencies such as law enforcement and judicial agencies; (8) human relations and cultural diversity; (9) the dynamics of adult abuse and neglect within family systems and the appropriate methods for interviewing relatives in the course of the assessment or investigation; (10) the protective social services that are available to protect alleged victims from further abuse, neglect, or financial exploitation; (11) the methods by which lead investigative agency investigators and law enforcement workers cooperate in conducting assessments and investigations in order to avoid duplication of efforts; and (12) data practices laws and procedures, including provisions for sharing data.

new text begin (b) The commissioner of human services shall conduct an outreach campaign to promote the common entry point for reporting vulnerable adult maltreatment. This campaign shall use the Internet and other means of communication. new text end

deleted text begin (b)deleted text end new text begin (c)new text end The commissioners of health, human services, and public safety shall offer at least annual education to others on the requirements of this section, on how this section is implemented, and investigation techniques.

deleted text begin (c)deleted text end new text begin (d)new text end The commissioner of human services, in coordination with the commissioner of public safety shall provide training for the common entry point staff as required in this subdivision and the program courses described in this subdivision, at least four times per year. At a minimum, the training shall be held twice annually in the seven-county metropolitan area and twice annually outside the seven-county metropolitan area. The commissioners shall give priority in the program areas cited in paragraph (a) to persons currently performing assessments and investigations pursuant to this section.

deleted text begin (d)deleted text end new text begin (e)new text end The commissioner of public safety shall notify in writing law enforcement personnel of any new requirements under this section. The commissioner of public safety shall conduct regional training for law enforcement personnel regarding their responsibility under this section.

deleted text begin (e)deleted text end new text begin (f)new text end Each lead investigative agency investigator must complete the education program specified by this subdivision within the first 12 months of work as a lead investigative agency investigator.

A lead investigative agency investigator employed when these requirements take effect must complete the program within the first year after training is available or as soon as training is available.

All lead investigative agency investigators having responsibility for investigation duties under this section must receive a minimum of eight hours of continuing education or in-service training each year specific to their duties under this section.

Sec. 44.

new text begin FEDERAL APPROVAL. new text end

new text begin This article is contingent on federal approval. new text end

Sec. 45.

new text begin REPEALER. new text end

new text begin (a) new text end new text begin Minnesota Statutes 2012, sections 245A.655; and 256B.0917, subdivisions 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, and 12, new text end new text begin are repealed. new text end

new text begin (b) new text end new text begin Minnesota Statutes 2012, section 256B.0911, subdivisions 4a, 4b, and 4c, new text end new text begin are repealed effective October 1, 2013. new text end

ARTICLE 3

SAFE AND HEALTHY DEVELOPMENT OF CHILDREN, YOUTH, AND FAMILIES

Section 1.

Minnesota Statutes 2012, section 119B.011, is amended by adding a subdivision to read:

new text begin Subd. 19b. new text end

new text begin Student parent. new text end

new text begin "Student parent" means a person who is: new text end

new text begin (1) under 21 years of age and has a child; new text end

new text begin (2) pursuing a high school or general equivalency diploma; new text end

new text begin (3) residing within a county that has a basic sliding fee waiting list under section 119B.03, subdivision 4; and new text end

new text begin (4) not an MFIP participant. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective November 11, 2013. new text end

Sec. 2.

Minnesota Statutes 2012, section 119B.02, is amended by adding a subdivision to read:

new text begin Subd. 7. new text end

new text begin Child care market rate survey. new text end

new text begin Biennially, the commissioner shall survey prices charged by child care providers in Minnesota to determine the 75th percentile for like-care arrangements in county price clusters. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective February 3, 2014. new text end

Sec. 3.

Minnesota Statutes 2012, section 119B.025, subdivision 1, is amended to read:

Subdivision 1.

Factors which must be verified.

(a) The county shall verify the following at all initial child care applications using the universal application:

(1) identity of adults;

(2) presence of the minor child in the home, if questionable;

(3) relationship of minor child to the parent, stepparent, legal guardian, eligible relative caretaker, or the spouses of any of the foregoing;

(4) age;

(5) immigration status, if related to eligibility;

(6) Social Security number, if given;

(7) income;

(8) spousal support and child support payments made to persons outside the household;

(9) residence; and

(10) inconsistent information, if related to eligibility.

(b) If a family did not use the universal application or child care addendum to apply for child care assistance, the family must complete the universal application or child care addendum at its next eligibility redetermination and the county must verify the factors listed in paragraph (a) as part of that redetermination. Once a family has completed a universal application or child care addendum, the county shall use the redetermination form described in paragraph (c) for that family's subsequent redeterminations. Eligibility must be redetermined at least every six months. new text begin A family is considered to have met the eligibility redetermination requirement if a complete redetermination form and all required verifications are received within 30 days after the date the form was due. Assistance shall be payable retroactively from the redetermination due date. new text end For a family where at least one parent is under the age of 21, does not have a high school or general equivalency diploma, and is a student in a school district or another similar program that provides or arranges for child care, as well as parenting, social services, career and employment supports, and academic support to achieve high school graduation, the redetermination of eligibility shall be deferred beyond six months, but not to exceed 12 months, to the end of the student's school year. If a family reports a change in an eligibility factor before the family's next regularly scheduled redetermination, the county must recalculate eligibility without requiring verification of any eligibility factor that did not change.

(c) The commissioner shall develop a redetermination form to redetermine eligibility and a change report form to report changes that minimize paperwork for the county and the participant.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 4, 2014. new text end

Sec. 4.

Minnesota Statutes 2012, section 119B.03, subdivision 4, is amended to read:

Subd. 4.

Funding priority.

(a) First priority for child care assistance under the basic sliding fee program must be given to eligible non-MFIP families who do not have a high school or general equivalency diploma or who need remedial and basic skill courses in order to pursue employment or to pursue education leading to employment and who need child care assistance to participate in the education program. new text begin This includes student parents as defined under section 119B.011, subdivision 19b. new text end Within this priority, the following subpriorities must be used:

(1) child care needs of minor parents;

(2) child care needs of parents under 21 years of age; and

(3) child care needs of other parents within the priority group described in this paragraph.

(b) Second priority must be given to parents who have completed their MFIP or DWP transition year, or parents who are no longer receiving or eligible for diversionary work program supports.

(c) Third priority must be given to families who are eligible for portable basic sliding fee assistance through the portability pool under subdivision 9.

(d) Fourth priority must be given to families in which at least one parent is a veteran as defined under section 197.447.

(e) Families under paragraph (b) must be added to the basic sliding fee waiting list on the date they begin the transition year under section 119B.011, subdivision 20, and must be moved into the basic sliding fee program as soon as possible after they complete their transition year.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective November 11, 2013. new text end

Sec. 5.

Minnesota Statutes 2012, section 119B.05, subdivision 1, is amended to read:

Subdivision 1.

Eligible participants.

Families eligible for child care assistance under the MFIP child care program are:

(1) MFIP participants who are employed or in job search and meet the requirements of section 119B.10;

(2) persons who are members of transition year families under section 119B.011, subdivision 20, and meet the requirements of section 119B.10;

(3) families who are participating in employment orientation or job search, or other employment or training activities that are included in an approved employability development plan under section 256J.95;

(4) MFIP families who are participating in work job search, job support, employment, or training activities as required in their employment plan, or in appeals, hearings, assessments, or orientations according to chapter 256J;

(5) MFIP families who are participating in social services activities under chapter 256J as required in their employment plan approved according to chapter 256J;

(6) families who are participating in services or activities that are included in an approved family stabilization plan under section 256J.575;

(7) families who are participating in programs as required in tribal contracts under section 119B.02, subdivision 2, or 256.01, subdivision 2; deleted text begin anddeleted text end

(8) families who are participating in the transition year extension under section 119B.011, subdivision 20anew text begin ; andnew text end

new text begin (9) student parents as defined under section 119B.011, subdivision 19bnew text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective November 11, 2013. new text end

Sec. 6.

Minnesota Statutes 2012, section 119B.13, subdivision 1, is amended to read:

Subdivision 1.

Subsidy restrictions.

(a) Beginning deleted text begin October 31, 2011deleted text end new text begin February 3, 2014new text end , the maximum rate paid for child care assistance in any county or deleted text begin multicounty regiondeleted text end new text begin county price clusternew text end under the child care fund shall be the deleted text begin rate for like-care arrangements in the county effective July 1, 2006, decreased by 2.5 percentdeleted text end new text begin greater of the 25th percentile of the 2011 child care provider rate survey or the maximum rate effective November 28, 2011. The commissioner may: (1) assign a county with no reported provider prices to a similar price cluster; and (2) consider county level access when determining final price clustersnew text end .

deleted text begin (b) Biennially, beginning in 2012, the commissioner shall survey rates charged by child care providers in Minnesota to determine the 75th percentile for like-care arrangements in counties. When the commissioner determines that, using the commissioner's established protocol, the number of providers responding to the survey is too small to determine the 75th percentile rate for like-care arrangements in a county or multicounty region, the commissioner may establish the 75th percentile maximum rate based on like-care arrangements in a county, region, or category that the commissioner deems to be similar. deleted text end

deleted text begin (c)deleted text end new text begin (b)new text end A rate which includes a special needs rate paid under subdivision 3 or under a school readiness service agreement paid under section 119B.231, may be in excess of the maximum rate allowed under this subdivision.

deleted text begin (d)deleted text end new text begin (c)new text end The department shall monitor the effect of this paragraph on provider rates. The county shall pay the provider's full charges for every child in care up to the maximum established. The commissioner shall determine the maximum rate for each type of care on an hourly, full-day, and weekly basis, including special needs and disability care. The maximum payment to a provider for one day of care must not exceed the daily rate. The maximum payment to a provider for one week of care must not exceed the weekly rate.

deleted text begin (e)deleted text end new text begin (d)new text end Child care providers receiving reimbursement under this chapter must not be paid activity fees or an additional amount above the maximum rates for care provided during nonstandard hours for families receiving assistance.

deleted text begin (f)deleted text end new text begin (e)new text end When the provider charge is greater than the maximum provider rate allowed, the parent is responsible for payment of the difference in the rates in addition to any family co-payment fee.

deleted text begin (g)deleted text end new text begin (f)new text end All maximum provider rates changes shall be implemented on the Monday following the effective date of the maximum provider rate.

new text begin (g) Notwithstanding Minnesota Rules, part 3400.0130, subpart 7, maximum registration fees in effect on January 1, 2013, shall remain in effect. new text end

Sec. 7.

Minnesota Statutes 2012, section 119B.13, subdivision 1a, is amended to read:

Subd. 1a.

Legal nonlicensed family child care provider rates.

(a) Legal nonlicensed family child care providers receiving reimbursement under this chapter must be paid on an hourly basis for care provided to families receiving assistance.

(b) The maximum rate paid to legal nonlicensed family child care providers must be 68 percent of the county maximum hourly rate for licensed family child care providers. In counties new text begin or county price clusters new text end where the maximum hourly rate for licensed family child care providers is higher than the maximum weekly rate for those providers divided by 50, the maximum hourly rate that may be paid to legal nonlicensed family child care providers is the rate equal to the maximum weekly rate for licensed family child care providers divided by 50 and then multiplied by 0.68. The maximum payment to a provider for one day of care must not exceed the maximum hourly rate times ten. The maximum payment to a provider for one week of care must not exceed the maximum hourly rate times 50.

(c) A rate which includes a special needs rate paid under subdivision 3 may be in excess of the maximum rate allowed under this subdivision.

(d) Legal nonlicensed family child care providers receiving reimbursement under this chapter may not be paid registration fees for families receiving assistance.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective February 3, 2014. new text end

Sec. 8.

Minnesota Statutes 2012, section 119B.13, subdivision 3a, is amended to read:

Subd. 3a.

Provider rate differential for accreditation.

A family child care provider or child care center shall be paid a 15 percent differential above the maximum rate established in subdivision 1, up to the actual provider rate, if the provider or center holds a current early childhood development credential or is accredited. For a family child care provider, early childhood development credential and accreditation includes an individual who has earned a child development associate degree, a child development associate credential, a diploma in child development from a Minnesota state technical college, or a bachelor's or post baccalaureate degree in early childhood education from an accredited college or university, or who is accredited by the National Association for Family Child Care or the Competency Based Training and Assessment Program. For a child care center, accreditation includes accreditation that meets the following criteria: the accrediting organization must demonstrate the use of standards that promote the physical, social, emotional, and cognitive development of children. The accreditation standards shall include, but are not limited to, positive interactions between adults and children, age-appropriate learning activities, a system of tracking children's learning, use of assessment to meet children's needs, specific qualifications for staff, a learning environment that supports developmentally appropriate experiences for children, health and safety requirements, and family engagement strategies. deleted text begin The commissioner of human services, in conjunction with the commissioners of education and health, will develop an application and approval process based on the criteria in this section and any additional criteria. The process developed by the commissioner of human services must address periodic reassessment of approved accreditations. The commissioner of human services must report the criteria developed, the application, approval, and reassessment processes, and any additional recommendations by February 15, 2013, to the chairs and ranking minority members of the legislative committees having jurisdiction over early childhood issues.deleted text end new text begin Based on an application process developed by the commissioner in conjunction with the commissioners of education and health, the Department of Human Services must accept applications from accrediting organizations beginning on July 1, 2013, and on an annual basis thereafter. The provider rate differential shall be paid to centers holding an accreditation from an approved accrediting organization beginning on a billing cycle to be determined by the commissioner, no later than the last Monday in February of a calendar year. The commissioner shall annually publish a list of approved accrediting organizations. An approved accreditation must be reassessed by the commissioner every two years. If an approved accrediting organization is determined to no longer meet the approval criteria, the organization and centers being paid the differential under that accreditation must be given a 90-day notice by the commissioner and the differential payment must end after a 15-day notice to affected families and centers as directed in Minnesota Rules, part 3400.0185, subparts 3 and 4.new text end The following accreditations shall be recognized for the provider rate differential until an approval process is implemented: the National Association for the Education of Young Children, the Council on Accreditation, the National Early Childhood Program Accreditation, the National School-Age Care Association, or the National Head Start Association Program of Excellence. For Montessori programs, accreditation includes the American Montessori Society, Association of Montessori International-USA, or the National Center for Montessori Education.

Sec. 9.

Minnesota Statutes 2012, section 119B.13, is amended by adding a subdivision to read:

new text begin Subd. 3b. new text end

new text begin Provider rate differential for Parent Aware. new text end

new text begin A family child care provider or child care center shall be paid a 15 percent differential if they hold a three-star Parent Aware rating or a 20 percent differential if they hold a four-star Parent Aware rating. A 15 percent or 20 percent rate differential must be paid above the maximum rate established in subdivision 1, up to the actual provider rate. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 3, 2014. new text end

Sec. 10.

Minnesota Statutes 2012, section 119B.13, is amended by adding a subdivision to read:

new text begin Subd. 3c. new text end

new text begin Weekly rate paid for children attending high-quality care. new text end

new text begin A licensed child care provider or license-exempt center may be paid up to the applicable weekly maximum rate, not to exceed the provider's actual charge, when the following conditions are met: new text end

new text begin (1) the child is age birth to five years, but not yet in kindergarten; new text end

new text begin (2) the child attends a child care provider that qualifies for the rate differential identified in subdivision 3a or 3b; and new text end

new text begin (3) the applicant's activities qualify for at least 30 hours of care per week under sections 119B.03, 119B.05, 119B.10, and Minnesota Rules, chapter 3400. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 4, 2014. new text end

Sec. 11.

Minnesota Statutes 2012, section 119B.13, subdivision 6, is amended to read:

Subd. 6.

Provider payments.

(a) The provider shall bill for services provided within ten days of the end of the service period. If bills are submitted within ten days of the end of the service period, payments under the child care fund shall be made within 30 days of receiving a bill from the provider. Counties or the state may establish policies that make payments on a more frequent basis.

(b) If a provider has received an authorization of care and been issued a billing form for an eligible family, the bill must be submitted within 60 days of the last date of service on the bill. A bill submitted more than 60 days after the last date of service must be paid if the county determines that the provider has shown good cause why the bill was not submitted within 60 days. Good cause must be defined in the county's child care fund plan under section 119B.08, subdivision 3, and the definition of good cause must include county error. Any bill submitted more than a year after the last date of service on the bill must not be paid.

(c) If a provider provided care for a time period without receiving an authorization of care and a billing form for an eligible family, payment of child care assistance may only be made retroactively for a maximum of six months from the date the provider is issued an authorization of care and billing form.

(d) A county may refuse to issue a child care authorization to a licensed or legal nonlicensed provider, revoke an existing child care authorization to a licensed or legal nonlicensed provider, stop payment issued to a licensed or legal nonlicensed provider, or refuse to pay a bill submitted by a licensed or legal nonlicensed provider if:

(1) the provider admits to intentionally giving the county materially false information on the provider's billing forms;

(2) a county finds by a preponderance of the evidence that the provider intentionally gave the county materially false information on the provider's billing forms;

(3) the provider is in violation of child care assistance program rules, until the agency determines those violations have been corrected;

(4) the provider is operating after receipt of an order of suspension or an order of revocation of the provider's license, or the provider has been issued an order citing violations of licensing standards that affect the health and safety of children in care due to the nature, chronicity, or severity of the licensing violations, until the licensing agency determines those violations have been corrected;

(5) the provider submits false attendance reports or refuses to provide documentation of the child's attendance upon request; or

(6) the provider gives false child care price information.

new text begin The county may withhold the provider's authorization or payment for a period of time not to exceed three months beyond the time the condition has been corrected. new text end

(e) A county's payment policies must be included in the county's child care plan under section 119B.08, subdivision 3. If payments are made by the state, in addition to being in compliance with this subdivision, the payments must be made in compliance with section 16A.124.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective February 3, 2014. new text end

Sec. 12.

Minnesota Statutes 2012, section 119B.13, subdivision 7, is amended to read:

Subd. 7.

Absent days.

(a) Licensed child care providers and license-exempt centers must not be reimbursed for more than deleted text begin tendeleted text end new text begin 25new text end full-day absent days per child, excluding holidays, in a fiscal yearnew text begin , or for more than ten consecutive full-day absent daysnew text end . Legal nonlicensed family child care providers must not be reimbursed for absent days. If a child attends for part of the time authorized to be in care in a day, but is absent for part of the time authorized to be in care in that same day, the absent time must be reimbursed but the time must not count toward the deleted text begin tendeleted text end absent deleted text begin daydeleted text end new text begin daysnew text end limit. Child care providers must only be reimbursed for absent days if the provider has a written policy for child absences and charges all other families in care for similar absences.

new text begin (b) Notwithstanding paragraph (a), children with documented medical conditions that cause more frequent absences may exceed the 25 absent days limit, or ten consecutive full-day absent days limit. Absences due to a documented medical condition of a parent or sibling who lives in the same residence as the child receiving child care assistance do not count against the absent days limit in a fiscal year. Documentation of medical conditions must be on the forms and submitted according to the timelines established by the commissioner. A public health nurse or school nurse may verify the illness in lieu of a medical practitioner. If a provider sends a child home early due to a medical reason, including, but not limited to, fever or contagious illness, the child care center director or lead teacher may verify the illness in lieu of a medical practitioner. new text end

deleted text begin (b)deleted text end new text begin (c)new text end Notwithstanding paragraph (a), children in families may exceed the deleted text begin tendeleted text end absent days limit if at least one parent: (1) is under the age of 21; (2) does not have a high school or general equivalency diploma; and (3) is a student in a school district or another similar program that provides or arranges for child care, parenting support, social services, career and employment supports, and academic support to achieve high school graduation, upon request of the program and approval of the county. If a child attends part of an authorized day, payment to the provider must be for the full amount of care authorized for that day.

deleted text begin (c)deleted text end new text begin (d)new text end Child care providers must be reimbursed for up to ten federal or state holidays or designated holidays per year when the provider charges all families for these days and the holiday or designated holiday falls on a day when the child is authorized to be in attendance. Parents may substitute other cultural or religious holidays for the ten recognized state and federal holidays. Holidays do not count toward the deleted text begin tendeleted text end absent deleted text begin daydeleted text end new text begin daysnew text end limit.

deleted text begin (d)deleted text end new text begin (e)new text end A family or child care provider must not be assessed an overpayment for an absent day payment unless (1) there was an error in the amount of care authorized for the family, (2) all of the allowed full-day absent payments for the child have been paid, or (3) the family or provider did not timely report a change as required under law.

deleted text begin (e)deleted text end new text begin (f)new text end The provider and family shall receive notification of the number of absent days used upon initial provider authorization for a family and ongoing notification of the number of absent days used as of the date of the notification.

new text begin (g) For purposes of this subdivision, "absent days limit" means 25 full-day absent days per child, excluding holidays, in a fiscal year; and ten consecutive full-day absent days. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective February 1, 2014. new text end

Sec. 13.

Minnesota Statutes 2012, section 245A.07, subdivision 2a, is amended to read:

Subd. 2a.

Immediate suspension expedited hearing.

(a) Within five working days of receipt of the license holder's timely appeal, the commissioner shall request assignment of an administrative law judge. The request must include a proposed date, time, and place of a hearing. A hearing must be conducted by an administrative law judge within 30 calendar days of the request for assignment, unless an extension is requested by either party and granted by the administrative law judge for good cause. The commissioner shall issue a notice of hearing by certified mail or personal service at least ten working days before the hearing. The scope of the hearing shall be limited solely to the issue of whether the temporary immediate suspension should remain in effect pending the commissioner's final order under section 245A.08, regarding a licensing sanction issued under subdivision 3 following the immediate suspension. The burden of proof in expedited hearings under this subdivision shall be limited to the commissioner's demonstration that reasonable cause exists to believe that the license holder's actions or failure to comply with applicable law or rule poses, or if the actions of other individuals or conditions in the program poses an imminent risk of harm to the health, safety, or rights of persons served by the program. "Reasonable cause" means there exist specific articulable facts or circumstances which provide the commissioner with a reasonable suspicion that there is an imminent risk of harm to the health, safety, or rights of persons served by the program.new text begin When the commissioner has determined there is reasonable cause to order the temporary immediate suspension of a license based on a violation of safe sleep requirements, as defined in section 245A.1435, the commissioner is not required to demonstrate that an infant died or was injured as a result of the safe sleep violations.new text end

(b) The administrative law judge shall issue findings of fact, conclusions, and a recommendation within ten working days from the date of hearing. The parties shall have ten calendar days to submit exceptions to the administrative law judge's report. The record shall close at the end of the ten-day period for submission of exceptions. The commissioner's final order shall be issued within ten working days from the close of the record. Within 90 calendar days after a final order affirming an immediate suspension, the commissioner shall make a determination regarding whether a final licensing sanction shall be issued under subdivision 3. The license holder shall continue to be prohibited from operation of the program during this 90-day period.

(c) When the final order under paragraph (b) affirms an immediate suspension, and a final licensing sanction is issued under subdivision 3 and the license holder appeals that sanction, the license holder continues to be prohibited from operation of the program pending a final commissioner's order under section 245A.08, subdivision 5, regarding the final licensing sanction.

Sec. 14.

Minnesota Statutes 2012, section 245A.1435, is amended to read:

245A.1435 REDUCTION OF RISK OF SUDDENnew text begin UNEXPECTEDnew text end INFANT DEATH deleted text begin SYNDROMEdeleted text end IN LICENSED PROGRAMS.

(a) When a license holder is placing an infant to sleep, the license holder must place the infant on the infant's back, unless the license holder has documentation from the infant's deleted text begin parentdeleted text end new text begin physiciannew text end directing an alternative sleeping position for the infant. The deleted text begin parentdeleted text end new text begin physiciannew text end directive must be on a form approved by the commissioner and must deleted text begin include a statement that the parent or legal guardian has read the information provided by the Minnesota Sudden Infant Death Center, related to the risk of SIDS and the importance of placing an infant or child on its back to sleep to reduce the risk of SIDS.deleted text end new text begin remain on file at the licensed location. An infant who independently rolls onto its stomach after being placed to sleep on its back may be allowed to remain sleeping on its stomach if the infant is at least six months of age or the license holder has a signed statement from the parent indicating that the infant regularly rolls over at home.new text end

(b) deleted text begin The license holder must place the infant in a crib directly on a firm mattress with a fitted crib sheet that fits tightly on the mattress and overlaps the mattress so it cannot be dislodged by pulling on the corner of the sheet. The license holder must not place pillows, quilts, comforters, sheepskin, pillow-like stuffed toys, or other soft products in the crib with the infantdeleted text end new text begin The license holder must place the infant in a crib directly on a firm mattress with a fitted sheet that is appropriate to the mattress size, that fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged by pulling on the corner of the sheet with reasonable effort. The license holder must not place anything in the crib with the infant except for the infant's pacifier, as defined in Code of Federal Regulations, title 16, part 1511new text end . The requirements of this section apply to license holders serving infants deleted text begin up to and including 12 monthsdeleted text end new text begin younger than one yearnew text end of age. Licensed child care providers must meet the crib requirements under section 245A.146.

new text begin (c) If an infant falls asleep before being placed in a crib, the license holder must move the infant to a crib as soon as practicable, and must keep the infant within sight of the license holder until the infant is placed in a crib. When an infant falls asleep while being held, the license holder must consider the supervision needs of other children in care when determining how long to hold the infant before placing the infant in a crib to sleep. The sleeping infant must not be in a position where the airway may be blocked or with anything covering the infant's face. new text end

new text begin (d) Placing a swaddled infant down to sleep in a licensed setting is not recommended for an infant of any age and is prohibited for any infant who has begun to roll over independently. However, with the written consent of a parent or guardian according to this paragraph, a license holder may place the infant who has not yet begun to roll over on its own down to sleep in a one-piece sleeper equipped with an attached system that fastens securely only across the upper torso, with no constriction of the hips or legs, to create a swaddle. Prior to any use of swaddling for sleep by a provider licensed under this chapter, the license holder must obtain informed written consent for the use of swaddling from the parent or guardian of the infant on a form provided by the commissioner and prepared in partnership with the Minnesota Sudden Infant Death Center. new text end

Sec. 15.

Minnesota Statutes 2012, section 245A.144, is amended to read:

245A.144 new text begin TRAINING ON RISK OF new text end SUDDEN new text begin UNEXPECTED new text end INFANT DEATH AND deleted text begin SHAKEN BABY SYNDROMEdeleted text end new text begin ABUSIVE HEAD TRAUMAnew text end FOR CHILD FOSTER CARE PROVIDERS.

(a) Licensed child foster care providers that care for infants or children through five years of age must document that before staff persons and caregivers assist in the care of infants or children through five years of age, they are instructed on the standards in section 245A.1435 and receive training on reducing the risk of suddennew text begin unexpectednew text end infant death deleted text begin syndromedeleted text end and deleted text begin shaken baby syndrome fordeleted text end new text begin abusive head trauma from shakingnew text end infants and young children. This section does not apply to emergency relative placement under section 245A.035. The training on reducing the risk of sudden new text begin unexpected new text end infant death deleted text begin syndromedeleted text end and deleted text begin shaken baby syndromedeleted text end new text begin abusive head traumanew text end may be provided as:

(1) orientation training to child foster care providers, who care for infants or children through five years of age, under Minnesota Rules, part 2960.3070, subpart 1; or

(2) in-service training to child foster care providers, who care for infants or children through five years of age, under Minnesota Rules, part 2960.3070, subpart 2.

(b) Training required under this section must be at least one hour in length and must be completed at least once every five years. At a minimum, the training must address the risk factors related to sudden new text begin unexpected new text end infant death deleted text begin syndromedeleted text end and deleted text begin shaken baby syndromedeleted text end new text begin abusive head traumanew text end , means of reducing the risk of sudden new text begin unexpected new text end infant death deleted text begin syndromedeleted text end and deleted text begin shaken baby syndromedeleted text end new text begin abusive head traumanew text end , and license holder communication with parents regarding reducing the risk of sudden new text begin unexpected new text end infant death deleted text begin syndromedeleted text end and deleted text begin shaken baby syndromedeleted text end new text begin abusive head traumanew text end .

(c) Training for child foster care providers must be approved by the county or private licensing agency that is responsible for monitoring the child foster care provider under section 245A.16. The approved training fulfills, in part, training required under Minnesota Rules, part 2960.3070.

Sec. 16.

Minnesota Statutes 2012, section 245A.1444, is amended to read:

245A.1444 TRAINING ON RISK OF SUDDEN new text begin UNEXPECTED new text end INFANT DEATH deleted text begin SYNDROMEdeleted text end AND deleted text begin SHAKEN BABY SYNDROMEdeleted text end new text begin ABUSIVE HEAD TRAUMAnew text end BY OTHER PROGRAMS.

A licensed chemical dependency treatment program that serves clients with infants or children through five years of age, who sleep at the program and a licensed children's residential facility that serves infants or children through five years of age, must document that before program staff persons or volunteers assist in the care of infants or children through five years of age, they are instructed on the standards in section 245A.1435 and receive training on reducing the risk of suddennew text begin unexpectednew text end infant death deleted text begin syndromedeleted text end and deleted text begin shaken baby syndromedeleted text end new text begin abusive head trauma from shaking infants and young childrennew text end . The training conducted under this section may be used to fulfill training requirements under Minnesota Rules, parts 2960.0100, subpart 3; and 9530.6490, subpart 4, item B.

This section does not apply to child care centers or family child care programs governed by sections 245A.40 and 245A.50.

Sec. 17.

new text begin [245A.148] FAMILY CHILD CARE DIAPERING AREA DISINFECTION. new text end

new text begin Notwithstanding Minnesota Rules, part 9502.0435, a family child care provider may disinfect the diaper changing surface with chlorine bleach in a manner consistent with label directions for disinfection or with a surface disinfectant that meets the following criteria: new text end

new text begin (1) the manufacturer's label or instructions state that the product is registered with the United States Environmental Protection Agency; new text end

new text begin (2) the manufacturer's label or instructions state that the disinfectant is effective against Staphylococcus aureus, Salmonella choleraesuis, and Pseudomonas aeruginosa; new text end

new text begin (3) the manufacturer's label or instructions state that the disinfectant is effective with a ten minute or less contact time; new text end

new text begin (4) the disinfectant is clearly labeled by the manufacturer with directions for mixing and use; new text end

new text begin (5) the disinfectant is used only in accordance with the manufacturer's directions; and new text end

new text begin (6) the product does not include triclosan or derivatives of triclosan. new text end

Sec. 18.

new text begin [245A.147] FAMILY CHILD CARE INFANT SLEEP SUPERVISION REQUIREMENTS. new text end

new text begin Subdivision 1. new text end

new text begin In-person checks on infants. new text end

new text begin (a) License holders that serve infants are encouraged to monitor sleeping infants by conducting in-person checks on each infant in their care every 30 minutes. new text end

new text begin (b) Upon enrollment of an infant in a family child care program, the license holder is encouraged to conduct in-person checks on the sleeping infant every 15 minutes, during the first four months of care. new text end

new text begin (c) When an infant has an upper respiratory infection, the license holder is encouraged to conduct in-person checks on the sleeping infant every 15 minutes throughout the hours of sleep. new text end

new text begin Subd. 2. new text end

new text begin Use of audio or visual monitoring devices. new text end

new text begin In addition to conducting the in-person checks encouraged under subdivision 1, license holders serving infants are encouraged to use and maintain an audio or visual monitoring device to monitor each sleeping infant in care during all hours of sleep. new text end

Sec. 19.

new text begin [245A.152] CHILD CARE LICENSE HOLDER INSURANCE. new text end

new text begin (a) A license holder must provide a written notice to all parents or guardians of all children to be accepted for care prior to admission stating whether the license holder has liability insurance. This notice may be incorporated into and provided on the admission form used by the license holder. new text end

new text begin (b) If the license holder has liability insurance: new text end

new text begin (1) the license holder shall inform parents in writing that a current certificate of coverage for insurance is available for inspection to all parents or guardians of children receiving services and to all parents seeking services from the family child care program; new text end

new text begin (2) the notice must provide the parent or guardian with the date of expiration or next renewal of the policy; and new text end

new text begin (3) upon the expiration date of the policy, the license holder must provide a new written notice indicating whether the insurance policy has lapsed or whether the license holder has renewed the policy. new text end

new text begin If the policy was renewed, the license holder must provide the new expiration date of the policy in writing to the parents or guardians. new text end

new text begin (c) If the license holder does not have liability insurance, the license holder must provide an annual notice, on a form developed and made available by the commissioner, to the parents or guardians of children in care indicating that the license holder does not carry liability insurance. new text end

new text begin (d) The license holder must notify all parents and guardians in writing immediately of any change in insurance status. new text end

new text begin (e) The license holder must make available upon request the certificate of liability insurance to the parents of children in care, to the commissioner, and to county licensing agents. new text end

new text begin (f) The license holder must document, with the signature of the parent or guardian, that the parent or guardian received the notices required by this section. new text end

Sec. 20.

Minnesota Statutes 2012, section 245A.40, subdivision 5, is amended to read:

Subd. 5.

Sudden new text begin unexpected new text end infant death deleted text begin syndromedeleted text end and deleted text begin shaken baby syndromedeleted text end new text begin abusive head trauma new text end training.

(a) License holders must document that before staff persons new text begin and volunteers new text end care for infants, they are instructed on the standards in section 245A.1435 and receive training on reducing the risk of sudden new text begin unexpected new text end infant death deleted text begin syndromedeleted text end . In addition, license holders must document that before staff persons care for infants or children under school age, they receive training on the risk of deleted text begin shaken baby syndromedeleted text end new text begin abusive head trauma from shaking infants and young childrennew text end . The training in this subdivision may be provided as orientation training under subdivision 1 and in-service training under subdivision 7.

(b) Suddennew text begin unexpectednew text end infant death deleted text begin syndromedeleted text end reduction training required under this subdivision must be at least one-half hour in length and must be completed at least once every deleted text begin five yearsdeleted text end new text begin yearnew text end . At a minimum, the training must address the risk factors related to sudden new text begin unexpected new text end infant death deleted text begin syndromedeleted text end , means of reducing the risk of sudden new text begin unexpected new text end infant death deleted text begin syndromedeleted text end in child care, and license holder communication with parents regarding reducing the risk of sudden new text begin unexpected new text end infant death deleted text begin syndromedeleted text end .

(c) deleted text begin Shaken baby syndromedeleted text end new text begin Abusive head traumanew text end training under this subdivision must be at least one-half hour in length and must be completed at least once every deleted text begin five yearsdeleted text end new text begin yearnew text end . At a minimum, the training must address the risk factors related to deleted text begin shaken baby syndrome fordeleted text end new text begin shakingnew text end infants and young children, means to reduce the risk of deleted text begin shaken baby syndromedeleted text end new text begin abusive head traumanew text end in child care, and license holder communication with parents regarding reducing the risk of deleted text begin shaken baby syndromedeleted text end new text begin abusive head traumanew text end .

(d) The commissioner shall make available for viewing a video presentation on the dangers associated with shaking infants and young children. The video presentation must be part of the orientation and annual in-service training of licensed child care center staff persons caring for children under school age. The commissioner shall provide to child care providers and interested individuals, at cost, copies of a video approved by the commissioner of health under section 144.574 on the dangers associated with shaking infants and young children.

Sec. 21.

Minnesota Statutes 2012, section 245A.50, is amended to read:

245A.50 FAMILY CHILD CARE TRAINING REQUIREMENTS.

Subdivision 1.

Initial training.

(a) License holders, caregivers, and substitutes must comply with the training requirements in this section.

(b) Helpers who assist with care on a regular basis must complete six hours of training within one year after the date of initial employment.

Subd. 2.

Child growth and development new text begin and behavior guidance new text end training.

(a) For purposes of family and group family child care, the license holder and each adult caregiver who provides care in the licensed setting for more than 30 days in any 12-month period shall complete and document at least deleted text begin twodeleted text end new text begin fournew text end hours of child growth and development new text begin and behavior guidance new text end training deleted text begin within the first year ofdeleted text end new text begin prior to initialnew text end licensurenew text begin , and before caring for childrennew text end . For purposes of this subdivision, "child growth and development training" means training in understanding how children acquire language and develop physically, cognitively, emotionally, and socially.new text begin "Behavior guidance training" means training in the understanding of the functions of child behavior and strategies for managing challenging situations. Child growth and development and behavior guidance training must be repeated annually. Training curriculum shall be developed or approved by the commissioner of human services by January 1, 2014.new text end

(b) Notwithstanding paragraph (a), individuals are exempt from this requirement if they:

(1) have taken a three-credit course on early childhood development within the past five years;

(2) have received a baccalaureate or master's degree in early childhood education or school-age child care within the past five years;

(3) are licensed in Minnesota as a prekindergarten teacher, an early childhood educator, a kindergarten to grade 6 teacher with a prekindergarten specialty, an early childhood special education teacher, or an elementary teacher with a kindergarten endorsement; or

(4) have received a baccalaureate degree with a Montessori certificate within the past five years.

Subd. 3.

First aid.

(a) When children are present in a family child care home governed by Minnesota Rules, parts 9502.0315 to 9502.0445, at least one staff person must be present in the home who has been trained in first aid. The first aid training must have been provided by an individual approved to provide first aid instruction. First aid training may be less than eight hours and persons qualified to provide first aid training include individuals approved as first aid instructors.new text begin First aid training must be repeated every two years.new text end

(b) A family child care provider is exempt from the first aid training requirements under this subdivision related to any substitute caregiver who provides less than 30 hours of care during any 12-month period.

(c) Video training reviewed and approved by the county licensing agency satisfies the training requirement of this subdivision.

Subd. 4.

Cardiopulmonary resuscitation.

(a) When children are present in a family child care home governed by Minnesota Rules, parts 9502.0315 to 9502.0445, at least one staff person must be present in the home who has been trained in cardiopulmonary resuscitation (CPR) and in the treatment of obstructed airwaysnew text begin that includes CPR techniques for infants and childrennew text end . The CPR training must have been provided by an individual approved to provide CPR instruction, must be repeated at least once every deleted text begin threedeleted text end new text begin twonew text end years, and must be documented in the staff person's records.

(b) A family child care provider is exempt from the CPR training requirement in this subdivision related to any substitute caregiver who provides less than 30 hours of care during any 12-month period.

(c) deleted text begin Video training reviewed and approved by the county licensing agency satisfies the training requirement of this subdivision.deleted text end new text begin Persons providing CPR training must use CPR training that has been developed:new text end

new text begin (1) by the American Heart Association or the American Red Cross and incorporates psychomotor skills to support the instruction; or new text end

new text begin (2) using nationally recognized, evidence-based guidelines for CPR training and incorporates psychomotor skills to support the instruction. new text end

Subd. 5.

Suddennew text begin unexpectednew text end infant death deleted text begin syndromedeleted text end and deleted text begin shaken baby syndromedeleted text end new text begin abusive head traumanew text end training.

(a) License holders must document that before staff persons, caregivers, and helpers assist in the care of infants, they are instructed on the standards in section 245A.1435 and receive training on reducing the risk of sudden new text begin unexpected new text end infant death deleted text begin syndromedeleted text end . In addition, license holders must document that before staff persons, caregivers, and helpers assist in the care of infants and children under school age, they receive training on reducing the risk of deleted text begin shaken baby syndromedeleted text end new text begin abusive head trauma from shaking infants and young childrennew text end . The training in this subdivision may be provided as initial training under subdivision 1 or ongoing annual training under subdivision 7.

(b) Suddennew text begin unexpectednew text end infant death deleted text begin syndromedeleted text end reduction training required under this subdivision must be at least one-half hour in length and must be completed new text begin in personnew text end at least once every deleted text begin five yearsdeleted text end new text begin two yearsnew text end . new text begin On the years when the license holder is not receiving the in-person training on sudden unexpected infant death reduction, the license holder must receive sudden unexpected infant death reduction training through a video of no more than one hour in length developed or approved by the commissioner.new text end At a minimum, the training must address the risk factors related to sudden new text begin unexpected new text end infant death deleted text begin syndromedeleted text end , means of reducing the risk of sudden new text begin unexpected new text end infant death deleted text begin syndromedeleted text end in child care, and license holder communication with parents regarding reducing the risk of sudden new text begin unexpected new text end infant death deleted text begin syndromedeleted text end .

(c) deleted text begin Shaken baby syndromedeleted text end new text begin Abusive head traumanew text end training required under this subdivision must be at least one-half hour in length and must be completed at least once every deleted text begin five yearsdeleted text end new text begin yearnew text end . At a minimum, the training must address the risk factors related to deleted text begin shaken baby syndromedeleted text end new text begin shaking infants and young childrennew text end , means of reducing the risk of deleted text begin shaken baby syndromedeleted text end new text begin abusive head traumanew text end in child care, and license holder communication with parents regarding reducing the risk of deleted text begin shaken baby syndromedeleted text end new text begin abusive head traumanew text end .

(d) Training for family and group family child care providers must be new text begin developed by the commissioner in conjunction with the Minnesota Sudden Infant Death Center andnew text end approved deleted text begin by the county licensing agencydeleted text end new text begin by the Minnesota Center for Professional Developmentnew text end .

deleted text begin (e) The commissioner shall make available for viewing by all licensed child care providers a video presentation on the dangers associated with shaking infants and young children. The video presentation shall be part of the initial and ongoing annual training of licensed child care providers, caregivers, and helpers caring for children under school age. The commissioner shall provide to child care providers and interested individuals, at cost, copies of a video approved by the commissioner of health under section 144.574 on the dangers associated with shaking infants and young children. deleted text end

Subd. 6.

Child passenger restraint systems; training requirement.

(a) A license holder must comply with all seat belt and child passenger restraint system requirements under section 169.685.

(b) Family and group family child care programs licensed by the Department of Human Services that serve a child or children under nine years of age must document training that fulfills the requirements in this subdivision.

(1) Before a license holder, staff person, caregiver, or helper transports a child or children under age nine in a motor vehicle, the person placing the child or children in a passenger restraint must satisfactorily complete training on the proper use and installation of child restraint systems in motor vehicles. Training completed under this subdivision may be used to meet initial training under subdivision 1 or ongoing training under subdivision 7.

(2) Training required under this subdivision must be at least one hour in length, completed at initial training, and repeated at least once every five years. At a minimum, the training must address the proper use of child restraint systems based on the child's size, weight, and age, and the proper installation of a car seat or booster seat in the motor vehicle used by the license holder to transport the child or children.

(3) Training under this subdivision must be provided by individuals who are certified and approved by the Department of Public Safety, Office of Traffic Safety. License holders may obtain a list of certified and approved trainers through the Department of Public Safety Web site or by contacting the agency.

(c) Child care providers that only transport school-age children as defined in section 245A.02, subdivision 19, paragraph (f), in child care buses as defined in section 169.448, subdivision 1, paragraph (e), are exempt from this subdivision.

Subd. 7.

Training requirements for family and group family child care.

For purposes of family and group family child care, the license holder and each primary caregiver must complete deleted text begin eightdeleted text end new text begin 16new text end hours of new text begin ongoing new text end training each year. For purposes of this subdivision, a primary caregiver is an adult caregiver who provides services in the licensed setting for more than 30 days in any 12-month period. new text begin Repeat of topical training requirements in subdivisions 2 to 8 shall count toward the annual 16-hour training requirement. Additional new text end ongoing training subjects new text begin to meet the annual 16-hour training requirement new text end must be selected from the following areas:

(1) deleted text begin "deleted text end child growth and development trainingdeleted text begin " has the meaning given indeleted text end new text begin undernew text end subdivision 2, paragraph (a);

(2) deleted text begin "deleted text end learning environment and curriculumdeleted text begin " includesdeleted text end new text begin , includingnew text end training in establishing an environment and providing activities that provide learning experiences to meet each child's needs, capabilities, and interests;

(3) deleted text begin "deleted text end assessment and planning for individual needsdeleted text begin " includesdeleted text end new text begin , includingnew text end training in observing and assessing what children know and can do in order to provide curriculum and instruction that addresses their developmental and learning needs, including children with special needs and bilingual children or children for whom English is not their primary language;

(4) deleted text begin "deleted text end interactions with childrendeleted text begin " includesdeleted text end new text begin , includingnew text end training in establishing supportive relationships with children, guiding them as individuals and as part of a group;

(5) deleted text begin "deleted text end families and communitiesdeleted text begin " includesdeleted text end new text begin , includingnew text end training in working collaboratively with families and agencies or organizations to meet children's needs and to encourage the community's involvement;

(6) deleted text begin "deleted text end health, safety, and nutritiondeleted text begin " includesdeleted text end new text begin , includingnew text end training in establishing and maintaining an environment that ensures children's health, safety, and nourishment, including child abuse, maltreatment, prevention, and reporting; home and fire safety; child injury prevention; communicable disease prevention and control; first aid; and CPR; deleted text begin anddeleted text end

(7) deleted text begin "deleted text end program planning and evaluationdeleted text begin " includesdeleted text end new text begin , includingnew text end training in establishing, implementing, evaluating, and enhancing program operationsdeleted text begin .deleted text end new text begin ; andnew text end

new text begin (8) behavior guidance, including training in the understanding of the functions of child behavior and strategies for managing behavior. new text end

Subd. 8.

Other required training requirements.

(a) The training required of family and group family child care providers and staff must include training in the cultural dynamics of early childhood development and child care. The cultural dynamics and disabilities training and skills development of child care providers must be designed to achieve outcomes for providers of child care that include, but are not limited to:

(1) an understanding and support of the importance of culture and differences in ability in children's identity development;

(2) understanding the importance of awareness of cultural differences and similarities in working with children and their families;

(3) understanding and support of the needs of families and children with differences in ability;

(4) developing skills to help children develop unbiased attitudes about cultural differences and differences in ability;

(5) developing skills in culturally appropriate caregiving; and

(6) developing skills in appropriate caregiving for children of different abilities.

The commissioner shall approve the curriculum for cultural dynamics and disability training.

(b) The provider must meet the training requirement in section 245A.14, subdivision 11, paragraph (a), clause (4), to be eligible to allow a child cared for at the family child care or group family child care home to use the swimming pool located at the home.

new text begin Subd. 9. new text end

new text begin Supervising for safety; training requirement. new text end

new text begin Effective July 1, 2014, all family child care license holders and each adult caregiver who provides care in the licensed family child care home for more than 30 days in any 12-month period shall complete and document at least six hours of approved training on supervising for safety prior to initial licensure, and before caring for children. At least two hours of training on supervising for safety must be repeated annually. For purposes of this subdivision, "supervising for safety" includes supervision basics, supervision outdoors, equipment and materials, illness, injuries, and disaster preparedness. The commissioner shall develop the supervising for safety curriculum by January 1, 2014. new text end

new text begin Subd. 10. new text end

new text begin Approved training. new text end

new text begin County licensing staff must accept training approved by the Minnesota Center for Professional Development, including: new text end

new text begin (1) face-to-face or classroom training; new text end

new text begin (2) online training; and new text end

new text begin (3) relationship-based professional development, such as mentoring, coaching, and consulting. new text end

new text begin Subd. 11. new text end

new text begin Provider training. new text end

new text begin New and increased training requirements under this section must not be imposed on providers until the commissioner establishes statewide accessibility to the required provider training. new text end

Sec. 22.

Minnesota Statutes 2012, section 252.27, subdivision 2a, is amended to read:

Subd. 2a.

Contribution amount.

(a) The natural or adoptive parents of a minor child, including a child determined eligible for medical assistance without consideration of parental income, must contribute to the cost of services used by making monthly payments on a sliding scale based on income, unless the child is married or has been married, parental rights have been terminated, or the child's adoption is subsidized according to section 259.67 or through title IV-E of the Social Security Act. The parental contribution is a partial or full payment for medical services provided for diagnostic, therapeutic, curing, treating, mitigating, rehabilitation, maintenance, and personal care services as defined in United States Code, title 26, section 213, needed by the child with a chronic illness or disability.

(b) For households with adjusted gross income equal to or greater than deleted text begin 100deleted text end new text begin 275new text end percent of federal poverty guidelines, the parental contribution shall be computed by applying the following schedule of rates to the adjusted gross income of the natural or adoptive parents:

deleted text begin (1) if the adjusted gross income is equal to or greater than 100 percent of federal poverty guidelines and less than 175 percent of federal poverty guidelines, the parental contribution is $4 per month; deleted text end

deleted text begin (2)deleted text end new text begin (1)new text end if the adjusted gross income is equal to or greater than deleted text begin 175deleted text end new text begin 275new text end percent of federal poverty guidelines and less than or equal to 545 percent of federal poverty guidelines, the parental contribution shall be determined using a sliding fee scale established by the commissioner of human services which begins at deleted text begin onedeleted text end new text begin 2.76new text end percent of adjusted gross income at deleted text begin 175deleted text end new text begin 275new text end percent of federal poverty guidelines and increases to 7.5 percent of adjusted gross income for those with adjusted gross income up to 545 percent of federal poverty guidelines;

deleted text begin (3)deleted text end new text begin (2)new text end if the adjusted gross income is greater than 545 percent of federal poverty guidelines and less than 675 percent of federal poverty guidelines, the parental contribution shall be 7.5 percent of adjusted gross income;

deleted text begin (4)deleted text end new text begin (3)new text end if the adjusted gross income is equal to or greater than 675 percent of federal poverty guidelines and less than 975 percent of federal poverty guidelines, the parental contribution shall be determined using a sliding fee scale established by the commissioner of human services which begins at 7.5 percent of adjusted gross income at 675 percent of federal poverty guidelines and increases to ten percent of adjusted gross income for those with adjusted gross income up to 975 percent of federal poverty guidelines; and

deleted text begin (5)deleted text end new text begin (4)new text end if the adjusted gross income is equal to or greater than 975 percent of federal poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross income.

If the child lives with the parent, the annual adjusted gross income is reduced by $2,400 prior to calculating the parental contribution. If the child resides in an institution specified in section 256B.35, the parent is responsible for the personal needs allowance specified under that section in addition to the parental contribution determined under this section. The parental contribution is reduced by any amount required to be paid directly to the child pursuant to a court order, but only if actually paid.

(c) The household size to be used in determining the amount of contribution under paragraph (b) includes natural and adoptive parents and their dependents, including the child receiving services. Adjustments in the contribution amount due to annual changes in the federal poverty guidelines shall be implemented on the first day of July following publication of the changes.

(d) For purposes of paragraph (b), "income" means the adjusted gross income of the natural or adoptive parents determined according to the previous year's federal tax form, except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds have been used to purchase a home shall not be counted as income.

(e) The contribution shall be explained in writing to the parents at the time eligibility for services is being determined. The contribution shall be made on a monthly basis effective with the first month in which the child receives services. Annually upon redetermination or at termination of eligibility, if the contribution exceeded the cost of services provided, the local agency or the state shall reimburse that excess amount to the parents, either by direct reimbursement if the parent is no longer required to pay a contribution, or by a reduction in or waiver of parental fees until the excess amount is exhausted. All reimbursements must include a notice that the amount reimbursed may be taxable income if the parent paid for the parent's fees through an employer's health care flexible spending account under the Internal Revenue Code, section 125, and that the parent is responsible for paying the taxes owed on the amount reimbursed.

(f) The monthly contribution amount must be reviewed at least every 12 months; when there is a change in household size; and when there is a loss of or gain in income from one month to another in excess of ten percent. The local agency shall mail a written notice 30 days in advance of the effective date of a change in the contribution amount. A decrease in the contribution amount is effective in the month that the parent verifies a reduction in income or change in household size.

(g) Parents of a minor child who do not live with each other shall each pay the contribution required under paragraph (a). An amount equal to the annual court-ordered child support payment actually paid on behalf of the child receiving services shall be deducted from the adjusted gross income of the parent making the payment prior to calculating the parental contribution under paragraph (b).

(h) The contribution under paragraph (b) shall be increased by an additional five percent if the local agency determines that insurance coverage is available but not obtained for the child. For purposes of this section, "available" means the insurance is a benefit of employment for a family member at an annual cost of no more than five percent of the family's annual income. For purposes of this section, "insurance" means health and accident insurance coverage, enrollment in a nonprofit health service plan, health maintenance organization, self-insured plan, or preferred provider organization.

Parents who have more than one child receiving services shall not be required to pay more than the amount for the child with the highest expenditures. There shall be no resource contribution from the parents. The parent shall not be required to pay a contribution in excess of the cost of the services provided to the child, not counting payments made to school districts for education-related services. Notice of an increase in fee payment must be given at least 30 days before the increased fee is due.

(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, in the 12 months prior to July 1:

(1) the parent applied for insurance for the child;

(2) the insurer denied insurance;

(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted a complaint or appeal, in writing, to the commissioner of health or the commissioner of commerce, or litigated the complaint or appeal; and

(4) as a result of the dispute, the insurer reversed its decision and granted insurance.

For purposes of this section, "insurance" has the meaning given in paragraph (h).

A parent who has requested a reduction in the contribution amount under this paragraph shall submit proof in the form and manner prescribed by the commissioner or county agency, including, but not limited to, the insurer's denial of insurance, the written letter or complaint of the parents, court documents, and the written response of the insurer approving insurance. The determinations of the commissioner or county agency under this paragraph are not rules subject to chapter 14.

deleted text begin (j) Notwithstanding paragraph (b), for the period from July 1, 2010, to June 30, 2015, the parental contribution shall be computed by applying the following contribution schedule to the adjusted gross income of the natural or adoptive parents: deleted text end

deleted text begin (1) if the adjusted gross income is equal to or greater than 100 percent of federal poverty guidelines and less than 175 percent of federal poverty guidelines, the parental contribution is $4 per month; deleted text end

deleted text begin (2) if the adjusted gross income is equal to or greater than 175 percent of federal poverty guidelines and less than or equal to 525 percent of federal poverty guidelines, the parental contribution shall be determined using a sliding fee scale established by the commissioner of human services which begins at one percent of adjusted gross income at 175 percent of federal poverty guidelines and increases to eight percent of adjusted gross income for those with adjusted gross income up to 525 percent of federal poverty guidelines; deleted text end

deleted text begin (3) if the adjusted gross income is greater than 525 percent of federal poverty guidelines and less than 675 percent of federal poverty guidelines, the parental contribution shall be 9.5 percent of adjusted gross income; deleted text end

deleted text begin (4) if the adjusted gross income is equal to or greater than 675 percent of federal poverty guidelines and less than 900 percent of federal poverty guidelines, the parental contribution shall be determined using a sliding fee scale established by the commissioner of human services which begins at 9.5 percent of adjusted gross income at 675 percent of federal poverty guidelines and increases to 12 percent of adjusted gross income for those with adjusted gross income up to 900 percent of federal poverty guidelines; and deleted text end

deleted text begin (5) if the adjusted gross income is equal to or greater than 900 percent of federal poverty guidelines, the parental contribution shall be 13.5 percent of adjusted gross income. If the child lives with the parent, the annual adjusted gross income is reduced by $2,400 prior to calculating the parental contribution. If the child resides in an institution specified in section 256B.35, the parent is responsible for the personal needs allowance specified under that section in addition to the parental contribution determined under this section. The parental contribution is reduced by any amount required to be paid directly to the child pursuant to a court order, but only if actually paid. deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraph (b) is effective January 1, 2014. Paragraph (j) is effective July 1, 2013. new text end

Sec. 23.

Minnesota Statutes 2012, section 256.98, subdivision 8, is amended to read:

Subd. 8.

Disqualification from program.

(a) Any person found to be guilty of wrongfully obtaining assistance by a federal or state court or by an administrative hearing determination, or waiver thereof, through a disqualification consent agreement, or as part of any approved diversion plan under section 401.065, or any court-ordered stay which carries with it any probationary or other conditions, in the Minnesota family investment program and any affiliated program to include the diversionary work program and the work participation cash benefit program, the food stamp or food support program, the general assistance program, the group residential housing program, or the Minnesota supplemental aid program shall be disqualified from that program. In addition, any person disqualified from the Minnesota family investment program shall also be disqualified from the food stamp or food support program. The needs of that individual shall not be taken into consideration in determining the grant level for that assistance unit:

(1) for one year after the first offense;

(2) for two years after the second offense; and

(3) permanently after the third or subsequent offense.

The period of program disqualification shall begin on the date stipulated on the advance notice of disqualification without possibility of postponement for administrative stay or administrative hearing and shall continue through completion unless and until the findings upon which the sanctions were imposed are reversed by a court of competent jurisdiction. The period for which sanctions are imposed is not subject to review. The sanctions provided under this subdivision are in addition to, and not in substitution for, any other sanctions that may be provided for by law for the offense involved. A disqualification established through hearing or waiver shall result in the disqualification period beginning immediately unless the person has become otherwise ineligible for assistance. If the person is ineligible for assistance, the disqualification period begins when the person again meets the eligibility criteria of the program from which they were disqualified and makes application for that program.

(b) A family receiving assistance through child care assistance programs under chapter 119B with a family member who is found to be guilty of wrongfully obtaining child care assistance by a federal court, state court, or an administrative hearing determination or waiver, through a disqualification consent agreement, as part of an approved diversion plan under section 401.065, or a court-ordered stay with probationary or other conditions, is disqualified from child care assistance programs. The disqualifications must be for periods of deleted text begin three months, six months, anddeleted text end new text begin one year andnew text end two years for the firstdeleted text begin ,deleted text end new text begin andnew text end seconddeleted text begin , and thirddeleted text end offensesnew text begin ,new text end respectively. Subsequent violations must result in permanent disqualification. During the disqualification period, disqualification from any child care program must extend to all child care programs and must be immediately applied.

(c) A provider caring for children receiving assistance through child care assistance programs under chapter 119B is disqualified from receiving payment for child care services from the child care assistance program under chapter 119B when the provider is found to have wrongfully obtained child care assistance by a federal court, state court, or an administrative hearing determination or waiver under section 256.046, through a disqualification consent agreement, as part of an approved diversion plan under section 401.065, or a court-ordered stay with probationary or other conditions. The disqualification must be for a period of one year for the first offense and two years for the second offense. Any subsequent violation must result in permanent disqualification. The disqualification period must be imposed immediately after a determination is made under this paragraph. During the disqualification period, the provider is disqualified from receiving payment from any child care program under chapter 119B.

(d) Any person found to be guilty of wrongfully obtaining general assistance medical care, MinnesotaCare for adults without children, and upon federal approval, all categories of medical assistance and remaining categories of MinnesotaCare, except for children through age 18, by a federal or state court or by an administrative hearing determination, or waiver thereof, through a disqualification consent agreement, or as part of any approved diversion plan under section 401.065, or any court-ordered stay which carries with it any probationary or other conditions, is disqualified from that program. The period of disqualification is one year after the first offense, two years after the second offense, and permanently after the third or subsequent offense. The period of program disqualification shall begin on the date stipulated on the advance notice of disqualification without possibility of postponement for administrative stay or administrative hearing and shall continue through completion unless and until the findings upon which the sanctions were imposed are reversed by a court of competent jurisdiction. The period for which sanctions are imposed is not subject to review. The sanctions provided under this subdivision are in addition to, and not in substitution for, any other sanctions that may be provided for by law for the offense involved.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective February 3, 2014. new text end

Sec. 24.

Minnesota Statutes 2012, section 256J.08, subdivision 24, is amended to read:

Subd. 24.

Disregard.

"Disregard" means earned income that is not counted deleted text begin when determining initial eligibilitydeleted text end new text begin in the initial income test in section 256J.21, subdivision 3,new text end or new text begin income that is not counted when determining new text end ongoing eligibility and calculating the amount of the assistance payment for participants. The deleted text begin commissioner shall determine the amount of thedeleted text end disregard deleted text begin according to section 256J.24, subdivision 10deleted text end new text begin for ongoing eligibility shall be 50 percent of gross earned incomenew text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2014, or upon approval from the United States Department of Agriculture, whichever is later. new text end

Sec. 25.

Minnesota Statutes 2012, section 256J.21, subdivision 2, is amended to read:

Subd. 2.

Income exclusions.

The following must be excluded in determining a family's available income:

(1) payments for basic care, difficulty of care, and clothing allowances received for providing family foster care to children or adults under Minnesota Rules, parts 9555.5050 to 9555.6265, 9560.0521, and 9560.0650 to 9560.0655, and payments received and used for care and maintenance of a third-party beneficiary who is not a household member;

(2) reimbursements for employment training received through the Workforce Investment Act of 1998, United States Code, title 20, chapter 73, section 9201;

(3) reimbursement for out-of-pocket expenses incurred while performing volunteer services, jury duty, employment, or informal carpooling arrangements directly related to employment;

(4) all educational assistance, except the county agency must count graduate student teaching assistantships, fellowships, and other similar paid work as earned income and, after allowing deductions for any unmet and necessary educational expenses, shall count scholarships or grants awarded to graduate students that do not require teaching or research as unearned income;

(5) loans, regardless of purpose, from public or private lending institutions, governmental lending institutions, or governmental agencies;

(6) loans from private individuals, regardless of purpose, provided an applicant or participant documents that the lender expects repayment;

(7)(i) state income tax refunds; and

(ii) federal income tax refunds;

(8)(i) federal earned income credits;

(ii) Minnesota working family credits;

(iii) state homeowners and renters credits under chapter 290A; and

(iv) federal or state tax rebates;

(9) funds received for reimbursement, replacement, or rebate of personal or real property when these payments are made by public agencies, awarded by a court, solicited through public appeal, or made as a grant by a federal agency, state or local government, or disaster assistance organizations, subsequent to a presidential declaration of disaster;

(10) the portion of an insurance settlement that is used to pay medical, funeral, and burial expenses, or to repair or replace insured property;

(11) reimbursements for medical expenses that cannot be paid by medical assistance;

(12) payments by a vocational rehabilitation program administered by the state under chapter 268A, except those payments that are for current living expenses;

(13) in-kind income, including any payments directly made by a third party to a provider of goods and services;

(14) assistance payments to correct underpayments, but only for the month in which the payment is received;

(15) payments for short-term emergency needs under section 256J.626, subdivision 2;

(16) funeral and cemetery payments as provided by section 256.935;

(17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in a calendar month;

(18) any form of energy assistance payment made through Public Law 97-35, Low-Income Home Energy Assistance Act of 1981, payments made directly to energy providers by other public and private agencies, and any form of credit or rebate payment issued by energy providers;

(19) Supplemental Security Income (SSI), including retroactive SSI payments and other income of an SSI recipient, except as described in section 256J.37, subdivision 3b;

(20) Minnesota supplemental aid, including retroactive payments;

(21) proceeds from the sale of real or personal property;

(22) state adoption assistance payments under section 259.67, and up to an equal amount of county adoption assistance payments;

(23) state-funded family subsidy program payments made under section 252.32 to help families care for children with developmental disabilities, consumer support grant funds under section 256.476, and resources and services for a disabled household member under one of the home and community-based waiver services programs under chapter 256B;

(24) interest payments and dividends from property that is not excluded from and that does not exceed the asset limit;

(25) rent rebates;

(26) income earned by a minor caregiver, minor child through age 6, or a minor child who is at least a half-time student in an approved elementary or secondary education program;

(27) income earned by a caregiver under age 20 who is at least a half-time student in an approved elementary or secondary education program;

(28) MFIP child care payments under section 119B.05;

(29) all other payments made through MFIP to support a caregiver's pursuit of greater economic stability;

(30) income a participant receives related to shared living expenses;

(31) reverse mortgages;

(32) benefits provided by the Child Nutrition Act of 1966, United States Code, title 42, chapter 13A, sections 1771 to 1790;

(33) benefits provided by the women, infants, and children (WIC) nutrition program, United States Code, title 42, chapter 13A, section 1786;

(34) benefits from the National School Lunch Act, United States Code, title 42, chapter 13, sections 1751 to 1769e;

(35) relocation assistance for displaced persons under the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, United States Code, title 42, chapter 61, subchapter II, section 4636, or the National Housing Act, United States Code, title 12, chapter 13, sections 1701 to 1750jj;

(36) benefits from the Trade Act of 1974, United States Code, title 19, chapter 12, part 2, sections 2271 to 2322;

(37) war reparations payments to Japanese Americans and Aleuts under United States Code, title 50, sections 1989 to 1989d;

(38) payments to veterans or their dependents as a result of legal settlements regarding Agent Orange or other chemical exposure under Public Law 101-239, section 10405, paragraph (a)(2)(E);

(39) income that is otherwise specifically excluded from MFIP consideration in federal law, state law, or federal regulation;

(40) security and utility deposit refunds;

(41) American Indian tribal land settlements excluded under Public Laws 98-123, 98-124, and 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs reservations and payments to members of the White Earth Band, under United States Code, title 25, chapter 9, section 331, and chapter 16, section 1407;

(42) all income of the minor parent's parents and stepparents when determining the grant for the minor parent in households that include a minor parent living with parents or stepparents on MFIP with other children;

(43) income of the minor parent's parents and stepparents equal to 200 percent of the federal poverty guideline for a family size not including the minor parent and the minor parent's child in households that include a minor parent living with parents or stepparents not on MFIP when determining the grant for the minor parent. The remainder of income is deemed as specified in section 256J.37, subdivision 1b;

(44) payments made to children eligible for relative custody assistance under section 257.85;

(45) vendor payments for goods and services made on behalf of a client unless the client has the option of receiving the payment in cash;

(46) the principal portion of a contract for deed payment; deleted text begin anddeleted text end

(47) cash payments to individuals enrolled for full-time service as a volunteer under AmeriCorps programs including AmeriCorps VISTA, AmeriCorps State, AmeriCorps National, and AmeriCorps NCCCnew text begin ; andnew text end

new text begin (48) housing assistance grants under section 256J.35, paragraph (a)new text end .

Sec. 26.

Minnesota Statutes 2012, section 256J.21, subdivision 3, is amended to read:

Subd. 3.

Initial income test.

The county agency shall determine initial eligibility by considering all earned and unearned income that is not excluded under subdivision 2. To be eligible for MFIP, the assistance unit's countable income minus the disregards in paragraphs (a) and (b) must be below the deleted text begin transitional standard of assistancedeleted text end new text begin family wage levelnew text end according to section 256J.24 for that size assistance unit.

(a) The initial eligibility determination must disregard the following items:

(1) the employment disregard is 18 percent of the gross earned income whether or not the member is working full time or part time;

(2) dependent care costs must be deducted from gross earned income for the actual amount paid for dependent care up to a maximum of $200 per month for each child less than two years of age, and $175 per month for each child two years of age and older under this chapter and chapter 119B;

(3) all payments made according to a court order for spousal support or the support of children not living in the assistance unit's household shall be disregarded from the income of the person with the legal obligation to pay support, provided that, if there has been a change in the financial circumstances of the person with the legal obligation to pay support since the support order was entered, the person with the legal obligation to pay support has petitioned for a modification of the support order; and

(4) an allocation for the unmet need of an ineligible spouse or an ineligible child under the age of 21 for whom the caregiver is financially responsible and who lives with the caregiver according to section 256J.36.

(b) Notwithstanding paragraph (a), when determining initial eligibility for applicant units when at least one member has received MFIP in this state within four months of the most recent application for MFIP, apply the disregard as defined in section 256J.08, subdivision 24, for all unit members.

After initial eligibility is established, the assistance payment calculation is based on the monthly income test.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2014, or upon approval from the United States Department of Agriculture, whichever is later. new text end

Sec. 27.

Minnesota Statutes 2012, section 256J.24, subdivision 5, is amended to read:

Subd. 5.

MFIP transitional standard.

The MFIP transitional standard is based on the number of persons in the assistance unit eligible for both food and cash assistance deleted text begin unless the restrictions in subdivision 6 on the birth of a child applydeleted text end . The amount of the transitional standard is published annually by the Department of Human Services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2015. new text end

Sec. 28.

Minnesota Statutes 2012, section 256J.24, subdivision 7, is amended to read:

Subd. 7.

Family wage level.

The family wage level is 110 percent of the transitional standard under subdivision 5 or 6deleted text begin , when applicable, and is the standard used when there is earned income in the assistance unit. As specified in section 256J.21deleted text end new text begin . If there is earned income in the assistance unitnew text end , earned income is subtracted from the family wage level to determine the amount of the assistance paymentnew text begin , as specified in section 256J.21new text end . The assistance payment may not exceed the transitional standard under subdivision 5 or 6, or the shared household standard under subdivision 9, whichever is applicable, for the assistance unit.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2014, or upon approval from the United States Department of Agriculture, whichever is later. new text end

Sec. 29.

Minnesota Statutes 2012, section 256J.35, is amended to read:

256J.35 AMOUNT OF ASSISTANCE PAYMENT.

Except as provided in paragraphs (a) to deleted text begin (c)deleted text end new text begin (d)new text end , the amount of an assistance payment is equal to the difference between the MFIP standard of need or the Minnesota family wage level in section 256J.24 and countable income.

new text begin (a) Beginning July 1, 2015, MFIP assistance units are eligible for an MFIP housing assistance grant of $110 per month, unless: new text end

new text begin (1) the housing assistance unit is currently receiving public and assisted rental subsidies provided through the Department of Housing and Urban Development (HUD) and is subject to section 256J.37, subdivision 3a; or new text end

new text begin (2) the assistance unit is a child-only case under section 256J.88. new text end

deleted text begin (a)deleted text end new text begin (b) new text end When MFIP eligibility exists for the month of application, the amount of the assistance payment for the month of application must be prorated from the date of application or the date all other eligibility factors are met for that applicant, whichever is later. This provision applies when an applicant loses at least one day of MFIP eligibility.

deleted text begin (b)deleted text end new text begin (c) new text end MFIP overpayments to an assistance unit must be recouped according to section 256J.38, subdivision 4.

deleted text begin (c)deleted text end new text begin (d) new text end An initial assistance payment must not be made to an applicant who is not eligible on the date payment is made.

Sec. 30.

Minnesota Statutes 2012, section 256J.621, is amended to read:

256J.621 WORK PARTICIPATION CASH BENEFITS.

new text begin Subdivision 1. new text end

new text begin Program characteristics. new text end

(a) Effective October 1, 2009, upon exiting the diversionary work program (DWP) or upon terminating the Minnesota family investment program with earnings, a participant who is employed may be eligible for work participation cash benefits of $25 per month to assist in meeting the family's basic needs as the participant continues to move toward self-sufficiency.

(b) To be eligible for work participation cash benefits, the participant shall not receive MFIP or diversionary work program assistance during the month and the participant or participants must meet the following work requirements:

(1) if the participant is a single caregiver and has a child under six years of age, the participant must be employed at least 87 hours per month;

(2) if the participant is a single caregiver and does not have a child under six years of age, the participant must be employed at least 130 hours per month; or

(3) if the household is a two-parent family, at least one of the parents must be employed 130 hours per month.

Whenever a participant exits the diversionary work program or is terminated from MFIP and meets the other criteria in this section, work participation cash benefits are available for up to 24 consecutive months.

(c) Expenditures on the program are maintenance of effort state funds under a separate state program for participants under paragraph (b), clauses (1) and (2). Expenditures for participants under paragraph (b), clause (3), are nonmaintenance of effort funds. Months in which a participant receives work participation cash benefits under this section do not count toward the participant's MFIP 60-month time limit.

new text begin Subd. 2. new text end

new text begin Program suspension. new text end

new text begin (a) Effective December 1, 2014, the work participation cash benefits program shall be suspended. new text end

new text begin (b) The commissioner of human services may reinstate the work participation cash benefits program if the United States Department of Human Services determines that the state of Minnesota did not meet the federal TANF work participation rate and sends a notice of penalty to reduce Minnesota's federal TANF block grant authorized under title I of Public Law 104-193, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, and under Public Law 109-171, the Deficit Reduction Act of 2005. new text end

new text begin (c) The commissioner shall notify the chairs and ranking minority members of the legislative committees with jurisdiction over human services policy and finance of the potential penalty and the commissioner's plans to reinstate the work participation cash benefit program within 30 days of the date the commissioner receives notification that the state failed to meet the federal work participation rate. new text end

Sec. 31.

Minnesota Statutes 2012, section 256J.626, subdivision 7, is amended to read:

Subd. 7.

Performance base funds.

deleted text begin (a) For the purpose of this section, the following terms have the meanings given. deleted text end

deleted text begin (1) "Caseload Reduction Credit" (CRC) means the measure of how much Minnesota TANF and separate state program caseload has fallen relative to federal fiscal year 2005 based on caseload data from October 1 to September 30. deleted text end

deleted text begin (2) "TANF participation rate target" means a 50 percent participation rate reduced by the CRC for the previous year. deleted text end

deleted text begin (b)deleted text end new text begin (a)new text end For calendar year deleted text begin 2010deleted text end new text begin 2016new text end and yearly thereafter, each county and tribe deleted text begin willdeleted text end new text begin mustnew text end be allocated deleted text begin 95deleted text end new text begin 100new text end percent of their initial calendar year allocation. new text begin Allocations for new text end counties and tribes deleted text begin willdeleted text end new text begin mustnew text end be deleted text begin allocated additional fundsdeleted text end new text begin adjustednew text end based on performance as follows:

deleted text begin (1) a county or tribe that achieves the TANF participation rate target or a five percentage point improvement over the previous year's TANF participation rate under section 256J.751, subdivision 2, clause (7), as averaged across 12 consecutive months for the most recent year for which the measurements are available, will receive an additional allocation equal to 2.5 percent of its initial allocation; deleted text end

deleted text begin (2)deleted text end new text begin (1)new text end a county or tribe that performs deleted text begin within ordeleted text end above its range of expected performance on the annualized three-year self-support index under section 256J.751, subdivision 2, clause (6), deleted text begin willdeleted text end new text begin mustnew text end receive an additional allocation equal to 2.5 percent of its initial allocation; and

deleted text begin (3) a county or tribe that does not achieve the TANF participation rate target or a five percentage point improvement over the previous year's TANF participation rate under section 256J.751, subdivision 2, clause (7), as averaged across 12 consecutive months for the most recent year for which the measurements are available, will not receive an additional 2.5 percent of its initial allocation until after negotiating a multiyear improvement plan with the commissioner; or deleted text end

deleted text begin (4)deleted text end new text begin (2)new text end a county or tribe that deleted text begin does not perform within or abovedeleted text end new text begin performs belownew text end its range of expected performance on the annualized three-year self-support index under section 256J.751, subdivision 2, clause (6), deleted text begin will not receive an additional allocation equal to 2.5 percent of its initial allocation until after negotiatingdeleted text end new text begin for two consecutive years must negotiatenew text end a multiyear improvement plan with the commissioner.new text begin If no improvement is shown by the end of the multiyear plan, the county's or tribe's allocation must be decreased by 2.5 percent. The decrease must remain in effect until the county or tribe performs within or above its range of expected performance.new text end

deleted text begin (c)deleted text end new text begin (b)new text end For calendar year deleted text begin 2009deleted text end new text begin 2016new text end and yearly thereafter, performance-based funds for a federally approved tribal TANF program in which the state and tribe have in place a contract under section 256.01, addressing consolidated funding, deleted text begin willdeleted text end new text begin mustnew text end be allocated as follows:

deleted text begin (1) a tribe that achieves the participation rate approved in its federal TANF plan using the average of 12 consecutive months for the most recent year for which the measurements are available, will receive an additional allocation equal to 2.5 percent of its initial allocation; and deleted text end

deleted text begin (2)deleted text end new text begin (1)new text end a tribe that performs deleted text begin within ordeleted text end above its range of expected performance on the annualized three-year self-support index under section 256J.751, subdivision 2, clause (6), deleted text begin willdeleted text end new text begin mustnew text end receive an additional allocation equal to 2.5 percent of its initial allocation; or

deleted text begin (3) a tribe that does not achieve the participation rate approved in its federal TANF plan using the average of 12 consecutive months for the most recent year for which the measurements are available, will not receive an additional allocation equal to 2.5 percent of its initial allocation until after negotiating a multiyear improvement plan with the commissioner; or deleted text end

deleted text begin (4)deleted text end new text begin (2)new text end a tribe that deleted text begin does not perform within or abovedeleted text end new text begin performs belownew text end its range of expected performance on the annualized three-year self-support index under section 256J.751, subdivision 2, clause (6), deleted text begin will not receive an additional allocation equal to 2.5 percent until after negotiatingdeleted text end new text begin for two consecutive years must negotiatenew text end a multiyear improvement plan with the commissioner.new text begin If no improvement is shown by the end of the multiyear plan, the tribe's allocation must be decreased by 2.5 percent. The decrease must remain in effect until the tribe performs within or above its range of expected performance.new text end

deleted text begin (d)deleted text end new text begin (c)new text end Funds remaining unallocated after the performance-based allocations in paragraph deleted text begin (b)deleted text end new text begin (a)new text end are available to the commissioner for innovation projects under subdivision 5.

deleted text begin (1)deleted text end new text begin (d)new text end If available funds are insufficient to meet county and tribal allocations under deleted text begin paragraphdeleted text end new text begin paragraphs (a) andnew text end (b), the commissioner deleted text begin may make available for allocation funds that are unobligated and available from the innovation projects through the end of the current bienniumdeleted text end new text begin shall proportionally prorate funds to counties and tribes that qualify for a bonus under paragraphs (a), clause (1), and (b), clause (2)new text end .

deleted text begin (2) If after the application of clause (1) funds remain insufficient to meet county and tribal allocations under paragraph (b), the commissioner must proportionally reduce the allocation of each county and tribe with respect to their maximum allocation available under paragraph (b). deleted text end

Sec. 32.

new text begin [256J.78] TANF DEMONSTRATION PROJECTS OR WAIVER FROM FEDERAL RULES AND REGULATIONS. new text end

new text begin Subdivision 1. new text end

new text begin Duties of the commissioner. new text end

new text begin The commissioner of human services may pursue TANF demonstration projects or waivers of TANF requirements from the United States Department of Health and Human Services as needed to allow the state to build a more results-oriented Minnesota Family Investment Program to better meet the needs of Minnesota families. new text end

new text begin Subd. 2. new text end

new text begin Purpose. new text end

new text begin The purpose of the TANF demonstration projects or waivers is to: new text end

new text begin (1) replace the federal TANF process measure and its complex administrative requirements with state-developed outcomes measures that track adult employment and exits from MFIP cash assistance; new text end

new text begin (2) simplify programmatic and administrative requirements; and new text end

new text begin (3) make other policy or programmatic changes that improve the performance of the program and the outcomes for participants. new text end

new text begin Subd. 3. new text end

new text begin Report to legislature. new text end

new text begin The commissioner shall report to the members of the legislative committees having jurisdiction over human services issues by March 1, 2014, regarding the progress of this waiver or demonstration project. 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. 33.

Minnesota Statutes 2012, section 256K.45, is amended to read:

256K.45 deleted text begin RUNAWAY ANDdeleted text end HOMELESS YOUTH ACT.

new text begin Subdivision 1. new text end

new text begin Grant program established. new text end

new text begin The commissioner of human services shall establish a Homeless Youth Act fund and award grants to providers who are committed to serving homeless youth and youth at risk of homelessness, to provide street and community outreach and drop-in programs, emergency shelter programs, and integrated supportive housing and transitional living programs, consistent with the program descriptions in this act to reduce the incidence of homelessness among youth. new text end

deleted text begin Subdivision 1.deleted text end new text begin Subd. 1a.new text end

Definitions.

(a) The definitions in this subdivision apply to this section.

(b) "Commissioner" means the commissioner of human services.

(c) "Homeless youth" means a person 21 years of age or younger who is unaccompanied by a parent or guardian and is without shelter where appropriate care and supervision are available, whose parent or legal guardian is unable or unwilling to provide shelter and care, or who lacks a fixed, regular, and adequate nighttime residence. The following are not fixed, regular, or adequate nighttime residences:

(1) a supervised publicly or privately operated shelter designed to provide temporary living accommodations;

(2) an institution or a publicly or privately operated shelter designed to provide temporary living accommodations;

(3) transitional housing;

(4) a temporary placement with a peer, friend, or family member that has not offered permanent residence, a residential lease, or temporary lodging for more than 30 days; or

(5) a public or private place not designed for, nor ordinarily used as, a regular sleeping accommodation for human beings.

Homeless youth does not include persons incarcerated or otherwise detained under federal or state law.

(d) "Youth at risk of homelessness" means a person 21 years of age or younger whose status or circumstances indicate a significant danger of experiencing homelessness in the near future. Status or circumstances that indicate a significant danger may include: (1) youth exiting out-of-home placements; (2) youth who previously were homeless; (3) youth whose parents or primary caregivers are or were previously homeless; (4) youth who are exposed to abuse and neglect in their homes; (5) youth who experience conflict with parents due to chemical or alcohol dependency, mental health disabilities, or other disabilities; and (6) runaways.

(e) "Runaway" means an unmarried child under the age of 18 years who is absent from the home of a parent or guardian or other lawful placement without the consent of the parent, guardian, or lawful custodian.

Subd. 2.

Homeless deleted text begin and runawaydeleted text end youth report.

The commissioner shall deleted text begin develop adeleted text end deleted text begin report for homeless youth, youth at risk of homelessness, and runaways. The report shall deleted text end deleted text begin include coordination of services as defined under subdivisions 3 to 5deleted text end new text begin prepare a biennial report, beginning in February 2015, which provides meaningful information to the legislative committees having jurisdiction over the issue of homeless youth, that includes, but is not limited to: (1) a list of the areas of the state with the greatest need for services and housing for homeless youth, and the level and nature of the needs identified; (2) details about grants made; (3) the distribution of funds throughout the state based on population need; (4) follow-up information, if available, on the status of homeless youth and whether they have stable housing two years after services are provided; and (5) any other outcomes for populations served to determine the effectiveness of the programs and use of fundingnew text end .

Subd. 3.

Street and community outreach and drop-in program.

Youth drop-in centers must provide walk-in access to crisis intervention and ongoing supportive services including one-to-one case management services on a self-referral basis. Street and community outreach programs must locate, contact, and provide information, referrals, and services to homeless youth, youth at risk of homelessness, and runaways. Information, referrals, and services provided may include, but are not limited to:

(1) family reunification services;

(2) conflict resolution or mediation counseling;

(3) assistance in obtaining temporary emergency shelter;

(4) assistance in obtaining food, clothing, medical care, or mental health counseling;

(5) counseling regarding violence, deleted text begin prostitutiondeleted text end new text begin sexual exploitationnew text end , substance abuse, sexually transmitted diseases, and pregnancy;

(6) referrals to other agencies that provide support services to homeless youth, youth at risk of homelessness, and runaways;

(7) assistance with education, employment, and independent living skills;

(8) aftercare services;

(9) specialized services for highly vulnerable runaways and homeless youth, including teen parents, emotionally disturbed and mentally ill youth, and sexually exploited youth; and

(10) homelessness prevention.

Subd. 4.

Emergency shelter program.

(a) Emergency shelter programs must provide homeless youth and runaways with referral and walk-in access to emergency, short-term residential care. The program shall provide homeless youth and runaways with safe, dignified shelter, including private shower facilities, beds, and at least one meal each day; and shall assist a runaway new text begin and homeless youth new text end with reunification with the family or legal guardian when required or appropriate.

(b) The services provided at emergency shelters may include, but are not limited to:

(1) family reunification services;

(2) individual, family, and group counseling;

(3) assistance obtaining clothing;

(4) access to medical and dental care and mental health counseling;

(5) education and employment services;

(6) recreational activities;

(7) advocacy and referral services;

(8) independent living skills training;

(9) aftercare and follow-up services;

(10) transportation; and

(11) homelessness prevention.

Subd. 5.

Supportive housing and transitional living programs.

Transitional living programs must help homeless youth and youth at risk of homelessness to find and maintain safe, dignified housing. The program may also provide rental assistance and related supportive services, or refer youth to other organizations or agencies that provide such services. Services provided may include, but are not limited to:

(1) educational assessment and referrals to educational programs;

(2) career planning, employment, work skill training, and independent living skills training;

(3) job placement;

(4) budgeting and money management;

(5) assistance in securing housing appropriate to needs and income;

(6) counseling regarding violence, deleted text begin prostitutiondeleted text end new text begin sexual exploitationnew text end , substance abuse, sexually transmitted diseases, and pregnancy;

(7) referral for medical services or chemical dependency treatment;

(8) parenting skills;

(9) self-sufficiency support services or life skill training;

(10) aftercare and follow-up services; and

(11) homelessness prevention.

Subd. 6.

Funding.

deleted text begin Anydeleted text end Funds appropriated for this section may be expended on programs described under subdivisions 3 to 5, technical assistance, and capacity buildingdeleted text begin . Up to four percent of funds appropriated may be used for the purpose of monitoring and evaluating runaway and homeless youth programs receiving funding under this section. Funding shall be directed to meet the greatest need, with a significant share of the funding focused on homeless youth providers in greater Minnesotadeleted text end new text begin to meet the greatest need on a statewide basisnew text end .

Sec. 34.

Minnesota Statutes 2012, section 256M.40, subdivision 1, is amended to read:

Subdivision 1.

Formula.

The commissioner shall allocate state funds appropriated under this chapter to each county board on a calendar year basis in an amount determined according to the formula in paragraphs (a) to (e).

(a) For calendar years 2011 and 2012, the commissioner shall allocate available funds to each county in proportion to that county's share in calendar year 2010.

(b) For calendar year 2013new text begin and each calendar year thereafternew text end , the commissioner shall allocate available funds to each county as follows:

(1) 75 percent must be distributed on the basis of the county share in calendar year 2012;

(2) five percent must be distributed on the basis of the number of persons residing in the county as determined by the most recent data of the state demographer;

(3) ten percent must be distributed on the basis of the number of vulnerable children that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, and in the county as determined by the most recent data of the commissioner; and

(4) ten percent must be distributed on the basis of the number of vulnerable adults that are subjects of reports under section 626.557 in the county as determined by the most recent data of the commissioner.

(c) deleted text begin For calendar year 2014, the commissioner shall allocate available funds to each county as follows:deleted text end

deleted text begin (1) 50 percent must be distributed on the basis of the county share in calendar year 2012; deleted text end

deleted text begin (2) Ten percent must be distributed on the basis of the number of persons residing in the county as determined by the most recent data of the state demographer; deleted text end

deleted text begin (3) 20 percent must be distributed on the basis of the number of vulnerable children that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the county as determined by the most recent data of the commissioner; and deleted text end

deleted text begin (4) 20 percent must be distributed on the basis of the number of vulnerable adults that are subjects of reports under section 626.557 in the county as determined by the most recent data of the commissionerdeleted text end new text begin The commissioner is precluded from changing the formula under this subdivision or recommending a change to the legislature without public review and inputnew text end .

deleted text begin (d) For calendar year 2015, the commissioner shall allocate available funds to each county as follows: deleted text end

deleted text begin (1) 25 percent must be distributed on the basis of the county share in calendar year 2012; deleted text end

deleted text begin (2) 15 percent must be distributed on the basis of the number of persons residing in the county as determined by the most recent data of the state demographer; deleted text end

deleted text begin (3) 30 percent must be distributed on the basis of the number of vulnerable children that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the county as determined by the most recent data of the commissioner; and deleted text end

deleted text begin (4) 30 percent must be distributed on the basis of the number of vulnerable adults that are subjects of reports under section 626.557 in the county as determined by the most recent data of the commissioner. deleted text end

deleted text begin (e) For calendar year 2016 and each calendar year thereafter, the commissioner shall allocate available funds to each county as follows: deleted text end

deleted text begin (1) 20 percent must be distributed on the basis of the number of persons residing in the county as determined by the most recent data of the state demographer; deleted text end

deleted text begin (2) 40 percent must be distributed on the basis of the number of vulnerable children that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the county as determined by the most recent data of the commissioner; and deleted text end

deleted text begin (3) 40 percent must be distributed on the basis of the number of vulnerable adults that are subjects of reports under section 626.557 in the county as determined by the most recent data of the commissioner. deleted text end

Sec. 35.

Minnesota Statutes 2012, section 257.0755, subdivision 1, is amended to read:

Subdivision 1.

Creation.

deleted text begin Onedeleted text end new text begin Eachnew text end ombudsperson shall operate independently from but in collaboration with deleted text begin each of the following groupsdeleted text end new text begin the community-specific board that appointed the ombudsperson under section 257.0768new text end : the Indian Affairs Council, the Council on Affairs of Chicano/Latino people, the Council on Black Minnesotans, and the Council on Asian-Pacific Minnesotans.

Sec. 36.

Minnesota Statutes 2012, section 259A.20, subdivision 4, is amended to read:

Subd. 4.

Reimbursement for special nonmedical expenses.

(a) Reimbursement for special nonmedical expenses is available to children, except those eligible for adoption assistance based on being an at-risk child.

(b) Reimbursements under this paragraph shall be made only after the adoptive parent documents that the requested service was denied by the local social service agency, community agencies, the local school district, the local public health department, the parent's insurance provider, or the child's program. The denial must be for an eligible service or qualified item under the program requirements of the applicable agency or organization.

(c) Reimbursements must be previously authorized, adhere to the requirements and procedures prescribed by the commissioner, and be limited to:

(1) child care for a child age 12 and younger, or for a child age 13 or 14 who has a documented disability that requires special instruction for and services by the child care provider. Child care reimbursements may be made if all available adult caregivers are employednew text begin , unemployed due to a disability as defined in section 259A.01, subdivision 14,new text end or attending educational or vocational training programsnew text begin . Documentation from a qualified expert that is dated within the last 12 months must be provided to verify the disabilitynew text end . If a parent is attending an educational or vocational training program, child care reimbursement is limited to no more than the time necessary to complete the credit requirements for an associate or baccalaureate degree as determined by the educational institution. Child care reimbursement is not limited for an adoptive parent completing basic or remedial education programs needed to prepare for postsecondary education or employment;

(2) respite care provided for the relief of the child's parent up to 504 hours of respite care annually;

(3) camping up to 14 days per state fiscal year for a child to attend a special needs camp. The camp must be accredited by the American Camp Association as a special needs camp in order to be eligible for camp reimbursement;

(4) postadoption counseling to promote the child's integration into the adoptive family that is provided by the placing agency during the first year following the date of the adoption decree. Reimbursement is limited to 12 sessions of postadoption counseling;

(5) family counseling that is required to meet the child's special needs. Reimbursement is limited to the prorated portion of the counseling fees allotted to the family when the adoptive parent's health insurance or Medicaid pays for the child's counseling but does not cover counseling for the rest of the family members;

(6) home modifications to accommodate the child's special needs upon which eligibility for adoption assistance was approved. Reimbursement is limited to once every five years per child;

(7) vehicle modifications to accommodate the child's special needs upon which eligibility for adoption assistance was approved. Reimbursement is limited to once every five years per family; and

(8) burial expenses up to $1,000, if the special needs, upon which eligibility for adoption assistance was approved, resulted in the death of the child.

(d) The adoptive parent shall submit statements for expenses incurred between July 1 and June 30 of a given fiscal year to the state adoption assistance unit within 60 days after the end of the fiscal year in order for reimbursement to occur.

Sec. 37.

Minnesota Statutes 2012, section 260B.007, subdivision 6, is amended to read:

Subd. 6.

Delinquent child.

(a) Except as otherwise provided in paragraphs (b) and (c), "delinquent child" means a child:

(1) who has violated any state or local law, except as provided in section 260B.225, subdivision 1, and except for juvenile offenders as described in subdivisions 16 to 18;

(2) who has violated a federal law or a law of another state and whose case has been referred to the juvenile court if the violation would be an act of delinquency if committed in this state or a crime or offense if committed by an adult;

(3) who has escaped from confinement to a state juvenile correctional facility after being committed to the custody of the commissioner of corrections; or

(4) who has escaped from confinement to a local juvenile correctional facility after being committed to the facility by the court.

(b) The term delinquent child does not include a child alleged to have committed murder in the first degree after becoming 16 years of age, but the term delinquent child does include a child alleged to have committed attempted murder in the first degree.

(c) The term delinquent child does not include a child deleted text begin under the age of 16 yearsdeleted text end alleged to have engaged in conduct which would, if committed by an adult, violate any federal, state, or local law relating to being hired, offering to be hired, or agreeing to be hired by another individual to engage in sexual penetration or sexual conduct.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2014, and applies to offenses committed on or after that date. new text end

Sec. 38.

Minnesota Statutes 2012, section 260B.007, subdivision 16, is amended to read:

Subd. 16.

Juvenile petty offender; juvenile petty offense.

(a) "Juvenile petty offense" includes a juvenile alcohol offense, a juvenile controlled substance offense, a violation of section 609.685, or a violation of a local ordinance, which by its terms prohibits conduct by a child under the age of 18 years which would be lawful conduct if committed by an adult.

(b) Except as otherwise provided in paragraph (c), "juvenile petty offense" also includes an offense that would be a misdemeanor if committed by an adult.

(c) "Juvenile petty offense" does not include any of the following:

(1) a misdemeanor-level violation of section 518B.01, 588.20, 609.224, 609.2242, 609.324,new text begin subdivision 2 or 3,new text end 609.5632, 609.576, 609.66, 609.746, 609.748, 609.79, or 617.23;

(2) a major traffic offense or an adult court traffic offense, as described in section 260B.225;

(3) a misdemeanor-level offense committed by a child whom the juvenile court previously has found to have committed a misdemeanor, gross misdemeanor, or felony offense; or

(4) a misdemeanor-level offense committed by a child whom the juvenile court has found to have committed a misdemeanor-level juvenile petty offense on two or more prior occasions, unless the county attorney designates the child on the petition as a juvenile petty offender notwithstanding this prior record. As used in this clause, "misdemeanor-level juvenile petty offense" includes a misdemeanor-level offense that would have been a juvenile petty offense if it had been committed on or after July 1, 1995.

(d) A child who commits a juvenile petty offense is a "juvenile petty offender." The term juvenile petty offender does not include a child deleted text begin under the age of 16 yearsdeleted text end alleged to have violated any law relating to being hired, offering to be hired, or agreeing to be hired by another individual to engage in sexual penetration or sexual conduct which, if committed by an adult, would be a misdemeanor.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2014, and applies to offenses committed on or after that date. new text end

Sec. 39.

Minnesota Statutes 2012, section 260C.007, subdivision 6, is amended to read:

Subd. 6.

Child in need of protection or services.

"Child in need of protection or services" means a child who is in need of protection or services because the child:

(1) is abandoned or without parent, guardian, or custodian;

(2)(i) has been a victim of physical or sexual abuse as defined in section 626.556, subdivision 2, (ii) resides with or has resided with a victim of child abuse as defined in subdivision 5 or domestic child abuse as defined in subdivision 13, (iii) resides with or would reside with a perpetrator of domestic child abuse as defined in subdivision 13 or child abuse as defined in subdivision 5 or 13, or (iv) is a victim of emotional maltreatment as defined in subdivision 15;

(3) is without necessary food, clothing, shelter, education, or other required care for the child's physical or mental health or morals because the child's parent, guardian, or custodian is unable or unwilling to provide that care;

(4) is without the special care made necessary by a physical, mental, or emotional condition because the child's parent, guardian, or custodian is unable or unwilling to provide that care;

(5) is medically neglected, which includes, but is not limited to, the withholding of medically indicated treatment from a disabled infant with a life-threatening condition. The term "withholding of medically indicated treatment" means the failure to respond to the infant's life-threatening conditions by providing treatment, including appropriate nutrition, hydration, and medication which, in the treating physician's or physicians' reasonable medical judgment, will be most likely to be effective in ameliorating or correcting all conditions, except that the term does not include the failure to provide treatment other than appropriate nutrition, hydration, or medication to an infant when, in the treating physician's or physicians' reasonable medical judgment:

(i) the infant is chronically and irreversibly comatose;

(ii) the provision of the treatment would merely prolong dying, not be effective in ameliorating or correcting all of the infant's life-threatening conditions, or otherwise be futile in terms of the survival of the infant; or

(iii) the provision of the treatment would be virtually futile in terms of the survival of the infant and the treatment itself under the circumstances would be inhumane;

(6) is one whose parent, guardian, or other custodian for good cause desires to be relieved of the child's care and custody, including a child who entered foster care under a voluntary placement agreement between the parent and the responsible social services agency under section 260C.227;

(7) has been placed for adoption or care in violation of law;

(8) is without proper parental care because of the emotional, mental, or physical disability, or state of immaturity of the child's parent, guardian, or other custodian;

(9) is one whose behavior, condition, or environment is such as to be injurious or dangerous to the child or others. An injurious or dangerous environment may include, but is not limited to, the exposure of a child to criminal activity in the child's home;

(10) is experiencing growth delays, which may be referred to as failure to thrive, that have been diagnosed by a physician and are due to parental neglect;

(11) deleted text begin has engaged in prostitution as defined in section 609.321, subdivision 9deleted text end new text begin is a sexually exploited youthnew text end ;

(12) has committed a delinquent act or a juvenile petty offense before becoming ten years old;

(13) is a runaway;

(14) is a habitual truant;

(15) has been found incompetent to proceed or has been found not guilty by reason of mental illness or mental deficiency in connection with a delinquency proceeding, a certification under section 260B.125, an extended jurisdiction juvenile prosecution, or a proceeding involving a juvenile petty offense;new text begin ornew text end

(16) has a parent whose parental rights to one or more other children were involuntarily terminated or whose custodial rights to another child have been involuntarily transferred to a relative and there is a case plan prepared by the responsible social services agency documenting a compelling reason why filing the termination of parental rights petition under section 260C.301, subdivision 3, is not in the best interests of the childdeleted text begin ; ordeleted text end new text begin .new text end

deleted text begin (17) is a sexually exploited youth. deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2014. new text end

Sec. 40.

Minnesota Statutes 2012, section 260C.007, subdivision 31, is amended to read:

Subd. 31.

Sexually exploited youth.

"Sexually exploited youth" means an individual who:

(1) is alleged to have engaged in conduct which would, if committed by an adult, violate any federal, state, or local law relating to being hired, offering to be hired, or agreeing to be hired by another individual to engage in sexual penetration or sexual conduct;

(2) is a victim of a crime described in section 609.342, 609.343,new text begin 609.344,new text end 609.345, 609.3451, 609.3453, 609.352, 617.246, or 617.247;

(3) is a victim of a crime described in United States Code, title 18, section 2260; 2421; 2422; 2423; 2425; 2425A; or 2256; or

(4) is a sex trafficking victim as defined in section 609.321, subdivision 7b.

new text begin EFFECTIVE DATE. new text end

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

Sec. 41.

Minnesota Statutes 2012, section 518A.60, is amended to read:

518A.60 COLLECTION; ARREARS ONLY.

(a) Remedies available for the collection and enforcement of support in this chapter and chapters 256, 257, 518, and 518C also apply to cases in which the child or children for whom support is owed are emancipated and the obligor owes past support or has an accumulated arrearage as of the date of the youngest child's emancipation. Child support arrearages under this section include arrearages for child support, medical support, child care, pregnancy and birth expenses, and unreimbursed medical expenses as defined in section 518A.41, subdivision 1, paragraph (h).

(b) This section applies retroactively to any support arrearage that accrued on or before June 3, 1997, and to all arrearages accruing after June 3, 1997.

(c) Past support or pregnancy and confinement expenses ordered for which the obligor has specific court ordered terms for repayment may not be enforced using drivers' and occupational or professional license suspension, credit bureau reporting, and additional income withholding under section 518A.53, subdivision 10, paragraph (a), unless the obligor fails to comply with the terms of the court order for repayment.

(d) If an arrearage exists at the time a support order would otherwise terminate and section 518A.53, subdivision 10, paragraph (c), does not apply to this section, the arrearage shall be repaid in an amount equal to the current support order until all arrears have been paid in full, absent a court order to the contrary.

(e) If an arrearage exists according to a support order which fails to establish a monthly support obligation in a specific dollar amount, the public authority, if it provides child support services, or the obligee, may establish a payment agreement which shall equal what the obligor would pay for current support after application of section 518A.34, plus an additional 20 percent of the current support obligation, until all arrears have been paid in full. If the obligor fails to enter into or comply with a payment agreement, the public authority, if it provides child support services, or the obligee, may move the district court or child support magistrate, if section 484.702 applies, for an order establishing repayment terms.

new text begin (f) If there is no longer a current support order because all of the children of the order are emancipated, the public authority may discontinue child support services and close its case under title IV-D of the Social Security Act if: new text end

new text begin (1) the arrearage is under $500; or new text end

new text begin (2) the arrearage is considered unenforceable by the public authority because there have been no collections for three years, and all administrative and legal remedies have been attempted or are determined by the public authority to be ineffective because the obligor is unable to pay, the obligor has no known income or assets, and there is no reasonable prospect that the obligor will be able to pay in the foreseeable future. new text end

new text begin (g) At least 60 calendar days before the discontinuation of services under paragraph (f), the public authority must mail a written notice to the obligee and obligor at the obligee's and obligor's last known addresses that the public authority intends to close the child support enforcement case and explaining each party's rights. Seven calendar days after the first notice is mailed, the public authority must mail a second notice under this paragraph to the obligee. new text end

new text begin (h) The case must be kept open if the obligee responds before case closure and provides information that could reasonably lead to collection of arrears. If the case is closed, the obligee may later request that the case be reopened by completing a new application for services, if there is a change in circumstances that could reasonably lead to the collection of arrears. new text end

Sec. 42.

Laws 1998, chapter 407, article 6, section 116, is amended to read:

Sec. 116.

[256.9872] EBT TRANSACTION COSTSdeleted text begin ; APPROVAL FROM LEGISLATUREdeleted text end .

The commissioner of human services shall deleted text begin request and receive approval from the legislature before adjusting the payment todeleted text end new text begin not subsidizenew text end retailers for electronic benefit transfer deleted text begin transaction costsdeleted text end new text begin Supplemental Nutrition Assistance Program transactionsnew text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective 30 days after the commissioner notifies retailers of the termination of their agreement with the state. The commissioner of human services must notify the revisor of statutes of that date. new text end

Sec. 43.

Laws 2011, First Special Session chapter 9, article 1, section 3, the effective date, is amended to read:

EFFECTIVE DATE.

This section is effective deleted text begin January 1, 2013deleted text end new text begin July 1, 2014new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from January 1, 2013. new text end

Sec. 44.

new text begin DIRECTION TO COMMISSIONERS; INCOME AND ASSET EXCLUSION. new text end

new text begin (a) The commissioner of human services shall not count conditional cash transfers made to families participating in a family independence demonstration as income or assets for purposes of determining or redetermining eligibility for child care assistance programs under Minnesota Statutes, chapter 119B; general assistance under Minnesota Statutes, chapter 256D; group residential housing under Minnesota Statutes, chapter 256I; the Minnesota family investment program, work benefit program, or diversionary work program under Minnesota Statutes, chapter 256J, during the duration of the demonstration. new text end

new text begin (b) The commissioner of human services shall not count conditional cash transfers made to families participating in a family independence demonstration as income or assets for purposes of determining or redetermining eligibility for medical assistance under Minnesota Statutes, chapter 256B, and MinnesotaCare under Minnesota Statutes, chapter 256L, except that for enrollees subject to a modified adjusted gross income calculation to determine eligibility, the conditional cash transfer payments shall be counted as income if they are included on the enrollee's federal tax return as income, or if the payments can be taken into account in the month of receipt as a lump sum payment. new text end

new text begin (c) The commissioner of the Minnesota Housing Finance Agency shall not count conditional cash transfers made to families participating in a family independence demonstration as income or assets for purposes of determining or redetermining eligibility for housing assistance programs under Minnesota Statutes, section 462A.201, during the duration of the demonstration. new text end

new text begin (d) For the purposes of this section: new text end

new text begin (1) "conditional cash transfer" means a payment made to a participant in a family independence demonstration by a sponsoring organization to incent, support, or facilitate participation; and new text end

new text begin (2) "family independence demonstration" means an initiative sponsored or cosponsored by a governmental or nongovernmental organization, the goal of which is to facilitate individualized goal-setting and peer support for cohorts of no more than 12 families each toward the development of financial and nonfinancial assets that enable the participating families to achieve financial independence. new text end

new text begin (e) The citizens league shall provide a report to the legislative committees having jurisdiction over human services issues by July 1, 2016, informing the legislature on the progress and outcomes of the demonstration under this section. new text end

Sec. 45.

new text begin REDUCTION OF YOUTH HOMELESSNESS. new text end

new text begin (a) The Minnesota Interagency Council on Homelessness established under the authority of Minnesota Statutes, section 462A.29, as it updates its statewide plan to prevent and end homelessness, shall make recommendations on strategies to reduce the number of youth experiencing homelessness and to prevent homelessness for youth who are at risk of becoming homeless. new text end

new text begin (b) Recommended strategies must take into consideration, to the extent feasible, issues that contribute to or reduce youth homelessness including, but not limited to, mental health, chemical dependency, trafficking of youth for sex or other purposes, exiting foster care, and involvement in gangs. The recommended strategies must include supportive services as outlined in Minnesota Statutes, section 256K.45, subdivision 5. new text end

new text begin (c) The council shall provide an update on the status of its work by December 1, 2014, to the legislative committees with jurisdiction over housing, homelessness, and matters pertaining to youth. If the council determines legislative action is required to implement recommended strategies, the council shall submit proposals to the legislature at the earliest possible opportunity. new text end

Sec. 46.

new text begin [256J.351] HOUSING ASSISTANCE GRANTS; FORECASTED PROGRAM. new text end

new text begin Beginning July 1, 2015, housing assistance grants under Minnesota Statutes, section 256J.35, paragraph (a), must be a forecasted program and the commissioner, with the approval of the commissioner of management and budget, may transfer unencumbered appropriation balances within fiscal years of each biennium with other forecasted programs of the Department of Human Services. The commissioner shall inform the chairs and ranking minority members of the senate Health and Human Services Finance Division and the house of representatives Health and Human Services Finance committee quarterly about transfers made under this provision. new text end

Sec. 47.

new text begin PLAN FOR GROUP RESIDENTIAL HOUSING SPECIALTY RATE AND BANKED BEDS. new text end

new text begin The commissioner of human services, in consultation with and cooperation of the counties, shall review the statewide number and status of group residential housing beds with rates in excess of the MSA equivalent rate, including banked supplemental service rate beds. The commissioner shall study the type and amount of supplemental services delivered or planned for development, and develop a plan for rate setting criteria and an efficient use of these beds. The commissioner shall review the performance of all programs that receive supplemental service rates. The plan must require that all beds receiving supplemental service rates address critical service needs and must establish quality performance requirements for beds receiving supplemental service rates. The commissioner shall present the written plan no later than February 1, 2014, to the chairs and ranking minority members of the house of representatives and senate finance and policy committees and divisions with jurisdiction over the Department of Human Services. new text end

Sec. 48.

new text begin REPEALER. new text end

new text begin (a) new text end new text begin Minnesota Statutes 2012, section 256J.24, new text end new text begin is repealed January 1, 2015. new text end

new text begin (b) new text end new text begin Minnesota Statutes 2012, section 609.093, new text end new text begin is repealed effective the day following final enactment. new text end

ARTICLE 4

STRENGTHENING CHEMICAL AND MENTAL HEALTH SERVICES

Section 1.

Minnesota Statutes 2012, section 245.462, subdivision 20, is amended to read:

Subd. 20.

Mental illness.

(a) "Mental illness" means an organic disorder of the brain or a clinically significant disorder of thought, mood, perception, orientation, memory, or behavior that is detailed in a diagnostic codes list published by the commissioner, and that seriously limits a person's capacity to function in primary aspects of daily living such as personal relations, living arrangements, work, and recreation.

(b) An "adult with acute mental illness" means an adult who has a mental illness that is serious enough to require prompt intervention.

(c) For purposes of case management and community support services, a "person with serious and persistent mental illness" means an adult who has a mental illness and meets at least one of the following criteria:

(1) the adult has undergone two or more episodes of inpatient care for a mental illness within the preceding 24 months;

(2) the adult has experienced a continuous psychiatric hospitalization or residential treatment exceeding six months' duration within the preceding 12 months;

(3) the adult has been treated by a crisis team two or more times within the preceding 24 months;

(4) the adult:

(i) has a diagnosis of schizophrenia, bipolar disorder, major depression, new text begin schizoaffective disorder, new text end or borderline personality disorder;

(ii) indicates a significant impairment in functioning; and

(iii) has a written opinion from a mental health professional, in the last three years, stating that the adult is reasonably likely to have future episodes requiring inpatient or residential treatment, of a frequency described in clause (1) or (2), unless ongoing case management or community support services are provided;

(5) the adult has, in the last three years, been committed by a court as a person who is mentally ill under chapter 253B, or the adult's commitment has been stayed or continued; deleted text begin ordeleted text end

(6) the adult (i) was eligible under clauses (1) to (5), but the specified time period has expired or the adult was eligible as a child under section 245.4871, subdivision 6; and (ii) has a written opinion from a mental health professional, in the last three years, stating that the adult is reasonably likely to have future episodes requiring inpatient or residential treatment, of a frequency described in clause (1) or (2), unless ongoing case management or community support services are providednew text begin ; ornew text end

new text begin (7) the adult was eligible as a child under section 245.4871, subdivision 6, and is age 21 or youngernew text end .

Sec. 2.

Minnesota Statutes 2012, section 245.4661, subdivision 5, is amended to read:

Subd. 5.

Planning for pilot projects.

new text begin (a) new text end Each local plan for a pilot projectnew text begin , with the exception of the placement of a Minnesota specialty treatment facility as defined in paragraph (c),new text end must be developed under the direction of the county board, or multiple county boards acting jointly, as the local mental health authority. The planning process for each pilot shall include, but not be limited to, mental health consumers, families, advocates, local mental health advisory councils, local and state providers, representatives of state and local public employee bargaining units, and the department of human services. As part of the planning process, the county board or boards shall designate a managing entity responsible for receipt of funds and management of the pilot project.

new text begin (b) For Minnesota specialty treatment facilities, the commissioner shall issue a request for proposal for regions in which a need has been identified for services. new text end

new text begin (c) For purposes of this section, "Minnesota specialty treatment facility" is defined as an intensive rehabilitative mental health service under section 256B.0622, subdivision 2, paragraph (b). new text end

Sec. 3.

Minnesota Statutes 2012, section 245.4661, subdivision 6, is amended to read:

Subd. 6.

Duties of commissioner.

(a) For purposes of the pilot projects, the commissioner shall facilitate integration of funds or other resources as needed and requested by each project. These resources may include:

(1) residential services funds administered under Minnesota Rules, parts 9535.2000 to 9535.3000, in an amount to be determined by mutual agreement between the project's managing entity and the commissioner of human services after an examination of the county's historical utilization of facilities located both within and outside of the county and licensed under Minnesota Rules, parts 9520.0500 to 9520.0690;

(2) community support services funds administered under Minnesota Rules, parts 9535.1700 to 9535.1760;

(3) other mental health special project funds;

(4) medical assistance, general assistance medical care, MinnesotaCare and group residential housing if requested by the project's managing entity, and if the commissioner determines this would be consistent with the state's overall health care reform efforts; deleted text begin anddeleted text end

(5) regional treatment center resources consistent with section 246.0136, subdivision 1deleted text begin .deleted text end new text begin ; andnew text end

new text begin (6) funds transferred from section 246.18, subdivision 8, for grants to providers to participate in mental health specialty treatment services, awarded to providers through a request for proposal process. new text end

(b) The commissioner shall consider the following criteria in awarding start-up and implementation grants for the pilot projects:

(1) the ability of the proposed projects to accomplish the objectives described in subdivision 2;

(2) the size of the target population to be served; and

(3) geographical distribution.

(c) The commissioner shall review overall status of the projects initiatives at least every two years and recommend any legislative changes needed by January 15 of each odd-numbered year.

(d) The commissioner may waive administrative rule requirements which are incompatible with the implementation of the pilot project.

(e) The commissioner may exempt the participating counties from fiscal sanctions for noncompliance with requirements in laws and rules which are incompatible with the implementation of the pilot project.

(f) The commissioner may award grants to an entity designated by a county board or group of county boards to pay for start-up and implementation costs of the pilot project.

Sec. 4.

Minnesota Statutes 2012, section 245.4682, subdivision 2, is amended to read:

Subd. 2.

General provisions.

(a) In the design and implementation of reforms to the mental health system, the commissioner shall:

(1) consult with consumers, families, counties, tribes, advocates, providers, and other stakeholders;

(2) bring to the legislature, and the State Advisory Council on Mental Health, by January 15, 2008, recommendations for legislation to update the role of counties and to clarify the case management roles, functions, and decision-making authority of health plans and counties, and to clarify county retention of the responsibility for the delivery of social services as required under subdivision 3, paragraph (a);

(3) withhold implementation of any recommended changes in case management roles, functions, and decision-making authority until after the release of the report due January 15, 2008;

(4) ensure continuity of care for persons affected by these reforms including ensuring client choice of provider by requiring broad provider networks and developing mechanisms to facilitate a smooth transition of service responsibilities;

(5) provide accountability for the efficient and effective use of public and private resources in achieving positive outcomes for consumers;

(6) ensure client access to applicable protections and appeals; and

(7) make budget transfers necessary to implement the reallocation of services and client responsibilities between counties and health care programs that do not increase the state and county costs and efficiently allocate state funds.

(b) When making transfers under paragraph (a) necessary to implement movement of responsibility for clients and services between counties and health care programs, the commissioner, in consultation with counties, shall ensure that any transfer of state grants to health care programs, including the value of case management transfer grants under section 256B.0625, subdivision 20, does not exceed the value of the services being transferred for the latest 12-month period for which data is available. The commissioner may make quarterly adjustments based on the availability of additional data during the first four quarters after the transfers first occur. If case management transfer grants under section 256B.0625, subdivision 20, are repealed and the value, based on the last year prior to repeal, exceeds the value of the services being transferred, the difference becomes an ongoing part of each county's adult deleted text begin and children'sdeleted text end mental health grants under sections 245.4661deleted text begin , 245.4889,deleted text end and 256E.12.

(c) This appropriation is not authorized to be expended after December 31, 2010, unless approved by the legislature.

Sec. 5.

Minnesota Statutes 2012, section 245.4871, subdivision 26, is amended to read:

Subd. 26.

Mental health practitioner.

"Mental health practitioner" means a person providing services to children with emotional disturbances. A mental health practitioner must have training and experience in working with children. A mental health practitioner must be qualified in at least one of the following ways:

(1) holds a bachelor's degree in one of the behavioral sciences or related fields from an accredited college or university and:

(i) has at least 2,000 hours of supervised experience in the delivery of mental health services to children with emotional disturbances; or

(ii) is fluent in the non-English language of the ethnic group to which at least 50 percent of the practitioner's clients belong, completes 40 hours of training in the delivery of services to children with emotional disturbances, and receives clinical supervision from a mental health professional at least once a week until the requirement of 2,000 hours of supervised experience is met;

(2) has at least 6,000 hours of supervised experience in the delivery of mental health services to children with emotional disturbances; hours worked as a mental health behavioral aide I or II under section 256B.0943, subdivision 7, may be included in the 6,000 hours of experience;

(3) is a graduate student in one of the behavioral sciences or related fields and is formally assigned by an accredited college or university to an agency or facility for clinical training; or

(4) holds a master's or other graduate degree in one of the behavioral sciences or related fields from an accredited college or university deleted text begin and has less than 4,000 hours post-master's experience in the treatment of emotional disturbancedeleted text end .

Sec. 6.

Minnesota Statutes 2012, section 245.4875, subdivision 8, is amended to read:

Subd. 8.

Transition services.

The county board may continue to provide mental health services as defined in sections 245.487 to 245.4889 to persons over 18 years of age, but under 21 years of age, if the person was receiving case management or family community support services prior to age 18, and if one of the following conditions is met:

(1) the person is receiving special education services through the local school district; deleted text begin ordeleted text end

(2) it is in the best interest of the person to continue services defined in sections 245.487 to 245.4889new text begin ; ornew text end

new text begin (3) the person is requesting services and the services are medically necessarynew text end .

Sec. 7.

Minnesota Statutes 2012, section 245.4881, subdivision 1, is amended to read:

Subdivision 1.

Availability of case management services.

(a) The county board shall provide case management services for each child with severe emotional disturbance who is a resident of the county and the child's family who request or consent to the services. Case management services deleted text begin may be continueddeleted text end new text begin must be offered new text end to deleted text begin be provided fordeleted text end a child with a serious emotional disturbance who is over the age of 18 consistent with section 245.4875, subdivision 8new text begin , or the child's legal representative, provided the child's service needs can be met within the children's service system. Before discontinuing case management services under this subdivision for children between the ages of 17 and 21, a transition plan must be developed. The transition plan must be developed with the child and, with the consent of a child age 18 or over, the child's parent, guardian, or legal representative. The transition plan should include plans for health insurance, housing, education, employment, and treatmentnew text end . Staffing ratios must be sufficient to serve the needs of the clients. The case manager must meet the requirements in section 245.4871, subdivision 4.

(b) Except as permitted by law and the commissioner under demonstration projects, case management services provided to children with severe emotional disturbance eligible for medical assistance must be billed to the medical assistance program under sections 256B.02, subdivision 8, and 256B.0625.

(c) Case management services are eligible for reimbursement under the medical assistance program. Costs of mentoring, supervision, and continuing education may be included in the reimbursement rate methodology used for case management services under the medical assistance program.

Sec. 8.

Minnesota Statutes 2012, section 246.18, subdivision 8, is amended to read:

Subd. 8.

State-operated services account.

new text begin (a) new text end The state-operated services account is established in the special revenue fund. Revenue generated by new state-operated services listed under this section established after July 1, 2010, that are not enterprise activities must be deposited into the state-operated services account, unless otherwise specified in law:

(1) intensive residential treatment services;

(2) foster care services; and

(3) psychiatric extensive recovery treatment services.

new text begin (b) Funds deposited in the state-operated services account are available to the commissioner of human services for the purposes of: new text end

new text begin (1) providing services needed to transition individuals from institutional settings within state-operated services to the community when those services have no other adequate funding source; new text end

new text begin (2) grants to providers participating in mental health specialty treatment services under section 245.4661; and new text end

new text begin (3) to fund the operation of the Intensive Residential Treatment Service program in Willmar. new text end

Sec. 9.

Minnesota Statutes 2012, section 246.18, is amended by adding a subdivision to read:

new text begin Subd. 9. new text end

new text begin Transfers. new text end

new text begin The commissioner may transfer state mental health grant funds to the account in subdivision 8 for noncovered allowable costs of a provider certified and licensed under section 256B.0622 and operating under section 246.014. new text end

Sec. 10.

Minnesota Statutes 2012, section 246.54, is amended to read:

246.54 LIABILITY OF COUNTY; REIMBURSEMENT.

Subdivision 1.

County portion for cost of care.

(a) Except for chemical dependency services provided under sections 254B.01 to 254B.09, the client's county shall pay to the state of Minnesota a portion of the cost of care provided in a regional treatment center or a state nursing facility to a client legally settled in that county. A county's payment shall be made from the county's own sources of revenue and payments shall equal a percentage of the cost of care, as determined by the commissioner, for each day, or the portion thereof, that the client spends at a regional treatment center or a state nursing facility according to the following schedule:

(1) zero percent for the first 30 days;

(2) 20 percent for days 31 to 60; and

(3) deleted text begin 50deleted text end new text begin 75new text end percent for any days over 60.

(b) The increase in the county portion for cost of care under paragraph (a), clause (3), shall be imposed when the treatment facility has determined that it is clinically appropriate for the client to be discharged.

(c) If payments received by the state under sections 246.50 to 246.53 exceed 80 percent of the cost of care for days 31 to 60, or deleted text begin 50deleted text end new text begin 25new text end percent for days over 60, the county shall be responsible for paying the state only the remaining amount. The county shall not be entitled to reimbursement from the client, the client's estate, or from the client's relatives, except as provided in section 246.53.

Subd. 2.

Exceptions.

(a) Subdivision 1 does not apply to services provided at the Minnesota Security Hospital deleted text begin or the Minnesota extended treatment options programdeleted text end . For services at deleted text begin these facilitiesdeleted text end new text begin the Minnesota Security Hospitalnew text end , a county's payment shall be made from the county's own sources of revenue and payments deleted text begin shall be paid as follows:deleted text end new text begin . Excluding the state-operated forensic transition service,new text end payments to the state from the county shall equal ten percent of the cost of care, as determined by the commissioner, for each day, or the portion thereof, that the client spends at the facility. new text begin For the state-operated forensic transition service, payments to the state from the county shall equal 50 percent of the cost of care, as determined by the commissioner, for each day, or the portion thereof, that the client spends in the program. new text end If payments received by the state under sections 246.50 to 246.53 new text begin for services provided at the Minnesota Security Hospital, excluding the state-operated forensic transition service, new text end exceed 90 percent of the cost of care, the county shall be responsible for paying the state only the remaining amount. new text begin If payments received by the state under sections 246.50 to 246.53 for the state-operated forensic transition service exceed 50 percent of the cost of care, the county shall be responsible for paying the state only the remaining amount. new text end The county shall not be entitled to reimbursement from the client, the client's estate, or from the client's relatives, except as provided in section 246.53.

(b) Regardless of the facility to which the client is committed, subdivision 1 does not apply to the following individuals:

deleted text begin (1) clients who are committed as mentally ill and dangerous under section 253B.02, subdivision 17; deleted text end

deleted text begin (2)deleted text end new text begin (1)new text end clients who are committed as sexual psychopathic personalities under section 253B.02, subdivision 18b; and

deleted text begin (3)deleted text end new text begin (2)new text end clients who are committed as sexually dangerous persons under section 253B.02, subdivision 18c.

deleted text begin For each of the individuals in clauses (1) to (3), the payment by the county to the state shall equal ten percent of the cost of care for each day as determined by the commissioner. deleted text end

Sec. 11.

Minnesota Statutes 2012, section 253B.10, subdivision 1, is amended to read:

Subdivision 1.

Administrative requirements.

new text begin (a) new text end When a person is committed, the court shall issue a warrant or an order committing the patient to the custody of the head of the treatment facility. The warrant or order shall state that the patient meets the statutory criteria for civil commitment.

new text begin (b) The commissioner shall prioritize patients being admitted from jail or a correctional institution who are: new text end

new text begin (1) ordered confined in a state hospital for an examination under Minnesota Rules of Criminal Procedure, rules 20.01, subdivision 4, paragraph (a), and 20.02, subdivision 2; new text end

new text begin (2) under civil commitment for competency treatment and continuing supervision under Minnesota Rules of Criminal Procedure, rule 20.01, subdivision 7; new text end

new text begin (3) found not guilty by reason of mental illness under Minnesota Rules of Criminal Procedure, rule 20.02, subdivision 8, and under civil commitment or are ordered to be detained in a state hospital or other facility pending completion of the civil commitment proceedings; or new text end

new text begin (4) committed under this chapter to the commissioner after dismissal of the patient's criminal charges. new text end

new text begin Patients described in this paragraph must be admitted to a service operated by the commissioner within 48 hours. The commitment must be ordered by the court as provided in section 253B.09, subdivision 1, paragraph (c). new text end

new text begin (c) new text end Upon the arrival of a patient at the designated treatment facility, the head of the facility shall retain the duplicate of the warrant and endorse receipt upon the original warrant or acknowledge receipt of the order. The endorsed receipt or acknowledgment must be filed in the court of commitment. After arrival, the patient shall be under the control and custody of the head of the treatment facility.

new text begin (d) new text end Copies of the petition for commitment, the court's findings of fact and conclusions of law, the court order committing the patient, the report of the examiners, and the prepetition report shall be provided promptly to the treatment facility.

Sec. 12.

Minnesota Statutes 2012, section 254B.13, is amended to read:

254B.13 PILOT PROJECTS; CHEMICAL HEALTH CARE.

Subdivision 1.

Authorization for new text begin navigator new text end pilot projects.

The commissioner may approve and implement new text begin navigator new text end pilot projects developed under the planning process required under Laws 2009, chapter 79, article 7, section 26, to provide alternatives to and enhance coordination of the delivery of chemical health services required under section 254B.03.

Subd. 2.

Program design and implementation.

(a) The commissioner and counties participating in the new text begin navigator new text end pilot projects shall continue to work in partnership to refine and implement the new text begin navigator new text end pilot projects initiated under Laws 2009, chapter 79, article 7, section 26.

(b) The commissioner and counties participating in the new text begin navigator new text end pilot projects shall complete the planning phase deleted text begin by June 30, 2010,deleted text end and, if approved by the commissioner for implementation, enter into agreements governing the operation of the new text begin navigator new text end pilot projects deleted text begin with implementation scheduled no earlier than July 1, 2010deleted text end .

new text begin Subd. 2a. new text end

new text begin Eligibility for navigator pilot program. new text end

new text begin (a) To be considered for participation in a navigator pilot program, an individual must: new text end

new text begin (1) be a resident of a county with an approved navigator program; new text end

new text begin (2) be eligible for consolidated chemical dependency treatment fund services; new text end

new text begin (3) be a voluntary participant in the navigator program; new text end

new text begin (4) satisfy one of the following items: new text end

new text begin (i) have at least one severity rating of three or above in dimension four, five, or six in a comprehensive assessment under Minnesota Rules, part 9530.6422; or new text end

new text begin (ii) have at least one severity rating of two or above in dimension four, five, or six in a comprehensive assessment under Minnesota Rules, part 9530.6422, and be currently participating in a Rule 31 treatment program under Minnesota Rules, parts 9530.6405 to 9530.6505, or be within 60 days following discharge after participation in a Rule 31 treatment program; and new text end

new text begin (5) have had at least two treatment episodes in the past two years, not limited to episodes reimbursed by the consolidated chemical dependency treatment funds. An admission to an emergency room, a detoxification program, or a hospital may be substituted for one treatment episode if it resulted from the individual's substance use disorder. new text end

new text begin (b) New eligibility criteria may be added as mutually agreed upon by the commissioner and participating navigator programs. new text end

Subd. 3.

Program evaluation.

The commissioner shall evaluate new text begin navigator new text end pilot projects under this section and report the results of the evaluation to the chairs and ranking minority members of the legislative committees with jurisdiction over chemical health issues by January 15, 2014. Evaluation of the new text begin navigator new text end pilot projects must be based on outcome evaluation criteria negotiated with the new text begin navigator new text end pilot projects prior to implementation.

Subd. 4.

Notice of new text begin navigator pilot new text end project discontinuation.

Each county's participation in the new text begin navigator new text end pilot project may be discontinued for any reason by the county or the commissioner of human services after 30 days' written notice to the other party. deleted text begin Any unspent funds held for the exiting county's pro rata share in the special revenue fund under the authority in subdivision 5, paragraph (d), shall be transferred to the consolidated chemical dependency treatment fund following discontinuation of the pilot project.deleted text end

Subd. 5.

Duties of commissioner.

(a) Notwithstanding any other provisions in this chapter, the commissioner may authorize new text begin navigator new text end pilot projects to use chemical dependency treatment funds to pay for nontreatment new text begin navigator new text end pilot services:

(1) in addition to those authorized under section 254B.03, subdivision 2, paragraph (a); and

(2) by vendors in addition to those authorized under section 254B.05 when not providing chemical dependency treatment services.

(b) For purposes of this section, "nontreatment new text begin navigator new text end pilot services" include navigator services, peer support, family engagement and support, housing support, rent subsidies, supported employment, and independent living skills.

(c) State expenditures for chemical dependency services and nontreatment new text begin navigator new text end pilot services provided by or through the new text begin navigator new text end pilot projects must not be greater than the chemical dependency treatment fund expected share of forecasted expenditures in the absence of the new text begin navigator new text end pilot projects. The commissioner may restructure the schedule of payments between the state and participating counties under the local agency share and division of cost provisions under section 254B.03, subdivisions 3 and 4, as necessary to facilitate the operation of thenew text begin navigatornew text end pilot projects.

deleted text begin (d) To the extent that state fiscal year expenditures within a pilot project are less than the expected share of forecasted expenditures in the absence of the pilot projects, the commissioner shall deposit the unexpended funds in a separate account within the consolidated chemical dependency treatment fund, and make these funds available for expenditure by the pilot projects the following year. To the extent that treatment and nontreatment pilot services expenditures within the pilot project exceed the amount expected in the absence of the pilot projects, the pilot project county or counties are responsible for the portion of nontreatment pilot services expenditures in excess of the otherwise expected share of forecasted expenditures. deleted text end

deleted text begin (e)deleted text end new text begin (d)new text end The commissioner may waive administrative rule requirements that are incompatible with the implementation of the new text begin navigator new text end pilot project, except that any chemical dependency treatment funded under this section must continue to be provided by a licensed treatment provider.

deleted text begin (f)deleted text end new text begin (e)new text end The commissioner shall not approve or enter into any agreement related to new text begin navigator new text end pilot projects authorized under this section that puts current or future federal funding at risk.

new text begin (f) The commissioner shall provide participating navigator pilot projects with transactional data, reports, provider data, and other data generated by county activity to assess and measure outcomes. This information must be transmitted or made available in an acceptable form to participating navigator pilot projects at least once every six months or within a reasonable time following the commissioner's receipt of information from the counties needed to comply with this paragraph. new text end

Subd. 6.

Duties of county board.

The county board, or other county entity that is approved to administer a new text begin navigator new text end pilot project, shall:

(1) administer the new text begin navigator new text end pilot project in a manner consistent with the objectives described in subdivision 2 and the planning process in subdivision 5;

(2) ensure that no one is denied chemical dependency treatment services for which they would otherwise be eligible under section 254A.03, subdivision 3; and

(3) provide the commissioner with timely and pertinent information as negotiated in agreements governing operation of the new text begin navigator new text end pilot projects.

new text begin Subd. 7. new text end

new text begin Managed care. new text end

new text begin An individual who is eligible for the navigator pilot program under subdivision 2a is excluded from mandatory enrollment in managed care until these services are included in the health plan's benefit set. new text end

new text begin Subd. 8. new text end

new text begin Authorization for continuation of navigator pilots. new text end

new text begin The navigator pilot projects implemented pursuant to subdivision 1 are authorized to continue operation after July 1, 2013, under existing agreements governing operation of the pilot projects. new text end

new text begin EFFECTIVE DATE. new text end

new text begin The amendments to subdivisions 1 to 6 and 8 are effective August 1, 2013. Subdivision 7 is effective July 1, 2013. new text end

Sec. 13.

new text begin [254B.14] CONTINUUM OF CARE PILOT PROJECTS; CHEMICAL HEALTH CARE. new text end

new text begin Subdivision 1. new text end

new text begin Authorization for continuum of care pilot projects. new text end

new text begin The commissioner shall establish chemical dependency continuum of care pilot projects to begin implementing the measures developed with stakeholder input and identified in the report completed pursuant to Laws 2012, chapter 247, article 5, section 8. The pilot projects are intended to improve the effectiveness and efficiency of the service continuum for chemically dependent individuals in Minnesota while reducing duplication of efforts and promoting scientifically supported practices. new text end

new text begin Subd. 2. new text end

new text begin Program implementation. new text end

new text begin (a) The commissioner, in coordination with representatives of the Minnesota Association of County Social Service Administrators and the Minnesota Inter-County Association, shall develop a process for identifying and selecting interested counties and providers for participation in the continuum of care pilot projects. There shall be three pilot projects; one representing the northern region, one for the metro region, and one for the southern region. The selection process of counties and providers must include consideration of population size, geographic distribution, cultural and racial demographics, and provider accessibility. The commissioner shall identify counties and providers that are selected for participation in the continuum of care pilot projects no later than September 30, 2013. new text end

new text begin (b) The commissioner and entities participating in the continuum of care pilot projects shall enter into agreements governing the operation of the continuum of care pilot projects. The agreements shall identify pilot project outcomes and include timelines for implementation and beginning operation of the pilot projects. new text end

new text begin (c) Entities that are currently participating in the navigator pilot project are eligible to participate in the continuum of care pilot project subsequent to or instead of participating in the navigator pilot project. new text end

new text begin (d) The commissioner may waive administrative rule requirements that are incompatible with implementation of the continuum of care pilot projects. new text end

new text begin (e) Notwithstanding section 254A.19, the commissioner may designate noncounty entities to complete chemical use assessments and placement authorizations required under section 254A.19 and Minnesota Rules, parts 9530.6600 to 9530.6655. Section 254A.19, subdivision 3, is applicable to the continuum of care pilot projects at the discretion of the commissioner. new text end

new text begin Subd. 3. new text end

new text begin Program design. new text end

new text begin (a) The operation of the pilot projects shall include: new text end

new text begin (1) new services that are responsive to the chronic nature of substance use disorder; new text end

new text begin (2) telehealth services, when appropriate to address barriers to services; new text end

new text begin (3) services that assure integration with the mental health delivery system when appropriate; new text end

new text begin (4) services that address the needs of diverse populations; and new text end

new text begin (5) an assessment and access process that permits clients to present directly to a service provider for a substance use disorder assessment and authorization of services. new text end

new text begin (b) Prior to implementation of the continuum of care pilot projects, a utilization review process must be developed and agreed to by the commissioner, participating counties, and providers. The utilization review process shall be described in the agreements governing operation of the continuum of care pilot projects. new text end

new text begin Subd. 4. new text end

new text begin Notice of project discontinuation. new text end

new text begin Each entity's participation in the continuum of care pilot project may be discontinued for any reason by the county or the commissioner after 30 days' written notice to the entity. new text end

new text begin Subd. 5. new text end

new text begin Duties of commissioner. new text end

new text begin (a) Notwithstanding any other provisions in this chapter, the commissioner may authorize chemical dependency treatment funds to pay for nontreatment services arranged by continuum of care pilot projects. Individuals who are currently accessing Rule 31 treatment services are eligible for concurrent participation in the continuum of care pilot projects. new text end

new text begin (b) County expenditures for continuum of care pilot project services shall not be greater than their expected share of forecasted expenditures in the absence of the continuum of care pilot projects. new text end

new text begin Subd. 6. new text end

new text begin Managed care. new text end

new text begin An individual who is eligible for the continuum of care pilot project is excluded from mandatory enrollment in managed care unless these services are included in the health plan's benefit set. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2013. new text end

Sec. 14.

new text begin [256.478] HOME AND COMMUNITY-BASED SERVICES TRANSITIONS GRANTS. new text end

new text begin (a) The commissioner shall make available home and community-based services transition grants to serve individuals who do not meet eligibility criteria for the medical assistance program under section 256B.056 or 256B.057, but who otherwise meet the criteria under section 256B.092, subdivision 13, or 256B.49, subdivision 24. new text end

new text begin (b) For the purposes of this section, the commissioner has the authority to transfer funds between the medical assistance account and the home and community-based services transitions grants account. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013. new text end

Sec. 15.

new text begin [256B.0616] MENTAL HEALTH CERTIFIED FAMILY PEER SPECIALIST. new text end

new text begin Subdivision 1. new text end

new text begin Scope. new text end

new text begin 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. new text end

new text begin Subd. 2. new text end

new text begin Establishment. new text end

new text begin The commissioner of human services shall establish a certified family peer specialists program model which: new text end

new text begin (1) provides nonclinical family peer support counseling, building on the strengths of families and helping them achieve desired outcomes; new text end

new text begin (2) collaborates with others providing care or support to the family; new text end

new text begin (3) provides nonadversarial advocacy; new text end

new text begin (4) promotes the individual family culture in the treatment milieu; new text end

new text begin (5) links parents to other parents in the community; new text end

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

new text begin (7) assists parents in developing coping mechanisms and problem-solving skills; new text end

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

new text begin (9) establishes and provides peer led parent support groups; and new text end

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

new text begin Subd. 3. new text end

new text begin Eligibility. new text end

new text begin Family peer support services may be located in inpatient hospitalization, partial hospitalization, residential treatment, treatment foster care, day treatment, children's therapeutic services and supports, or crisis services. new text end

new text begin Subd. 4. new text end

new text begin Peer support specialist program providers. new text end

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

new text begin Subd. 5. new text end

new text begin Certified family peer specialist training and certification. new text end

new text begin 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 are 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 participating family peer specialists specific skills relevant to providing 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 counseling. new text end

Sec. 16.

Minnesota Statutes 2012, 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, deleted text begin anddeleted text end independent livingnew text begin , parenting skills,new text end 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 assistance, 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, new text begin parenting skills, new text end 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's 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.

Sec. 17.

Minnesota Statutes 2012, section 256B.0625, subdivision 48, is amended to read:

Subd. 48.

Psychiatric consultation to primary care practitioners.

deleted text begin Effective January 1, 2006,deleted text end Medical assistance covers consultation provided by a psychiatristnew text begin , a psychologist, or an advanced practice registered nurse certified in psychiatric mental healthnew text end via telephone, e-mail, facsimile, or other means of communication to primary care practitioners, including pediatricians. The need for consultation and the receipt of the consultation must be documented in the patient record maintained by the primary care practitioner. If the patient consents, and subject to federal limitations and data privacy provisions, the consultation may be provided without the patient present.

Sec. 18.

Minnesota Statutes 2012, section 256B.0625, subdivision 56, is amended to read:

Subd. 56.

Medical service coordination.

(a)new text begin (1) new text end Medical assistance covers in-reach community-based service coordination that is performed through a hospital emergency department as an eligible procedure under a state healthcare program for a frequent user. A frequent user is defined as an individual who has frequented the hospital emergency department for services three or more times in the previous four consecutive months. In-reach community-based service coordination includes navigating services to address a client's mental health, chemical health, social, economic, and housing needs, or any other activity targeted at reducing the incidence of emergency room and other nonmedically necessary health care utilization.

new text begin (2) Medical assistance covers in-reach community-based service coordination that is performed through a hospital emergency department or inpatient psychiatric unit for a child or young adult up to age 21 with a serious emotional disturbance who has frequented the hospital emergency room two or more times in the previous consecutive three months or been admitted to an inpatient psychiatric unit two or more times in the previous consecutive four months, or is being discharged to a shelter. new text end

(b) Reimbursement must be made in 15-minute increments and allowed for up to 60 days posthospital discharge based upon the specific identified emergency department visit or inpatient admitting event. In-reach community-based service coordination shall seek to connect frequent users with existing covered services available to them, including, but not limited to, targeted case management, waiver case management, or care coordination in a health care home. new text begin For children and young adults with a serious emotional disturbance, in-reach community-based service coordination includes navigating and arranging for community-based services prior to discharge to address a client's mental health, chemical health, social, educational, family support and housing needs, or any other activity targeted at reducing multiple incidents of emergency room use, inpatient readmissions, and other nonmedically necessary health care utilization. In-reach services shall seek to connect them with existing covered services, including targeted case management, waiver case management, care coordination in a health care home, children's therapeutic services and supports, crisis services, and respite care. new text end Eligible in-reach service coordinators must hold a minimum of a bachelor's degree in social work, public health, corrections, or a related field. The commissioner shall submit any necessary application for waivers to the Centers for Medicare and Medicaid Services to implement this subdivision.

(c)new text begin (1)new text end For the purposes of this subdivision, "in-reach community-based service coordination" means the practice of a community-based worker with training, knowledge, skills, and ability to access a continuum of services, including housing, transportation, chemical and mental health treatment, employment, new text begin education, new text end and peer support services, by working with an organization's staff to transition an individual back into the individual's living environment. In-reach community-based service coordination includes working with the individual during their discharge and for up to a defined amount of time in the individual's living environment, reducing the individual's need for readmittance.

new text begin (2) Hospitals utilizing in-reach service coordinators shall report annually to the commissioner on the number of adults, children, and adolescents served; the postdischarge services which they accessed; and emergency department/psychiatric hospitalization readmissions. The commissioner shall ensure that services and payments provided under in-reach care coordination do not duplicate services or payments provided under section 256B.0753, 256B.0755, or 256B.0625, subdivision 20. new text end

Sec. 19.

Minnesota Statutes 2012, section 256B.0625, is amended by adding a subdivision to read:

new text begin Subd. 61. new text end

new text begin Family psychoeducation services. new text end

new text begin Effective July 1, 2013, or upon federal approval, whichever is later, medical assistance covers family psychoeducation services provided to a child up to age 21 with a diagnosed mental health condition when identified in the child's individual treatment plan and provided by a licensed 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, who has determined it medically necessary to involve family members in the child's care. For the purposes of this subdivision, "family psychoeducation services" means information or demonstration provided to an individual or family as part of an individual, family, multifamily group, or peer group session to explain, educate, and support the child and family 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. new text end

Sec. 20.

Minnesota Statutes 2012, section 256B.0625, is amended by adding a subdivision to read:

new text begin Subd. 62. new text end

new text begin Mental health clinical care consultation. new text end

new text begin Effective July 1, 2013, or upon federal approval, whichever is later, medical assistance covers clinical care consultation for a person up to age 21 who is diagnosed with a complex mental health condition or a mental health condition that co-occurs with other complex and chronic conditions, when described in the person's individual treatment plan and provided by a licensed 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. For the purposes of this subdivision, "clinical care consultation" means communication from a treating mental health professional to other providers or educators not under the clinical supervision of the treating mental health professional who are 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; and to direct and coordinate clinical service components provided to the client and family. new text end

Sec. 21.

Minnesota Statutes 2012, section 256B.092, is amended by adding a subdivision to read:

new text begin Subd. 13. new text end

new text begin Waiver allocations for transition populations. new text end

new text begin (a) The commissioner shall make available additional waiver allocations and additional necessary resources to assure timely discharges from the Anoka Metro Regional Treatment Center and the Minnesota Security Hospital in St. Peter for individuals who meet the following criteria: new text end

new text begin (1) are otherwise eligible for the developmental disabilities waiver under this section; new text end

new text begin (2) who would otherwise remain at the Anoka Metro Regional Treatment Center or the Minnesota Security Hospital; new text end

new text begin (3) whose discharge would be significantly delayed without the available waiver allocation; and new text end

new text begin (4) who have met treatment objectives and no longer meet hospital level of care. new text end

new text begin (b) Additional waiver allocations under this subdivision must meet cost-effectiveness requirements of the federal approved waiver plan. new text end

new text begin (c) Any corporate foster care home developed under this subdivision must be considered an exception under section 245A.03, subdivision 7, paragraph (a). new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013. new text end

Sec. 22.

Minnesota Statutes 2012, 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. 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) "County board" means the county board of commissioners or board established under sections 402.01 to 402.10 or 471.59.

(d) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a.

(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 program consisting of group psychotherapy for more than three individuals and other intensive therapeutic services provided by a multidisciplinary team, under the clinical supervision of a mental health professional.

(g) "Diagnostic assessment" has the meaning given in section 245.4871, subdivision 11.

(h) "Direct service time" means the time that a mental health professional, mental health practitioner, or mental health behavioral aide spends face-to-face with a client and the client's family. Direct service time includes time in which the provider obtains a client's history 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, maintaining clinical records, consulting with others about the client's mental health status, preparing reports, receiving clinical supervision, and revising the client's individual treatment plan.

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

(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.

(l) "Individual treatment plan" has the meaning given in section 245.4871, subdivision 21.

(m) "Mental health behavioral aide services" means medically necessary one-on-one activities performed by a trained paraprofessional to assist a child retain or generalize psychosocial skills as taught 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 professional" means an individual as defined in section 245.4871, subdivision 27, clauses (1) to (6), or tribal vendor as defined in section 256B.02, subdivision 7, paragraph (b).

new text begin (o) "Mental health service plan development" includes: new text end

new text begin (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 new text end

new text begin (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. new text end

deleted text begin (o)deleted text end new text begin (p)new text end "Preschool program" means a day program licensed under Minnesota Rules, parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and supports provider to provide a structured treatment program to a child who is at least 33 months old but who has not yet attended the first day of kindergarten.

deleted text begin (p)deleted text end new text begin (q)new text end "Skills training" means individual, family, or group training, delivered by or under the direction 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 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 following requirements:

(1) a mental health professional or a mental health practitioner must provide skills training;

(2) the child must always be present during skills training; however, a brief absence of the child for no more than ten percent of the session unit may be allowed to redirect or instruct family members;

(3) skills training delivered to children or their families 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;

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

(5) 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:

(i) one mental health professional or one mental health practitioner under supervision of a licensed mental health professional must work with a group of four to eight clients; or

(ii) two mental health professionals or two mental health practitioners under supervision of a licensed mental health professional, or one professional plus one practitioner must work with a group of nine to 12 clients.

Sec. 23.

Minnesota Statutes 2012, 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) individual, family, and group psychotherapy;

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

(3) crisis assistance;

(4) mental health behavioral aide services; deleted text begin anddeleted text end

(5) direction of a mental health behavioral aidedeleted text begin .deleted text end new text begin ;new text end

new text begin (6) mental health service plan development; new text end

new text begin (7) clinical care consultation under section 256B.0625, subdivision 62; new text end

new text begin (8) family psychoeducation under section 256B.0625, subdivision 61; and new text end

new text begin (9) services provided by a family peer specialist under section 256B.0616. new text end

(c) Service components in paragraph (b) may be combined to constitute therapeutic programs, including day treatment programs and therapeutic preschool programs.

Sec. 24.

Minnesota Statutes 2012, 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 (n); or

(2) a mental health practitioner as defined in section 245.4871, subdivision 26. The mental health practitioner 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 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 primary caregiver to a child with severe emotional disturbance within the previous ten years; and

(iii) meet preservice 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 clinical services in the treatment of mental illness concerning children or adolescentsnew text begin or complete a certificate program established under subdivision 8anew text end ; and

(iii) meet preservice and continuing education requirements in subdivision 8.

(c) A preschool program multidisciplinary team must include at least one mental health professional and one or more of the following individuals under the clinical supervision of a mental health professional:

(i) a mental health practitioner; or

(ii) a program person, including a teacher, assistant teacher, or aide, who meets the qualifications and training standards of a level I mental health behavioral aide.

(d) A day treatment multidisciplinary team must include at least one mental health professional and one mental health practitioner.

Sec. 25.

Minnesota Statutes 2012, section 256B.0943, is amended by adding a subdivision to read:

new text begin Subd. 8a. new text end

new text begin Level II mental health behavioral aide. new text end

new text begin The commissioner of human services, in collaboration with children's mental health providers and the Board of Trustees of the Minnesota State Colleges and Universities, shall develop a certificate program for level II mental health behavioral aides. new text end

Sec. 26.

Minnesota Statutes 2012, section 256B.0946, is amended to read:

256B.0946 new text begin INTENSIVE new text end TREATMENTnew text begin INnew text end FOSTER CARE.

Subdivision 1.

new text begin Required new text end covered servicenew text begin componentsnew text end .

(a) Effective deleted text begin July 1, 2006,deleted text end new text begin upon enactmentnew text end and subject to federal approval, medical assistance covers medically necessary new text begin intensive treatment new text end 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 deleted text begin treatmentdeleted text end foster home licensed under Minnesota Rules, parts 2960.3000 to 2960.3340.

(b) new text begin Intensive treatment new text end services to children with deleted text begin severe emotional disturbancedeleted text end new text begin mental illnessnew text end residing in deleted text begin treatmentdeleted text end foster deleted text begin caredeleted text end new text begin familynew text end settings deleted text begin must meet the relevant standards for mental health services under sections 245.487 to 245.4889. In addition,deleted text end new text begin that comprisenew text end specific new text begin required new text end service componentsnew text begin provided in clauses (1) to (5), arenew text end reimbursed by medical assistance deleted text begin mustdeleted text end new text begin when theynew text end meet the following standards:

deleted text begin (1) case management service component must meet the standards in Minnesota Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10; deleted text end

new text begin (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; new text end

(2) deleted text begin psychotherapy,deleted text end crisis assistancedeleted text begin , and skills training components must meet thedeleted text end new text begin provided according tonew text end standards for children's therapeutic services and supports in section 256B.0943; deleted text begin anddeleted text end

(3)new text begin individualnew text end familynew text begin , and groupnew text end psychoeducation services deleted text begin under supervision ofdeleted text end new text begin , defined in subdivision 1a, paragraph (q), provided bynew text end a mental health professionaldeleted text begin .deleted text end new text begin or a clinical trainee;new text end

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

new text begin (5) service delivery payment requirements as provided under subdivision 4. new text end

new text begin Subd. 1a. new text end

new text begin Definitions. new text end

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

new text begin (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. new text end

new text begin (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. new text end

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

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

new text begin (e) "Crisis assistance" 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. new text end

new text begin (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. new text end

new text begin (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. new text end

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

new text begin (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. new text end

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

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

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

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

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

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

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

new text begin (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. new text end

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

new text begin (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 end

Subd. 2.

Determination of client eligibility.

deleted text begin A client's eligibility to receive treatment foster care under this section shall be determined bydeleted text end new text begin An eligible recipient is an individual, from birth through age 20, who is currently placed in a foster home licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, and has receivednew text end a diagnostic assessmentdeleted text begin ,deleted text end new text begin andnew text end an evaluation of level of care needed, deleted text begin and development of an individual treatment plan,deleted text end as defined in paragraphs (a) deleted text begin to (c)deleted text end new text begin and (b)new text end .

(a) The diagnostic assessment must:

(1) new text begin meet criteria described in Minnesota Rules, part 9505.0372, subpart 1, and new text end be conducted by a deleted text begin psychiatrist, licensed psychologist, or licensed independent clinical social worker that isdeleted text end new text begin mental health professional or a clinical trainee;new text end

new text begin (2) determine whether or not a child meets the criteria for mental illness, as defined in Minnesota Rules, part 9505.0370, subpart 20; new text end

new text begin (3) document that intensive treatment services are medically necessary within a foster family setting to ameliorate identified symptoms and functional impairments; new text end

new text begin (4) be new text end performed within 180 days deleted text begin prior todeleted text end new text begin beforenew text end the start of service;new text begin andnew text end

deleted text begin (2) include current diagnoses on all five axes of the client's current mental health status; deleted text end

deleted text begin (3) determine whether or not a child meets the criteria for severe emotional disturbance in section 245.4871, subdivision 6, or for serious and persistent mental illness in section 245.462, subdivision 20; and deleted text end

deleted text begin (4) be completed annually until age 18. For individuals between age 18 and 21, unless a client's mental health condition has changed markedly since the client's most recent diagnostic assessment, annual updating is necessary. For the purpose of this section, "updating" means a written summary, including current diagnoses on all five axes, by a mental health professional of the client's current mental status and service needs. deleted text end

new text begin (5) be completed as either a standard or extended diagnostic assessment annually to determine continued eligibility for the service. new text end

(b) The evaluation of level of care must be conducted by the placing county deleted text begin with an instrumentdeleted text end new text begin , tribe, or case manager in conjunction with the diagnostic assessment as described by Minnesota Rules, part 9505.0372, subpart 1, item B, using a validated toolnew text end approved by the commissioner of human servicesnew text begin and not subject to the rulemaking process, consistent with section 245.4885, subdivision 1, paragraph (d), the result of which evaluation demonstrates that the child requires intensive intervention without 24-hour medical monitoringnew text end . The commissioner shall update the list of approved level of care deleted text begin instrumentsdeleted text end new text begin toolsnew text end annuallynew text begin and publish on the department's Web sitenew text end .

deleted text begin (c) The individual treatment plan must be: deleted text end

deleted text begin (1) based on the information in the client's diagnostic assessment; deleted text end

deleted text begin (2) developed through a child-centered, family driven planning process that identifies service needs and individualized, planned, and culturally appropriate interventions that contain specific measurable treatment goals and objectives for the client and treatment strategies for the client's family and foster family; deleted text end

deleted text begin (3) reviewed at least once every 90 days and revised; and deleted text end

deleted text begin (4) signed by the client or, if appropriate, by the client's parent or other person authorized by statute to consent to mental health services for the client. deleted text end

Subd. 3.

Eligible new text begin mental health services new text end providers.

new text begin (a) Eligible providers for intensive children's mental health services in a foster family setting must be certified by the state and have a service provision contract with a county board or a reservation tribal council and must be able to demonstrate the ability to provide all of the services required in this section. new text end

new text begin (b) new text end For purposes of this section, a provider agency must deleted text begin have an individual placement agreement for each recipient and must be a licensed child placing agency, under Minnesota Rules, parts 9543.0010 to 9543.0150, and eitherdeleted text end new text begin benew text end :

(1) a deleted text begin countydeleted text end new text begin county-operated entity certified by the statenew text end ;

(2) an Indian Health Services facility operated by a tribe or tribal organization under funding authorized by United States Code, title 25, sections 450f to 450n, or title 3 of the Indian Self-Determination Act, Public Law 93-638, section 638 (facilities or providers); or

(3) a noncounty entity deleted text begin under contract with a county boarddeleted text end .

new text begin (c) Certified providers that do not meet the service delivery standards required in this section shall be subject to a decertification process. new text end

new text begin (d) For the purposes of this section, all services delivered to a client must be provided by a mental health professional or a clinical trainee. new text end

Subd. 4.

deleted text begin Eligible provider responsibilitiesdeleted text end new text begin Service delivery payment requirementsnew text end .

(a) To be deleted text begin andeleted text end eligible deleted text begin providerdeleted text end new text begin for paymentnew text end under this section, a provider must develop new text begin and practice new text end written policies and procedures for deleted text begin treatment foster care servicesdeleted text end new text begin intensive treatment in foster care,new text end consistent with subdivision 1, paragraph (b), deleted text begin clauses (1), (2), and (3)deleted text end new text begin and comply with the following requirements in paragraphs (b) to (n)new text end .

deleted text begin (b) In delivering services under this section, a treatment foster care provider must ensure that staff caseload size reasonably enables the provider to play an active role in service planning, monitoring, delivering, and reviewing for discharge planning to meet the needs of the client, the client's foster family, and the birth family, as specified in each client's individual treatment plan. deleted text end

new text begin (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. new text end

new text begin (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. new text end

new text begin (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. new text end

new text begin (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. new text end

new text begin (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). new text end

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

new text begin (h) Each client must have a crisis assistance 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 mobile crisis intervention team. new text end

new text begin (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. new text end

new text begin (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. new text end

new text begin (k) Treatment must be developmentally and culturally appropriate for the client. new text end

new text begin (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. new text end

new text begin (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. new text end

new text begin (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 end

Subd. 5.

Service authorization.

The commissioner will administer authorizations for services under this section in compliance with section 256B.0625, subdivision 25.

Subd. 6.

Excluded services.

(a) Services in clauses (1) to deleted text begin (4)deleted text end new text begin (7)new text end are not new text begin covered under this section and are not new text end eligible new text begin for medical assistance payment new text end as components of new text begin intensive new text end treatment new text begin in new text end foster care servicesnew text begin , but may be billed separatelynew text end :

deleted text begin (1) treatment foster care services provided in violation of medical assistance policy in Minnesota Rules, part 9505.0220; deleted text end

deleted text begin (2) service components of children's therapeutic services and supports simultaneously provided by more than one treatment foster care provider; deleted text end

deleted text begin (3) home and community-based waiver services; and deleted text end

deleted text begin (4) treatment foster care services provided to a child without a level of care determination according to section 245.4885, subdivision 1. deleted text end

new text begin (1) inpatient psychiatric hospital treatment; new text end

new text begin (2) mental health targeted case management; new text end

new text begin (3) partial hospitalization; new text end

new text begin (4) medication management; new text end

new text begin (5) children's mental health day treatment services; new text end

new text begin (6) crisis response services under section 256B.0944; and new text end

new text begin (7) transportation. new text end

(b) Children receiving new text begin intensive new text end treatment new text begin in new text end foster care services are not eligible for medical assistance reimbursement for the following services while receiving new text begin intensive new text end treatment new text begin in new text end foster care:

deleted text begin (1) mental health case management services under section 256B.0625, subdivision 20; and deleted text end

deleted text begin (2)deleted text end new text begin (1)new text end psychotherapy and deleted text begin skilldeleted text end new text begin skillsnew text end training components of children's therapeutic services and supports under section 256B.0625, subdivision 35bdeleted text begin .deleted text end new text begin ;new text end

new text begin (2) mental health behavioral aide services as defined in section 256B.0943, subdivision 1, paragraph (m); new text end

new text begin (3) home and community-based waiver services; new text end

new text begin (4) mental health residential treatment; and new text end

new text begin (5) room and board costs as defined in section 256I.03, subdivision 6. new text end

new text begin Subd. 7. new text end

new text begin Medical assistance payment and rate setting. new text end

new text begin The commissioner shall establish a single daily per-client encounter rate for intensive treatment in foster care services. The rate must be constructed to cover only eligible services delivered to an eligible recipient by an eligible provider, as prescribed in subdivision 1, paragraph (b). new text end

Sec. 27.

Minnesota Statutes 2012, section 256B.49, is amended by adding a subdivision to read:

new text begin Subd. 24. new text end

new text begin Waiver allocations for transition populations. new text end

new text begin (a) The commissioner shall make available additional waiver allocations and additional necessary resources to assure timely discharges from the Anoka Metro Regional Treatment Center and the Minnesota Security Hospital in St. Peter for individuals who meet the following criteria: new text end

new text begin (1) are otherwise eligible for the brain injury, community alternatives for disabled individuals, or community alternative care waivers under this section; new text end

new text begin (2) who would otherwise remain at the Anoka Metro Regional Treatment Center or the Minnesota Security Hospital; new text end

new text begin (3) whose discharge would be significantly delayed without the available waiver allocation; and new text end

new text begin (4) who have met treatment objectives and no longer meet hospital level of care. new text end

new text begin (b) Additional waiver allocations under this subdivision must meet cost-effectiveness requirements of the federal approved waiver plan. new text end

new text begin (c) Any corporate foster care home developed under this subdivision must be considered an exception under section 245A.03, subdivision 7, paragraph (a). new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013. new text end

Sec. 28.

Minnesota Statutes 2012, section 256B.761, is amended to read:

256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.

(a) Effective for services rendered on or after July 1, 2001, payment for medication management provided to psychiatric patients, outpatient mental health services, day treatment services, home-based mental health services, and family community support services shall be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the 50th percentile of 1999 charges.

(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health services provided by an entity that operates: (1) a Medicare-certified comprehensive outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, 1993, with at least 33 percent of the clients receiving rehabilitation services in the most recent calendar year who are medical assistance recipients, will be increased by 38 percent, when those services are provided within the comprehensive outpatient rehabilitation facility and provided to residents of nursing facilities owned by the entity.

(c) The commissioner shall establish three levels of payment for mental health diagnostic assessment, based on three levels of complexity. The aggregate payment under the tiered rates must not exceed the projected aggregate payments for mental health diagnostic assessment under the previous single rate. The new rate structure is effective January 1, 2011, or upon federal approval, whichever is later.

new text begin (d) In addition to rate increases otherwise provided, the commissioner may restructure coverage policy and rates to improve access to adult rehabilitative mental health services under section 256B.0623 and related mental health support services under section 256B.021, subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and 2016, the projected state share of increased costs due to this paragraph is transferred from adult mental health grants under sections 245.4661 and 256E.12. The transfer for fiscal year 2016 is a permanent base adjustment for subsequent fiscal years. Payments made to managed care plans and county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the rate changes described in this paragraph. new text end

Sec. 29.

new text begin CHILD AND ADOLESCENT BEHAVIORAL HEALTH SERVICES. new text end

new text begin The commissioner of human services shall, in consultation with children's mental health community providers, hospitals providing care to children, children's mental health advocates, and other interested parties, develop recommendations and legislation, if necessary, for the state-operated child and adolescent behavioral health services facility to ensure that: new text end

new text begin (1) the facility and the services provided meet the needs of children with serious emotional disturbances, autism spectrum disorders, reactive attachment disorder, PTSD, serious emotional disturbance co-occurring with a developmental disability, borderline personality disorder, schizophrenia, fetal alcohol spectrum disorders, brain injuries, violent tendencies, and complex medical issues; new text end

new text begin (2) qualified personnel and staff can be recruited who have specific expertise and training to treat the children in the facility; and new text end

new text begin (3) the treatment provided at the facility is high-quality, effective treatment. new text end

Sec. 30.

new text begin PILOT PROVIDER INPUT SURVEY OF PEDIATRIC SERVICES AND CHILDREN'S MENTAL HEALTH SERVICES. new text end

new text begin (a) To assess the efficiency and other operational issues in the management of the health care delivery system, the commissioner of human services shall initiate a provider survey. The pilot survey shall consist of an electronic survey of providers of pediatric home health care services and children's mental health services to identify and measure issues that arise in dealing with the management of medical assistance. To the maximum degree possible, existing technology shall be used and interns sought to analyze the results. new text end

new text begin (b) The survey questions must focus on seven key business functions provided by medical assistance contractors: provider inquiries; provider outreach and education; claims processing; appeals; provider enrollment; medical review; and provider audit and reimbursement. The commissioner must consider the results of the survey in evaluating and renewing managed care and fee-for-service management contracts. new text end

new text begin (c) The commissioner shall report by January 15, 2014, the results of the survey to the chairs of the health and human services policy and finance committees and shall make recommendations on the value of implementing an annual survey with a rotating list of provider groups as a component of the continuous quality improvement system for medical assistance. new text end

Sec. 31.

new text begin MENTALLY ILL AND DANGEROUS COMMITMENTS STAKEHOLDERS GROUP. new text end

new text begin (a) The commissioner of human services, in consultation with the state court administrator, shall convene a stakeholder group to develop recommendations for the legislature that address issues raised in the February 2013 Office of the Legislative Auditor report on State-Operated Services for persons committed to the commissioner as mentally ill and dangerous under Minnesota Statutes, section 253B.18. Stakeholders must include representatives from the Department of Human Services, county human services, county attorneys, commitment defense attorneys, the ombudsman for mental health and developmental disabilities, the federal protection and advocacy system, and consumers and advocates for persons with mental illnesses. new text end

new text begin (b) The stakeholder group shall provide recommendations in the following areas: new text end

new text begin (1) the role of the special review board, including the scope of authority of the special review board and the authority of the commissioner to accept or reject special review board recommendations; new text end

new text begin (2) review of special review board decisions by the district court; new text end

new text begin (3) annual district court review of commitment, scope of court authority, and appropriate review criteria; new text end

new text begin (4) options, including annual court hearing and review, as alternatives to indeterminate commitment under Minnesota Statutes, section 253B.18; and new text end

new text begin (5) extension of the right to petition the court under Minnesota Statutes, section 253B.17, to those committed under Minnesota Statutes, section 253B.18. The commissioner of human services and the state court administrator shall provide relevant data for the group's consideration in developing these recommendations, including numbers of proceedings in each category and costs associated with court and administrative proceedings under Minnesota Statutes, section 253B.18. new text end

new text begin (c) By January 15, 2014, the commissioner of human services shall submit the recommendations of the stakeholder group to the chairs and ranking minority members of the committees of the legislature with jurisdiction over civil commitment and human services issues. new text end

Sec. 32.

new text begin STATE ASSISTANCE TO COUNTIES; TRANSITIONS FOR HIGH NEEDS POPULATIONS. new text end

new text begin (a) Effective immediately, the commissioner of human services shall work with counties that request assistance to assure timely discharge from Anoka Metro Regional Treatment Center and the Minnesota Security Hospital for individuals who are ready for discharge but for whom the county may not have provider resources or appropriate placement available. Special consideration must be given to uninsured individuals who are not eligible for medical assistance and who may need continued treatment, and individuals with complex needs and other factors that hinder county efforts to place the individual in a safe, affordable setting. new text end

new text begin (b) The commissioner shall assure that, given Olmstead court directives and the role family and friends play in treatment progress, metropolitan area residents are asked whether they wished to be placed in an Intensive Residential Treatment Service program at Willmar or Cambridge or to be placed in a location more accessible to family, friends, and health providers. new text end

ARTICLE 5

DEPARTMENT OF HUMAN SERVICES PROGRAM INTEGRITY

Section 1.

Minnesota Statutes 2012, section 13.461, is amended by adding a subdivision to read:

new text begin Subd. 7b. new text end

new text begin Child care provider and recipient fraud investigations. new text end

new text begin Data related to child care fraud and recipient fraud investigations are governed by section 245E.01, subdivision 15. new text end

Sec. 2.

Minnesota Statutes 2012, section 243.166, subdivision 7, is amended to read:

Subd. 7.

Use of data.

new text begin (a) new text end Except as otherwise provided in subdivision 7a or sections 244.052 and 299C.093, the data provided under this section is private data on individuals under section 13.02, subdivision 12.

new text begin (b) new text end The data may be used only deleted text begin fordeleted text end new text begin by law enforcement and corrections agencies fornew text end law enforcement and corrections purposes.

new text begin (c) The commissioner of human services is authorized to have access to the data for: new text end

new text begin (1)new text end state-operated services, as defined in section 246.014, deleted text begin are also authorized to have access to the datadeleted text end for the purposes described in section 246.13, subdivision 2, paragraph (b)new text begin ; andnew text end

new text begin (2) purposes of completing background studies under chapter 245Cnew text end .

Sec. 3.

Minnesota Statutes 2012, section 245C.04, is amended by adding a subdivision to read:

new text begin Subd. 4a. new text end

new text begin Agency background studies. new text end

new text begin (a) The commissioner shall develop and implement an electronic process for the regular transfer of new criminal case information that is added to the Minnesota court information system. The commissioner's system must include for review only information that relates to individuals who have been the subject of a background study under this chapter that remain affiliated with the agency that initiated the background study. For purposes of this paragraph, an individual remains affiliated with an agency that initiated the background study until the agency informs the commissioner that the individual is no longer affiliated. When any individual no longer affiliated according to this paragraph returns to a position requiring a background study under this chapter, the agency with whom the individual is again affiliated shall initiate a new background study regardless of the length of time the individual was no longer affiliated with the agency. new text end

new text begin (b) The commissioner shall develop and implement an online system for agencies that initiate background studies under this chapter to access and maintain records of background studies initiated by that agency. The system must show all active background study subjects affiliated with that agency and the status of each individual's background study. Each agency that initiates background studies must use this system to notify the commissioner of discontinued affiliation for purposes of the processes required under paragraph (a). new text end

Sec. 4.

Minnesota Statutes 2012, section 245C.08, subdivision 1, is amended to read:

Subdivision 1.

Background studies conducted by Department of Human Services.

(a) For a background study conducted by the Department of Human Services, the commissioner shall review:

(1) information related to names of substantiated perpetrators of maltreatment of vulnerable adults that has been received by the commissioner as required under section 626.557, subdivision 9c, paragraph (j);

(2) the commissioner's records relating to the maltreatment of minors in licensed programs, and from findings of maltreatment of minors as indicated through the social service information system;

(3) information from juvenile courts as required in subdivision 4 for individuals listed in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;

(4) information from the Bureau of Criminal Apprehensionnew text begin , including information regarding a background study subject's registration in Minnesota as a predatory offender under section 243.166new text end ;

(5) except as provided in clause (6), information from the national crime information system when the commissioner has reasonable cause as defined under section 245C.05, subdivision 5; and

(6) for a background study related to a child foster care application for licensure or adoptions, the commissioner shall also review:

(i) information from the child abuse and neglect registry for any state in which the background study subject has resided for the past five years; and

(ii) information from national crime information databases, when the background study subject is 18 years of age or older.

(b) Notwithstanding expungement by a court, the commissioner may consider information obtained under paragraph (a), clauses (3) and (4), unless the commissioner received notice of the petition for expungement and the court order for expungement is directed specifically to the commissioner.

new text begin (c) The commissioner shall also review criminal case information received according to section 245C.04, subdivision 4a, from the Minnesota court information system that relates to individuals who have already been studied under this chapter and who remain affiliated with the agency that initiated the background study. new text end

Sec. 5.

new text begin [245E.01] CHILD CARE PROVIDER AND RECIPIENT FRAUD INVESTIGATIONS WITHIN THE CHILD CARE ASSISTANCE PROGRAM. new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the terms defined in this subdivision have the meanings given them. new text end

new text begin (b) "Applicant" has the meaning given in section 119B.011, subdivision 2. new text end

new text begin (c) "Child care assistance program" means any of the assistance programs under chapter 119B. new text end

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

new text begin (e) "Controlling individual" has the meaning given in section 245A.02, subdivision 5a. new text end

new text begin (f) "County" means a local county child care assistance program staff or subcontracted staff, or a county investigator acting on behalf of the commissioner. new text end

new text begin (g) "Department" means the Department of Human Services. new text end

new text begin (h) "Financial misconduct" or "misconduct" means an entity's or individual's acts or omissions that result in fraud and abuse or error against the Department of Human Services. new text end

new text begin (i) "Identify" means to furnish the full name, current or last known address, phone number, and e-mail address of the individual or business entity. new text end

new text begin (j) "License holder" has the meaning given in section 245A.02, subdivision 9. new text end

new text begin (k) "Mail" means the use of any mail service with proof of delivery and receipt. new text end

new text begin (l) "Provider" means either a provider as defined in section 119B.011, subdivision 19, or a legal unlicensed provider as defined in section 119B.011, subdivision 16. new text end

new text begin (m) "Recipient" means a family receiving assistance as defined under section 119B.011, subdivision 13. new text end

new text begin (n) "Terminate" means revocation of participation in the child care assistance program. new text end

new text begin Subd. 2. new text end

new text begin Investigating provider or recipient financial misconduct. new text end

new text begin The department shall investigate alleged or suspected financial misconduct by providers and errors related to payments issued by the child care assistance program under this chapter. Recipients, employees, and staff may be investigated when the evidence shows that their conduct is related to the financial misconduct of a provider, license holder, or controlling individual. new text end

new text begin Subd. 3. new text end

new text begin Scope of investigations. new text end

new text begin (a) The department may contact any person, agency, organization, or other entity that is necessary to an investigation. new text end

new text begin (b) The department may examine or interview any individual, document, or piece of evidence that may lead to information that is relevant to child care assistance program benefits, payments, and child care provider authorizations. This includes, but is not limited to: new text end

new text begin (1) child care assistance program payments; new text end

new text begin (2) services provided by the program or related to child care assistance program recipients; new text end

new text begin (3) services provided to a provider; new text end

new text begin (4) provider financial records of any type; new text end

new text begin (5) daily attendance records of the children receiving services from the provider; new text end

new text begin (6) billings; and new text end

new text begin (7) verification of the credentials of a license holder, controlling individual, employee, staff person, contractor, subcontractor, and entities under contract with the provider to provide services or maintain service and the provider's financial records related to those services. new text end

new text begin Subd. 4. new text end

new text begin Determination of investigation. new text end

new text begin After completing its investigation, the department shall issue one of the following determinations: new text end

new text begin (1) no violation of child care assistance requirements occurred; new text end

new text begin (2) there is insufficient evidence to show that a violation of child care assistance requirements occurred; new text end

new text begin (3) a preponderance of evidence shows a violation of child care assistance program law, rule, or policy; or new text end

new text begin (4) there exists a credible allegation of fraud. new text end

new text begin Subd. 5. new text end

new text begin Actions or administrative sanctions. new text end

new text begin (a) After completing the determination under subdivision 4, the department may take one or more of the actions or sanctions specified in this subdivision. new text end

new text begin (b) The department may take the following actions: new text end

new text begin (1) refer the investigation to law enforcement or a county attorney for possible criminal prosecution; new text end

new text begin (2) refer relevant information to the department's licensing division, the child care assistance program, the Department of Education, the federal child and adult care food program, or appropriate child or adult protection agency; new text end

new text begin (3) enter into a settlement agreement with a provider, license holder, controlling individual, or recipient; or new text end

new text begin (4) refer the matter for review by a prosecutorial agency with appropriate jurisdiction for possible civil action under the Minnesota False Claims Act, chapter 15C. new text end

new text begin (c) In addition to section 256.98, the department may impose sanctions by: new text end

new text begin (1) pursuing administrative disqualification through hearings or waivers; new text end

new text begin (2) establishing and seeking monetary recovery or recoupment; or new text end

new text begin (3) issuing an order of corrective action that states the practices that are violations of child care assistance program policies, laws, or regulations, and that they must be corrected. new text end

new text begin Subd. 6. new text end

new text begin Duty to provide access. new text end

new text begin (a) A provider, license holder, controlling individual, employee, staff person, or recipient has an affirmative duty to provide access upon request to information specified under subdivision 8 or the program facility. new text end

new text begin (b) Failure to provide access may result in denial or termination of authorizations for or payments to a recipient, provider, license holder, or controlling individual in the child care assistance program. new text end

new text begin (c) When a provider fails to provide access, a 15-day notice of denial or termination must be issued to the provider, which prohibits the provider from participating in the child care assistance program. Notice must be sent to recipients whose children are under the provider's care pursuant to Minnesota Rules, part 3400.0185. new text end

new text begin (d) If the provider continues to fail to provide access at the expiration of the 15-day notice period, child care assistance program payments to the provider must be denied beginning the 16th day following notice of the initial failure or refusal to provide access. The department may rescind the denial based upon good cause if the provider submits in writing a good cause basis for having failed or refused to provide access. The writing must be postmarked no later than the 15th day following the provider's notice of initial failure to provide access. Additionally, the provider, license holder, or controlling individual must immediately provide complete, ongoing access to the department. Repeated failures to provide access must, after the initial failure or for any subsequent failure, result in termination from participation in the child care assistance program. new text end

new text begin (e) The department, at its own expense, may photocopy or otherwise duplicate records referenced in subdivision 8. Photocopying must be done on the provider's premises on the day of the request or other mutually agreeable time, unless removal of records is specifically permitted by the provider. If requested, a provider, license holder, or controlling individual, or a designee, must assist the investigator in duplicating any record, including a hard copy or electronically stored data, on the day of the request. new text end

new text begin (f) A provider, license holder, controlling individual, employee, or staff person must grant the department access during the department's normal business hours, and any hours that the program is operated, to examine the provider's program or the records listed in subdivision 8. A provider shall make records available at the provider's place of business on the day for which access is requested, unless the provider and the department both agree otherwise. The department's normal business hours are 8:00 a.m. to 5:00 p.m., Monday through Friday, excluding state holidays as defined in section 645.44, subdivision 5. new text end

new text begin Subd. 7. new text end

new text begin Honest and truthful statements. new text end

new text begin It shall be unlawful for a provider, license holder, controlling individual, or recipient to: new text end

new text begin (1) falsify, conceal, or cover up by any trick, scheme, or device a material fact; new text end

new text begin (2) make any materially false, fictitious, or fraudulent statement or representation; or new text end

new text begin (3) make or use any false writing or document knowing the same to contain any materially false, fictitious, or fraudulent statement or entry related to any child care assistance program services that the provider, license holder, or controlling individual supplies or in relation to any child care assistance payments received by a provider, license holder, or controlling individual or to any fraud investigator or law enforcement officer conducting a financial misconduct investigation. new text end

new text begin Subd. 8. new text end

new text begin Record retention. new text end

new text begin (a) The following records must be maintained, controlled, and made immediately accessible to license holders, providers, and controlling individuals. The records must be organized and labeled to correspond to categories that make them easy to identify so that they can be made available immediately upon request to an investigator acting on behalf of the commissioner at the provider's place of business: new text end

new text begin (1) payroll ledgers, canceled checks, bank deposit slips, and any other accounting records; new text end

new text begin (2) daily attendance records required by and that comply with section 119B.125, subdivision 6; new text end

new text begin (3) billing transmittal forms requesting payments from the child care assistance program and billing adjustments related to child care assistance program payments; new text end

new text begin (4) records identifying all persons, corporations, partnerships, and entities with an ownership or controlling interest in the provider's child care business; new text end

new text begin (5) employee records identifying those persons currently employed by the provider's child care business or who have been employed by the business at any time within the previous five years. The records must include each employee's name, hourly and annual salary, qualifications, position description, job title, and dates of employment. In addition, employee records that must be made available include the employee's time sheets, current home address of the employee or last known address of any former employee, and documentation of background studies required under chapter 119B or 245C; new text end

new text begin (6) records related to transportation of children in care, including but not limited to: new text end

new text begin (i) the dates and times that transportation is provided to children for transportation to and from the provider's business location for any purpose. For transportation related to field trips or locations away from the provider's business location, the names and addresses of those field trips and locations must also be provided; new text end

new text begin (ii) the name, business address, phone number, and Web site address, if any, of the transportation service utilized; and new text end

new text begin (iii) all billing or transportation records related to the transportation. new text end

new text begin (b) A provider, license holder, or controlling individual must retain all records in paragraph (a) for at least six years after the last date of service. Microfilm or electronically stored records satisfy the record keeping requirements of this subdivision. new text end

new text begin (c) A provider, license holder, or controlling individual who withdraws or is terminated from the child care assistance program must retain the records required under this subdivision and make them available to the department on demand. new text end

new text begin (d) If the ownership of a provider changes, the transferor, unless otherwise provided by law or by written agreement with the transferee, is responsible for maintaining, preserving, and upon request from the department, making available the records related to the provider that were generated before the date of the transfer. Any written agreement affecting this provision must be held in the possession of the transferor and transferee. The written agreement must be provided to the department or county immediately upon request, and the written agreement must be retained by the transferor and transferee for six years after the agreement is fully executed. new text end

new text begin (e) In the event of an appealed case, the provider must retain all records required in this subdivision for the duration of the appeal or six years, whichever is longer. new text end

new text begin (f) A provider's use of electronic record keeping or electronic signatures is governed by chapter 325L. new text end

new text begin Subd. 9. new text end

new text begin Factors regarding imposition of administrative sanctions. new text end

new text begin (a) The department shall consider the following factors in determining the administrative sanctions to be imposed: new text end

new text begin (1) nature and extent of financial misconduct; new text end

new text begin (2) history of financial misconduct; new text end

new text begin (3) actions taken or recommended by other state agencies, other divisions of the department, and court and administrative decisions; new text end

new text begin (4) prior imposition of sanctions; new text end

new text begin (5) size and type of provider; new text end

new text begin (6) information obtained through an investigation from any source; new text end

new text begin (7) convictions or pending criminal charges; and new text end

new text begin (8) any other information relevant to the acts or omissions related to the financial misconduct. new text end

new text begin (b) Any single factor under paragraph (a) may be determinative of the department's decision of whether and what sanctions are imposed. new text end

new text begin Subd. 10. new text end

new text begin Written notice of department sanction. new text end

new text begin (a) The department shall give notice in writing to a person of an administrative sanction that is to be imposed. The notice shall be sent by mail as defined in subdivision 1, paragraph (k). new text end

new text begin (b) The notice shall state: new text end

new text begin (1) the factual basis for the department's determination; new text end

new text begin (2) the sanction the department intends to take; new text end

new text begin (3) the dollar amount of the monetary recovery or recoupment, if any; new text end

new text begin (4) how the dollar amount was computed; new text end

new text begin (5) the right to dispute the department's determination and to provide evidence; new text end

new text begin (6) the right to appeal the department's proposed sanction; and new text end

new text begin (7) the option to meet informally with department staff, and to bring additional documentation or information, to resolve the issues. new text end

new text begin (c) In cases of determinations resulting in denial or termination of payments, in addition to the requirements of paragraph (b), the notice must state: new text end

new text begin (1) the length of the denial or termination; new text end

new text begin (2) the requirements and procedures for reinstatement; and new text end

new text begin (3) the provider's right to submit documents and written arguments against the denial or termination of payments for review by the department before the effective date of denial or termination. new text end

new text begin (d) The submission of documents and written argument for review by the department under paragraph (b), clause (5) or (7), or paragraph (c), clause (3), does not stay the deadline for filing an appeal. new text end

new text begin (e) Unless timely appealed, the effective date of the proposed sanction shall be 30 days after the license holder's, provider's, controlling individual's, or recipient's receipt of the notice. If a timely appeal is made, the proposed sanction shall be delayed pending the final outcome of the appeal. Implementation of a proposed sanction following the resolution of a timely appeal may be postponed if, in the opinion of the department, the delay of sanction is necessary to protect the health or safety of children in care. The department may consider the economic hardship of a person in implementing the proposed sanction, but economic hardship shall not be a determinative factor in implementing the proposed sanction. new text end

new text begin (f) Requests for an informal meeting to attempt to resolve issues and requests for appeals must be sent or delivered to the department's Office of Inspector General, Financial Fraud and Abuse Division. new text end

new text begin Subd. 11. new text end

new text begin Appeal of department sanction under this section. new text end

new text begin (a) If the department does not pursue a criminal action against a provider, license holder, controlling individual, or recipient for financial misconduct, but the department imposes an administrative sanction under subdivision 5, paragraph (c), any individual or entity against whom the sanction was imposed may appeal the department's administrative sanction under this section pursuant to section 119B.16 or 256.045 with the additional requirements in clauses (1) to (4). An appeal must specify: new text end

new text begin (1) each disputed item, the reason for the dispute, and an estimate of the dollar amount involved for each disputed item, if appropriate; new text end

new text begin (2) the computation that is believed to be correct, if appropriate; new text end

new text begin (3) the authority in the statute or rule relied upon for each disputed item; and new text end

new text begin (4) the name, address, and phone number of the person at the provider's place of business with whom contact may be made regarding the appeal. new text end

new text begin (b) An appeal is considered timely only if postmarked or received by the department's Appeals Division within 30 days after receiving a notice of department sanction. new text end

new text begin (c) Before the appeal hearing, the department may deny or terminate authorizations or payment to the entity or individual if the department determines that the action is necessary to protect the public welfare or the interests of the child care assistance program. new text end

new text begin Subd. 12. new text end

new text begin Consolidated hearings with licensing sanction. new text end

new text begin If a financial misconduct sanction has an appeal hearing right and it is timely appealed, and a licensing sanction exists for which there is an appeal hearing right and the sanction is timely appealed, and the overpayment recovery action and licensing sanction involve the same set of facts, the overpayment recovery action and licensing sanction must be consolidated in the contested case hearing related to the licensing sanction. new text end

new text begin Subd. 13. new text end

new text begin Grounds for and methods of monetary recovery. new text end

new text begin (a) The department may obtain monetary recovery from a provider who has been improperly paid by the child care assistance program, regardless of whether the error was intentional or county error. The department does not need to establish a pattern as a precondition of monetary recovery of erroneous or false billing claims, duplicate billing claims, or billing claims based on false statements or financial misconduct. new text end

new text begin (b) The department shall obtain monetary recovery from providers by the following means: new text end

new text begin (1) permitting voluntary repayment of money, either in lump-sum payment or installment payments; new text end

new text begin (2) using any legal collection process; new text end

new text begin (3) deducting or withholding program payments; or new text end

new text begin (4) utilizing the means set forth in chapter 16D. new text end

new text begin Subd. 14. new text end

new text begin Reporting of suspected fraudulent activity. new text end

new text begin (a) A person who, in good faith, makes a report of or testifies in any action or proceeding in which financial misconduct is alleged, and who is not involved in, has not participated in, or has not aided and abetted, conspired, or colluded in the financial misconduct, shall have immunity from any liability, civil or criminal, that results by reason of the person's report or testimony. For the purpose of any proceeding, the good faith of any person reporting or testifying under this provision shall be presumed. new text end

new text begin (b) If a person that is or has been involved in, participated in, aided and abetted, conspired, or colluded in the financial misconduct reports the financial misconduct, the department may consider that person's report and assistance in investigating the misconduct as a mitigating factor in the department's pursuit of civil, criminal, or administrative remedies. new text end

new text begin Subd. 15. new text end

new text begin Data privacy. new text end

new text begin Data of any kind obtained or created in relation to a provider or recipient investigation under this section is defined, classified, and protected the same as all other data under section 13.46, and this data has the same classification as licensing data. new text end

new text begin Subd. 16. new text end

new text begin Monetary recovery; random sample extrapolation. new text end

new text begin The department is authorized to calculate the amount of monetary recovery from a provider, license holder, or controlling individual based upon extrapolation from a statistical random sample of claims submitted by the provider, license holder, or controlling individual and paid by the child care assistance program. The department's random sample extrapolation shall constitute a rebuttable presumption of the accuracy of the calculation of monetary recovery. If the presumption is not rebutted by the provider, license holder, or controlling individual in the appeal process, the department shall use the extrapolation as the monetary recovery figure. The department may use sampling and extrapolation to calculate the amount of monetary recovery if the claims to be reviewed represent services to 50 or more children in care. new text end

new text begin Subd. 17. new text end

new text begin Effect of department's monetary penalty determination. new text end

new text begin Unless a timely and proper appeal is received by the department, the department's administrative determination or sanction shall be considered a final department determination. new text end

new text begin Subd. 18. new text end

new text begin Office of Inspector General recoveries. new text end

new text begin Overpayment recoveries resulting from child care provider fraud investigations initiated by the department's Office of Inspector General's fraud investigations staff are excluded from the county recovery provision in section 119B.11, subdivision 3. new text end

Sec. 6.

Minnesota Statutes 2012, 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 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 deleted text begin Minnesota Department of Human Servicesdeleted text end new text begin commissionernew text end 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.new text begin 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.new text end

(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.

new text begin (g)(1) Upon initial enrollment, reenrollment, and revalidation, all durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers 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. new text end

new text begin (2) At the time of initial enrollment or reenrollment, the provider agency must purchase a performance 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 performance 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 performance bond of $100,000. The performance bond must allow for recovery of costs and fees in pursuing a claim on the bond. new text end

new text begin (h) The Department of Human Services may require a provider to purchase a performance 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 performance 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 performance 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. 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 2012, section 256B.04, is amended by adding a subdivision to read:

new text begin Subd. 22. new text end

new text begin Application fee. new text end

new text begin (a) The commissioner must collect and retain federally required nonrefundable application fees to pay for provider screening activities in accordance with Code of Federal Regulations, title 42, section 455, subpart E. The enrollment application must be made under the procedures specified by the commissioner, in the form specified by the commissioner, and accompanied by an application fee described in paragraph (b), or a request for a hardship exception as described in the specified procedures. Application fees must be deposited in the provider screening account in the special revenue fund. Amounts in the provider screening account are appropriated to the commissioner for costs associated with the provider screening activities required in Code of Federal Regulations, title 42, section 455, subpart E. The commissioner shall conduct screening activities as required by Code of Federal Regulations, title 42, section 455, subpart E, and as otherwise provided by law, to include database checks, unannounced pre- and postenrollment site visits, fingerprinting, and criminal background studies. The commissioner must revalidate all providers under this subdivision at least once every five years. new text end

new text begin (b) The application fee under this subdivision is $532 for the calendar year 2013. For calendar year 2014 and subsequent years, the fee: new text end

new text begin (1) is adjusted by the percentage change to the consumer price index for all urban consumers, United States city average, for the 12-month period ending with June of the previous year. The resulting fee must be announced in the Federal Register; new text end

new text begin (2) is effective from January 1 to December 31 of a calendar year; new text end

new text begin (3) is required on the submission of an initial application, an application to establish a new practice location, an application for re-enrollment when the provider is not enrolled at the time of application of re-enrollment, or at revalidation when required by federal regulation; and new text end

new text begin (4) must be in the amount in effect for the calendar year during which the application for enrollment, new practice location, or re-enrollment is being submitted. new text end

new text begin (c) The application fee under this subdivision cannot be charged to: new text end

new text begin (1) providers who are enrolled in Medicare or who provide documentation of payment of the fee to, and enrollment with, another state, unless the commissioner is required to rescreen the provider; new text end

new text begin (2) providers who are enrolled but are required to submit new applications for purposes of reenrollment; new text end

new text begin (3) a provider who enrolls as an individual; and new text end

new text begin (4) group practices and clinics that bill on behalf of individually enrolled providers within the practice who have reassigned their billing privileges to the group practice or clinic. 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 2012, section 256B.064, subdivision 1a, is amended to read:

Subd. 1a.

Grounds for sanctions against vendors.

The commissioner may impose sanctions against a vendor of medical care for any of the following: (1) fraud, theft, or abuse in connection with the provision of medical care to recipients of public assistance; (2) a pattern of presentment of false or duplicate claims or claims for services not medically necessary; (3) a pattern of making false statements of material facts for the purpose of obtaining greater compensation than that to which the vendor is legally entitled; (4) suspension or termination as a Medicare vendor; (5) refusal to grant the state agency access during regular business hours to examine all records necessary to disclose the extent of services provided to program recipients and appropriateness of claims for payment; (6) failure to repay an overpayment new text begin or a fine new text end finally established under this section; deleted text begin anddeleted text end (7) new text begin failure to correct errors in the maintenance of health service or financial records for which a fine was imposed or after issuance of a warning by the commissioner; and (8) new text end any reason for which a vendor could be excluded from participation in the Medicare program under section 1128, 1128A, or 1866(b)(2) of the Social Security Act. The determination of services not medically necessary may be made by the commissioner in consultation with a peer advisory task force appointed by the commissioner on the recommendation of appropriate professional organizations. The task force expires as provided in section 15.059, subdivision 5.

Sec. 9.

Minnesota Statutes 2012, 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 programnew text begin , 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 vendornew text end . Regardless of imposition of sanctions, the commissioner may make a referral to the appropriate state licensing board.

Sec. 10.

Minnesota Statutes 2012, section 256B.064, subdivision 2, is amended to read:

Subd. 2.

Imposition of monetary recovery and sanctions.

(a) The commissioner shall determine any monetary amounts to be recovered and sanctions to be imposed upon a vendor of medical care under this section. Except as provided in paragraphs (b) and (d), neither a monetary recovery nor a sanction will be imposed by the commissioner without prior notice and an opportunity for a hearing, according to chapter 14, on the commissioner's proposed action, provided that the commissioner may suspend or reduce payment to a vendor of medical care, except a nursing home or convalescent care facility, after notice and prior to the hearing if in the commissioner's opinion that action is necessary to protect the public welfare and the interests of the program.

(b) Except when the commissioner finds good cause not to suspend payments under Code of Federal Regulations, title 42, section 455.23 (e) or (f), the commissioner shall withhold or reduce payments to a vendor of medical care without providing advance notice of such withholding or reduction if either of the following occurs:

(1) the vendor is convicted of a crime involving the conduct described in subdivision 1a; or

(2) the commissioner determines there is a credible allegation of fraud for which an investigation is pending under the program. A credible allegation of fraud is an allegation which has been verified by the state, from any source, including but not limited to:

(i) fraud hotline complaints;

(ii) claims data mining; and

(iii) patterns identified through provider audits, civil false claims cases, and law enforcement investigations.

Allegations are considered to be credible when they have an indicia of reliability and the state agency has reviewed all allegations, facts, and evidence carefully and acts judiciously on a case-by-case basis.

(c) The commissioner must send notice of the withholding or reduction of payments under paragraph (b) within five days of taking such action unless requested in writing by a law enforcement agency to temporarily withhold the notice. The notice must:

(1) state that payments are being withheld according to paragraph (b);

(2) set forth the general allegations as to the nature of the withholding action, but need not disclose any specific information concerning an ongoing investigation;

(3) except in the case of a conviction for conduct described in subdivision 1a, state that the withholding is for a temporary period and cite the circumstances under which withholding will be terminated;

(4) identify the types of claims to which the withholding applies; and

(5) inform the vendor of the right to submit written evidence for consideration by the commissioner.

The withholding or reduction of payments will not continue after the commissioner determines there is insufficient evidence of fraud by the vendor, or after legal proceedings relating to the alleged fraud are completed, unless the commissioner has sent notice of intention to impose monetary recovery or sanctions under paragraph (a).

(d) The commissioner shall suspend or terminate a vendor's participation in the program without providing advance notice and an opportunity for a hearing when the suspension or termination is required because of the vendor's exclusion from participation in Medicare. Within five days of taking such action, the commissioner must send notice of the suspension or termination. The notice must:

(1) state that suspension or termination is the result of the vendor's exclusion from Medicare;

(2) identify the effective date of the suspension or termination; and

(3) inform the vendor of the need to be reinstated to Medicare before reapplying for participation in the program.

(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or sanction is to be imposed, a vendor may request a contested case, as defined in section 14.02, subdivision 3, by filing with the commissioner a written request of appeal. The appeal request must be received by the commissioner no later than 30 days after the date the notification of monetary recovery or sanction was mailed to the vendor. The appeal request must specify:

(1) each disputed item, the reason for the dispute, and an estimate of the dollar amount involved for each disputed item;

(2) the computation that the vendor believes is correct;

(3) the authority in statute or rule upon which the vendor relies for each disputed item;

(4) the name and address of the person or entity with whom contacts may be made regarding the appeal; and

(5) other information required by the commissioner.

new text begin (f) The commissioner may order a vendor to forfeit a fine for failure to fully document services according to standards in this chapter and Minnesota Rules, chapter 9505. The commissioner may assess fines if specific required components of documentation are missing. The fine for incomplete documentation shall equal 20 percent of the amount paid on the claims for reimbursement submitted by the vendor, or up to $5,000, whichever is less. new text end

new text begin (g) The vendor shall pay the fine assessed on or before the payment date specified. If the vendor fails to pay the fine, the commissioner may withhold or reduce payments and recover the amount of the fine. A timely appeal shall stay payment of the fine until the commissioner issues a final order. new text end

Sec. 11.

Minnesota Statutes 2012, section 256B.0659, subdivision 21, is amended to read:

Subd. 21.

Requirements for deleted text begin initialdeleted text end new text begin providernew text end enrollment of personal care assistance provider agencies.

(a) All personal care assistance provider agencies must provide, at the time of enrollmentnew text begin , reenrollment, and revalidationnew text end 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;

deleted text begin (2) proof of surety bond coverage in the amount of $50,000 or ten percent of the provider's payments from Medicaid in the previous year, whichever is less; deleted text end

new text begin (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 performance bond of $50,000. If the Medicaid revenue in the previous year is over $300,000, the provider agency must purchase a performance bond of $100,000. The performance bond must be in a form approved by the commissioner, must be renewed annually, and must allow for recovery of costs and fees in pursuing a claim on the bond; new text end

(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. 12.

Minnesota Statutes 2012, section 299C.093, is amended to read:

299C.093 DATABASE OF REGISTERED PREDATORY OFFENDERS.

The superintendent of the Bureau of Criminal Apprehension shall maintain a computerized data system relating to individuals required to register as predatory offenders under section 243.166. To the degree feasible, the system must include the data required to be provided under section 243.166, subdivisions 4 and 4a, and indicate the time period that the person is required to register. The superintendent shall maintain this data in a manner that ensures that it is readily available to law enforcement agencies. This data is private data on individuals under section 13.02, subdivision 12, but may be used for law enforcement and corrections purposes. new text begin The commissioner of human services has access to the data for new text end state-operated services, as defined in section 246.014, deleted text begin are also authorized to have access to the datadeleted text end for the purposes described in section 246.13, subdivision 2, paragraph (b)new text begin , and for purposes of conducting background studies under chapter 245Cnew text end .

Sec. 13.

Minnesota Statutes 2012, section 402A.10, is amended to read:

402A.10 DEFINITIONS.

Subdivision 1.

Terms defined.

For the purposes of this chapter, the terms defined in this section have the meanings given.

new text begin Subd. 1a. new text end

new text begin Balanced set of program measures. new text end

new text begin A "balanced set of program measures" is a set of measures that, together, adequately quantify achievement toward a particular program's outcome. As directed by section 402A.16, the Human Services Performance Council must recommend to the commissioner when a particular program has a balanced set of program measures. new text end

Subd. 2.

Commissioner.

"Commissioner" means the commissioner of human services.

Subd. 3.

Council.

"Council" means the State-County Results, Accountability, and Service Delivery Redesign Council established in section 402A.20.

Subd. 4.

Essential human services or essential services.

"Essential human services" or "essential services" means assistance and services to recipients or potential recipients of public welfare and other services delivered by counties or tribes that are mandated in federal and state law that are to be available in all counties of the state.

new text begin Subd. 4a. new text end

new text begin Essential human services program. new text end

new text begin An "essential human services program" for the purposes of remedies under section 402A.18 means the following programs: new text end

new text begin (1) child welfare, including protection, truancy, minor parent, guardianship, and adoption; new text end

new text begin (2) children's mental health; new text end

new text begin (3) children's disability services; new text end

new text begin (4) public assistance eligibility, including measures related to processing timelines across information services programs; new text end

new text begin (5) MFIP; new text end

new text begin (6) child support; new text end

new text begin (7) chemical dependency; new text end

new text begin (8) adult disability; new text end

new text begin (9) adult mental health; new text end

new text begin (10) adult services such as long-term care; and new text end

new text begin (11) adult protection. new text end

new text begin Subd. 4b. new text end

new text begin Measure. new text end

new text begin A "measure" means a quantitative indicator of a performance outcome. new text end

new text begin Subd. 4c. new text end

new text begin Performance improvement plan. new text end

new text begin A "performance improvement plan" means a plan developed by a county or service delivery authority that describes steps the county or service delivery authority must take to improve performance on a specific measure or set of measures. The performance improvement plan must be negotiated with and approved by the commissioner. The performance improvement plan must require a specific numerical improvement in the measure or measures on which the plan is based and may include specific programmatic best practices or specific performance management practices that the county must implement. new text end

new text begin Subd. 4d. new text end

new text begin Performance management system for human services. new text end

new text begin A "performance management system for human services" means a process by which performance data for essential human services is collected from counties or service delivery authorities and used to inform a variety of stakeholders and to improve performance over time. new text end

Subd. 5.

Service delivery authority.

"Service delivery authority" means a single county, or consortium of counties operating by execution of a joint powers agreement under section 471.59 or other contractual agreement, that has voluntarily chosen by resolution of the county board of commissioners to participate in the redesign under this chapter or has been assigned by the commissioner pursuant to section 402A.18. A service delivery authority includes an Indian tribe or group of tribes that have voluntarily chosen by resolution of tribal government to participate in redesign under this chapter.

Subd. 6.

Steering committee.

"Steering committee" means the Steering Committee on Performance and Outcome Reforms.

Sec. 14.

new text begin [402A.12] ESTABLISHMENT OF A PERFORMANCE MANAGEMENT SYSTEM FOR HUMAN SERVICES. new text end

new text begin By January 1, 2014, the commissioner shall implement a performance management system for essential human services as described in sections 402A.15 to 402A.18 that includes initial performance measures and standards consistent with the recommendations of the Steering Committee on Performance and Outcome Reforms in the December 2012 report to the legislature. new text end

Sec. 15.

new text begin [402A.16] HUMAN SERVICES PERFORMANCE COUNCIL. new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin By October 1, 2013, the commissioner shall convene a Human Services Performance Council to advise the commissioner on the implementation and operation of the performance management system for human services. new text end

new text begin Subd. 2. new text end

new text begin Duties. new text end

new text begin The Human Services Performance Council shall: new text end

new text begin (1) hold meetings at least quarterly that are in compliance with Minnesota's Open Meeting Law under chapter 13D; new text end

new text begin (2) annually review the annual performance data submitted by counties or service delivery authorities; new text end

new text begin (3) review and advise the commissioner on department procedures related to the implementation of the performance management system and system process requirements and on barriers to process improvement in human services delivery; new text end

new text begin (4) advise the commissioner on the training and technical assistance needs of county or service delivery authority and department personnel; new text end

new text begin (5) review instances in which a county or service delivery authority has not made adequate progress on a performance improvement plan and make recommendations to the commissioner under section 402A.18; new text end

new text begin (6) consider appeals from counties or service delivery authorities that are in the remedies process and make recommendations to the commissioner on resolving the issue; new text end

new text begin (7) convene working groups to update and develop outcomes, measures, and performance standards for the performance management system and, on an annual basis, present these recommendations to the commissioner, including recommendations on when a particular essential human service program has a balanced set of program measures in place; new text end

new text begin (8) make recommendations on human services administrative rules or statutes that could be repealed in order to improve service delivery; new text end

new text begin (9) provide information to stakeholders on the council's role and regularly collect stakeholder input on performance management system performance; and new text end

new text begin (10) submit an annual report to the legislature and the commissioner, which includes a comprehensive report on the performance of individual counties or service delivery authorities as it relates to system measures; a list of counties or service delivery authorities that have been required to create performance improvement plans and the areas identified for improvement as part of the remedies process; a summary of performance improvement training and technical assistance activities offered to the county personnel by the department; recommendations on administrative rules or state statutes that could be repealed in order to improve service delivery; recommendations for system improvements, including updates to system outcomes, measures, and standards; and a response from the commissioner. new text end

new text begin Subd. 3. new text end

new text begin Membership. new text end

new text begin (a) Human Services Performance Council membership shall be equally balanced among the following five stakeholder groups: the Association of Minnesota Counties, the Minnesota Association of County Social Service Administrators, the Department of Human Services, tribes and communities of color, and service providers and advocates for persons receiving human services. The Association of Minnesota Counties and the Minnesota Association of County Social Service Administrators shall appoint their own respective representatives. The commissioner of human services shall appoint representatives of the Department of Human Services, tribes and communities of color, and social services providers and advocates. Minimum council membership shall be 15 members, with at least three representatives from each stakeholder group, and maximum council membership shall be 20 members, with four representatives from each stakeholder group. new text end

new text begin (b) Notwithstanding section 15.059, Human Services Performance Council members shall be appointed for a minimum of two years, but may serve longer terms at the discretion of their appointing authority. new text end

new text begin (c) Notwithstanding section 15.059, members of the council shall receive no compensation for their services. new text end

new text begin (d) A commissioner's representative and a county representative from either the Association of Minnesota Counties or the Minnesota Association of County Social Service Administrators shall serve as Human Services Performance Council cochairs. new text end

new text begin Subd. 4. new text end

new text begin Commissioner duties. new text end

new text begin The commissioner shall: new text end

new text begin (1) implement and maintain the performance management system for human services; new text end

new text begin (2) establish and regularly update the system's outcomes, measures, and standards, including the minimum performance standard for each performance measure; new text end

new text begin (3) determine when a particular program has a balanced set of measures; new text end

new text begin (4) receive reports from counties or service delivery authorities at least annually on their performance against system measures, provide counties with data needed to assess performance and monitor progress, and provide timely feedback to counties or service delivery authorities on their performance; new text end

new text begin (5) implement and monitor the remedies process in section 402A.18; new text end

new text begin (6) report to the Human Services Performance Council on county or service delivery authority performance on a semiannual basis; new text end

new text begin (7) provide general training and technical assistance to counties or service delivery authorities on topics related to performance measurement and performance improvement; new text end

new text begin (8) provide targeted training and technical assistance to counties or service delivery authorities that supports their performance improvement plans; and new text end

new text begin (9) provide staff support for the Human Services Performance Council. new text end

new text begin Subd. 5. new text end

new text begin County or service delivery authority duties. new text end

new text begin The counties or service delivery authorities shall: new text end

new text begin (1) report performance data to meet performance management system requirements; and new text end

new text begin (2) provide training to personnel on basic principles of performance measurement and improvement and participate in training provided by the department. new text end

Sec. 16.

Minnesota Statutes 2012, section 402A.18, is amended to read:

402A.18 COMMISSIONER POWER TO REMEDY FAILURE TO MEET PERFORMANCE OUTCOMES.

Subdivision 1.

Underperforming county; specific service.

If the commissioner determines that a county or service delivery authority is deficient in achieving minimum performance deleted text begin outcomesdeleted text end new text begin standardsnew text end for a specific essential deleted text begin servicedeleted text end new text begin human services programnew text end , the commissioner may impose the following remedies and adjust state and federal program allocations accordingly:

(1) voluntary incorporation of the administration and operation of the specific essential deleted text begin servicedeleted text end new text begin human services programnew text end with an existing service delivery authority or another county. A service delivery authority or county incorporating an underperforming county shall not be financially liable for the costs associated with remedying performance outcome deficiencies;

(2) mandatory incorporation of the administration and operation of the specific essential deleted text begin servicedeleted text end new text begin human services programnew text end with an existing service delivery authority or another county. A service delivery authority or county incorporating an underperforming county shall not be financially liable for the costs associated with remedying performance outcome deficiencies; or

(3) transfer of authority for program administration and operation of the specific essential deleted text begin servicedeleted text end new text begin human services programnew text end to the commissioner.

Subd. 2.

Underperforming county; more than one-half of services.

If the commissioner determines that a county or service delivery authority is deficient in achieving minimum performance deleted text begin outcomesdeleted text end new text begin standardsnew text end for more than one-half of the defined essential new text begin human new text end servicesnew text begin programsnew text end , the commissioner may impose the following remedies:

(1) voluntary incorporation of the administration and operation of essential new text begin human new text end services new text begin programs new text end with an existing service delivery authority or another county. A service delivery authority or county incorporating an underperforming county shall not be financially liable for the costs associated with remedying performance outcome deficiencies;

(2) mandatory incorporation of the administration and operation of essential new text begin human new text end services new text begin programs new text end with an existing service delivery authority or another county. A service delivery authority or county incorporating an underperforming county shall not be financially liable for the costs associated with remedying performance outcome deficiencies; or

(3) transfer of authority for deleted text begin programdeleted text end administration and operation of essential new text begin human new text end services new text begin programs new text end to the commissioner.

Subd. 2a.

Financial responsibility of underperforming county.

A county subject to remedies under subdivision 1 or 2 shall provide to the entity assuming administration of the deleted text begin essential service ordeleted text end essential new text begin human new text end services new text begin program or programs new text end the amount of nonfederal and nonstate funding needed to remedy performance outcome deficiencies.

Subd. 3.

Conditions prior to imposing remedies.

deleted text begin Before the commissioner may impose the remedies authorized under this section, the following conditions must be met: deleted text end

deleted text begin (1) the county or service delivery authority determined by the commissioner to be deficient in achieving minimum performance outcomes has the opportunity, in coordination with the council, to develop a program outcome improvement plan. The program outcome improvement plan must be developed no later than six months from the date of the deficiency determination; and deleted text end

deleted text begin (2) the council has conducted an assessment of the program outcome improvement plan to determine if the county or service delivery authority has made satisfactory progress toward performance outcomes and has made a recommendation about remedies to the commissioner. The assessment and recommendation must be made to the commissioner within 12 months from the date of the deficiency determination. deleted text end new text begin (a) The commissioner shall notify a county or service delivery authority that it must submit a performance improvement plan if: new text end

new text begin (1) the county or service delivery authority does not meet the minimum performance standard for a measure; or new text end

new text begin (2) the county or service delivery authority does not meet the minimum performance standard for one or more racial or ethnic subgroup for which there is a statistically valid population size for three or more measures, even if the county or service delivery authority met the standard for the overall population. new text end

new text begin The commissioner must approve the performance improvement plan. The county or service delivery authority may negotiate the terms of the performance improvement plan with the commissioner. new text end

new text begin (b) When the department determines that a county or service delivery authority does not meet the minimum performance standard for a given measure, the commissioner must advise the county or service delivery authority that fiscal penalties may result if the performance does not improve. The department must offer technical assistance to the county or service delivery authority. Within 30 days of the initial advisement from the department, the county or service delivery authority may claim and the department may approve an extenuating circumstance that relieves the county or service delivery authority of any further remedy. If a county or service delivery authority has a small number of participants in an essential human services program such that reliable measurement is not possible, the commissioner may approve extenuating circumstances or may average performance over three years. new text end

new text begin (c) If there are no extenuating circumstances, the county or service delivery authority must submit a performance improvement plan to the commissioner within 60 days of the initial advisement from the department. The term of the performance improvement plan must be two years, starting with the date the plan is approved by the commissioner. This plan must include a target level for improvement for each measure that did not meet the minimum performance standard. The commissioner must approve the performance improvement plan within 60 days of submittal. new text end

new text begin (d) The department must monitor the performance improvement plan for two years. After two years, if the county or service delivery authority meets the minimum performance standard, there is no further remedy. If the county or service delivery authority fails to meet the minimum performance standard, but meets the improvement target in the performance improvement plan, the county or service delivery authority shall modify the performance improvement plan for further improvement and the department shall continue to monitor the plan. new text end

new text begin (e) If, after two years of monitoring, the county or service delivery authority fails to meet both the minimum performance standard and the improvement target identified in the performance improvement plan, the next step of the remedies process shall be invoked by the commissioner. This phase of the remedies process may include: new text end

new text begin (1) fiscal penalties for the county or service delivery authority that do not exceed one percent of the county's human services expenditures and that are negotiated in the performance improvement plan, based on what is needed to improve outcomes. Counties or service delivery authorities must reinvest the amount of the fiscal penalty into the essential human services program that was underperforming. A county or service delivery authority shall not be required to pay more than three fiscal penalties in a year; and new text end

new text begin (2) the department's provision of technical assistance to the county or service delivery authority that is targeted to address the specific performance issues. new text end

new text begin The commissioner shall continue monitoring the performance improvement plan for a third year. new text end

new text begin (f) If, after the third year of monitoring, the county or service delivery authority meets the minimum performance standard, there is no further remedy. If the county or service delivery authority fails to meet the minimum performance standard, but meets the improvement target for the performance improvement plan, the county or service delivery authority shall modify the performance improvement plan for further improvement and the department shall continue to monitor the plan. new text end

new text begin (g) If, after the third year of monitoring, the county or service delivery authority fails to meet the minimum performance standard and the improvement target identified in the performance improvement plan, the Human Services Performance Council shall review the situation and recommend a course of action to the commissioner. new text end

new text begin (h) If the commissioner has determined that a program has a balanced set of program measures and a county or service delivery authority is subject to fiscal penalties for more than one-half of the measures for that program, the commissioner may apply further remedies as described in subdivisions 1 and 2. new text end

Sec. 17.

new text begin INSTRUCTIONS TO THE COMMISSIONER. new text end

new text begin In collaboration with labor organizations, the commissioner of human services shall develop clear and consistent standards for state-operated services programs to: new text end

new text begin (1) address direct service staffing shortages; new text end

new text begin (2) identify and help resolve workplace safety issues; and new text end

new text begin (3) elevate the use and visibility of performance measures and objectives related to overtime use. new text end

ARTICLE 6

HEALTH CARE

Section 1.

Minnesota Statutes 2012, section 245.03, subdivision 1, is amended to read:

Subdivision 1.

Establishment.

There is created a Department of Human Services. A commissioner of human services shall be appointed by the governor under the provisions of section 15.06. The commissioner shall be selected on the basis of ability and experience in welfare and without regard to political affiliations. The commissioner deleted text begin shalldeleted text end new text begin maynew text end appoint deleted text begin adeleted text end new text begin up to twonew text end deputy deleted text begin commissionerdeleted text end new text begin commissionersnew text end .

Sec. 2.

Minnesota Statutes 2012, section 256.9657, subdivision 3, is amended to read:

Subd. 3.

Surcharge on HMOs and community integrated service networks.

(a) Effective October 1, 1992, each health maintenance organization with a certificate of authority issued by the commissioner of health under chapter 62D and each community integrated service network licensed by the commissioner under chapter 62N shall pay to the commissioner of human services a surcharge equal to six-tenths of one percent of the total premium revenues of the health maintenance organization or community integrated service network as reported to the commissioner of health according to the schedule in subdivision 4.

(b) For purposes of this subdivision, total premium revenue means:

(1) premium revenue recognized on a prepaid basis from individuals and groups for provision of a specified range of health services over a defined period of time which is normally one month, excluding premiums paid to a health maintenance organization or community integrated service network from the Federal Employees Health Benefit Program;

(2) premiums from Medicare wraparound subscribers for health benefits which supplement Medicare coverage;

(3) Medicare revenue, as a result of an arrangement between a health maintenance organization or a community integrated service network and the Centers for Medicare and Medicaid Services of the federal Department of Health and Human Services, for services to a Medicare beneficiary, excluding Medicare revenue that states are prohibited from taxing under sections 1854, 1860D-12, and 1876 of title XVIII of the federal Social Security Act, codified as United States Code, title 42, sections 1395mm, 1395w-112, and 1395w-24, respectively, as they may be amended from time to time; and

(4) medical assistance revenue, as a result of an arrangement between a health maintenance organization or community integrated service network and a Medicaid state agency, for services to a medical assistance beneficiary.

If advance payments are made under clause (1) or (2) to the health maintenance organization or community integrated service network for more than one reporting period, the portion of the payment that has not yet been earned must be treated as a liability.

(c) When a health maintenance organization or community integrated service network merges or consolidates with or is acquired by another health maintenance organization or community integrated service network, the surviving corporation or the new corporation shall be responsible for the annual surcharge originally imposed on each of the entities or corporations subject to the merger, consolidation, or acquisition, regardless of whether one of the entities or corporations does not retain a certificate of authority under chapter 62D or a license under chapter 62N.

(d) Effective deleted text begin July 1deleted text end new text begin June 15new text end of each year, the surviving corporation's or the new corporation's surcharge shall be based on the revenues earned in the deleted text begin seconddeleted text end previous calendar year by all of the entities or corporations subject to the merger, consolidation, or acquisition regardless of whether one of the entities or corporations does not retain a certificate of authority under chapter 62D or a license under chapter 62N until the total premium revenues of the surviving corporation include the total premium revenues of all the merged entities as reported to the commissioner of health.

(e) When a health maintenance organization or community integrated service network, which is subject to liability for the surcharge under this chapter, transfers, assigns, sells, leases, or disposes of all or substantially all of its property or assets, liability for the surcharge imposed by this chapter is imposed on the transferee, assignee, or buyer of the health maintenance organization or community integrated service network.

(f) In the event a health maintenance organization or community integrated service network converts its licensure to a different type of entity subject to liability for the surcharge under this chapter, but survives in the same or substantially similar form, the surviving entity remains liable for the surcharge regardless of whether one of the entities or corporations does not retain a certificate of authority under chapter 62D or a license under chapter 62N.

(g) The surcharge assessed to a health maintenance organization or community integrated service network ends when the entity ceases providing services for premiums and the cessation is not connected with a merger, consolidation, acquisition, or conversion.

Sec. 3.

Minnesota Statutes 2012, section 256.9657, subdivision 4, is amended to read:

Subd. 4.

Payments into the account.

(a) Payments to the commissioner under deleted text begin subdivisionsdeleted text end new text begin subdivision new text end 1 deleted text begin to 3deleted text end must be paid in monthly installments due on the 15th of the month beginning October 15, 1992. The monthly payment must be equal to the annual surcharge divided by 12. deleted text begin Payments to the commissioner under subdivisions 2 and 3 for fiscal year 1993 must be based on calendar year 1990 revenues. Effective July 1 of each year, beginning in 1993, payments under subdivisions 2 and 3 must be based on revenues earned in the second previous calendar year.deleted text end

new text begin (b) Effective October 15, 2014, payment to the commissioner under subdivision 2 must be paid in nine monthly installments due on the 15th of the month beginning October 15, 2014, through June 15 of the following year. The monthly payment must be equal to the annual surcharge divided by nine. new text end

deleted text begin (b)deleted text end new text begin (c)new text end Effective October 1, deleted text begin 1995deleted text end new text begin 2014new text end , and each October 1 thereafter, the payments in deleted text begin subdivisionsdeleted text end new text begin subdivisionnew text end 2 deleted text begin and 3deleted text end must be based on revenues earned in the previous calendar year.

deleted text begin (c)deleted text end new text begin (d)new text end If the commissioner of health does not provide by August 15 of any year data needed to update the base year for the hospital deleted text begin anddeleted text end new text begin or April 15 of any year data needed to update the base year for thenew text end health maintenance organization surcharges, the commissioner of human services may estimate base year revenue and use that estimate for the purposes of this section until actual data is provided by the commissioner of health.

deleted text begin (d)deleted text end new text begin (e)new text end Payments to the commissioner under subdivision 3a must be paid in monthly installments due on the 15th of the month beginning July 15, 2003. The monthly payment must be equal to the annual surcharge divided by 12.

new text begin (f) Payments due in July through September 2014 under subdivision 3 for revenue earned in calendar year 2012 shall be paid in a lump sum on June 15, 2014. On June 15, 2014, each health maintenance organization and community-integrated service network shall pay all payments under subdivision 3 in a lump sum for revenue earned in calendar year 2013. Effective June 15, 2015, and each June 15 thereafter, the payments in subdivision 3 shall be based on revenues earned in the previous calendar year and paid in a lump sum on June 15 of each year. new text end

Sec. 4.

Minnesota Statutes 2012, section 256.969, subdivision 29, is amended to read:

Subd. 29.

Reimbursement for the fee increase for the early hearing detection and intervention program.

new text begin (a) new text end For admissions occurring on or after July 1, 2010, payment rates shall be adjusted to include the increase to the fee that is effective on July 1, 2010, for the early hearing detection and intervention program recipients under section 144.125, subdivision 1, that is paid by the hospital for public program recipients. This payment increase shall be in effect until the increase is fully recognized in the base year cost under subdivision 2b. This payment shall be included in payments to contracted managed care organizations.

new text begin (b) For admissions occurring on or after July 1, 2013, payment rates shall be adjusted to include the increase to the fee that is effective July 1, 2013, for the early hearing detection and intervention program under section 144.125, subdivision 1, paragraph (d), that is paid by the hospital for medical assistance and MinnesotaCare program enrollees. This payment increase shall be in effect until the increase is fully recognized in the base-year cost under subdivision 2b. This payment shall be included in payments to managed care plans and county-based purchasing plans. new text end

Sec. 5.

Minnesota Statutes 2012, section 256B.04, is amended by adding a subdivision to read:

new text begin Subd. 23. new text end

new text begin Medical assistance costs for certain inmates. new text end

new text begin The commissioner shall execute an interagency agreement with the commissioner of corrections to recover the state cost attributable to medical assistance eligibility for inmates of public institutions admitted to a medical institution on an inpatient basis. The annual amount to be transferred from the Department of Corrections under the agreement must include all eligible state medical assistance costs, including administrative costs incurred by the Department of Human Services, attributable to inmates under state and county jurisdiction admitted to medical institutions on an inpatient basis that are related to the implementation of section 256B.055, subdivision 14, paragraph (c). new text end

Sec. 6.

Minnesota Statutes 2012, section 256B.055, subdivision 14, is amended to read:

Subd. 14.

Persons detained by law.

(a) Medical assistance may be paid for an inmate of a correctional facility who is conditionally released as authorized under section 241.26, 244.065, or 631.425, if the individual does not require the security of a public detention facility and is housed in a halfway house or community correction center, or under house arrest and monitored by electronic surveillance in a residence approved by the commissioner of corrections, and if the individual meets the other eligibility requirements of this chapter.

(b) An individual who is enrolled in medical assistance, and who is charged with a crime and incarcerated for less than 12 months shall be suspended from eligibility at the time of incarceration until the individual is released. Upon release, medical assistance eligibility is reinstated without reapplication using a reinstatement process and form, if the individual is otherwise eligible.

(c) An individual, regardless of age, who is considered an inmate of a public institution as defined in Code of Federal Regulations, title 42, section 435.1010, new text begin and who meets the eligibility requirements in section 256B.056, new text end is not eligible for medical assistancenew text begin , except for covered services received while an inpatient in a medical institution as defined in Code of Federal Regulations, title 42, section 435.1010. Security issues, including costs, related to the inpatient treatment of an inmate are the responsibility of the entity with jurisdiction over the inmatenew text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 7.

Minnesota Statutes 2012, section 256B.06, subdivision 4, is amended to read:

Subd. 4.

Citizenship requirements.

(a) Eligibility for medical assistance is limited to citizens of the United States, qualified noncitizens as defined in this subdivision, and other persons residing lawfully in the United States. Citizens or nationals of the United States must cooperate in obtaining satisfactory documentary evidence of citizenship or nationality according to the requirements of the federal Deficit Reduction Act of 2005, Public Law 109-171.

(b) "Qualified noncitizen" means a person who meets one of the following immigration criteria:

(1) admitted for lawful permanent residence according to United States Code, title 8;

(2) admitted to the United States as a refugee according to United States Code, title 8, section 1157;

(3) granted asylum according to United States Code, title 8, section 1158;

(4) granted withholding of deportation according to United States Code, title 8, section 1253(h);

(5) paroled for a period of at least one year according to United States Code, title 8, section 1182(d)(5);

(6) granted conditional entrant status according to United States Code, title 8, section 1153(a)(7);

(7) determined to be a battered noncitizen by the United States Attorney General according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;

(8) is a child of a noncitizen determined to be a battered noncitizen by the United States Attorney General according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill, Public Law 104-200; or

(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public Law 96-422, the Refugee Education Assistance Act of 1980.

(c) All qualified noncitizens who were residing in the United States before August 22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for medical assistance with federal financial participation.

(d) Beginning December 1, 1996, qualified noncitizens who entered the United States on or after August 22, 1996, and who otherwise meet the eligibility requirements of this chapter are eligible for medical assistance with federal participation for five years if they meet one of the following criteria:

(1) refugees admitted to the United States according to United States Code, title 8, section 1157;

(2) persons granted asylum according to United States Code, title 8, section 1158;

(3) persons granted withholding of deportation according to United States Code, title 8, section 1253(h);

(4) veterans of the United States armed forces with an honorable discharge for a reason other than noncitizen status, their spouses and unmarried minor dependent children; or

(5) persons on active duty in the United States armed forces, other than for training, their spouses and unmarried minor dependent children.

Beginning July 1, 2010, children and pregnant women who are noncitizens described in paragraph (b) or who are lawfully present in the United States as defined in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet eligibility requirements of this chapter, are eligible for medical assistance with federal financial participation as provided by the federal Children's Health Insurance Program Reauthorization Act of 2009, Public Law 111-3.

(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this subdivision, a "nonimmigrant" is a person in one of the classes listed in United States Code, title 8, section 1101(a)(15).

(f) Payment shall also be made for care and services that are furnished to noncitizens, regardless of immigration status, who otherwise meet the eligibility requirements of this chapter, if such care and services are necessary for the treatment of an emergency medical condition.

(g) For purposes of this subdivision, the term "emergency medical condition" means a medical condition that meets the requirements of United States Code, title 42, section 1396b(v).

(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment of an emergency medical condition are limited to the following:

(i) services delivered in an emergency room or by an ambulance service licensed under chapter 144E that are directly related to the treatment of an emergency medical condition;

(ii) services delivered in an inpatient hospital setting following admission from an emergency room or clinic for an acute emergency condition; and

(iii) follow-up services that are directly related to the original service provided to treat the emergency medical condition and are covered by the global payment made to the provider.

(2) Services for the treatment of emergency medical conditions do not include:

(i) services delivered in an emergency room or inpatient setting to treat a nonemergency condition;

(ii) organ transplants, stem cell transplants, and related care;

(iii) services for routine prenatal care;

(iv) continuing care, including long-term care, nursing facility services, home health care, adult day care, day training, or supportive living services;

(v) elective surgery;

(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as part of an emergency room visit;

(vii) preventative health care and family planning services;

deleted text begin (viii) dialysis; deleted text end

deleted text begin (ix) chemotherapy or therapeutic radiation services; deleted text end

deleted text begin (x)deleted text end new text begin (viii)new text end rehabilitation services;

deleted text begin (xi)deleted text end new text begin (ix)new text end physical, occupational, or speech therapy;

deleted text begin (xii)deleted text end new text begin (x)new text end transportation services;

deleted text begin (xiii)deleted text end new text begin (xi)new text end case management;

deleted text begin (xiv)deleted text end new text begin (xii)new text end prosthetics, orthotics, durable medical equipment, or medical supplies;

deleted text begin (xv)deleted text end new text begin (xiii)new text end dental services;

deleted text begin (xvi)deleted text end new text begin (xiv)new text end hospice care;

deleted text begin (xvii)deleted text end new text begin (xv)new text end audiology services and hearing aids;

deleted text begin (xviii)deleted text end new text begin (xvi)new text end podiatry services;

deleted text begin (xix)deleted text end new text begin (xvii)new text end chiropractic services;

deleted text begin (xx)deleted text end new text begin (xviii)new text end immunizations;

deleted text begin (xxi)deleted text end new text begin (xix)new text end vision services and eyeglasses;

deleted text begin (xxii)deleted text end new text begin (xx)new text end waiver services;

deleted text begin (xxiii)deleted text end new text begin (xxi)new text end individualized education programs; or

deleted text begin (xxiv)deleted text end new text begin (xxii)new text end chemical dependency treatment.

(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented, nonimmigrants, or lawfully present in the United States as defined in Code of Federal Regulations, title 8, section 103.12, are not covered by a group health plan or health insurance coverage according to Code of Federal Regulations, title 42, section 457.310, and who otherwise meet the eligibility requirements of this chapter, are eligible for medical assistance through the period of pregnancy, including labor and delivery, and 60 days postpartum, to the extent federal funds are available under title XXI of the Social Security Act, and the state children's health insurance program.

(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation services from a nonprofit center established to serve victims of torture and are otherwise ineligible for medical assistance under this chapter are eligible for medical assistance without federal financial participation. These individuals are eligible only for the period during which they are receiving services from the center. Individuals eligible under this paragraph shall not be required to participate in prepaid medical assistance.

new text begin (k) Notwithstanding paragraph (h), clause (2), the following services are covered as emergency medical conditions under paragraph (f) except where coverage is prohibited under federal law: new text end

new text begin (1) dialysis services provided in a hospital or freestanding dialysis facility; and new text end

new text begin (2) surgery and the administration of chemotherapy, radiation, and related services necessary to treat cancer if the recipient has a cancer diagnosis that is not in remission and requires surgery, chemotherapy, or radiation treatment. new text end

new text begin (l) Effective July 1, 2013, recipients of emergency medical assistance under this subdivision are eligible for coverage of the elderly waiver services provided under section 256B.0915, and coverage of rehabilitative services provided in a nursing facility. The age limit for elderly waiver services does not apply. In order to qualify for coverage, a recipient of emergency medical assistance is subject to the assessment and reassessment requirements of section 256B.0911. Initial and continued enrollment under this paragraph is subject to the limits of available funding. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013. new text end

Sec. 8.

Minnesota Statutes 2012, section 256B.0625, subdivision 9, is amended to read:

Subd. 9.

Dental services.

(a) Medical assistance covers dental services.

(b) Medical assistance dental coverage for nonpregnant adults is limited to the following services:

(1) comprehensive exams, limited to once every five years;

(2) periodic exams, limited to one per year;

(3) limited exams;

(4) bitewing x-rays, limited to one per year;

(5) periapical x-rays;

(6) panoramic x-rays, limited to one every five years except (1) when medically necessary for the diagnosis and follow-up of oral and maxillofacial pathology and trauma or (2) once every two years for patients who cannot cooperate for intraoral film due to a developmental disability or medical condition that does not allow for intraoral film placement;

(7) prophylaxis, limited to one per year;

(8) application of fluoride varnish, limited to one per year;

(9) posterior fillings, all at the amalgam rate;

(10) anterior fillings;

(11) endodontics, limited to root canals on the anterior and premolars only;

(12) removable prostheses, each dental arch limited to one every six years;

(13) oral surgery, limited to extractions, biopsies, and incision and drainage of abscesses;

(14) palliative treatment and sedative fillings for relief of pain; and

(15) full-mouth debridement, limited to one every five years.

(c) In addition to the services specified in paragraph (b), medical assistance covers the following services for adults, if provided in an outpatient hospital setting or freestanding ambulatory surgical center as part of outpatient dental surgery:

(1) periodontics, limited to periodontal scaling and root planing once every two years;

(2) general anesthesia; and

(3) full-mouth survey once every five years.

(d) Medical assistance covers medically necessary dental services for children and pregnant women. The following guidelines apply:

(1) posterior fillings are paid at the amalgam rate;

(2) application of sealants are covered once every five years per permanent molar for children only;

(3) application of fluoride varnish is covered once every six months; and

(4) orthodontia is eligible for coverage for children only.

new text begin (e) In addition to the services specified in paragraphs (b) and (c), medical assistance covers the following services for adults: new text end

new text begin (1) house calls or extended care facility calls for on-site delivery of covered services; new text end

new text begin (2) behavioral management when additional staff time is required to accommodate behavioral challenges and sedation is not used; new text end

new text begin (3) oral or IV sedation, if the covered dental service cannot be performed safely without it or would otherwise require the service to be performed under general anesthesia in a hospital or surgical center; and new text end

new text begin (4) prophylaxis, in accordance with an appropriate individualized treatment plan, but no more than four times per year. new text end

Sec. 9.

Minnesota Statutes 2012, section 256B.0625, subdivision 13, is amended to read:

Subd. 13.

Drugs.

(a) Medical assistance covers drugs, except for fertility drugs when specifically used to enhance fertility, if prescribed by a licensed practitioner and dispensed by a licensed pharmacist, by a physician enrolled in the medical assistance program as a dispensing physician, or by a physician, physician assistant, or a nurse practitioner employed by or under contract with a community health board as defined in section 145A.02, subdivision 5, for the purposes of communicable disease control.

(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply, unless authorized by the commissioner.

(c) For the purpose of this subdivision and subdivision 13d, an "active pharmaceutical ingredient" is defined as a substance that is represented for use in a drug and when used in the manufacturing, processing, or packaging of a drug becomes an active ingredient of the drug product. An "excipient" is defined as an inert substance used as a diluent or vehicle for a drug. The commissioner shall establish a list of active pharmaceutical ingredients and excipients which are included in the medical assistance formulary. Medical assistance covers selected active pharmaceutical ingredients and excipients used in compounded prescriptions when the compounded combination is specifically approved by the commissioner or when a commercially available product:

(1) is not a therapeutic option for the patient;

(2) does not exist in the same combination of active ingredients in the same strengths as the compounded prescription; and

(3) cannot be used in place of the active pharmaceutical ingredient in the compounded prescription.

(d) Medical assistance covers the following over-the-counter drugs when prescribed by a licensed practitioner or by a licensed pharmacist who meets standards established by the commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, family planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults with documented vitamin deficiencies, vitamins for children under the age of seven and pregnant or nursing women, and any other over-the-counter drug identified by the commissioner, in consultation with the formulary committee, as necessary, appropriate, and cost-effective for the treatment of certain specified chronic diseases, conditions, or disorders, and this determination shall not be subject to the requirements of chapter 14. A pharmacist may prescribe over-the-counter medications as provided under this paragraph for purposes of receiving reimbursement under Medicaid. When prescribing over-the-counter drugs under this paragraph, licensed pharmacists must consult with the recipient to determine necessity, provide drug counseling, review drug therapy for potential adverse interactions, and make referrals as needed to other health care professionals. Over-the-counter medications must be dispensed in a quantity that is the lower of: (1) the number of dosage units contained in the manufacturer's original package; and (2) the number of dosage units required to complete the patient's course of therapy.

(e) Effective January 1, 2006, medical assistance shall not cover drugs that are coverable under Medicare Part D as defined in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), for individuals eligible for drug coverage as defined in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Public Law 108-173, section 1860D-1(a)(3)(A). For these individuals, medical assistance may cover drugs from the drug classes listed in United States Code, title 42, section 1396r-8(d)(2), subject to this subdivision and subdivisions 13a to 13g, except that drugs listed in United States Code, title 42, section 1396r-8(d)(2)(E), shall not be covered.

new text begin (f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing Program and dispensed by 340B covered entities and ambulatory pharmacies under common ownership of the 340B covered entity. Medical assistance does not cover drugs acquired through the federal 340B Drug Pricing Program and dispensed by 340B contract pharmacies. new text end

Sec. 10.

Minnesota Statutes 2012, section 256B.0625, subdivision 13e, is amended to read:

Subd. 13e.

Payment rates.

(a) The basis for determining the amount of payment shall be the lower of the actual acquisition costs of the drugs or the maximum allowable cost by the commissioner plus the fixed dispensing fee; or the usual and customary price charged to the public. The amount of payment basis must be reduced to reflect all discount amounts applied to the charge by any provider/insurer agreement or contract for submitted charges to medical assistance programs. The net submitted charge may not be greater than the patient liability for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee for intravenous solutions which must be compounded by the pharmacist shall be $8 per bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral nutritional products dispensed in quantities greater than one liter. Actual acquisition cost includes quantity and other special discounts except time and cash discounts. The actual acquisition cost of a drug shall be estimated by the commissioner at wholesale acquisition cost plus four percent for independently owned pharmacies located in a designated rural area within Minnesota, and at wholesale acquisition cost plus two percent for all other pharmacies. A pharmacy is "independently owned" if it is one of four or fewer pharmacies under the same ownership nationally. A "designated rural area" means an area defined as a small rural area or isolated rural area according to the four-category classification of the Rural Urban Commuting Area system developed for the United States Health Resources and Services Administration.new text begin Effective January 1, 2014, the actual acquisition cost of a drug acquired through the federal 340B Drug Pricing Program shall be estimated by the commissioner at wholesale acquisition cost minus 40 percent.new text end Wholesale acquisition cost is defined as the manufacturer's list price for a drug or biological to wholesalers or direct purchasers in the United States, not including prompt pay or other discounts, rebates, or reductions in price, for the most recent month for which information is available, as reported in wholesale price guides or other publications of drug or biological pricing data. The maximum allowable cost of a multisource drug may be set by the commissioner and it shall be comparable to, but no higher than, the maximum amount paid by other third-party payors in this state who have maximum allowable cost programs. Establishment of the amount of payment for drugs shall not be subject to the requirements of the Administrative Procedure Act.

(b) An additional dispensing fee of $.30 may be added to the dispensing fee paid to pharmacists for legend drug prescriptions dispensed to residents of long-term care facilities when a unit dose blister card system, approved by the department, is used. Under this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. The National Drug Code (NDC) from the drug container used to fill the blister card must be identified on the claim to the department. The unit dose blister card containing the drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider will be required to credit the department for the actual acquisition cost of all unused drugs that are eligible for reuse. The commissioner may permit the drug clozapine to be dispensed in a quantity that is less than a 30-day supply.

(c) Whenever a maximum allowable cost has been set for a multisource drug, payment shall be the lower of the usual and customary price charged to the public or the maximum allowable cost established by the commissioner unless prior authorization for the brand name product has been granted according to the criteria established by the Drug Formulary Committee as required by subdivision 13f, paragraph (a), and the prescriber has indicated "dispense as written" on the prescription in a manner consistent with section 151.21, subdivision 2.

(d) The basis for determining the amount of payment for drugs administered in an outpatient setting shall be the lower of the usual and customary cost submitted by the provider deleted text begin ordeleted text end new text begin ,new text end 106 percent of the average sales price as determined by the United States Department of Health and Human Services pursuant to title XVIII, section 1847a of the federal Social Security Actnew text begin , the specialty pharmacy rate, or the maximum allowable cost set by the commissionernew text end . If average sales price is unavailable, the amount of payment must be lower of the usual and customary cost submitted by the provider deleted text begin ordeleted text end new text begin ,new text end the wholesale acquisition costnew text begin , the specialty pharmacy rate, or the maximum allowable cost set by the commissioner. Effective January 1, 2014, the commissioner shall discount the payment rate for drugs obtained through the federal 340B Drug Pricing Program by 20 percent. The payment for drugs administered in an outpatient setting shall be made to the administering facility or practitioner. A retail or specialty pharmacy dispensing a drug for administration in an outpatient setting is not eligible for direct reimbursementnew text end .

(e) The commissioner may negotiate lower reimbursement rates for specialty pharmacy products than the rates specified in paragraph (a). The commissioner may require individuals enrolled in the health care programs administered by the department to obtain specialty pharmacy products from providers with whom the commissioner has negotiated lower reimbursement rates. Specialty pharmacy products are defined as those used by a small number of recipients or recipients with complex and chronic diseases that require expensive and challenging drug regimens. Examples of these conditions include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of cancer. Specialty pharmaceutical products include injectable and infusion therapies, biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies that require complex care. The commissioner shall consult with the formulary committee to develop a list of specialty pharmacy products subject to this paragraph. In consulting with the formulary committee in developing this list, the commissioner shall take into consideration the population served by specialty pharmacy products, the current delivery system and standard of care in the state, and access to care issues. The commissioner shall have the discretion to adjust the reimbursement rate to prevent access to care issues.

(f) Home infusion therapy services provided by home infusion therapy pharmacies must be paid at rates according to subdivision 8d.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013. new text end

Sec. 11.

Minnesota Statutes 2012, section 256B.0625, is amended by adding a subdivision to read:

new text begin Subd. 28b. new text end

new text begin Doula services. new text end

new text begin Medical assistance covers doula services provided by a certified doula as defined in section 148.995, subdivision 2, of the mother's choice. For purposes of this section, "doula services" means childbirth education and support services, including emotional and physical support provided during pregnancy, labor, birth, and postpartum. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2014, or upon federal approval, whichever is later, and applies to services provided on or after the effective date. new text end

Sec. 12.

Minnesota Statutes 2012, section 256B.0625, subdivision 31, is amended to read:

Subd. 31.

Medical supplies and equipment.

(a) Medical assistance covers medical supplies and equipment. Separate payment outside of the facility's payment rate shall be made for wheelchairs and wheelchair accessories for recipients who are residents of intermediate care facilities for the developmentally disabled. Reimbursement for wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same conditions and limitations as coverage for recipients who do not reside in institutions. A wheelchair purchased outside of the facility's payment rate is the property of the recipient. The commissioner may set reimbursement rates for specified categories of medical supplies at levels below the Medicare payment rate.

(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies must enroll as a Medicare provider.

(c) When necessary to ensure access to durable medical equipment, prosthetics, orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare enrollment requirement if:

(1) the vendor supplies only one type of durable medical equipment, prosthetic, orthotic, or medical supply;

(2) the vendor serves ten or fewer medical assistance recipients per year;

(3) the commissioner finds that other vendors are not available to provide same or similar durable medical equipment, prosthetics, orthotics, or medical supplies; and

(4) the vendor complies with all screening requirements in this chapter and Code of Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare and Medicaid Services approved national accreditation organization as complying with the Medicare program's supplier and quality standards and the vendor serves primarily pediatric patients.

(d) Durable medical equipment means a device or equipment that:

(1) can withstand repeated use;

(2) is generally not useful in the absence of an illness, injury, or disability; and

(3) is provided to correct or accommodate a physiological disorder or physical condition or is generally used primarily for a medical purpose.

new text begin (e) Electronic tablets may be considered durable medical equipment if the electronic tablet will be used as an augmentative and alternative communication system as defined under subdivision 31a, paragraph (a). To be covered by medical assistance, the device must be locked in order to prevent use not related to communication. new text end

Sec. 13.

Minnesota Statutes 2012, section 256B.0625, is amended by adding a subdivision to read:

new text begin Subd. 31b. new text end

new text begin Preferred diabetic testing supply program. new text end

new text begin (a) The commissioner shall implement a point-of-sale preferred diabetic testing supply program by January 1, 2014. Medical assistance coverage for diabetic testing supplies shall conform to the limitations established under the program. The commissioner may enter into a contract with a vendor for the purpose of participating in a preferred diabetic testing supply list and supplemental rebate program. The commissioner shall ensure that any contract meets all federal requirements and maximizes federal financial participation. The commissioner shall maintain an accurate and up-to-date list on the department's Web site. new text end

new text begin (b) The commissioner may add to, delete from, and otherwise modify the preferred diabetic testing supply program drug list after consulting with the Drug Formulary Committee and appropriate medical specialists and providing public notice and the opportunity for public comment. new text end

new text begin (c) The commissioner shall adopt and administer the preferred diabetic testing supply program as part of the administration of the diabetic testing supply rebate program. Reimbursement for diabetic testing supplies not on the preferred diabetic testing supply list may be subject to prior authorization. new text end

new text begin (d) All claims for diabetic testing supplies in categories on the preferred diabetic testing supply list must be submitted by enrolled pharmacy providers using the most current National Council of Prescription Drug Plans electronic claims standard. new text end

new text begin (e) For purposes of this subdivision, "preferred diabetic testing supply list" means a list of diabetic testing supplies selected by the commissioner, for which prior authorization is not required. new text end

new text begin (f) The commissioner shall seek any federal waivers or approvals necessary to implement this subdivision. new text end

Sec. 14.

Minnesota Statutes 2012, section 256B.0625, subdivision 39, is amended to read:

Subd. 39.

Childhood immunizations.

Providers who administer pediatric vaccines within the scope of their licensure, and who are enrolled as a medical assistance provider, must enroll in the pediatric vaccine administration program established by section 13631 of the Omnibus Budget Reconciliation Act of 1993. Medical assistance shall pay deleted text begin an $8.50 fee per dosedeleted text end for administration of the vaccine to children eligible for medical assistance. Medical assistance does not pay for vaccines that are available at no cost from the pediatric vaccine administration program.

Sec. 15.

Minnesota Statutes 2012, section 256B.0625, subdivision 58, is amended to read:

Subd. 58.

Early and periodic screening, diagnosis, and treatment services.

Medical assistance covers early and periodic screening, diagnosis, and treatment services (EPSDT). The payment amount for a complete EPSDT screening new text begin shall not include charges for vaccines that are available at no cost to the provider and new text end shall not exceed the rate established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.

Sec. 16.

Minnesota Statutes 2012, section 256B.0625, is amended by adding a subdivision to read:

new text begin Subd. 63. new text end

new text begin Payment for multiple services provided on the same day. new text end

new text begin The commissioner shall not prohibit payment, including supplemental payments, for mental health services or dental services provided to a patient by a clinic or health care professional solely because the mental health or dental services were provided on the same day as other covered health services furnished by the same provider. new text end

Sec. 17.

Minnesota Statutes 2012, section 256B.0631, subdivision 1, is amended to read:

Subdivision 1.

Cost-sharing.

(a) Except as provided in subdivision 2, the medical assistance benefit plan shall include the following cost-sharing for all recipients, effective for services provided on or after September 1, 2011:

(1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes of this subdivision, a visit means an episode of service which is required because of a recipient's symptoms, diagnosis, or established illness, and which is delivered in an ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, audiologist, optician, or optometrist;

(2) $3.50 for nonemergency visits to a hospital-based emergency room, except that this co-payment shall be increased to $20 upon federal approval;

(3) $3 per brand-name drug prescription and $1 per generic drug prescription, subject to a $12 per month maximum for prescription drug co-payments. No co-payments shall apply to antipsychotic drugs when used for the treatment of mental illness;

(4) effective January 1, 2012, a family deductible equal to the maximum amount allowed under Code of Federal Regulations, title 42, part 447.54; and

(5) for individuals identified by the commissioner with income at or below 100 percent of the federal poverty guidelines, total monthly cost-sharing must not exceed five percent of family income. For purposes of this paragraph, family income is the total earned and unearned income of the individual and the individual's spouse, if the spouse is enrolled in medical assistance and also subject to the five percent limit on cost-sharing.

(b) Recipients of medical assistance are responsible for all co-payments and deductibles in this subdivision.

(c) Notwithstanding paragraph (b), the commissioner, through the contracting process under sections 256B.69 and 256B.692, may allow managed care plans and county-based purchasing plans to waive the family deductible under paragraph (a), clause (4). The value of the family deductible shall not be included in the capitation payment to managed care plans and county-based purchasing plans. Managed care plans and county-based purchasing plans shall certify annually to the commissioner the dollar value of the family deductible.

(d) Notwithstanding paragraph (b), the commissioner may waive the collection of the family deductible described under paragraph (a), clause (4), from individuals and allow long-term care and waivered service providers to assume responsibility for payment.

new text begin (e) Notwithstanding paragraph (b), the commissioner, through the contracting process under section 256B.0756 shall allow the pilot program in Hennepin County to waive co-payments. The value of the co-payments shall not be included in the capitation payment amount to the integrated health care delivery networks under the pilot program. new text end

Sec. 18.

Minnesota Statutes 2012, section 256B.0756, is amended to read:

256B.0756 HENNEPIN AND RAMSEY COUNTIES PILOT PROGRAM.

(a) The commissioner, upon federal approval of a new waiver request or amendment of an existing demonstration, may establish a pilot program in Hennepin County or Ramsey County, or both, to test alternative and innovative integrated health care delivery networks.

(b) Individuals eligible for the pilot program shall be individuals who are eligible for medical assistance under section 256B.055deleted text begin , subdivision 15,deleted text end and who reside in Hennepin County or Ramsey County. new text begin The commissioner may identify individuals to be enrolled in the Hennepin County pilot program based on zip code in Hennepin County or whether the individuals would benefit from an integrated health care delivery network.new text end

(c) Individuals enrolled in the pilot program shall be enrolled in an integrated health care delivery network in their county of residence. The integrated health care delivery network in Hennepin County shall be a network, such as an accountable care organization or a community-based collaborative care network, created by or including Hennepin County Medical Center. The integrated health care delivery network in Ramsey County shall be a network, such as an accountable care organization or community-based collaborative care network, created by or including Regions Hospital.

deleted text begin (d) The commissioner shall cap pilot program enrollment at 7,000 enrollees for Hennepin County and 3,500 enrollees for Ramsey County. deleted text end

deleted text begin (e)deleted text end new text begin (d)new text end In developing a payment system for the pilot programs, the commissioner shall establish a total cost of care for the recipients enrolled in the pilot programs that equals the cost of care that would otherwise be spent for these enrollees in the prepaid medical assistance program.

deleted text begin (f) Counties may transfer funds necessary to support the nonfederal share of payments for integrated health care delivery networks in their county. Such transfers per county shall not exceed 15 percent of the expected expenses for county enrollees. deleted text end

deleted text begin (g)deleted text end new text begin (e)new text end The commissioner shall apply to the federal government for, or as appropriate, cooperate with counties, providers, or other entities that are applying for any applicable grant or demonstration under the Patient Protection and Affordable Health Care Act, Public Law 111-148, or the Health Care and Education Reconciliation Act of 2010, Public Law 111-152, that would further the purposes of or assist in the creation of an integrated health care delivery network for the purposes of this subdivision, including, but not limited to, a global payment demonstration or the community-based collaborative care network grants.

Sec. 19.

Minnesota Statutes 2012, section 256B.196, subdivision 2, is amended to read:

Subd. 2.

Commissioner's duties.

(a) For the purposes of this subdivision and subdivision 3, the commissioner shall determine the fee-for-service outpatient hospital services upper payment limit for nonstate government hospitals. The commissioner shall then determine the amount of a supplemental payment to Hennepin County Medical Center and Regions Hospital for these services that would increase medical assistance spending in this category to the aggregate upper payment limit for all nonstate government hospitals in Minnesota. In making this determination, the commissioner shall allot the available increases between Hennepin County Medical Center and Regions Hospital based on the ratio of medical assistance fee-for-service outpatient hospital payments to the two facilities. The commissioner shall adjust this allotment as necessary based on federal approvals, the amount of intergovernmental transfers received from Hennepin and Ramsey Counties, and other factors, in order to maximize the additional total payments. The commissioner shall inform Hennepin County and Ramsey County of the periodic intergovernmental transfers necessary to match federal Medicaid payments available under this subdivision in order to make supplementary medical assistance payments to Hennepin County Medical Center and Regions Hospital equal to an amount that when combined with existing medical assistance payments to nonstate governmental hospitals would increase total payments to hospitals in this category for outpatient services to the aggregate upper payment limit for all hospitals in this category in Minnesota. Upon receipt of these periodic transfers, the commissioner shall make supplementary payments to Hennepin County Medical Center and Regions Hospital.

(b) For the purposes of this subdivision and subdivision 3, the commissioner shall determine an upper payment limit for physicians and other billing professionals affiliated with Hennepin County Medical Center and with Regions Hospital. The upper payment limit shall be based on the average commercial rate or be determined using another method acceptable to the Centers for Medicare and Medicaid Services. The commissioner shall inform Hennepin County and Ramsey County of the periodic intergovernmental transfers necessary to match the federal Medicaid payments available under this subdivision in order to make supplementary payments to physicians and other billing professionals affiliated with Hennepin County Medical Center and to make supplementary payments to physicians and other billing professionals affiliated with Regions Hospital through HealthPartners Medical Group equal to the difference between the established medical assistance payment for physician and other billing professional services and the upper payment limit. Upon receipt of these periodic transfers, the commissioner shall make supplementary payments to physicians and other billing professionals affiliated with Hennepin County Medical Center and shall make supplementary payments to physicians and other billing professionals affiliated with Regions Hospital through HealthPartners Medical Group.

(c) Beginning January 1, 2010, Hennepin County and Ramsey County may make monthly voluntary intergovernmental transfers to the commissioner in amounts not to exceed $12,000,000 per year from Hennepin County and $6,000,000 per year from Ramsey County. The commissioner shall increase the medical assistance capitation payments to any licensed health plan under contract with the medical assistance program that agrees to make enhanced payments to Hennepin County Medical Center or Regions Hospital. The increase shall be in an amount equal to the annual value of the monthly transfers plus federal financial participation, with each health plan receiving its pro rata share of the increase based on the pro rata share of medical assistance admissions to Hennepin County Medical Center and Regions Hospital by those plans. Upon the request of the commissioner, health plans shall submit individual-level cost data for verification purposes. The commissioner may ratably reduce these payments on a pro rata basis in order to satisfy federal requirements for actuarial soundness. If payments are reduced, transfers shall be reduced accordingly. Any licensed health plan that receives increased medical assistance capitation payments under the intergovernmental transfer described in this paragraph shall increase its medical assistance payments to Hennepin County Medical Center and Regions Hospital by the same amount as the increased payments received in the capitation payment described in this paragraph.

(d) new text begin For the purposes of this subdivision and subdivision 3, the commissioner shall determine an upper payment limit for ambulance services affiliated with Hennepin County Medical Center and the city of St. Paul. The upper payment limit shall be based on the average commercial rate or be determined using another method acceptable to the Centers for Medicare and Medicaid Services. The commissioner shall inform Hennepin County and the city of St. Paul of the periodic intergovernmental transfers necessary to match the federal Medicaid payments available under this subdivision in order to make supplementary payments to Hennepin County Medical Center and the city of St. Paul equal to the difference between the established medical assistance payment for ambulance services and the upper payment limit. Upon receipt of these periodic transfers, the commissioner shall make supplementary payments to Hennepin County Medical Center and the city of St. Paul.new text end

new text begin (e) new text end The commissioner shall inform the transferring governmental entities on an ongoing basis of the need for any changes needed in the intergovernmental transfers in order to continue the payments under paragraphs (a) to deleted text begin (c)deleted text end new text begin (d)new text end , at their maximum level, including increases in upper payment limits, changes in the federal Medicaid match, and other factors.

deleted text begin (e)deleted text end new text begin (f)new text end The payments in paragraphs (a) to deleted text begin (c)deleted text end new text begin (d)new text end shall be implemented independently of each other, subject to federal approval and to the receipt of transfers under subdivision 3.

Sec. 20.

Minnesota Statutes 2012, section 256B.69, subdivision 5c, is amended to read:

Subd. 5c.

Medical education and research fund.

(a) The commissioner of human services shall transfer each year to the medical education and research fund established under section 62J.692, an amount specified in this subdivision. The commissioner shall calculate the following:

(1) an amount equal to the reduction in the prepaid medical assistance payments as specified in this clause. Until January 1, 2002, the county medical assistance capitation base rate prior to plan specific adjustments and after the regional rate adjustments under subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after January 1, 2002, the county medical assistance capitation base rate prior to plan specific adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing facility and elderly waiver payments and demonstration project payments operating under subdivision 23 are excluded from this reduction. The amount calculated under this clause shall not be adjusted for periods already paid due to subsequent changes to the capitation payments;

(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this section;

(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates paid under this section; and

(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid under this section.

(b) This subdivision shall be effective upon approval of a federal waiver which allows federal financial participation in the medical education and research fund. The amount specified under paragraph (a), clauses (1) to (4), shall not exceed the total amount transferred for fiscal year 2009. Any excess shall first reduce the amounts specified under paragraph (a), clauses (2) to (4). Any excess following this reduction shall proportionally reduce the amount specified under paragraph (a), clause (1).

(c) Beginning September 1, 2011, of the amount in paragraph (a), the commissioner shall transfer $21,714,000 each fiscal year to the medical education and research fund.

(d) Beginning September 1, 2011, of the amount in paragraph (a), following the transfer under paragraph (c), the commissioner shall transfer to the medical education research fund $23,936,000 in fiscal years 2012 and 2013 and deleted text begin $36,744,000deleted text end new text begin $49,552,000new text end in fiscal year 2014 and thereafter.

Sec. 21.

Minnesota Statutes 2012, section 256B.69, subdivision 5i, is amended to read:

Subd. 5i.

Administrative expenses.

(a) Managed care plan and county-based purchasing plan administrative costs for a prepaid health plan provided under this section or section 256B.692 must not exceed by more than five percent that prepaid health plan's or county-based purchasing plan's actual calculated administrative spending for the previous calendar year as a percentage of total revenue. The penalty for exceeding this limit must be the amount of administrative spending in excess of 105 percent of the actual calculated amount. The commissioner may waive this penalty if the excess administrative spending is the result of unexpected shifts in enrollment or member needs or new program requirements.

(b) deleted text begin Expenses listed under section 62D.12, subdivision 9a, clause (4), are not allowable administrative expenses for rate-setting purposes under this section, unless approved by the commissioner.deleted text end new text begin The following expenses are not allowable administrative expenses for rate-setting purposes under this section:new text end

new text begin (1) charitable contributions made by the managed care plan or the county-based purchasing plan; new text end

new text begin (2) any portion of an individual's compensation in excess of $200,000 paid by the managed care plan or county-based purchasing plan; new text end

new text begin (3) any penalties or fines assessed against the managed care plan or county-based purchasing plan; and new text end

new text begin (4) any indirect marketing or advertising expenses of the managed care plan or county-based purchasing plan. new text end

new text begin For the purposes of this subdivision, compensation includes salaries, bonuses and incentives, other reportable compensation on an IRS 990 form, retirement and other deferred compensation, and nontaxable benefits. new text end

Sec. 22.

Minnesota Statutes 2012, section 256B.69, subdivision 9c, is amended to read:

Subd. 9c.

Managed care financial reporting.

(a) The commissioner shall collect detailed data regarding financials, provider payments, provider rate methodologies, and other data as determined by the commissioner deleted text begin and managed care and county-based purchasing plans that are required to be submitted under this sectiondeleted text end . The commissioner, in consultation with the commissioners of health and commerce, and in consultation with managed care plans and county-based purchasing plans, shall set uniform criteria, definitions, and standards for the data to be submitted, and shall require managed care and county-based purchasing plans to comply with these criteria, definitions, and standards when submitting data under this section. In carrying out the responsibilities of this subdivision, the commissioner shall ensure that the data collection is implemented in an integrated and coordinated manner that avoids unnecessary duplication of effort. To the extent possible, the commissioner shall use existing data sources and streamline data collection in order to reduce public and private sector administrative costs. Nothing in this subdivision shall allow release of information that is nonpublic data pursuant to section 13.02.

(b) new text begin Effective January 1, 2014, new text end each managed care and county-based purchasing plan must deleted text begin annuallydeleted text end new text begin quarterlynew text end provide to the commissioner the following information on state public programs, in the form and manner specified by the commissioner, according to guidelines developed by the commissioner in consultation with managed care plans and county-based purchasing plans under contract:

new text begin (1) an income statement by program; new text end

new text begin (2) financial statement footnotes; new text end

new text begin (3) quarterly profitability by program and population group; new text end

new text begin (4) a medical liability summary by program and population group; new text end

new text begin (5) received but unpaid claims report by program; new text end

new text begin (6) services versus payment lags by program for hospital services, outpatient services, physician services, other medical services, and pharmaceutical benefits; new text end

new text begin (7) utilization reports that summarize utilization and unit cost information by program for hospitalization services, outpatient services, physician services, and other medical services; new text end

new text begin (8) pharmaceutical statistics by program and population group for measures of price and utilization of pharmaceutical services; new text end

new text begin (9) subcapitation expenses by population group; new text end

new text begin (10) third-party payments by program; new text end

new text begin (11) all new, active, and closed subrogation cases by program; new text end

new text begin (12) all new, active, and closed fraud and abuse cases by program; new text end

new text begin (13) medical loss ratios by program; new text end

deleted text begin (1)deleted text end new text begin (14)new text end administrative expenses by category and subcategory deleted text begin consistent with administrative expense reportingdeleted text end new text begin by program that reconcilenew text end to other state and federal regulatory agenciesdeleted text begin , by programdeleted text end ;

deleted text begin (2)deleted text end new text begin (15)new text end revenues by program, including investment income;

deleted text begin (3)deleted text end new text begin (16)new text end nonadministrative service payments, provider payments, and reimbursement rates by provider type or service category, by program, paid by the managed care plan under this section or the county-based purchasing plan under section 256B.692 to providers and vendors for administrative services under contract with the plan, including but not limited to:

(i) individual-level provider payment and reimbursement rate data;

(ii) provider reimbursement rate methodologies by provider type, by program, including a description of alternative payment arrangements and payments outside the claims process;

(iii) data on implementation of legislatively mandated provider rate changes; and

(iv) individual-level provider payment and reimbursement rate data and plan-specific provider reimbursement rate methodologies by provider type, by program, including alternative payment arrangements and payments outside the claims process, provided to the commissioner under this subdivision are nonpublic data as defined in section 13.02;

deleted text begin (4)deleted text end new text begin (17)new text end data on the amount of reinsurance or transfer of risk by program; and

deleted text begin (5)deleted text end new text begin (18) new text end contribution to reserve, by program.

(c) In the event a report is published or released based on data provided under this subdivision, the commissioner shall provide the report to managed care plans and county-based purchasing plans deleted text begin 30deleted text end new text begin 15new text end days prior to the publication or release of the report. Managed care plans and county-based purchasing plans shall have deleted text begin 30deleted text end new text begin 15new text end days to review the report and provide comment to the commissioner.

new text begin The quarterly reports shall be submitted to the commissioner no later than 60 days after the end of the previous quarter, except the fourth-quarter report, which shall be submitted by April 1 of each year. The fourth-quarter report shall include audited financial statements, parent company audited financial statements, an income statement reconciliation report, and any other documentation necessary to reconcile the detailed reports to the audited financial statements. new text end

Sec. 23.

Minnesota Statutes 2012, section 256B.69, subdivision 31, is amended to read:

Subd. 31.

Payment reduction.

(a) Beginning September 1, 2011, the commissioner shall reduce payments and limit future rate increases paid to managed care plans and county-based purchasing plans. The limits in paragraphs (a) to (f) shall be achieved on a statewide aggregate basis by program. The commissioner may use competitive bidding, payment reductions, or other reductions to achieve the reductions and limits in this subdivision.

(b) Beginning September 1, 2011, the commissioner shall reduce payments to managed care plans and county-based purchasing plans as follows:

(1) 2.0 percent for medical assistance elderly basic care. This shall not apply to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver services;

(2) 2.82 percent for medical assistance families and children;

(3) 10.1 percent for medical assistance adults without children; and

(4) 6.0 percent for MinnesotaCare families and children.

(c) Beginning January 1, 2012, the commissioner shall limit rates paid to managed care plans and county-based purchasing plans for calendar year 2012 to a percentage of the rates in effect on August 31, 2011, as follows:

(1) 98 percent for medical assistance elderly basic care. This shall not apply to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver services;

(2) 97.18 percent for medical assistance families and children;

(3) 89.9 percent for medical assistance adults without children; and

(4) 94 percent for MinnesotaCare families and children.

(d) Beginning January 1, 2013, to December 31, 2013, the commissioner shall limit the maximum annual trend increases to rates paid to managed care plans and county-based purchasing plans as follows:

(1) 7.5 percent for medical assistance elderly basic care. This shall not apply to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver services;

(2) 5.0 percent for medical assistance special needs basic care;

(3) 2.0 percent for medical assistance families and children;

(4) 3.0 percent for medical assistance adults without children;

(5) 3.0 percent for MinnesotaCare families and children; and

(6) 3.0 percent for MinnesotaCare adults without children.

(e) The commissioner may limit trend increases to less than the maximum. Beginning July 1, 2014, the commissioner shall limit the maximum annual trend increases to rates paid to managed care plans and county-based purchasing plans as follows for calendar years 2014 and 2015:

(1) 7.5 percent for medical assistance elderly basic care. This shall not apply to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver services;

(2) 5.0 percent for medical assistance special needs basic care;

(3) 2.0 percent for medical assistance families and children;

(4) 3.0 percent for medical assistance adults without children;

(5) 3.0 percent for MinnesotaCare families and children; and

(6) 4.0 percent for MinnesotaCare adults without children.

The commissioner may limit trend increases to less than the maximum.new text begin For calendar year 2014, the commissioner shall reduce the maximum aggregate trend increases by $47,000,000 in state and federal funds to account for the reductions in administrative expenses in subdivision 5i.new text end

Sec. 24.

Minnesota Statutes 2012, section 256B.69, is amended by adding a subdivision to read:

new text begin Subd. 34. new text end

new text begin Supplemental recovery program. new text end

new text begin The commissioner shall conduct a supplemental recovery program for third-party liabilities not recovered by managed care plans and county-based purchasing plans for state public health programs. Any third-party liability identified and recovered by the commissioner more than six months after the date a managed care plan or county-based purchasing plan receives a health care claim shall be retained by the commissioner and deposited in the general fund. The commissioner shall establish a mechanism for managed care plans and county-based purchasing plans to coordinate third-party liability collections efforts with the commissioner to ensure there is no duplication of efforts. The coordination mechanism must be consistent with the reporting requirements in subdivision 9c. new text end

Sec. 25.

Minnesota Statutes 2012, section 256B.76, subdivision 1, is amended to read:

Subdivision 1.

Physician reimbursement.

(a) Effective for services rendered on or after October 1, 1992, the commissioner shall make payments for physician services as follows:

(1) payment for level one Centers for Medicare and Medicaid Services' common procedural coding system codes titled "office and other outpatient services," "preventive medicine new and established patient," "delivery, antepartum, and postpartum care," "critical care," cesarean delivery and pharmacologic management provided to psychiatric patients, and level three codes for enhanced services for prenatal high risk, shall be paid at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 30, 1992. If the rate on any procedure code within these categories is different than the rate that would have been paid under the methodology in section 256B.74, subdivision 2, then the larger rate shall be paid;

(2) payments for all other services shall be paid at the lower of (i) submitted charges, or (ii) 15.4 percent above the rate in effect on June 30, 1992; and

(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th percentile of 1989, less the percent in aggregate necessary to equal the above increases except that payment rates for home health agency services shall be the rates in effect on September 30, 1992.

(b) Effective for services rendered on or after January 1, 2000, payment rates for physician and professional services shall be increased by three percent over the rates in effect on December 31, 1999, except for home health agency and family planning agency services. The increases in this paragraph shall be implemented January 1, 2000, for managed care.

(c) Effective for services rendered on or after July 1, 2009, payment rates for physician and professional services shall be reduced by five percent, except that for the period July 1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent for the medical assistance and general assistance medical care programs, over the rates in effect on June 30, 2009. This reduction and the reductions in paragraph (d) do not apply to office or other outpatient visits, preventive medicine visits and family planning visits billed by physicians, advanced practice nurses, or physician assistants in a family planning agency or in one of the following primary care practices: general practice, general internal medicine, general pediatrics, general geriatrics, and family medicine. This reduction and the reductions in paragraph (d) do not apply to federally qualified health centers, rural health centers, and Indian health services. Effective October 1, 2009, payments made to managed care plans and county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment reduction described in this paragraph.

(d) Effective for services rendered on or after July 1, 2010, payment rates for physician and professional services shall be reduced an additional seven percent over the five percent reduction in rates described in paragraph (c). This additional reduction does not apply to physical therapy services, occupational therapy services, and speech pathology and related services provided on or after July 1, 2010. This additional reduction does not apply to physician services billed by a psychiatrist or an advanced practice nurse with a specialty in mental health. Effective October 1, 2010, payments made to managed care plans and county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment reduction described in this paragraph.

(e) Effective for services rendered on or after September 1, 2011, through June 30, 2013, payment rates for physician and professional services shall be reduced three percent from the rates in effect on August 31, 2011. This reduction does not apply to physical therapy services, occupational therapy services, and speech pathology and related services.

new text begin (f) Effective for services rendered on or after September 1, 2014, payment rates for physician and professional services, including physical therapy, occupational therapy, speech pathology, and mental health services shall be increased by five percent from the rates in effect on August 31, 2014. In calculating this rate increase, the commissioner shall not include in the base rate for August 31, 2014, the rate increase provided under section 256B.76, subdivision 7. This increase does not apply to federally qualified health centers, rural health centers, and Indian health services. Payments made to managed care plans and county-based purchasing plans shall not be adjusted to reflect payments under this paragraph. new text end

Sec. 26.

Minnesota Statutes 2012, section 256B.76, subdivision 2, is amended to read:

Subd. 2.

Dental reimbursement.

(a) Effective for services rendered on or after October 1, 1992, the commissioner shall make payments for dental services as follows:

(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 30, 1992; and

(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th percentile of 1989, less the percent in aggregate necessary to equal the above increases.

(b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.

(c) Effective for services rendered on or after January 1, 2000, payment rates for dental services shall be increased by three percent over the rates in effect on December 31, 1999.

(d) Effective for services provided on or after January 1, 2002, payment for diagnostic examinations and dental x-rays provided to children under age 21 shall be the lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.

(e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, 2000, for managed care.

(f) Effective for dental services rendered on or after October 1, 2010, by a state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based on the Medicare principles of reimbursement. This payment shall be effective for services rendered on or after January 1, 2011, to recipients enrolled in managed care plans or county-based purchasing plans.

(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal year, a supplemental state payment equal to the difference between the total payments in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated services for the operation of the dental clinics.

(h) If the cost-based payment system for state-operated dental clinics described in paragraph (f) does not receive federal approval, then state-operated dental clinics shall be designated as critical access dental providers under subdivision 4, paragraph (b), and shall receive the critical access dental reimbursement rate as described under subdivision 4, paragraph (a).

(i) Effective for services rendered on or after September 1, 2011, through June 30, 2013, payment rates for dental services shall be reduced by three percent. This reduction does not apply to state-operated dental clinics in paragraph (f).

new text begin (j) Effective for services rendered on or after January 1, 2014, payment rates for dental services shall be increased by five percent from the rates in effect on December 31, 2013. This increase does not apply to state-operated dental clinics in paragraph (f), federally qualified health centers, rural health centers, and Indian health services. Effective January 1, 2014, payments made to managed care plans and county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment increase described in this paragraph. new text end

Sec. 27.

Minnesota Statutes 2012, section 256B.76, subdivision 4, is amended to read:

Subd. 4.

Critical access dental providers.

(a) Effective for dental services rendered on or after January 1, 2002, the commissioner shall increase reimbursements to dentists and dental clinics deemed by the commissioner to be critical access dental providers. For dental services rendered on or after July 1, 2007, the commissioner shall increase reimbursement by deleted text begin 30deleted text end new text begin 35new text end percent above the reimbursement rate that would otherwise be paid to the critical access dental provider. The commissioner shall pay the managed care plans and county-based purchasing plans in amounts sufficient to reflect increased reimbursements to critical access dental providers as approved by the commissioner.

(b) The commissioner shall designate the following dentists and dental clinics as critical access dental providers:

(1) nonprofit community clinics that:

(i) have nonprofit status in accordance with chapter 317A;

(ii) have tax exempt status in accordance with the Internal Revenue Code, section 501(c)(3);

(iii) are established to provide oral health services to patients who are low income, uninsured, have special needs, and are underserved;

(iv) have professional staff familiar with the cultural background of the clinic's patients;

(v) charge for services on a sliding fee scale designed to provide assistance to low-income patients based on current poverty income guidelines and family size;

(vi) do not restrict access or services because of a patient's financial limitations or public assistance status; and

(vii) have free care available as needed;

(2) federally qualified health centers, rural health clinics, and public health clinics;

(3) new text begin city or new text end county owned and operated hospital-based dental clinics;

(4) a dental clinic or dental group owned and operated by a nonprofit corporation in accordance with chapter 317A with more than 10,000 patient encounters per year with patients who are uninsured or covered by medical assistancedeleted text begin , general assistance medical care,deleted text end or MinnesotaCare; deleted text begin anddeleted text end

(5) a dental clinic owned and operated by the University of Minnesota or the Minnesota State Colleges and Universities systemdeleted text begin .deleted text end new text begin ; andnew text end

new text begin (6) private practicing dentists if: new text end

new text begin (i) the dentist's office is located within a health professional shortage area as defined under Code of Federal Regulations, title 42, part 5, and United States Code, title 42, section 254E; new text end

new text begin (ii) more than 50 percent of the dentist's patient encounters per year are with patients who are uninsured or covered by medical assistance or MinnesotaCare; new text end

new text begin (iii) the dentist does not restrict access or services because of a patient's financial limitations or public assistance status; and new text end

new text begin (iv) the level of service provided by the dentist is critical to maintaining adequate levels of patient access within the service area in which the dentist operates. new text end

deleted text begin (c) The commissioner may designate a dentist or dental clinic as a critical access dental provider if the dentist or dental clinic is willing to provide care to patients covered by medical assistance, general assistance medical care, or MinnesotaCare at a level which significantly increases access to dental care in the service area. deleted text end

deleted text begin (d)deleted text end new text begin (c)new text end A designated critical access clinic shall receive the reimbursement rate specified in paragraph (a) for dental services provided off site at a private dental office if the following requirements are met:

(1) the designated critical access dental clinic is located within a health professional shortage area as defined under Code of Federal Regulations, title 42, part 5, and United States Code, title 42, section 254E, and is located outside the seven-county metropolitan area;

(2) the designated critical access dental clinic is not able to provide the service and refers the patient to the off-site dentist;

(3) the service, if provided at the critical access dental clinic, would be reimbursed at the critical access reimbursement rate;

(4) the dentist and allied dental professionals providing the services off site are licensed and in good standing under chapter 150A;

(5) the dentist providing the services is enrolled as a medical assistance provider;

(6) the critical access dental clinic submits the claim for services provided off site and receives the payment for the services; and

(7) the critical access dental clinic maintains dental records for each claim submitted under this paragraph, including the name of the dentist, the off-site location, and the license number of the dentist and allied dental professionals providing the services.

Sec. 28.

Minnesota Statutes 2012, section 256B.76, is amended by adding a subdivision to read:

new text begin Subd. 7. new text end

new text begin Payment for certain primary care services and immunization administration. new text end

new text begin Payment for certain primary care services and immunization administration services rendered on or after January 1, 2013, through December 31, 2014, shall be made in accordance with section 1902(a)(13) of the Social Security Act. new text end

Sec. 29.

Minnesota Statutes 2012, section 256B.764, is amended to read:

256B.764 REIMBURSEMENT FOR FAMILY PLANNING SERVICES.

new text begin (a) new text end Effective for services rendered on or after July 1, 2007, payment rates for family planning services shall be increased by 25 percent over the rates in effect June 30, 2007, when these services are provided by a community clinic as defined in section 145.9268, subdivision 1.

new text begin (b) Effective for services rendered on or after July 1, 2013, payment rates for family planning services shall be increased by 20 percent over the rates in effect June 30, 2013, when these services are provided by a community clinic as defined in section 145.9268, subdivision 1. The commissioner shall adjust capitation rates to managed care and county-based purchasing plans to reflect this increase, and shall require plans to pass on the full amount of the rate increase to eligible community clinics, in the form of higher payment rates for family planning services. new text end

Sec. 30.

Minnesota Statutes 2012, section 256B.766, is amended to read:

256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.

(a) Effective for services provided on or after July 1, 2009, total payments for basic care services, shall be reduced by three percent, except that for the period July 1, 2009, through June 30, 2011, total payments shall be reduced by 4.5 percent for the medical assistance and general assistance medical care programs, prior to third-party liability and spenddown calculation. Effective July 1, 2010, the commissioner shall classify physical therapy services, occupational therapy services, and speech-language pathology and related services as basic care services. The reduction in this paragraph shall apply to physical therapy services, occupational therapy services, and speech-language pathology and related services provided on or after July 1, 2010.

(b) Payments made to managed care plans and county-based purchasing plans shall be reduced for services provided on or after October 1, 2009, to reflect the reduction effective July 1, 2009, and payments made to the plans shall be reduced effective October 1, 2010, to reflect the reduction effective July 1, 2010.

(c) Effective for services provided on or after September 1, 2011, through June 30, 2013, total payments for outpatient hospital facility fees shall be reduced by five percent from the rates in effect on August 31, 2011.

(d) Effective for services provided on or after September 1, 2011, through June 30, 2013, total payments for ambulatory surgery centers facility fees, medical supplies and durable medical equipment not subject to a volume purchase contract, prosthetics and orthotics, renal dialysis services, laboratory services, public health nursing services, physical therapy services, occupational therapy services, speech therapy services, eyeglasses not subject to a volume purchase contract, hearing aids not subject to a volume purchase contract,new text begin and new text end anesthesia servicesdeleted text begin , and hospice servicesdeleted text end shall be reduced by three percent from the rates in effect on August 31, 2011.

new text begin (e) Effective for services provided on or after September 1, 2014, payments for ambulatory surgery centers facility fees, medical supplies and durable medical equipment not subject to a volume purchase contract, prosthetics and orthotics, hospice services, renal dialysis services, laboratory services, public health nursing services, eyeglasses not subject to a volume purchase contract, and hearing aids not subject to a volume purchase contract shall be increased by three percent and payments for outpatient hospital facility fees shall be increased by three percent. Payments made to managed care plans and county-based purchasing plans shall not be adjusted to reflect payments under this paragraph. new text end

deleted text begin (e)deleted text end new text begin (f)new text end This section does not apply to physician and professional services, inpatient hospital services, family planning services, mental health services, dental services, prescription drugs, medical transportation, federally qualified health centers, rural health centers, Indian health services, and Medicare cost-sharing.

Sec. 31.

Minnesota Statutes 2012, section 256B.767, is amended to read:

256B.767 MEDICARE PAYMENT LIMIT.

(a) Effective for services rendered on or after July 1, 2010, fee-for-service payment rates for physician and professional services under section 256B.76, subdivision 1, and basic care services subject to the rate reduction specified in section 256B.766, shall not exceed the Medicare payment rate for the applicable service, as adjusted for any changes in Medicare payment rates after July 1, 2010. The commissioner shall implement this section after any other rate adjustment that is effective July 1, 2010, and shall reduce rates under this section by first reducing or eliminating provider rate add-ons.

(b) This section does not apply to services provided by advanced practice certified nurse midwives licensed under chapter 148 or traditional midwives licensed under chapter 147D. Notwithstanding this exemption, medical assistance fee-for-service payment rates for advanced practice certified nurse midwives and licensed traditional midwives shall equal and shall not exceed the medical assistance payment rate to physicians for the applicable service.

(c) This section does not apply to mental health services or physician services billed by a psychiatrist or an advanced practice registered nurse with a specialty in mental health.

new text begin (d) Effective for durable medical equipment, prosthetics, orthotics, or supplies provided on or after July 1, 2013, through June 30, 2014, the payment rate for items that are subject to the rates established under Medicare's National Competitive Bidding Program shall be equal to the rate that applies to the same item when not subject to the rate established under Medicare's National Competitive Bidding Program. This paragraph does not apply to mail order diabetic supplies and does not apply to items provided to dually eligible recipients when Medicare is the primary payer of the item. new text end

Sec. 32.

Laws 2013, chapter 1, section 6, is amended to read:

Sec. 6.

TRANSFER.

new text begin (a) new text end The commissioner of management and budget shall transfer from the health care access fund to the general fund up to $21,319,000 in fiscal year 2014; up to $42,314,000 in fiscal year 2015; up to $56,147,000 in fiscal year 2016; and up to $64,683,000 in fiscal year 2017.

new text begin (b) The commissioner of human services shall determine the difference between the actual or forecasted cost to the medical assistance program of adding 19- and 20-year-olds and parents and relative caretaker populations with income between 100 and 138 percent of the federal poverty guidelines and the cost of adding those populations that was estimated during the 2013 legislative session based on the data from the February 2013 forecast. new text end

new text begin (c) For each fiscal year from 2014 to 2017, the commissioner of human services shall certify and report to the commissioner of management and budget the actual or forecasted cost difference of adding 19- and 20-year-olds and parents and relative caretaker populations with income between 100 and 138 percent of the federal poverty guidelines, as determined under paragraph (b), to the commissioner of management and budget at least four weeks prior to the release of a forecast under Minnesota Statutes, section 16A.103, of each fiscal year. new text end

new text begin (d) No later than three weeks before the release of the forecast under Minnesota Statutes, section 16A.103, the commissioner of management and budget shall reduce the health care access fund transfer in paragraph (a), by the cumulative differences in costs reported by the commissioner of human services under paragraph (c). If, for any fiscal year, the amount of the cumulative cost differences determined under paragraph (b) is positive, no change is made to the appropriation. If, for any fiscal year, the amount of the cumulative cost differences determined under paragraph (b) is less than the amount of the original appropriation, the appropriation for that year must be zero. new text end

Sec. 33.

new text begin REQUEST FOR INFORMATION; EMERGENCY MEDICAL ASSISTANCE AND THE UNINSURED STUDY. new text end

new text begin (a) The commissioner of human services, in consultation with safety net hospitals, nonprofit health care coverage programs, nonprofit community clinics, counties, and other interested parties, shall identify alternatives and make recommendations for providing coordinated and cost-effective health care and coverage to individuals who: new text end

new text begin (1) meet eligibility standards for emergency medical assistance; or new text end

new text begin (2) are uninsured and ineligible for other state public health care programs, have incomes below 400 percent of the federal poverty level, and are ineligible for premium credits through the Minnesota Insurance Marketplace as defined under Minnesota Statutes, section 62V.02. new text end

new text begin (b) The commissioner of human services shall issue a request for information to help identify options for coverage of medically necessary services not eligible for federal financial participation for emergency medical assistance recipients and medically necessary services for individuals who are uninsured and ineligible for other state public health care programs or coverage through the Minnesota Insurance Marketplace. The request for information shall provide: new text end

new text begin (1) the identification of services, including community-based medical, dental, and behavioral health services, necessary to reduce emergency department and inpatient hospital utilization for these recipients; new text end

new text begin (2) delivery system options, including for each option how the system would be organized to promote care coordination and cost-effectiveness, and how the system would be available statewide; new text end

new text begin (3) funding options and payment mechanisms to encourage providers to manage the delivery of care to these populations at a lower cost of care and with better patient outcomes than the current system; new text end

new text begin (4) how the funding and delivery of services will be coordinated with the services covered under emergency medical assistance; new text end

new text begin (5) options for administration of eligibility determination and service delivery; and new text end

new text begin (6) evaluation methods to measure cost-effectiveness and health outcomes that take into consideration the social determinants of health care for recipients participating in this alternative coverage option. new text end

new text begin (c) The commissioner shall issue a request for information by August 1, 2013, and respondents to the request must submit information to the commissioner by October 1, 2013. new text end

new text begin (d) The commissioner shall incorporate the information obtained through the request for information described in paragraph (b) and information collected by the commissioner of health and other relevant sources related to the uninsured in this state when developing recommendations. new text end

new text begin (e) The commissioner shall submit recommendations to the chairs and ranking minority members of the legislative committees and divisions with jurisdiction over health and human services and finance by January 15, 2014. 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. 34.

new text begin REQUEST FOR INFORMATION; EMERGENCY MEDICAL ASSISTANCE. new text end

new text begin (a) The commissioner of human services shall issue a request for information (RFI) to identify and develop options for a program to provide emergency medical assistance recipients with coverage for medically necessary services not eligible for federal financial participation. The RFI must focus on providing coverage for nonemergent services for recipients who have two or more chronic conditions and have had two or more hospitalizations covered by emergency medical assistance in a one-year period. new text end

new text begin (b) The RFI must be issued by August 1, 2013, and require respondents to submit information to the commissioner by November 1, 2013. The RFI must request information on: new text end

new text begin (1) services necessary to reduce emergency department and inpatient hospital use for emergency medical assistance recipients; new text end

new text begin (2) methods of service delivery that promote efficiency and cost-effectiveness, and provide statewide access; new text end

new text begin (3) funding options for the services to be covered under the program; new text end

new text begin (4) coordination of service delivery and funding with services covered under emergency medical assistance; new text end

new text begin (5) options for program administration; and new text end

new text begin (6) methods to evaluate the program, including evaluation of cost-effectiveness and health outcomes for those emergency medical assistance recipients eligible for coverage of additional services under the program. new text end

new text begin (c) The commissioner shall make information submitted in response to the RFI available on the agency Web site. The commissioner, based on the responses to the RFI, shall submit recommendations on providing emergency medical assistance recipients with coverage for nonemergent services, as described in paragraph (a), to the chairs and ranking minority members of the legislative committees with jurisdiction over health and human services policy and finance by January 15, 2014. new text end

Sec. 35.

new text begin DENTAL ACCESS AND REIMBURSEMENT REPORT. new text end

new text begin Subdivision 1. new text end

new text begin Study. new text end

new text begin (a) The commissioner of human services shall study the current oral health and dental services delivery system for state public health care programs to improve access and ensure cost-effective delivery of services. The commissioner shall make recommendations on modifying the delivery of services and reimbursement methods, including modifications to the critical access dental provider payments under Minnesota Statutes, section 256B.76, subdivision 4. new text end

new text begin (b) The commissioner shall consult with dental providers enrolled in Minnesota health care programs, including providers who serve substantial numbers of low-income and uninsured patients and are currently receiving enhanced critical access dental provider payments. new text end

new text begin Subd. 2. new text end

new text begin Service delivery and reimbursement methods. new text end

new text begin The recommendations must address: new text end

new text begin (1) targeting state funding and critical access dental payments to improve access to oral health services for individuals enrolled in Minnesota health care programs who are not receiving timely and appropriate dental services; new text end

new text begin (2) encouraging the use of cost-effective service delivery methods, workforce innovations, and the delivery of preventive services, including, but not limited to, dental sealants that will reduce dental disease and future costs of treatment; new text end

new text begin (3) improving access in all geographic areas of the state; new text end

new text begin (4) encouraging the use of tele-dentistry and mobile dental equipment to serve underserved patients and communities; new text end

new text begin (5) evaluating the use of a single administrator delivery model; new text end

new text begin (6) compensating providers for the added costs to providers of serving low-income and underserved patients and populations who experience the greatest oral health disparities in terms of incidence of oral health disease and access to and utilization of needed oral health services; new text end

new text begin (7) encouraging coordination of oral health care with other health care services; new text end

new text begin (8) preventing overtreatment, fraud, and abuse; and new text end

new text begin (9) reducing administrative costs for the state and for dental providers. new text end

new text begin Subd. 3. new text end

new text begin Report. new text end

new text begin The commissioner shall submit a report on the recommendations to the chairs and ranking minority members of the of the legislative committees and divisions with jurisdiction over health and human services policy and finance by December 15, 2013. new text end

ARTICLE 7

CONTINUING CARE

Section 1.

Minnesota Statutes 2012, section 144.0724, subdivision 6, is amended to read:

Subd. 6.

Penalties for late or nonsubmission.

new text begin (a) new text end A facility that fails to complete or submit an assessment for a RUG-III or RUG-IV classification within seven days of the time requirements in subdivisions 4 and 5 is subject to a reduced rate for that resident. The reduced rate shall be the lowest rate for that facility. The reduced rate is effective on the day of admission for new admission assessments or on the day that the assessment was due for all other assessments and continues in effect until the first day of the month following the date of submission of the resident's assessment.

new text begin (b) If loss of revenue due to penalties incurred by a facility for any period of 92 days are equal to or greater than 1.0 percent of the total operating costs on the facility's most recent annual statistical and cost report, a facility may apply to the commissioner of human services for a reduction in the total penalty amount. The commissioner of human services, in consultation with the commissioner of health, may, at the sole discretion of the commissioner of human services, limit the penalty for residents covered by medical assistance to 15 days. new text end

Sec. 2.

Minnesota Statutes 2012, section 144A.071, subdivision 4b, is amended to read:

Subd. 4b.

Licensed beds on layaway status.

A licensed and certified nursing facility may lay away, upon prior written notice to the commissioner of health, licensed and certified beds. A nursing facility may not discharge a resident in order to lay away a bed. Notice to the commissioner shall be given 60 days prior to the effective date of the layaway. Beds on layaway shall have the same status as voluntarily delicensed and decertified beds and shall not be subject to license fees and license surcharge fees. In addition, beds on layaway may be removed from layaway at any time on or after deleted text begin one yeardeleted text end new text begin six months new text end after the effective date of layaway in the facility of origin, with a 60-day notice to the commissioner. A nursing facility that removes beds from layaway may not place beds on layaway status for deleted text begin one yeardeleted text end new text begin six months new text end after the effective date of the removal from layaway. The commissioner may approve the immediate removal of beds from layaway if necessary to provide access to those nursing home beds to residents relocated from other nursing homes due to emergency situations or closure. In the event approval is granted, the deleted text begin one-yeardeleted text end new text begin six-month new text end restriction on placing beds on layaway after a removal of beds from layaway shall not apply. Beds may remain on layaway for up to ten years. The commissioner may approve placing and removing beds on layaway at any time during renovation or construction related to a moratorium project approved under this section or section 144A.073. Nursing facilities are not required to comply with any licensure or certification requirements for beds on layaway status.

Sec. 3.

Minnesota Statutes 2012, 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. 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, and determined to be needed by the commissioner under paragraph (b);

(3) new foster care licenses determined to be needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment centerdeleted text begin , ordeleted text end new text begin ;new text end restructuring of state-operated services that limits the capacity of state-operated facilities;new text begin 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;new text end

(4) new foster care licenses determined to be needed by the commissioner under paragraph (b) for persons requiring hospital level care; or

(5) new foster care licenses determined to be needed by the commissioner for the transition of people from personal care assistance to the home and community-based services.

(b) The commissioner shall determine the need for newly licensed foster care homes 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.

deleted text begin (c) The commissioner shall study the effects of the license moratorium under this subdivision and shall report back to the legislature by January 15, 2011. This study shall include, but is not limited to the following: deleted text end

deleted text begin (1) the overall capacity and utilization of foster care beds where the physical location is not the primary residence of the license holder prior to and after implementation of the moratorium; deleted text end

deleted text begin (2) the overall capacity and utilization of foster care beds where the physical location is the primary residence of the license holder prior to and after implementation of the moratorium; and deleted text end

deleted text begin (3) the number of licensed and occupied ICF/MR beds prior to and after implementation of the moratorium. deleted text end

deleted text begin (d)deleted text end new text begin (c)new text end When a foster care recipient 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), the county shall immediately inform the Department of Human Services Licensing Division. The department shall decrease the statewide licensed capacity for foster care settings where the physical location is not the primary residence of the license holder, if the voluntary changes described in paragraph deleted text begin (f)deleted text end new text begin (e)new text end 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. Under this paragraph, the commissioner has the authority to reduce unused licensed capacity of a current foster care program to accomplish the consolidation or closure of settings.new text begin 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 process in paragraph (e).new text end A decreased licensed capacity according to this paragraph is not subject to appeal under this chapter.

deleted text begin (e)deleted text end new text begin (d)new text end Residential settings that would otherwise be subject to the decreased license capacity established in paragraph deleted text begin (d)deleted text end new text begin (c)new text end shall be exempt under the following circumstances:

(1) until August 1, 2013, the license holder's beds occupied by residents whose primary diagnosis is mental illness and the license holder is:

(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental health services (ARMHS) as defined in section 256B.0623;

(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to 9520.0870;

(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to 9520.0870; or

(iv) a provider of intensive residential treatment services (IRTS) licensed under Minnesota Rules, parts 9520.0500 to 9520.0670; or

(2) new text begin the license holder's beds occupied by residents whose primary diagnosis is mental illness andnew text end the license holder is certified under the requirements in subdivision 6a.

deleted text begin (f)deleted text end new text begin (e)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 deleted text begin (d)deleted text end new text begin (c)new text end 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 deleted text begin of eachdeleted text end new text begin , 2013, and August 1, 2014, and each followingnew text end 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.

deleted text begin (g)deleted text end new text begin (f)new text end 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.

deleted text begin (h)deleted text end new text begin (g)new text end License holders of foster care homes identified under paragraph deleted text begin (g)deleted text end new text begin (f)new text end 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. These license holders must be considered registered under section 256B.092, subdivision 11, paragraph (c), and this registration status must be identified on their license certificates.

Sec. 4.

Minnesota Statutes 2012, section 252.291, is amended by adding a subdivision to read:

new text begin Subd. 2b. new text end

new text begin Nicollet County facility project. new text end

new text begin The commissioner of health shall certify one additional bed in an intermediate care facility for persons with developmental disabilities in Nicollet County. new text end

Sec. 5.

Minnesota Statutes 2012, section 256.9657, subdivision 3a, is amended to read:

Subd. 3a.

deleted text begin ICF/MRdeleted text end new text begin ICF/DDnew text end license surcharge.

new text begin (a) new text end Effective July 1, 2003, each non-state-operated facility as defined under section 256B.501, subdivision 1, shall pay to the commissioner an annual surcharge according to the schedule in subdivision 4, paragraph (d). The annual surcharge shall be $1,040 per licensed bed. If the number of licensed beds is reduced, the surcharge shall be based on the number of remaining licensed beds the second month following the receipt of timely notice by the commissioner of human services that beds have been delicensed. The facility must notify the commissioner of health in writing when beds are delicensed. The commissioner of health must notify the commissioner of human services within ten working days after receiving written notification. If the notification is received by the commissioner of human services by the 15th of the month, the invoice for the second following month must be reduced to recognize the delicensing of beds. The commissioner may reduce, and may subsequently restore, the surcharge under this subdivision based on the commissioner's determination of a permissible surcharge.

new text begin (b) Effective July 1, 2013, the surcharge under paragraph (a) is increased to $3,679 per licensed bed. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013. new text end

Sec. 6.

Minnesota Statutes 2012, section 256B.0915, subdivision 3a, is amended to read:

Subd. 3a.

Elderly waiver cost limits.

(a) The monthly limit for the cost of waivered services to an individual elderly waiver client except for individuals described in deleted text begin paragraphdeleted text end new text begin paragraphsnew text end (b)new text begin and (d)new text end shall be the weighted average monthly nursing facility rate of the case mix resident class to which the elderly waiver client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in which the resident assessment system as described in section 256B.438 for nursing home rate determination is implemented. Effective on the first day of the state fiscal year in which the resident assessment system as described in section 256B.438 for nursing home rate determination is implemented and the first day of each subsequent state fiscal year, the monthly limit for the cost of waivered services to an individual elderly waiver client shall be the rate of the case mix resident class to which the waiver client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the previous state fiscal year, adjusted by any legislatively adopted home and community-based services percentage rate adjustment.

(b) The monthly limit for the cost of waivered services to an individual elderly waiver client assigned to a case mix classification A under paragraph (a) with:

(1) no dependencies in activities of daily living; or

(2) up to two dependencies in bathing, dressing, grooming, walking, and eating when the dependency score in eating is three or greater as determined by an assessment performed under section 256B.0911 shall be $1,750 per month effective on July 1, 2011, for all new participants enrolled in the program on or after July 1, 2011. This monthly limit shall be applied to all other participants who meet this criteria at reassessment. This monthly limit shall be increased annually as described in paragraph (a).

(c) If extended medical supplies and equipment or environmental modifications are or will be purchased for an elderly waiver client, the costs may be prorated for up to 12 consecutive months beginning with the month of purchase. If the monthly cost of a recipient's waivered services exceeds the monthly limit established in paragraph (a) or (b), the annual cost of all waivered services shall be determined. In this event, the annual cost of all waivered services shall not exceed 12 times the monthly limit of waivered services as described in paragraph (a) or (b).

new text begin (d) Effective July 1, 2013, the monthly cost limit of waiver services, including any necessary home care services described in section 256B.0651, subdivision 2, for individuals who meet the criteria as ventilator-dependent given in section 256B.0651, subdivision 1, paragraph (g), shall be the average of the monthly medical assistance amount established for home care services as described in section 256B.0652, subdivision 7, and the annual average contracted amount established by the commissioner for nursing facility services for ventilator-dependent individuals. This monthly limit shall be increased annually as described in paragraph (a). new text end

Sec. 7.

Minnesota Statutes 2012, section 256B.0915, is amended by adding a subdivision to read:

new text begin Subd. 3j. new text end

new text begin Individual community living support. new text end

new text begin Upon federal approval, there is established a new service called individual community living support (ICLS) that is available on the elderly waiver. ICLS providers may not be the landlord of recipients, nor have any interest in the recipient's housing. ICLS must be delivered in a single-family home or apartment where the service recipient or their family owns or rents, as demonstrated by a lease agreement, and maintains control over the individual unit. Case managers or care coordinators must develop individual ICLS plans in consultation with the client using a tool developed by the commissioner. The commissioner shall establish payment rates and mechanisms to align payments with the type and amount of service provided, assure statewide uniformity for payment rates, and assure cost-effectiveness. Licensing standards for ICLS shall be reviewed jointly by the Departments of Health and Human Services to avoid conflict with provider regulatory standards pursuant to section 144A.43 and chapter 245D. new text end

Sec. 8.

Minnesota Statutes 2012, section 256B.0916, is amended by adding a subdivision to read:

new text begin Subd. 11. new text end

new text begin Excess spending. new text end

new text begin County and tribal agencies are responsible for spending in excess of the allocation made by the commissioner. In the event a county or tribal agency spends in excess of the allocation made by the commissioner for a given allocation period, they must submit a corrective action plan to the commissioner. The plan must state the actions the agency will take to correct their overspending for the year following the period when the overspending occurred. Failure to correct overspending shall result in recoupment of spending in excess of the allocation. Nothing in this subdivision shall be construed as reducing the county's responsibility to offer and make available feasible home and community-based options to eligible waiver recipients within the resources allocated to them for that purpose. new text end

Sec. 9.

Minnesota Statutes 2012, section 256B.092, subdivision 7, is amended to read:

Subd. 7.

Screening teams.

(a) For persons with developmental disabilities, screening teams shall be established which shall evaluate the need for the level of care provided by residential-based habilitation services, residential services, training and habilitation services, and nursing facility services. The evaluation shall address whether home and community-based services are appropriate for persons who are at risk of placement in an intermediate care facility for persons with developmental disabilities, or for whom there is reasonable indication that they might require this level of care. The screening team shall make an evaluation of need within 60 working days of a request for service by a person with a developmental disability, and within five working days of an emergency admission of a person to an intermediate care facility for persons with developmental disabilities.

(b) The screening team shall consist of the case manager for persons with developmental disabilities, the person, the person's legal guardian or conservator, or the parent if the person is a minor, and a qualified developmental disability professional, as defined in Code of Federal Regulations, title 42, section 483.430, as amended through June 3, 1988. The case manager may also act as the qualified developmental disability professional if the case manager meets the federal definition.

(c) County social service agencies may contract with a public or private agency or individual who is not a service provider for the person for the public guardianship representation required by the screening or individual service planning process. The contract shall be limited to public guardianship representation for the screening and individual service planning activities. The contract shall require compliance with the commissioner's instructions and may be for paid or voluntary services.

(d) For persons determined to have overriding health care needs and are seeking admission to a nursing facility or an ICF/MR, or seeking access to home and community-based waivered services, a registered nurse must be designated as either the case manager or the qualified developmental disability professional.

(e) For persons under the jurisdiction of a correctional agency, the case manager must consult with the corrections administrator regarding additional health, safety, and supervision needs.

(f) The case manager, with the concurrence of the person, the person's legal guardian or conservator, or the parent if the person is a minor, may invite other individuals to attend meetings of the screening team. With the permission of the person being screened or the person's designated legal representative, the person's current provider of services may submit a written report outlining their recommendations regarding the person's care needs prepared by a direct service employee with at least 20 hours of service to that client. The screening team must notify the provider of the date by which this information is to be submitted. This information must be provided to the screening team and the person or the person's legal representative and must be considered prior to the finalization of the screening.

new text begin (g) Upon federal approval, if during an assessment or reassessment the recipient is determined to be able to have the recipient's needs met through alternative services in a less restrictive setting, the case manager shall help the recipient develop a plan to transition to an appropriate less restrictive setting. new text end

deleted text begin (g)deleted text end new text begin (h)new text end No member of the screening team shall have any direct or indirect service provider interest in the case.

deleted text begin (h)deleted text end new text begin (i)new text end Nothing in this section shall be construed as requiring the screening team meeting to be separate from the service planning meeting.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 10.

Minnesota Statutes 2012, section 256B.092, subdivision 11, is amended to read:

Subd. 11.

Residential support services.

(a) Upon federal approval, there is established a new service called residential support that is available on the community alternative care, community alternatives for disabled individuals, developmental disabilities, and brain injury waivers. Existing waiver service descriptions must be modified to the extent necessary to ensure there is no duplication between other services. Residential support services must be provided by vendors licensed as a community residential setting as defined in section 245A.11, subdivision 8.

(b) Residential support services must meet the following criteria:

(1) providers of residential support services must own or control the residential site;

(2) the residential site must not be the primary residence of the license holder;

(3) the residential site must have a designated program supervisor responsible for program oversight, development, and implementation of policies and procedures;

(4) the provider of residential support services must provide supervision, training, and assistance as described in the person's coordinated service and support plan; and

(5) the provider of residential support services must meet the requirements of licensure and additional requirements of the person's coordinated service and support plan.

(c) Providers of residential support services that meet the definition in paragraph (a) must be registered using a process determined by the commissioner beginning July 1, 2009. Providers licensed to provide child foster care under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, and that meet the requirements in section 245A.03, subdivision 7, paragraph deleted text begin (g)deleted text end new text begin (f)new text end , are considered registered under this section.

Sec. 11.

Minnesota Statutes 2012, section 256B.092, subdivision 12, is amended to read:

Subd. 12.

Waivered services statewide priorities.

(a) The commissioner shall establish statewide priorities for individuals on the waiting list for developmental disabilities (DD) waiver services, as of January 1, 2010. The statewide priorities must include, but are not limited to, individuals who continue to have a need for waiver services after they have maximized the use of state plan services and other funding resources, including natural supports, prior to accessing waiver services, and who meet at least one of the following criteria:

new text begin (1) no longer require the intensity of services provided where they are currently living; or new text end

new text begin (2) make a request to move from an institutional setting. new text end

new text begin (b) After the priorities in paragraph (a) are met, priority must also be given to individuals who meet at least one of the following criteria: new text end

(1) have unstable living situations due to the age, incapacity, or sudden loss of the primary caregivers;

(2) are moving from an institution due to bed closures;

(3) experience a sudden closure of their current living arrangement;

(4) require protection from confirmed abuse, neglect, or exploitation;

(5) experience a sudden change in need that can no longer be met through state plan services or other funding resources alone; or

(6) meet other priorities established by the department.

deleted text begin (b)deleted text end new text begin (c)new text end When allocating resources to lead agencies, the commissioner must take into consideration the number of individuals waiting who meet statewide priorities and the lead agencies' current use of waiver funds and existing service options.new text begin The commissioner has the authority to transfer funds between counties, groups of counties, and tribes to accommodate statewide priorities and resource needs while accounting for a necessary base level reserve amount for each county, group of counties, and tribe.new text end

deleted text begin (c) The commissioner shall evaluate the impact of the use of statewide priorities and provide recommendations to the legislature on whether to continue the use of statewide priorities in the November 1, 2011, annual report required by the commissioner in sections 256B.0916, subdivision 7, and 256B.49, subdivision 21. deleted text end

Sec. 12.

Minnesota Statutes 2012, section 256B.092, is amended by adding a subdivision to read:

new text begin Subd. 14. new text end

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

new text begin (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: new text end

new text begin (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; new text end

new text begin (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, access to crisis mobility services, mental health services, use of technology, and crisis stabilization services in section 256B.0624, subdivision 7; and new text end

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

new text begin (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 end

Sec. 13.

new text begin [256B.0922] ESSENTIAL COMMUNITY SUPPORTS. new text end

new text begin Subdivision 1. new text end

new text begin Essential community supports. new text end

new text begin (a) The purpose of the essential community supports program is to provide targeted services to persons age 65 and older who need essential community support, but whose needs do not meet the level of care required for nursing facility placement under section 144.0724, subdivision 11. new text end

new text begin (b) Essential community supports are available not to exceed $400 per person per month. Essential community supports may be used as authorized within an authorization period not to exceed 12 months. Services must be available to a person who: new text end

new text begin (1) is age 65 or older; new text end

new text begin (2) is not eligible for medical assistance; new text end

new text begin (3) has received a community assessment under section 256B.0911, subdivision 3a or 3b, and does not require the level of care provided in a nursing facility; new text end

new text begin (4) meets the financial eligibility criteria for the alternative care program under section 256B.0913, subdivision 4; new text end

new text begin (5) has a community support plan; and new text end

new text begin (6) has been determined by a community assessment under section 256B.0911, subdivision 3a or 3b, to be a person who would require provision of at least one of the following services, as defined in the approved elderly waiver plan, in order to maintain their community residence: new text end

new text begin (i) caregiver support; new text end

new text begin (ii) homemaker support; new text end

new text begin (iii) chores; new text end

new text begin (iv) a personal emergency response device or system; new text end

new text begin (v) home-delivered meals; or new text end

new text begin (vi) community living assistance as defined by the commissioner. new text end

new text begin (c) The person receiving any of the essential community supports in this subdivision must also receive service coordination, not to exceed $600 in a 12-month authorization period, as part of their community support plan. new text end

new text begin (d) A person who has been determined to be eligible for essential community supports must be reassessed at least annually and continue to meet the criteria in paragraph (b) to remain eligible for essential community supports. new text end

new text begin (e) The commissioner is authorized to use federal matching funds for essential community supports as necessary and to meet demand for essential community supports as outlined in subdivision 2, and that amount of federal funds is appropriated to the commissioner for this purpose. new text end

new text begin Subd. 2. new text end

new text begin Essential community supports for people in transition. new text end

new text begin (a) Essential community supports under subdivision 1 are also available to an individual who: new text end

new text begin (1) is receiving nursing facility services or home and community-based long-term services and supports under section 256B.0915 or 256B.49 on the effective date of implementation of the revised nursing facility level of care under section 144.0724, subdivision 11; new text end

new text begin (2) meets one of the following criteria: new text end

new text begin (i) due to the implementation of the revised nursing facility level of care, loses eligibility for continuing medical assistance payment of nursing facility services at the first reassessment under section 144.0724, subdivision 11, paragraph (b), that occurs on or after the effective date of the revised nursing facility level of care criteria under section 144.0724, subdivision 11; or new text end

new text begin (ii) due to the implementation of the revised nursing facility level of care, loses eligibility for continuing medical assistance payment of home and community-based long-term services and supports under section 256B.0915 or 256B.49 at the first reassessment required under those sections that occurs on or after the effective date of implementation of the revised nursing facility level of care under section 144.0724, subdivision 11; new text end

new text begin (3) is not eligible for personal care attendant services; and new text end

new text begin (4) has an assessed need for one or more of the supportive services offered under essential community supports under subdivision 1, paragraph (b), clause (6). new text end

new text begin Individuals eligible under this paragraph includes individuals who continue to be eligible for medical assistance state plan benefits and those who are not or are no longer financially eligible for medical assistance. new text end

new text begin (b) Additional onetime case management is available for participants under paragraph (a), not to exceed $600 per person to be used within one authorization period not to exceed 12 months. This service is provided in addition to the essential community supports benefit described under subdivision 1, paragraph (b). new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 14.

new text begin [256B.0949] AUTISM EARLY INTENSIVE INTERVENTION BENEFIT. new text end

new text begin Subdivision 1. new text end

new text begin Purpose. new text end

new text begin This section creates a new benefit to provide early intensive intervention to a child with an autism spectrum disorder diagnosis. This benefit must provide coverage for diagnosis, multidisciplinary assessment, ongoing progress evaluation, and medically necessary treatment of autism spectrum disorder. new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

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

new text begin (b) "Autism spectrum disorder diagnosis" is defined by diagnostic code 299 in the current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM). new text end

new text begin (c) "Child" means a person under the age of 18. new text end

new text begin (d) "Commissioner" means the commissioner of human services, unless otherwise specified. new text end

new text begin (e) "Early intensive intervention benefit" means autism treatment options based in behavioral and developmental science, which may include modalities such as applied behavior analysis, developmental treatment approaches, and naturalistic and parent training models. new text end

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

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

new text begin Subd. 3. new text end

new text begin Initial eligibility. new text end

new text begin This benefit is available to a child enrolled in medical assistance who: new text end

new text begin (1) has an autism spectrum disorder diagnosis; new text end

new text begin (2) has had a diagnostic assessment described in subdivision 5, which recommends early intensive intervention services; and new text end

new text begin (3) meets the criteria for medically necessary autism early intensive intervention services. new text end

new text begin Subd. 4. new text end

new text begin Diagnosis. new text end

new text begin (a) A diagnosis must: new text end

new text begin (1) be based upon current DSM criteria including direct observations of the child and reports from parents or primary caregivers; and new text end

new text begin (2) be completed by both a licensed physician or advanced practice registered nurse and a mental health professional. new text end

new text begin (b) Additional diagnostic assessment information may be considered including from special education evaluations and licensed school personnel, and from professionals licensed in the fields of medicine, speech and language, psychology, occupational therapy, and physical therapy. new text end

new text begin (c) If the commissioner determines there are access problems or delays in diagnosis for a geographic area due to the lack of qualified professionals, the commissioner shall waive the requirement in paragraph (a), clause (2), for two professionals and allow a diagnosis to be made by one professional for that geographic area. This exception must be limited to a specific period of time until, with stakeholder input as described in subdivision 8, there is a determination of an adequate number of professionals available to require two professionals for each diagnosis. new text end

new text begin Subd. 5. new text end

new text begin Diagnostic assessment. new text end

new text begin The following information and assessments must be performed, reviewed, and relied upon for the eligibility determination, treatment and services recommendations, and treatment plan development for the child: new text end

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

new text begin (2) an assessment of parental or caregiver capacity to participate in therapy including the type and level of parental or caregiver involvement and training recommended. new text end

new text begin Subd. 6. new text end

new text begin Treatment plan. new text end

new text begin (a) Each child's treatment plan must be: new text end

new text begin (1) based on the diagnostic assessment information specified in subdivisions 4 and 5; new text end

new text begin (2) coordinated with medically necessary occupational, physical, and speech and language therapies, special education, and other services the child and family are receiving; new text end

new text begin (3) family-centered; new text end

new text begin (4) culturally sensitive; and new text end

new text begin (5) individualized based on the child's developmental status and the child's and family's identified needs. new text end

new text begin (b) The treatment plan must specify the: new text end

new text begin (1) child's goals which are developmentally appropriate, functional, and generalizable; new text end

new text begin (2) treatment modality; new text end

new text begin (3) treatment intensity; new text end

new text begin (4) setting; and new text end

new text begin (5) level and type of parental or caregiver involvement. new text end

new text begin (c) The treatment must be supervised by a professional with expertise and training in autism and child development who is a licensed physician, advanced practice registered nurse, or mental health professional. new text end

new text begin (d) The treatment plan must be submitted to the commissioner for approval in a manner determined by the commissioner for this purpose. new text end

new text begin (e) Services authorized must be consistent with the child's approved treatment plan. new text end

new text begin Services included in the treatment plan must meet all applicable requirements for medical necessity and coverage. new text end

new text begin Subd. 7. new text end

new text begin Ongoing eligibility. new text end

new text begin (a) An independent progress evaluation conducted by a licensed mental health professional with expertise and training in autism spectrum disorder and child development must be completed after each six months of treatment, or more frequently as determined by the commissioner, to determine if progress is being made toward achieving generalizable goals and meeting functional goals contained in the treatment plan. new text end

new text begin (b) The progress evaluation must include: new text end

new text begin (1) the treating provider's report; new text end

new text begin (2) parental or caregiver input; new text end

new text begin (3) an independent observation of the child which can be performed by the child's licensed special education staff; new text end

new text begin (4) any treatment plan modifications; and new text end

new text begin (5) recommendations for continued treatment services. new text end

new text begin (c) Progress evaluations must be submitted to the commissioner in a manner determined by the commissioner for this purpose. new text end

new text begin (d) A child who continues to achieve generalizable goals and treatment goals as specified in the treatment plan is eligible to continue receiving this benefit. new text end

new text begin (e) A child's treatment shall continue during the progress evaluation using the process determined under subdivision 8, clause (8). Treatment may continue during an appeal pursuant to section 256.045. new text end

new text begin Subd. 8. new text end

new text begin Refining the benefit with stakeholders. new text end

new text begin The commissioner must develop the implementation details of the benefit in consultation with stakeholders and consider recommendations from the Health Services Advisory Council, the Department of Human Services Autism Spectrum Disorder Advisory Council, the Legislative Autism Spectrum Disorder Task Force, and the Interagency Task Force of the Departments of Health, Education, and Human Services. The commissioner must release these details for a 30-day public comment period prior to submission to the federal government for approval. The implementation details must include, but are not limited to, the following components: new text end

new text begin (1) a definition of the qualifications, standards, and roles of the treatment team, including recommendations after stakeholder consultation on whether board-certified behavior analysts and other types of professionals trained in autism spectrum disorder and child development should be added as mental health or other professionals for treatment supervision or other functions under medical assistance; new text end

new text begin (2) development of initial, uniform parameters for comprehensive multidisciplinary diagnostic assessment information and progress evaluation standards; new text end

new text begin (3) the design of an effective and consistent process for assessing parent and caregiver capacity to participate in the child's early intervention treatment and methods of involving the parents and caregivers in the treatment of the child; new text end

new text begin (4) formulation of a collaborative process in which professionals have opportunities to collectively inform a comprehensive, multidisciplinary diagnostic assessment and progress evaluation processes and standards to support quality improvement of early intensive intervention services; new text end

new text begin (5) coordination of this benefit and its interaction with other services provided by the Departments of Human Services, Health, and Education; new text end

new text begin (6) evaluation, on an ongoing basis, of research regarding the program and treatment modalities provided to children under this benefit; new text end

new text begin (7) determination of the availability of licensed physicians, nurse practitioners, and mental health professionals with expertise and training in autism spectrum disorder throughout the state to assess whether there are sufficient professionals to require involvement of both a physician or nurse practitioner and a mental health professional to provide access and prevent delay in the diagnosis and treatment of young children, so as to implement subdivision 4, and to ensure treatment is effective, timely, and accessible; and new text end

new text begin (8) development of the process for the progress evaluation that will be used to determine the ongoing eligibility, including necessary documentation, timelines, and responsibilities of all parties. new text end

new text begin Subd. 9. new text end

new text begin Revision of treatment options. new text end

new text begin (a) The commissioner may revise covered treatment options as needed based on outcome data and other evidence. new text end

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

new text begin Subd. 10. new text end

new text begin Coordination between agencies. new text end

new text begin The commissioners of human services and education must develop the capacity to coordinate services and information including diagnostic, functional, developmental, medical, and educational assessments; service delivery; and progress evaluations across health and education sectors. new text end

new text begin Subd. 11. new text end

new text begin Federal approval of the autism benefit. new text end

new text begin The provisions of subdivision 9 shall apply to state plan services under Title XIX of the Social Security Act when federal approval is granted under a 1915(i) waiver or other authority which allows children eligible for medical assistance through the TEFRA option under section 256B.055, subdivision 12, to qualify and includes children eligible for medical assistance in families over 150 percent of the federal poverty guidelines. new text end

new text begin EFFECTIVE DATE. new text end

new text begin Subdivisions 1 to 7 and 9, are effective upon federal approval consistent with subdivision 11, but no earlier than March 1, 2014. Subdivisions 8, 10, and 11 are effective July 1, 2013. new text end

Sec. 15.

Minnesota Statutes 2012, section 256B.095, is amended to read:

256B.095 QUALITY ASSURANCE SYSTEM ESTABLISHED.

(a) Effective July 1, 1998, a quality assurance system for persons with developmental disabilities, which includes an alternative quality assurance licensing system for programs, is established in Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele, Wabasha, and Winona Counties for the purpose of improving the quality of services provided to persons with developmental disabilities. A county, at its option, may choose to have all programs for persons with developmental disabilities located within the county licensed under chapter 245A using standards determined under the alternative quality assurance licensing system or may continue regulation of these programs under the licensing system operated by the commissioner. deleted text begin The project expires on June 30, 2014.deleted text end

(b) Effective July 1, 2003, a county not listed in paragraph (a) may apply to participate in the quality assurance system established under paragraph (a). The commission established under section 256B.0951 may, at its option, allow additional counties to participate in the system.

(c) Effective July 1, 2003, any county or group of counties not listed in paragraph (a) may establish a quality assurance system under this section. A new system established under this section shall have the same rights and duties as the system established under paragraph (a). A new system shall be governed by a commission under section 256B.0951. The commissioner shall appoint the initial commission members based on recommendations from advocates, families, service providers, and counties in the geographic area included in the new system. Counties that choose to participate in a new system shall have the duties assigned under section 256B.0952. The new system shall establish a quality assurance process under section 256B.0953. The provisions of section 256B.0954 shall apply to a new system established under this paragraph. The commissioner shall delegate authority to a new system established under this paragraph according to section 256B.0955.

(d) Effective July 1, 2007, the quality assurance system may be expanded to include programs for persons with disabilities and older adults.

new text begin (e) Effective July 1, 2013, a provider of service located in a county listed in paragraph (a) that is a non-opted-in county may opt in to the quality assurance system provided the county where services are provided indicates its agreement with a county with a delegation agreement with the Department of Human Services. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013. new text end

Sec. 16.

Minnesota Statutes 2012, section 256B.0951, subdivision 1, is amended to read:

Subdivision 1.

Membership.

The Quality Assurance Commission is established. The commission consists of at least 14 but not more than 21 members as follows: at least three but not more than five members representing advocacy organizations; at least three but not more than five members representing consumers, families, and their legal representatives; at least three but not more than five members representing service providers; at least three but not more than five members representing counties; and the commissioner of human services or the commissioner's designee. The first commission shall establish membership guidelines for the transition and recruitment of membership for the commission's ongoing existence. Members of the commission who do not receive a salary or wages from an employer for time spent on commission duties may receive a per diem payment when performing commission duties and functions. All members may be reimbursed for expenses related to commission activities. deleted text begin Notwithstanding the provisions of section 15.059, subdivision 5, the commission expires on June 30, 2014.deleted text end

Sec. 17.

Minnesota Statutes 2012, section 256B.0951, subdivision 4, is amended to read:

Subd. 4.

Commission's authority to recommend variances of licensing standards.

The commission may recommend to the commissioners of human services and health variances from the standards governing licensure of programs for persons with deleted text begin developmentaldeleted text end disabilities in order to improve the quality of services by implementing an alternative deleted text begin developmentaldeleted text end disabilities licensing system if the commission determines that the alternative licensing system does not adversely affect the health or safety of persons being served by the licensed program nor compromise the qualifications of staff to provide services.

Sec. 18.

Minnesota Statutes 2012, section 256B.0952, subdivision 1, is amended to read:

Subdivision 1.

Notification.

Counties new text begin or providers new text end shall give notice to the commission and commissioners of human services and health of intent to join the alternative quality assurance licensing system. A county new text begin or provider new text end choosing to participate in the alternative quality assurance licensing system commits to participate for three years.

Sec. 19.

Minnesota Statutes 2012, section 256B.0952, subdivision 5, is amended to read:

Subd. 5.

Quality assurance teams.

Quality assurance teams shall be comprised of county staff; providers; consumers, families, and their legal representatives; members of advocacy organizations; and other involved community members. Team members must satisfactorily complete the training program approved by the commission and must demonstrate performance-based competency. Team members are not considered to be county employees for purposes of workers' compensation, unemployment insurance, or state retirement laws solely on the basis of participation on a quality assurance team. deleted text begin The county may paydeleted text end A per diem new text begin may be paid new text end to team members for time spent on alternative quality assurance process matters. All team members may be reimbursed for expenses related to their participation in the alternative process.

Sec. 20.

Minnesota Statutes 2012, section 256B.0955, is amended to read:

256B.0955 DUTIES OF THE COMMISSIONER OF HUMAN SERVICES.

(a) Effective July 1, 1998, the commissioner of human services shall delegate authority to perform licensing functions and activities, in accordance with section 245A.16, to counties participating in the alternative quality assurance licensing system. The commissioner shall not license or reimburse a facility, program, or service for persons with deleted text begin developmentaldeleted text end disabilities in a county that participates in the alternative quality assurance licensing system if the commissioner has received from the appropriate county notification that the facility, program, or service has been reviewed by a quality assurance team and has failed to qualify for licensure.

(b) The commissioner may conduct random licensing inspections based on outcomes adopted under section 256B.0951 at facilities, programs, and services governed by the alternative quality assurance licensing system. The role of such random inspections shall be to verify that the alternative quality assurance licensing system protects the safety and well-being of consumers and maintains the availability of high-quality services for persons with developmental disabilities.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013. new text end

Sec. 21.

Minnesota Statutes 2012, section 256B.097, subdivision 1, is amended to read:

Subdivision 1.

Scope.

(a) In order to improve the quality of services provided to Minnesotans with disabilities and to meet the requirements of the federally approved home and community-based waivers under section 1915c of the Social Security Act, a State Quality Assurance, Quality Improvement, and Licensing System for Minnesotans receiving disability services is enacted. This system is a partnership between the Department of Human Services and the State Quality Council established under subdivision 3.

(b) This system is a result of the recommendations from the Department of Human Services' licensing and alternative quality assurance study mandated under Laws 2005, First Special Session chapter 4, article 7, section 57, and presented to the legislature in February 2007.

(c) The disability services eligible under this section include:

(1) the home and community-based services waiver programs for persons with developmental disabilities under section 256B.092, subdivision 4, or section 256B.49, including brain injuries and services for those who qualify for nursing facility level of care or hospital facility level of carenew text begin and any other services licensed under chapter 245Dnew text end ;

(2) home care services under section 256B.0651;

(3) family support grants under section 252.32;

(4) consumer support grants under section 256.476;

(5) semi-independent living services under section 252.275; and

(6) services provided through an intermediate care facility for the developmentally disabled.

(d) For purposes of this section, the following definitions apply:

(1) "commissioner" means the commissioner of human services;

(2) "council" means the State Quality Council under subdivision 3;

(3) "Quality Assurance Commission" means the commission under section 256B.0951; and

(4) "system" means the State Quality Assurance, Quality Improvement and Licensing System under this section.

Sec. 22.

Minnesota Statutes 2012, section 256B.097, subdivision 3, is amended to read:

Subd. 3.

State Quality Council.

(a) There is hereby created a State Quality Council which must define regional quality councils, and carry out a community-based, person-directed quality review component, and a comprehensive system for effective incident reporting, investigation, analysis, and follow-up.

(b) By August 1, 2011, the commissioner of human services shall appoint the members of the initial State Quality Council. Members shall include representatives from the following groups:

(1) disability service recipients and their family members;

(2) during the first deleted text begin twodeleted text end new text begin fournew text end years of the State Quality Council, there must be at least three members from the Region 10 stakeholders. As regional quality councils are formed under subdivision 4, each regional quality council shall appoint one member;

(3) disability service providers;

(4) disability advocacy groups; and

(5) county human services agencies and staff from the Department of Human Services and Ombudsman for Mental Health and Developmental Disabilities.

(c) Members of the council who do not receive a salary or wages from an employer for time spent on council duties may receive a per diem payment when performing council duties and functions.

(d) The State Quality Council shall:

(1) assist the Department of Human Services in fulfilling federally mandated obligations by monitoring disability service quality and quality assurance and improvement practices in Minnesota;

(2) establish state quality improvement priorities with methods for achieving results and provide an annual report to the legislative committees with jurisdiction over policy and funding of disability services on the outcomes, improvement priorities, and activities undertaken by the commission during the previous state fiscal year;

(3) identify issues pertaining to financial and personal risk that impede Minnesotans with disabilities from optimizing choice of community-based services; and

(4) recommend to the chairs and ranking minority members of the legislative committees with jurisdiction over human services and civil law by January 15, deleted text begin 2013deleted text end new text begin 2014new text end , statutory and rule changes related to the findings under clause (3) that promote individualized service and housing choices balanced with appropriate individualized protection.

(e) The State Quality Council, in partnership with the commissioner, shall:

(1) approve and direct implementation of the community-based, person-directed system established in this section;

(2) recommend an appropriate method of funding this system, and determine the feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;

(3) approve measurable outcomes in the areas of health and safety, consumer evaluation, education and training, providers, and systems;

(4) establish variable licensure periods not to exceed three years based on outcomes achieved; and

(5) in cooperation with the Quality Assurance Commission, design a transition plan for licensed providers from Region 10 into the alternative licensing system deleted text begin by July 1, 2013deleted text end .

(f) The State Quality Council shall notify the commissioner of human services that a facility, program, or service has been reviewed by quality assurance team members under subdivision 4, paragraph (b), clause (13), and qualifies for a license.

(g) The State Quality Council, in partnership with the commissioner, shall establish an ongoing review process for the system. The review shall take into account the comprehensive nature of the system which is designed to evaluate the broad spectrum of licensed and unlicensed entities that provide services to persons with disabilities. The review shall address efficiencies and effectiveness of the system.

(h) The State Quality Council may recommend to the commissioner certain variances from the standards governing licensure of programs for persons with disabilities in order to improve the quality of services so long as the recommended variances do not adversely affect the health or safety of persons being served or compromise the qualifications of staff to provide services.

(i) The safety standards, rights, or procedural protections referenced under subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make recommendations to the commissioner or to the legislature in the report required under paragraph (c) regarding alternatives or modifications to the safety standards, rights, or procedural protections referenced under subdivision 2, paragraph (c).

(j) The State Quality Council may hire staff to perform the duties assigned in this subdivision.

Sec. 23.

Minnesota Statutes 2012, section 256B.431, subdivision 44, is amended to read:

Subd. 44.

Property rate deleted text begin increasedeleted text end new text begin increasesnew text end for deleted text begin a facility in Bloomington effective November 1, 2010deleted text end new text begin certain nursing facilitiesnew text end .

new text begin (a) new text end Notwithstanding any other law to the contrary, money available for moratorium projects under section 144A.073, subdivision 11, shall be used, effective November 1, 2010, to fund an approved moratorium exception project for a nursing facility in Bloomington licensed for 137 beds as of November 1, 2010, up to a total property rate adjustment of $19.33.

new text begin (b) Effective June 1, 2012, any nursing facility in McLeod County licensed for 110 beds shall have its replacement-cost-new limit under subdivision 17e adjusted to allow $1,129,463 of a completed construction project to increase the property payment rate. Notwithstanding any other law to the contrary, money available under section 144A.073, subdivision 11, after the completion of the moratorium exception approval process in 2013 under section 144A.073, subdivision 3, shall be used to reduce the fiscal impact to the medical assistance budget for the increase in the replacement-cost-new limit. new text end

new text begin (c) Effective July 1, 2012, any nursing facility in Dakota County licensed for 61 beds shall have their replacement-cost-new limit under subdivision 17e adjusted to allow $1,407,624 of a completed construction project to increase their property payment rate. Effective September 1, 2013, or later, their replacement-cost-new limit under subdivision 17e shall be adjusted to allow $1,244,599 of a completed construction project to increase the property payment rate. Notwithstanding any other law to the contrary, money available under section 144A.073, subdivision 11, after the completion of the moratorium exception approval process in 2013 under section 144A.073, subdivision 3, shall be used to reduce the fiscal impact to the medical assistance budget for the increase in the replacement-cost-new limit. new text end

new text begin (d) Effective July 1, 2013, or later, any boarding care facility in Hennepin County licensed for 101 beds shall be allowed to receive a property rate adjustment for a construction project that takes action to come into compliance with Minnesota Department of Labor and Industry elevator upgrade requirements, with costs below the minimum threshold under subdivision 16. Only costs related to the construction project that brings the facility into compliance with the elevator requirements shall be allowed. Notwithstanding any other law to the contrary, money available under section 144A.073, subdivision 11, after the completion of the moratorium exception approval process in 2013 under section 144A.073, subdivision 3, shall be used to reduce the fiscal impact to the medical assistance program. new text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraph (b) is effective retroactively from June 1, 2012. Paragraph (c) is effective retroactively from July 1, 2012. new text end

Sec. 24.

Minnesota Statutes 2012, section 256B.434, subdivision 4, is amended to read:

Subd. 4.

Alternate rates for nursing facilities.

(a) For nursing facilities which have their payment rates determined under this section rather than section 256B.431, the commissioner shall establish a rate under this subdivision. The nursing facility must enter into a written contract with the commissioner.

(b) A nursing facility's case mix payment rate for the first rate year of a facility's contract under this section is the payment rate the facility would have received under section 256B.431.

(c) A nursing facility's case mix payment rates for the second and subsequent years of a facility's contract under this section are the previous rate year's contract payment rates plus an inflation adjustment and, for facilities reimbursed under this section or section 256B.431, an adjustment to include the cost of any increase in Health Department licensing fees for the facility taking effect on or after July 1, 2001. The index for the inflation adjustment must be based on the change in the Consumer Price Index-All Items (United States City average) (CPI-U) forecasted by the commissioner of management and budget's national economic consultant, as forecasted in the fourth quarter of the calendar year preceding the rate year. The inflation adjustment must be based on the 12-month period from the midpoint of the previous rate year to the midpoint of the rate year for which the rate is being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007, July 1, 2008, October 1, 2009, and October 1, 2010, this paragraph shall apply only to the property-related payment rate. For the rate years beginning on October 1, 2011, deleted text begin anddeleted text end October 1, 2012, new text begin October 1, 2013, October 1, 2014, October 1, 2015, and October 1, 2016, new text end the rate adjustment under this paragraph shall be suspended. Beginning in 2005, adjustment to the property payment rate under this section and section 256B.431 shall be effective on October 1. In determining the amount of the property-related payment rate adjustment under this paragraph, the commissioner shall determine the proportion of the facility's rates that are property-related based on the facility's most recent cost report.

(d) The commissioner shall develop additional incentive-based payments of up to five percent above a facility's operating payment rate for achieving outcomes specified in a contract. The commissioner may solicit contract amendments and implement those which, on a competitive basis, best meet the state's policy objectives. The commissioner shall limit the amount of any incentive payment and the number of contract amendments under this paragraph to operate the incentive payments within funds appropriated for this purpose. The contract amendments may specify various levels of payment for various levels of performance. Incentive payments to facilities under this paragraph may be in the form of time-limited rate adjustments or onetime supplemental payments. In establishing the specified outcomes and related criteria, the commissioner shall consider the following state policy objectives:

(1) successful diversion or discharge of residents to the residents' prior home or other community-based alternatives;

(2) adoption of new technology to improve quality or efficiency;

(3) improved quality as measured in the Nursing Home Report Card;

(4) reduced acute care costs; and

(5) any additional outcomes proposed by a nursing facility that the commissioner finds desirable.

(e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that take action to come into compliance with existing or pending requirements of the life safety code provisions or federal regulations governing sprinkler systems must receive reimbursement for the costs associated with compliance if all of the following conditions are met:

(1) the expenses associated with compliance occurred on or after January 1, 2005, and before December 31, 2008;

(2) the costs were not otherwise reimbursed under subdivision 4f or section 144A.071 or 144A.073; and

(3) the total allowable costs reported under this paragraph are less than the minimum threshold established under section 256B.431, subdivision 15, paragraph (e), and subdivision 16.

The commissioner shall use money appropriated for this purpose to provide to qualifying nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30, 2008. Nursing facilities that have spent money or anticipate the need to spend money to satisfy the most recent life safety code requirements by (1) installing a sprinkler system or (2) replacing all or portions of an existing sprinkler system may submit to the commissioner by June 30, 2007, on a form provided by the commissioner the actual costs of a completed project or the estimated costs, based on a project bid, of a planned project. The commissioner shall calculate a rate adjustment equal to the allowable costs of the project divided by the resident days reported for the report year ending September 30, 2006. If the costs from all projects exceed the appropriation for this purpose, the commissioner shall allocate the money appropriated on a pro rata basis to the qualifying facilities by reducing the rate adjustment determined for each facility by an equal percentage. Facilities that used estimated costs when requesting the rate adjustment shall report to the commissioner by January 31, 2009, on the use of this money on a form provided by the commissioner. If the nursing facility fails to provide the report, the commissioner shall recoup the money paid to the facility for this purpose. If the facility reports expenditures allowable under this subdivision that are less than the amount received in the facility's annualized rate adjustment, the commissioner shall recoup the difference.

Sec. 25.

Minnesota Statutes 2012, section 256B.434, is amended by adding a subdivision to read:

new text begin Subd. 19a. new text end

new text begin Nursing facility rate adjustments beginning September 1, 2013. new text end

new text begin A total of a five percent average rate adjustment shall be provided as described under this subdivision and under section 256B.441, subdivision 46b. new text end

new text begin (a) Beginning September 1, 2013, the commissioner shall make available to each nursing facility reimbursed under this section a 3.75 percent operating payment rate increase, in accordance with paragraphs (b) to (g). new text end

new text begin (b) Seventy-five percent of the money resulting from the rate adjustment under paragraph (a) must be used for increases in compensation-related costs for employees directly employed by the nursing facility on or after the effective date of the rate adjustment, except: new text end

new text begin (1) the administrator; new text end

new text begin (2) persons employed in the central office of a corporation that has an ownership interest in the nursing facility or exercises control over the nursing facility; and new text end

new text begin (3) persons paid by the nursing facility under a management contract. new text end

new text begin (c) The commissioner shall allow as compensation-related costs all costs for: new text end

new text begin (1) wage and salary increases effective after May 25, 2013; new text end

new text begin (2) the employer's share of FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers' compensation; new text end

new text begin (3) the employer's share of health and dental insurance, life insurance, disability insurance, long-term care insurance, uniform allowance, and pensions; and new text end

new text begin (4) other benefits provided and workforce needs, including the recruiting and training of employees, subject to the approval of the commissioner. new text end

new text begin (d) The portion of the rate adjustment under paragraph (a) that is not subject to the requirements of paragraph (b) shall be provided to nursing facilities effective September 1, 2013. Nursing facilities may apply for the portion of the rate adjustment under paragraph (a) that is subject to the requirements in paragraph (b). The application must be submitted to the commissioner within six months of the effective date of the rate adjustment, and the nursing facility must provide additional information required by the commissioner within nine months of the effective date of the rate adjustment. The commissioner must respond to all applications within three weeks of receipt. The commissioner may waive the deadlines in this paragraph under extraordinary circumstances, to be determined at the sole discretion of the commissioner. The application must contain: new text end

new text begin (1) an estimate of the amounts of money that must be used as specified in paragraph (b); new text end

new text begin (2) a detailed distribution plan specifying the allowable compensation-related increases the nursing facility will implement to use the funds available in clause (1); new text end

new text begin (3) a description of how the nursing facility will notify eligible employees of the contents of the approved application, which must provide for giving each eligible employee a copy of the approved application, excluding the information required in clause (1), or posting a copy of the approved application, excluding the information required in clause (1), for a period of at least six weeks in an area of the nursing facility to which all eligible employees have access; and new text end

new text begin (4) instructions for employees who believe they have not received the compensation-related increases specified in clause (2), as approved by the commissioner, and which must include a mailing address, e-mail address, and the telephone number that may be used by the employee to contact the commissioner or the commissioner's representative. new text end

new text begin (e) The commissioner shall ensure that cost increases in distribution plans under paragraph (d), clause (2), that may be included in approved applications, comply with the following requirements: new text end

new text begin (1) a portion of the costs resulting from tenure-related wage or salary increases may be considered to be allowable wage increases, according to formulas that the commissioner shall provide, where employee retention is above the average statewide rate of retention of direct-care employees; new text end

new text begin (2) the annualized amount of increases in costs for the employer's share of health and dental insurance, life insurance, disability insurance, and workers' compensation shall be allowable compensation-related increases if they are effective on or after April 1, 2013, and prior to April 1, 2014; and new text end

new text begin (3) for nursing facilities in which employees are represented by an exclusive bargaining representative, the commissioner shall approve the application only upon receipt of a letter of acceptance of the distribution plan, in regard to members of the bargaining unit, signed by the exclusive bargaining agent, and dated after May 25, 2013. Upon receipt of the letter of acceptance, the commissioner shall deem all requirements of this provision as having been met in regard to the members of the bargaining unit. new text end

new text begin (f) The commissioner shall review applications received under paragraph (d) and shall provide the portion of the rate adjustment under paragraph (b) if the requirements of this statute have been met. The rate adjustment shall be effective September 1, 2013. Notwithstanding paragraph (a), if the approved application distributes less money than is available, the amount of the rate adjustment shall be reduced so that the amount of money made available is equal to the amount to be distributed. new text end

new text begin (g) The increase in this subdivision shall be applied as a percentage to operating payment rates in effect on August 31, 2013. For each facility, the commissioner shall determine the operating payment rate, not including any rate components resulting from equitable cost-sharing for publicly owned nursing facility program participation under section 256B.441, subdivision 55a, critical access nursing facility program participation under section 256B.441, subdivision 63, or performance-based incentive payment program participation under subdivision 4, paragraph (d), for a RUG class with a weight of 1.00 in effect on August 31, 2013. new text end

Sec. 26.

Minnesota Statutes 2012, section 256B.434, is amended by adding a subdivision to read:

new text begin Subd. 19b. new text end

new text begin Nursing facility rate adjustments beginning October 1, 2015. new text end

new text begin A total of a 3.2 percent average rate adjustment shall be provided as described under this subdivision and under section 256B.441, subdivision 46c. new text end

new text begin (a) Beginning October 1, 2015, the commissioner shall make available to each nursing facility reimbursed under this section a 2.4 percent operating payment rate increase, in accordance with paragraphs (b) to (g). new text end

new text begin (b) Seventy-five percent of the money resulting from the rate adjustment under paragraph (a) must be used for increases in compensation-related costs for employees directly employed by the nursing facility on or after the effective date of the rate adjustment, except: new text end

new text begin (1) the administrator; new text end

new text begin (2) persons employed in the central office of a corporation that has an ownership interest in the nursing facility or exercises control over the nursing facility; and new text end

new text begin (3) persons paid by the nursing facility under a management contract. new text end

new text begin (c) The commissioner shall allow as compensation-related costs all costs for: new text end

new text begin (1) wage and salary increases effective after May 25, 2015; new text end

new text begin (2) the employer's share of FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers' compensation; new text end

new text begin (3) the employer's share of health and dental insurance, life insurance, disability insurance, long-term care insurance, uniform allowance, and pensions; and new text end

new text begin (4) other benefits provided and workforce needs, including the recruiting and training of employees, subject to the approval of the commissioner. new text end

new text begin (d) The portion of the rate adjustment under paragraph (a) that is not subject to the requirements of paragraph (b) shall be provided to nursing facilities effective October 1, 2015. Nursing facilities may apply for the portion of the rate adjustment under paragraph (a) that is subject to the requirements in paragraph (b). The application must be submitted to the commissioner within six months of the effective date of the rate adjustment, and the nursing facility must provide additional information required by the commissioner within nine months of the effective date of the rate adjustment. The commissioner must respond to all applications within three weeks of receipt. The commissioner may waive the deadlines in this paragraph under extraordinary circumstances, to be determined at the sole discretion of the commissioner. The application must contain: new text end

new text begin (1) an estimate of the amounts of money that must be used as specified in paragraph (b); new text end

new text begin (2) a detailed distribution plan specifying the allowable compensation-related increases the nursing facility will implement to use the funds available in clause (1); new text end

new text begin (3) a description of how the nursing facility will notify eligible employees of the contents of the approved application, which must provide for giving each eligible employee a copy of the approved application, excluding the information required in clause (1), or posting a copy of the approved application, excluding the information required in clause (1), for a period of at least six weeks in an area of the nursing facility to which all eligible employees have access; and new text end

new text begin (4) instructions for employees who believe they have not received the compensation-related increases specified in clause (2), as approved by the commissioner, and which must include a mailing address, e-mail address, and the telephone number that may be used by the employee to contact the commissioner or the commissioner's representative. new text end

new text begin (e) The commissioner shall ensure that cost increases in distribution plans under paragraph (d), clause (2), that may be included in approved applications, comply with the following requirements: new text end

new text begin (1) a portion of the costs resulting from tenure-related wage or salary increases may be considered to be allowable wage increases, according to formulas that the commissioner shall provide, where employee retention is above the average statewide rate of retention of direct-care employees; new text end

new text begin (2) the annualized amount of increases in costs for the employer's share of health and dental insurance, life insurance, disability insurance, and workers' compensation shall be allowable compensation-related increases if they are effective on or after April 1, 2015, and prior to April 1, 2016; and new text end

new text begin (3) for nursing facilities in which employees are represented by an exclusive bargaining representative, the commissioner shall approve the application only upon receipt of a letter of acceptance of the distribution plan, in regard to members of the bargaining unit, signed by the exclusive bargaining agent and dated after May 25, 2015. new text end

new text begin Upon receipt of the letter of acceptance, the commissioner shall deem all requirements of this provision as having been met in regard to the members of the bargaining unit. new text end

new text begin (f) The commissioner shall review applications received under paragraph (d) and shall provide the portion of the rate adjustment under paragraph (b) if the requirements of this statute have been met. The rate adjustment shall be effective October 1, 2015. Notwithstanding paragraph (a), if the approved application distributes less money than is available, the amount of the rate adjustment shall be reduced so that the amount of money made available is equal to the amount to be distributed. new text end

new text begin (g) The increase in this subdivision shall be applied as a percentage to operating payment rates in effect on September 30, 2015. For each facility, the commissioner shall determine the operating payment rate, not including any rate components resulting from equitable cost-sharing for publicly owned nursing facility program participation under section 256B.441, subdivision 55a, critical access nursing facility program participation under section 256B.441, subdivision 63, or performance-based incentive payment program participation under subdivision 4, paragraph (d), for a RUG class with a weight of 1.00 in effect on September 30, 2015. new text end

Sec. 27.

Minnesota Statutes 2012, section 256B.437, subdivision 6, is amended to read:

Subd. 6.

Planned closure rate adjustment.

(a) The commissioner of human services shall calculate the amount of the planned closure rate adjustment available under subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):

(1) the amount available is the net reduction of nursing facility beds multiplied by $2,080;

(2) the total number of beds in the nursing facility or facilities receiving the planned closure rate adjustment must be identified;

(3) capacity days are determined by multiplying the number determined under clause (2) by 365; and

(4) the planned closure rate adjustment is the amount available in clause (1), divided by capacity days determined under clause (3).

(b) A planned closure rate adjustment under this section is effective on the first day of the month following completion of closure of the facility designated for closure in the application and becomes part of the nursing facility's deleted text begin total operatingdeleted text end new text begin external fixednew text end payment rate.

deleted text begin (c) Applicants may use the planned closure rate adjustment to allow for a property payment for a new nursing facility or an addition to an existing nursing facility or as an operating payment rate adjustment. Applications approved under this subdivision are exempt from other requirements for moratorium exceptions under section 144A.073, subdivisions 2 and 3. deleted text end

deleted text begin (d)deleted text end new text begin (c)new text end Upon the request of a closing facility, the commissioner must allow the facility a closure rate adjustment as provided under section 144A.161, subdivision 10.

deleted text begin (e)deleted text end new text begin (d)new text end A facility that has received a planned closure rate adjustment may reassign it to another facility that is under the same ownership at any time within three years of its effective date. The amount of the adjustment shall be computed according to paragraph (a).

deleted text begin (f)deleted text end new text begin (e)new text end If the per bed dollar amount specified in paragraph (a), clause (1), is increased, the commissioner shall recalculate planned closure rate adjustments for facilities that delicense beds under this section on or after July 1, 2001, to reflect the increase in the per bed dollar amount. The recalculated planned closure rate adjustment shall be effective from the date the per bed dollar amount is increased.

deleted text begin (g)deleted text end new text begin (f)new text end For planned closures approved after June 30, 2009, the commissioner of human services shall calculate the amount of the planned closure rate adjustment available under subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).

deleted text begin (h) Beginningdeleted text end new text begin (g) Betweennew text end July 16, 2011, new text begin and June 30, 2013, new text end the commissioner shall deleted text begin no longerdeleted text end new text begin notnew text end accept applications for planned closure rate adjustments under subdivision 3.

Sec. 28.

Minnesota Statutes 2012, section 256B.439, subdivision 1, is amended to read:

Subdivision 1.

Development and implementation of quality profiles.

(a) The commissioner of human services, in cooperation with the commissioner of health, shall develop and implement deleted text begin adeleted text end quality deleted text begin profile systemdeleted text end new text begin profilesnew text end for nursing facilities and, beginning not later than July 1, deleted text begin 2004, other providers of long-term care servicesdeleted text end new text begin 2014, for home and community-based services providersnew text end , except when the quality profile system would duplicate requirements under section 256B.5011, 256B.5012, or 256B.5013. new text begin For purposes of this section, home and community-based services providers are defined as providers of home and community-based services under sections 256B.0913, 256B.0915, 256B.092, and 256B.49, and intermediate care facilities for persons with developmental disabilities providers under section 256B.5013. To the extent possible, quality profiles must be developed for providers of services to older adults and people with disabilities, regardless of payor source, for the purposes of providing information to consumers. new text end The deleted text begin systemdeleted text end new text begin quality profiles new text end must be developed deleted text begin and implemented to the extent possible without the collection of significant amounts of new data. To the extent possible, the systemdeleted text end new text begin using existing data sets maintained by the commissioners of health and human services to the extent possible. The profiles new text end must incorporate or be coordinated with information on quality maintained by area agencies on aging, long-term care trade associations,new text begin the ombudsman offices, counties, tribes, health plans,new text end and other entitiesnew text begin and the long-term care database maintained under section 256.975, subdivision 7new text end . The deleted text begin systemdeleted text end new text begin profilesnew text end must be designed to provide information on quality to:

(1) consumers and their families to facilitate informed choices of service providers;

(2) providers to enable them to measure the results of their quality improvement efforts and compare quality achievements with other service providers; and

(3) public and private purchasers of long-term care services to enable them to purchase high-quality care.

(b) The deleted text begin systemdeleted text end new text begin profilesnew text end must be developed in consultation with the long-term care task force, area agencies on aging, and representatives of consumers, providers, and labor unions. Within the limits of available appropriations, the commissioners may employ consultants to assist with this project.

Sec. 29.

Minnesota Statutes 2012, section 256B.439, subdivision 2, is amended to read:

Subd. 2.

Quality measurement toolsnew text begin for nursing facilitiesnew text end .

The commissioners shall identify and apply existing quality measurement tools to:

(1) emphasize quality of care and its relationship to quality of life; and

(2) address the needs of various users of long-term care services, including, but not limited to, short-stay residents, persons with behavioral problems, persons with dementia, and persons who are members of minority groups.

The tools must be identified and applied, to the extent possible, without requiring providers to supply information beyond deleted text begin currentdeleted text end state and federal requirements.

Sec. 30.

Minnesota Statutes 2012, section 256B.439, is amended by adding a subdivision to read:

new text begin Subd. 2a. new text end

new text begin Quality measurement tools for home and community-based services. new text end

new text begin (a) The commissioners shall identify and apply quality measurement tools to: new text end

new text begin (1) emphasize service quality and its relationship to quality of life; and new text end

new text begin (2) address the needs of various users of home and community-based services. new text end

new text begin (b) The tools must include, but not be limited to, surveys of consumers of home and community-based services. The tools must be identified and applied, to the extent possible, without requiring providers to supply information beyond state and federal requirements, for purposes of this subdivision. new text end

Sec. 31.

Minnesota Statutes 2012, section 256B.439, is amended by adding a subdivision to read:

new text begin Subd. 3a. new text end

new text begin Consumer surveys for home and community-based services. new text end

new text begin Following identification of the quality measurement tool, and within the limits of the appropriation, the commissioner shall conduct surveys of home and community-based services consumers to develop quality profiles of providers. To the extent possible, surveys must be conducted face-to-face by state employees or contractors. At the discretion of the commissioner, surveys may be conducted by an alternative method. Surveys must be conducted periodically to update quality profiles of individual service providers. new text end

Sec. 32.

Minnesota Statutes 2012, section 256B.439, is amended by adding a subdivision to read:

new text begin Subd. 5. new text end

new text begin Implementation of home and community-based services performance-based incentive payment program. new text end

new text begin By April 1, 2014, the commissioner shall develop incentive-based grants for home and community-based services providers for achieving outcomes specified in a contract. The commissioner may solicit proposals from home and community-based services providers and implement those that, on a competitive basis, best meet the state's policy objectives. The commissioner shall determine the types of home and community-based services providers that will participate in the program. The determination of participating provider types may be revised annually by the commissioner. The commissioner shall limit the amount of any incentive-based grants and the number of grants under this subdivision to operate the incentive payments within funds appropriated for this purpose. The grant agreements may specify various levels of payment for various levels of performance. In establishing the specified outcomes and related criteria, the commissioner shall consider the following state policy objectives: new text end

new text begin (1) provide more efficient, higher quality services; new text end

new text begin (2) encourage home and community-based services providers to innovate; new text end

new text begin (3) equip home and community-based services providers with organizational tools and expertise to improve their quality; new text end

new text begin (4) incentivize home and community-based services providers to invest in better services; and new text end

new text begin (5) disseminate successful performance improvement strategies statewide. new text end

Sec. 33.

Minnesota Statutes 2012, section 256B.439, is amended by adding a subdivision to read:

new text begin Subd. 6. new text end

new text begin Calculation of home and community-based services quality score. new text end

new text begin (a) The commissioner shall determine a quality score for each participating home and community-based services provider using quality measures established in subdivisions 1 and 2a, according to methods determined by the commissioner in consultation with stakeholders and experts. These methods shall be exempt from the rulemaking requirements under chapter 14. new text end

new text begin (b) For each quality measure, a score shall be determined with a maximum number of points available and number of points assigned as determined by the commissioner using the methodology established according to this subdivision. The determination of the quality measures to be used and the methods of calculating scores may be revised annually by the commissioner. new text end

Sec. 34.

Minnesota Statutes 2012, section 256B.439, is amended by adding a subdivision to read:

new text begin Subd. 7. new text end

new text begin Calculation of home and community-based services quality add-on. new text end

new text begin Effective July 1, 2015, the commissioner shall determine the quality add-on payment for participating home and community-based services providers. The payment rate for the quality add-on shall be a variable amount based on each provider's quality score as determined in subdivisions 1 and 2a. The commissioner shall limit the types of home and community-based services providers that may receive the quality add-on and the amount of the quality add-on payments to operate the quality add-on within funds appropriated for this purpose and based on the availability of the quality measures. new text end

Sec. 35.

Minnesota Statutes 2012, section 256B.441, subdivision 44, is amended to read:

Subd. 44.

Calculation of a quality score.

(a) The commissioner shall determine a quality score for each nursing facility using quality measures established in section 256B.439, according to methods determined by the commissioner in consultation with stakeholders and experts. These methods shall be exempt from the rulemaking requirements under chapter 14.

(b) For each quality measure, a score shall be determined with a maximum number of points available and number of points assigned as determined by the commissioner using the methodology established according to this subdivision. The scores determined for all quality measures shall be totaled. The determination of the quality measures to be used and the methods of calculating scores may be revised annually by the commissioner.

(c) For the initial rate year under the new payment system, the quality measures shall include:

(1) staff turnover;

(2) staff retention;

(3) use of pool staff;

(4) quality indicators from the minimum data set; and

(5) survey deficiencies.

(d) deleted text begin For rate years beginning after October 1, 2006, when making revisions to the quality measures or method for calculating scores, the commissioner shall publish the methodology in the State Register at least 15 months prior to the start of the rate year for which the revised methodology is to be used for rate-setting purposes. The quality score used to determine payment rates shall be established for a rate year using data submitted in the statistical and cost report from the associated reporting year, and using data from other sources related to a period beginning no more than six months prior to the associated reporting yeardeleted text end new text begin Beginning July 1, 2013, the quality score shall be a value between zero and 100, using data as provided in the Minnesota nursing home report card, with 50 percent derived from the Minnesota quality indicators score, 40 percent derived from the resident quality of life score, and ten percent derived from the state inspection results scorenew text end .

new text begin (e) The commissioner, in cooperation with the commissioner of health, may adjust the formula in paragraph (d), or the methodology for computing the total quality score, effective July 1 of any year beginning in 2014, with five months advance public notice. In changing the formula, the commissioner shall consider quality measure priorities registered by report card users, advice of stakeholders, and available research. new text end

Sec. 36.

Minnesota Statutes 2012, section 256B.441, is amended by adding a subdivision to read:

new text begin Subd. 46b. new text end

new text begin Calculation of quality add-on, with an average value of 1.25 percent, effective September 1, 2013. new text end

new text begin (a) The commissioner shall determine quality add-ons to the operating payment rates for each facility. The increase in this subdivision shall be applied as a percentage to operating payment rates in effect on August 31, 2013. For each facility, the commissioner shall determine the operating payment rate, not including any rate components resulting from equitable cost-sharing for publicly owned nursing facility program participation under subdivision 55a, critical access nursing facility program participation under subdivision 63, or performance-based incentive payment program participation under section 256B.434, subdivision 4, paragraph (d), for a RUG class with a weight of 1.00 in effect on August 31, 2013. new text end

new text begin (b) For each facility, the commissioner shall compute a quality factor by subtracting 40 from the most recent quality score computed under subdivision 44, and then dividing by 60. If the quality factor is less than zero, the commissioner shall use the value zero. new text end

new text begin (c) The quality add-ons shall be the operating payment rates determined in paragraph (a), multiplied by the quality factor determined in paragraph (b), and then multiplied by 3.2 percent. The commissioner shall implement the quality add-ons effective September 1, 2013. new text end

Sec. 37.

Minnesota Statutes 2012, section 256B.441, is amended by adding a subdivision to read:

new text begin Subd. 46c. new text end

new text begin Quality improvement incentive system beginning October 1, 2015. new text end

new text begin The commissioner shall develop a quality improvement incentive program in consultation with stakeholders. The annual funding pool available for quality improvement incentive payments shall be equal to 0.8 percent of all operating payments, not including any rate components resulting from equitable cost-sharing for publicly owned nursing facility program participation under subdivision 55a, critical access nursing facility program participation under subdivision 63, or performance-based incentive payment program participation under section 256B.434, subdivision 4, paragraph (d). Beginning October 1, 2015, annual rate adjustments provided under this subdivision shall be effective for one year, starting October 1 and ending the following September 30. new text end

Sec. 38.

Minnesota Statutes 2012, section 256B.49, subdivision 11a, is amended to read:

Subd. 11a.

Waivered services statewide priorities.

(a) The commissioner shall establish statewide priorities for individuals on the waiting list for community alternative care, community alternatives for disabled individuals, and brain injury waiver services, as of January 1, 2010. The statewide priorities must include, but are not limited to, individuals who continue to have a need for waiver services after they have maximized the use of state plan services and other funding resources, including natural supports, prior to accessing waiver services, and who meet at least one of the following criteria:

new text begin (1) no longer require the intensity of services provided where they are currently living; or new text end

new text begin (2) make a request to move from an institutional setting. new text end

new text begin (b) After the priorities in paragraph (a) are met, priority must also be given to individuals who meet at least one of the following criteria: new text end

(1) have unstable living situations due to the age, incapacity, or sudden loss of the primary caregivers;

(2) are moving from an institution due to bed closures;

(3) experience a sudden closure of their current living arrangement;

(4) require protection from confirmed abuse, neglect, or exploitation;

(5) experience a sudden change in need that can no longer be met through state plan services or other funding resources alone; or

(6) meet other priorities established by the department.

deleted text begin (b)deleted text end new text begin (c)new text end When allocating resources to lead agencies, the commissioner must take into consideration the number of individuals waiting who meet statewide priorities and the lead agencies' current use of waiver funds and existing service options.new text begin The commissioner has the authority to transfer funds between counties, groups of counties, and tribes to accommodate statewide priorities and resource needs while accounting for a necessary base level reserve amount for each county, group of counties, and tribe.new text end

deleted text begin (c) The commissioner shall evaluate the impact of the use of statewide priorities and provide recommendations to the legislature on whether to continue the use of statewide priorities in the November 1, 2011, annual report required by the commissioner in sections 256B.0916, subdivision 7, and 256B.49, subdivision 21. deleted text end

Sec. 39.

Minnesota Statutes 2012, section 256B.49, subdivision 14, is amended to read:

Subd. 14.

Assessment and reassessment.

(a) Assessments and reassessments shall be conducted by certified assessors according to section 256B.0911, subdivision 2b. With the permission of the recipient or the recipient's designated legal representative, the recipient's current provider of services may submit a written report outlining their recommendations regarding the recipient'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.

(b) There must be a determination that the client requires a hospital level of care or a nursing facility level of care as defined in section 256B.0911, subdivision 4a, paragraph (d), at initial and subsequent assessments to initiate and maintain participation in the waiver program.

(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as appropriate to determine nursing facility level of care for purposes of medical assistance payment for nursing facility services, only face-to-face assessments conducted according to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care determination or a nursing facility level of care determination must be accepted for purposes of initial and ongoing access to waiver services payment.

(d) Recipients who are found eligible for home and community-based services under this section before their 65th birthday may remain eligible for these services after their 65th birthday if they continue to meet all other eligibility factors.

deleted text begin (e) The commissioner shall develop criteria to identify recipients whose level of functioning is reasonably expected to improve and reassess these recipients to establish a baseline assessment. Recipients who meet these criteria must have a comprehensive transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be reassessed every six months until there has been no significant change in the recipient's functioning for at least 12 months. After there has been no significant change in the recipient's functioning for at least 12 months, reassessments of the recipient's strengths, informal support systems, and need for services shall be conducted at least every 12 months and at other times when there has been a significant change in the recipient's functioning. Counties, case managers, and service providers are responsible for conducting these reassessments and shall complete the reassessments out of existing funds. deleted text end

Sec. 40.

Minnesota Statutes 2012, section 256B.49, subdivision 15, is amended to read:

Subd. 15.

Coordinated service and support plan; comprehensive transitional service plan; maintenance service plan.

(a) Each recipient of home and community-based waivered services shall be provided a copy of the written coordinated service and support plan which meets the requirements in section 256B.092, subdivision 1b.

(b) In developing the comprehensive transitional service plan, the individual receiving services, the case manager, and the guardian, if applicable, will identify the transitional service plan fundamental service outcome and anticipated timeline to achieve this outcome. Within the first 20 days following a recipient's request for an assessment or reassessment, the transitional service planning team must be identified. A team leader must be identified who will be responsible for assigning responsibility and communicating with team members to ensure implementation of the transition plan and ongoing assessment and communication process. The team leader should be an individual, such as the case manager or guardian, who has the opportunity to follow the recipient to the next level of service.

Within ten days following an assessment, a comprehensive transitional service plan must be developed incorporating elements of a comprehensive functional assessment and including short-term measurable outcomes and timelines for achievement of and reporting on these outcomes. Functional milestones must also be identified and reported according to the timelines agreed upon by the transitional service planning team. In addition, the comprehensive transitional service plan must identify additional supports that may assist in the achievement of the fundamental service outcome such as the development of greater natural community support, increased collaboration among agencies, and technological supports.

The timelines for reporting on functional milestones will prompt a reassessment of services provided, the units of services, rates, and appropriate service providers. It is the responsibility of the transitional service planning team leader to review functional milestone reporting to determine if the milestones are consistent with observable skills and that milestone achievement prompts any needed changes to the comprehensive transitional service plan.

For those whose fundamental transitional service outcome involves the need to procure housing, a plan for the recipient to seek the resources necessary to secure the least restrictive housing possible should be incorporated into the plan, including employment and public supports such as housing access and shelter needy funding.

(c) Counties and other agencies responsible for funding community placement and ongoing community supportive services are responsible for the implementation of the comprehensive transitional service plans. Oversight responsibilities include both ensuring effective transitional service delivery and efficient utilization of funding resources.

(d) Following one year of transitional services, the transitional services planning team will make a determination as to whether or not the individual receiving services requires the current level of continuous and consistent support in order to maintain the recipient's current level of functioning. Recipients who are determined to have not had a significant change in functioning for 12 months must move from a transitional to a maintenance service plan. Recipients on a maintenance service plan must be reassessed to determine if the recipient would benefit from a transitional service plan at least every 12 months and at other times when there has been a significant change in the recipient's functioning. This assessment should consider any changes to technological or natural community supports.

(e) When a county is evaluating denials, reductions, or terminations of home and community-based services under section 256B.49 for an individual, the case manager shall offer to meet with the individual or the individual's guardian in order to discuss the prioritization of service needs within the coordinated service and support plan, comprehensive transitional service plan, or maintenance service plan. The reduction in the authorized services for an individual due to changes in funding for waivered services may not exceed the amount needed to ensure medically necessary services to meet the individual's health, safety, and welfare.

(f) At the time of reassessment, local agency case managers shall assess each recipient of community alternatives for disabled individuals or brain injury waivered services currently residing in a licensed adult foster home that is not the primary residence of the license holder, or in which the license holder is not the primary caregiver, to determine if that recipient could appropriately be served in a community-living setting. If appropriate for the recipient, the case manager shall offer the recipient, through a person-centered planning process, the option to receive alternative housing and service options. In the event that the recipient chooses to transfer from the adult foster home, the vacated bed shall not be filled with another recipient of waiver services and group residential housing and the licensed capacity shall be reduced accordingly, unless the savings required by the licensed bed closure reductions under Laws 2011, First Special Session chapter 9, article 7, sections 1 and 40, paragraph (f), for foster care settings where the physical location is not the primary residence of the license holder are met through voluntary changes described in section 245A.03, subdivision 7, paragraph deleted text begin (f)deleted text end new text begin (e)new text end , or as provided under paragraph (a), clauses (3) and (4). If the adult foster home becomes no longer viable due to these transfers, the county agency, with the assistance of the department, shall facilitate a consolidation of settings or closure. This reassessment process shall be completed by July 1, 2013.

Sec. 41.

Minnesota Statutes 2012, section 256B.49, is amended by adding a subdivision to read:

new text begin Subd. 25. new text end

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

new text begin (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: new text end

new text begin (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; new text end

new text begin (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, access to crisis mobility services, mental health services, use of technology, and crisis stabilization services in section 256B.0624, subdivision 7; and new text end

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

new text begin (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 end

Sec. 42.

Minnesota Statutes 2012, section 256B.49, is amended by adding a subdivision to read:

new text begin Subd. 26. new text end

new text begin Excess allocations. new text end

new text begin County and tribal agencies will be responsible for authorizations in excess of the allocation made by the commissioner. In the event a county or tribal agency authorizes in excess of the allocation made by the commissioner for a given allocation period, the county or tribal agency must submit a corrective action plan to the commissioner. The plan must state the actions the agency will take to correct their overspending for the year following the period when the overspending occurred. Failure to correct overauthorizations shall result in recoupment of authorizations in excess of the allocation. Nothing in this subdivision shall be construed as reducing the county's responsibility to offer and make available feasible home and community-based options to eligible waiver recipients within the resources allocated to them for that purpose. new text end

Sec. 43.

Minnesota Statutes 2012, section 256B.492, is amended to read:

256B.492 HOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE WITH DISABILITIES.

(a) Individuals receiving services under a home and community-based waiver under section 256B.092 or 256B.49 may receive services in the following settings:

(1) an individual's own home or family home;

(2) a licensed adult foster care setting of up to five people; and

(3) community living settings as defined in section 256B.49, subdivision 23, where individuals with disabilities may reside in all of the units in a building of four or fewer units, and no more than the greater of four or 25 percent of the units in a multifamily building of more than four unitsnew text begin , unless required by the Housing Opportunities for Persons with AIDS Programnew text end .

(b) The settings in paragraph (a) must not:

(1) be located in a building that is a publicly or privately operated facility that provides institutional treatment or custodial care;

(2) be located in a building on the grounds of or adjacent to a public or private institution;

(3) be a housing complex designed expressly around an individual's diagnosis or disabilitynew text begin , unless required by the Housing Opportunities for Persons with AIDS Programnew text end ;

(4) be segregated based on a disability, either physically or because of setting characteristics, from the larger community; and

(5) have the qualities of an institution which include, but are not limited to: regimented meal and sleep times, limitations on visitors, and lack of privacy. Restrictions agreed to and documented in the person's individual service plan shall not result in a residence having the qualities of an institution as long as the restrictions for the person are not imposed upon others in the same residence and are the least restrictive alternative, imposed for the shortest possible time to meet the person's needs.

(c) The provisions of paragraphs (a) and (b) do not apply to any setting in which individuals receive services under a home and community-based waiver as of July 1, 2012, and the setting does not meet the criteria of this section.

(d) Notwithstanding paragraph (c), a program in Hennepin County established as part of a Hennepin County demonstration project is qualified for the exception allowed under paragraph (c).

(e) The commissioner shall submit an amendment to the waiver plan no later than December 31, 2012.

Sec. 44.

Minnesota Statutes 2012, section 256B.493, subdivision 2, is amended to read:

Subd. 2.

Planned closure process needs determination.

The commissioner shall announce and implement a program for planned closure of adult foster care homes. Planned closure shall be the preferred method for achieving necessary budgetary savings required by the licensed bed closure budget reduction in section 245A.03, subdivision 7, paragraph deleted text begin (d)deleted text end new text begin (c)new text end . If additional closures are required to achieve the necessary savings, the commissioner shall use the process and priorities in section 245A.03, subdivision 7, paragraph deleted text begin (d)deleted text end new text begin (c)new text end .

Sec. 45.

Minnesota Statutes 2012, section 256B.501, is amended by adding a subdivision to read:

new text begin Subd. 14. new text end

new text begin Rate adjustment for ICF/DD in Cottonwood County. new text end

new text begin The commissioner of health shall decertify three beds in an intermediate care facility for persons with developmental disabilities with 21 certified beds located in Cottonwood County. The total payment rate shall be $282.62 per bed, per day. new text end

Sec. 46.

Minnesota Statutes 2012, section 256B.5012, is amended by adding a subdivision to read:

new text begin Subd. 14. new text end

new text begin Rate increase effective June 1, 2013. new text end

new text begin For rate periods beginning on or after June 1, 2013, the commissioner shall increase the total operating payment rate for each facility reimbursed under this section by $7.81 per day. The increase shall not be subject to any annual percentage increase. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective June 1, 2013. new text end

Sec. 47.

Minnesota Statutes 2012, section 256B.5012, is amended by adding a subdivision to read:

new text begin Subd. 15. new text end

new text begin ICF/DD rate increases effective April 1, 2014. new text end

new text begin (a) Notwithstanding subdivision 12, for each facility reimbursed under this section, for the rate period beginning April 1, 2014, the commissioner shall increase operating payments equal to one percent of the operating payment rates in effect on March 31, 2014. new text end

new text begin (b) For each facility, the commissioner shall apply the rate increase based on occupied beds, using the percentage specified in this subdivision multiplied by the total payment rate, including the variable rate, but excluding the property-related payment rate in effect on the preceding date. The total rate increase shall include the adjustment provided in section 256B.501, subdivision 12. new text end

Sec. 48.

Minnesota Statutes 2012, section 256B.69, is amended by adding a subdivision to read:

new text begin Subd. 32a. new text end

new text begin Initiatives to improve early screening, diagnosis, and treatment of children with autism spectrum disorder and other developmental conditions. new text end

new text begin (a) The commissioner shall require managed care plans and county-based purchasing plans, as a condition of contract, to implement strategies that facilitate access for young children between the ages of one and three years to periodic developmental and social-emotional screenings, as recommended by the Minnesota Interagency Developmental Screening Task Force, and that those children who do not meet milestones are provided access to appropriate evaluation and assessment, including treatment recommendations, expected to improve the child's functioning, with the goal of meeting milestones by age five. new text end

new text begin (b) The following information from encounter data provided to the commissioner shall be reported on the department's public Web site for each managed care plan and county-based purchasing plan annually by July 31 of each year beginning in 2014: new text end

new text begin (1) the number of children who received a diagnostic assessment; new text end

new text begin (2) the total number of children ages one to six with a diagnosis of autism spectrum disorder who received treatments; new text end

new text begin (3) the number of children identified under clause (2) reported by each 12-month age group beginning with age one and ending with age six; and new text end

new text begin (4) the types of treatments provided to children identified under clause (2) listed by billing code, including the number of units billed for each child. new text end

new text begin (c) The managed care plans and county-based purchasing plans shall also report on any barriers to providing screening, diagnosis, and treatment of young children between the ages of one and three years, any strategies implemented to address those barriers, and make recommendations on how to measure and report on the effectiveness of the strategies implemented to facilitate access for young children to provide developmental and social-emotional screening, diagnosis, and treatment as described in paragraph (a). new text end

Sec. 49.

new text begin [256B.85] COMMUNITY FIRST SERVICES AND SUPPORTS. new text end

new text begin Subdivision 1. new text end

new text begin Basis and scope. new text end

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

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

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

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

new text begin Subd. 2. new text end

new text begin Definitions. new text end

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

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

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

new text begin (d) "Behavior" means a description of a need for services and supports used to determine the home care rating and additional service units. The presence of Level I behavior is used to determine the home care rating. "Level I behavior" means physical aggression towards self or others or destruction of property that requires the immediate response of another person. If qualified for a home care rating as described in subdivision 8, additional service units can be added as described in subdivision 8, paragraph (f), for the following behaviors: new text end

new text begin (1) Level I behavior; new text end

new text begin (2) increased vulnerability due to cognitive deficits or socially inappropriate behavior; or new text end

new text begin (3) increased need for assistance for recipients who are verbally aggressive or resistive to care so that time needed to perform activities of daily living is increased. new text end

new text begin (e) "Complex health-related needs" means an intervention listed in clauses (1) to (8) that has been ordered by a physician, and is specified in a community support plan, including: new text end

new text begin (1) tube feedings requiring: new text end

new text begin (i) a gastrojejunostomy tube; or new text end

new text begin (ii) continuous tube feeding lasting longer than 12 hours per day; new text end

new text begin (2) wounds described as: new text end

new text begin (i) stage III or stage IV; new text end

new text begin (ii) multiple wounds; new text end

new text begin (iii) requiring sterile or clean dressing changes or a wound vac; or new text end

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

new text begin (3) parenteral therapy described as: new text end

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

new text begin (ii) total parenteral nutrition (TPN) daily; new text end

new text begin (4) respiratory interventions, including: new text end

new text begin (i) oxygen required more than eight hours per day; new text end

new text begin (ii) respiratory vest more than one time per day; new text end

new text begin (iii) bronchial drainage treatments more than two times per day; new text end

new text begin (iv) sterile or clean suctioning more than six times per day; new text end

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

new text begin (vi) ventilator dependence under section 256B.0652; new text end

new text begin (5) insertion and maintenance of catheter, including: new text end

new text begin (i) sterile catheter changes more than one time per month; new text end

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

new text begin (iii) bladder irrigations; new text end

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

new text begin (7) neurological intervention, including: new text end

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

new text begin (ii) swallowing disorders diagnosed by a physician and requiring specialized assistance from another on a daily basis; and new text end

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

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

new text begin (g) "Community first services and supports service delivery plan" or "service delivery plan" means a written summary of the services and supports, that is based on the community support plan identified in section 256B.0911 and coordinated services and support plan and budget identified in section 256B.0915, subdivision 6, if applicable, that is determined by the participant to meet the assessed needs, using a person-centered planning process. new text end

new text begin (h) "Critical activities of daily living" means transferring, mobility, eating, and toileting. new text end

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

new text begin (j) "Extended CFSS" means CFSS services and supports under the agency–provider model included in a service plan through one of the home and community-based services waivers authorized under sections 256B.0915; 256B.092, subdivision 5; and 256B.49, which exceed the amount, duration, and frequency of the state plan CFSS services for participants. new text end

new text begin (k) "Financial management services contractor or vendor" means a qualified organization having a written contract with the department to provide services necessary to use the budget model under subdivision 13, that include but are not limited to: participant education and technical assistance; CFSS service delivery planning and budgeting; billing, making payments, and monitoring of spending; and assisting the participant in fulfilling employer-related requirements in accordance with Section 3504 of the IRS code and the IRS Revenue Procedure 70-6. new text end

new text begin (l) "Budget model" means a service delivery method of CFSS that allows the use of an individualized CFSS service delivery plan and service budget and provides assistance from the financial management services contractor to facilitate participant employment of support workers and the acquisition of supports and goods. new text end

new text begin (m) "Health-related procedures and tasks" means procedures and tasks related to the specific needs of an individual that can be delegated or assigned by a state-licensed healthcare or mental health professional and performed by a support worker. new text end

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

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

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

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

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

new text begin (3) providing verbal or visual reminders to perform regularly scheduled medications. new text end

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

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

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

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

new text begin (r) "Person-centered planning process" means a process that is directed by the participant to plan for services and supports. The person-centered planning process must: new text end

new text begin (1) include people chosen by the participant; new text end

new text begin (2) provide necessary information and support to ensure that the participant directs the process to the maximum extent possible, and is enabled to make informed choices and decisions; new text end

new text begin (3) be timely and occur at time and locations of convenience to the participant; new text end

new text begin (4) reflect cultural considerations of the participant; new text end

new text begin (5) include strategies for solving conflict or disagreement within the process, including clear conflict-of-interest guidelines for all planning; new text end

new text begin (6) provide the participant choices of the services and supports they receive and the staff providing those services and supports; new text end

new text begin (7) include a method for the participant to request updates to the plan; and new text end

new text begin (8) record the alternative home and community-based settings that were considered by the participant. new text end

new text begin (s) "Shared services" means the provision of CFSS services by the same CFSS support worker to two or three participants who voluntarily enter into an agreement to receive services at the same time and in the same setting by the same provider. new text end

new text begin (t) "Support specialist" means a professional with the skills and ability to assist the participant using either the agency provider model under subdivision 11 or the flexible spending model under subdivision 13, in services including but not limited to assistance regarding: new text end

new text begin (1) the development, implementation, and evaluation of the CFSS service delivery plan under subdivision 6; new text end

new text begin (2) recruitment, training, or supervision, including supervision of health-related tasks or behavioral supports appropriately delegated or assigned by a health care professional, and evaluation of support workers; and new text end

new text begin (3) facilitating the use of informal and community supports, goods, or resources. new text end

new text begin (u) "Support worker" means an employee of the agency provider or of the participant who has direct contact with the participant and provides services as specified within the participant's service delivery plan. new text end

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

new text begin Subd. 3. new text end

new text begin Eligibility. new text end

new text begin (a) CFSS is available to a person who meets one of the following: new text end

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

new text begin (2) is a recipient of the alternative care program under section 256B.0913; new text end

new text begin (3) is a waiver recipient as defined under section 256B.0915, 256B.092, 256B.093, or 256B.49; or new text end

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

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

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

new text begin (2) is not a recipient under the family support grant under section 252.32; new text end

new text begin (3) lives in the person's own apartment or home including a family foster care setting licensed under chapter 245A, but not in corporate foster care under chapter 245A; or a noncertified boarding care or boarding and lodging establishments under chapter 157. new text end

new text begin Subd. 4. new text end

new text begin Eligibility for other services. new text end

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

new text begin Subd. 5. new text end

new text begin Assessment requirements. new text end

new text begin (a) The assessment of functional need must: new text end

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

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

new text begin (3) be completed using the format established by the commissioner. new text end

new text begin (b) A participant who is residing in a facility may be assessed and choose CFSS for the purpose of using CFSS to return to the community as described in subdivisions 3 and 7, paragraph (a), clause (5). new text end

new text begin (c) The results of the assessment and any recommendations and authorizations for CFSS must be determined and communicated in writing by the lead agency's certified assessor as defined in section 256B.0911 to the participant and the agency-provider or financial management services provider chosen by the participant within 40 calendar days and must include the participant's right to appeal under section 256.045, subdivision 3. new text end

new text begin (d) The lead agency assessor may request a temporary authorization for CFSS services. Authorization for a temporary level of CFSS services is limited to the time specified by the commissioner, but shall not exceed 45 days. The level of services authorized under this provision shall have no bearing on a future authorization. new text end

new text begin Subd. 6. new text end

new text begin Community first services and support service delivery plan. new text end

new text begin (a) The CFSS service delivery plan must be developed, implemented, and evaluated through a person-centered planning process by the participant, or the participant's representative or legal representative who may be assisted by a support specialist. The CFSS service delivery plan must reflect the services and supports that are important to the participant and for the participant to meet the needs assessed by the certified assessor and identified in the community support plan under section 256B.0911, subdivision 3, or the coordinated services and support plan identified in section 256B.0915, subdivision 6, if applicable. The CFSS service delivery plan must be reviewed by the participant and the agency-provider or financial management services contractor at least annually upon reassessment, or when there is a significant change in the participant's condition, or a change in the need for services and supports. new text end

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

new text begin (c) The CFSS service delivery plan must be person-centered and: new text end

new text begin (1) specify the agency-provider or financial management services contractor selected by the participant; new text end

new text begin (2) reflect the setting in which the participant resides that is chosen by the participant; new text end

new text begin (3) reflect the participant's strengths and preferences; new text end

new text begin (4) include the means to address the clinical and support needs as identified through an assessment of functional needs; new text end

new text begin (5) include individually identified goals and desired outcomes; new text end

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

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

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

new text begin (9) be understandable to the participant and the individuals providing support; new text end

new text begin (10) identify the individual or entity responsible for monitoring the plan; new text end

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

new text begin (12) be distributed to the participant and other people involved in the plan; and new text end

new text begin (13) prevent the provision of unnecessary or inappropriate care. new text end

new text begin (d) The total units of agency-provider services or the budget allocation amount for the budget model include both annual totals and a monthly average amount that cover the number of months of the service authorization. The amount used each month may vary, but additional funds must not be provided above the annual service authorization amount unless a change in condition is assessed and authorized by the certified assessor and documented in the community support plan, coordinated services and supports plan, and service delivery plan. new text end

new text begin Subd. 7. new text end

new text begin Community first services and supports; covered services. new text end

new text begin Within the service unit authorization or budget allocation, services and supports covered under CFSS include: new text end

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

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

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

new text begin (i) relate to a need identified in a participant's CFSS service delivery plan; new text end

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

new text begin (4) observation and redirection for behavior or symptoms where there is a need for assistance. An assessment of behaviors must meet the criteria in this clause. A recipient qualifies as having a need for assistance due to behaviors if the recipient's behavior requires assistance at least four times per week and shows one or more of the following behaviors: new text end

new text begin (i) physical aggression towards self or others, or destruction of property that requires the immediate response of another person; new text end

new text begin (ii) increased vulnerability due to cognitive deficits or socially inappropriate behavior; or new text end

new text begin (iii) increased need for assistance for recipients who are verbally aggressive or resistive to care so that time needed to perform activities of daily living is increased; new text end

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

new text begin (6) transition costs, including: new text end

new text begin (i) deposits for rent and utilities; new text end

new text begin (ii) first month's rent and utilities; new text end

new text begin (iii) bedding; new text end

new text begin (iv) basic kitchen supplies; new text end

new text begin (v) other necessities, to the extent that these necessities are not otherwise covered under any other funding that the participant is eligible to receive; and new text end

new text begin (vi) other required necessities for an individual to make the transition from a nursing facility, institution for mental diseases, or intermediate care facility for persons with developmental disabilities to a community-based home setting where the participant resides; and new text end

new text begin (7) services by a support specialist defined under subdivision 2 that are chosen by the participant. new text end

new text begin Subd. 8. new text end

new text begin Determination of CFSS service methodology. new text end

new text begin (a) All community first services and supports must be authorized by the commissioner or the commissioner's designee before services begin, except for the assessments established in section 256B.0911. The authorization for CFSS must be completed as soon as possible following an assessment but no later than 40 calendar days from the date of the assessment. new text end

new text begin (b) The amount of CFSS authorized must be based on the recipient's home care rating described in subdivision 8, paragraphs (d) and (e), and any additional service units for which the person qualifies as described in subdivision 8, paragraph (f). new text end

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

new text begin (1) the total number of dependencies of activities of daily living as defined in subdivision 2, paragraph (b); new text end

new text begin (2) the presence of complex health-related needs as defined in subdivision 2, paragraph (e); and new text end

new text begin (3) the presence of Level I behavior as defined in subdivision 2, paragraph (d), clause (1). new text end

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

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

new text begin (i) P home care rating requires Level 1 behavior or one to three dependencies in ADLs and qualifies one for five service units; new text end

new text begin (ii) Q home care rating requires Level 1 behavior and one to three dependencies in ADLs and qualifies one for six service units; new text end

new text begin (iii) R home care rating requires a complex health-related need and one to three dependencies in ADLs and qualifies one for seven service units; new text end

new text begin (iv) S home care rating requires four to six dependencies in ADLs and qualifies one for ten service units; new text end

new text begin (v) T home care rating requires four to six dependencies in ADLs and Level 1 behavior and qualifies one for 11 service units; new text end

new text begin (vi) U home care rating requires four to six dependencies in ADLs and a complex health need and qualifies one for 14 service units; new text end

new text begin (vii) V home care rating requires seven to eight dependencies in ADLs and qualifies one for 17 service units; new text end

new text begin (viii) W home care rating requires seven to eight dependencies in ADLs and Level 1 behavior and qualifies one for 20 service units; new text end

new text begin (ix) Z home care rating requires seven to eight dependencies in ADLs and a complex health related need and qualifies one for 30 service units; and new text end

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

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

new text begin (1) 30 additional minutes per day for a dependency in each critical activity of daily living as defined in subdivision 2, paragraph (h); new text end

new text begin (2) 30 additional minutes per day for each complex health-related function as defined in subdivision 2, paragraph (e); and new text end

new text begin (3) 30 additional minutes per day for each behavior issue as defined in subdivision 2, paragraph (d). new text end

new text begin Subd. 9. new text end

new text begin Noncovered services. new text end

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

new text begin (1) are not authorized by the certified assessor or included in the written service delivery plan; new text end

new text begin (2) are provided prior to the authorization of services and the approval of the written CFSS service delivery plan; new text end

new text begin (3) are duplicative of other paid services in the written service delivery plan; new text end

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

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

new text begin (6) are available through other funding sources, including, but not limited to, funding through Title IV-E of the Social Security Act. new text end

new text begin (b) Additional services, goods, or supports that are not covered include: new text end

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

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

new text begin (3) insurance, except for insurance costs related to employee coverage; new text end

new text begin (4) room and board costs for the participant with the exception of allowable transition costs in subdivision 7, clause (6); new text end

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

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

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

new text begin (8) medical supplies and equipment; new text end

new text begin (9) environmental modifications, except as specified in subdivision 7; new text end

new text begin (10) expenses for travel, lodging, or meals related to training the participant, the participant's representative, legal representative, or paid or unpaid caregivers that exceed $500 in a 12-month period; new text end

new text begin (11) experimental treatments; new text end

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

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

new text begin (14) vacation expenses other than the cost of direct services; new text end

new text begin (15) vehicle maintenance or modifications not related to the disability, health condition, or physical need; and new text end

new text begin (16) tickets and related costs to attend sporting or other recreational or entertainment events. new text end

new text begin Subd. 10. new text end

new text begin Provider qualifications and general requirements. new text end

new text begin Agency-providers delivering services under the agency-provider model under subdivision 11 or financial management service (FMS) contractors under subdivision 13 shall: new text end

new text begin (1) enroll as a medical assistance Minnesota health care programs provider and meet all applicable provider standards; new text end

new text begin (2) comply with medical assistance provider enrollment requirements; new text end

new text begin (3) demonstrate compliance with law and policies of CFSS as determined by the commissioner; new text end

new text begin (4) comply with background study requirements under chapter 245C; new text end

new text begin (5) verify and maintain records of all services and expenditures by the participant, including hours worked by support workers and support specialists; new text end

new text begin (6) not engage in any agency-initiated direct contact or marketing in person, by telephone, or other electronic means to potential participants, guardians, family member, or participants' representatives; new text end

new text begin (7) pay support workers and support specialists based upon actual hours of services provided; new text end

new text begin (8) withhold and pay all applicable federal and state payroll taxes; new text end

new text begin (9) make arrangements and pay unemployment insurance, taxes, workers' compensation, liability insurance, and other benefits, if any; new text end

new text begin (10) enter into a written agreement with the participant, participant's representative, or legal representative that assigns roles and responsibilities to be performed before services, supports, or goods are provided using a format established by the commissioner; new text end

new text begin (11) report maltreatment as required under sections 626.556 and 626.557; and new text end

new text begin (12) provide the participant with a copy of the service-related rights under subdivision 19 at the start of services and supports. new text end

new text begin Subd. 11. new text end

new text begin Agency-provider model. new text end

new text begin (a) The agency-provider model is limited to the services provided by support workers and support specialists who are employed by an agency-provider that is licensed according to chapter 245A or meets other criteria established by the commissioner, including required training. new text end

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

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

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

new text begin (e) The agency-provider must use a minimum of 72.5 percent of the revenue generated by the medical assistance payment for CFSS for support worker wages and benefits. The agency-provider must document how this requirement is being met. The revenue generated by the support specialist and the reasonable costs associated with the support specialist must not be used in making this calculation. new text end

new text begin (f) The agency-provider model must be used by individuals who have been restricted by the Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160 to 9505.2245. new text end

new text begin Subd. 12. new text end

new text begin Requirements for enrollment of CFSS provider agencies. new text end

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

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

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

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

new text begin (4) proof of workers' compensation insurance coverage; new text end

new text begin (5) proof of liability insurance; new text end

new text begin (6) a description of the CFSS provider agency's organization identifying the names or all owners, managing employees, staff, board of directors, and the affiliations of the directors, owners, or staff to other service providers; new text end

new text begin (7) a copy of the CFSS 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; new text end

new text begin (8) copies of all other forms the CFSS provider agency uses in the course of daily business including, but not limited to: new text end

new text begin (i) a copy of the CFSS provider agency's time sheet if the time sheet varies from the standard time sheet for CFSS services approved by the commissioner, and a letter requesting approval of the CFSS provider agency's nonstandard time sheet; and new text end

new text begin (ii) the CFSS provider agency's template for the CFSS care plan; new text end

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

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

new text begin (11) documentation of the agency's marketing practices; new text end

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

new text begin (13) documentation that the agency will use at least the following percentages of revenue generated from the medical assistance rate paid for CFSS services for employee personal care assistant wages and benefits: 72.5 percent of revenue from CFSS providers. The revenue generated by the support specialist and the reasonable costs associated with the support specialist shall not be used in making this calculation; and new text end

new text begin (14) 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 CFSS recipient or for another CFSS 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. new text end

new text begin (b) CFSS provider agencies shall provide to the commissioner the information specified in paragraph (a). new text end

new text begin (c) All CFSS 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. Employees in management and supervisory positions and owners who are active in the day-to-day operations of an agency who have completed the required training as an employee with a CFSS 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. CFSS provider agency billing staff shall complete training about CFSS program financial management. Any new owners or employees in management and supervisory positions involved in the day-to-day operations are required to complete mandatory training as a requisite of working for the agency. CFSS provider agencies certified for participation in Medicare as home health agencies are exempt from the training required in this subdivision. new text end

new text begin Subd. 13. new text end

new text begin Budget model. new text end

new text begin (a) Under the budget model participants can exercise more responsibility and control over the services and supports described and budgeted within the CFSS service delivery plan. Under this model, participants may use their budget allocation to: new text end

new text begin (1) directly employ support workers; new text end

new text begin (2) obtain supports and goods as defined in subdivision 7; and new text end

new text begin (3) choose a range of support assistance services from the financial management services (FMS) contractor related to: new text end

new text begin (i) assistance in managing the budget to meet the service delivery plan needs, consistent with federal and state laws and regulations; new text end

new text begin (ii) the employment, training, supervision, and evaluation of workers by the participant; new text end

new text begin (iii) acquisition and payment for supports and goods; and new text end

new text begin (iv) evaluation of individual service outcomes as needed for the scope of the participant's degree of control and responsibility. new text end

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

new text begin (c) The FMS contractor shall not provide CFSS services and supports under the agency-provider service model. The FMS contractor shall provide service functions as determined by the commissioner that include but are not limited to: new text end

new text begin (1) information and consultation about CFSS; new text end

new text begin (2) assistance with the development of the service delivery plan and budget model as requested by the participant; new text end

new text begin (3) billing and making payments for budget model expenditures; new text end

new text begin (4) assisting participants in fulfilling employer-related requirements according to Internal Revenue Code Procedure 70-6, section 3504, Agency Employer Tax Liability, regulation 137036-08, which includes assistance with filing and paying payroll taxes, and obtaining worker compensation coverage; new text end

new text begin (5) data recording and reporting of participant spending; and new text end

new text begin (6) other duties established in the contract with the department, including with respect to providing assistance to the participant, participant's representative, or legal representative in performing their employer responsibilities regarding support workers. The support worker shall not be considered the employee of the financial management services contractor. new text end

new text begin (d) A participant who requests to purchase goods and supports along with support worker services under the agency-provider model must use the budget model with a service delivery plan that specifies the amount of services to be authorized to the agency-provider and the expenditures to be paid by the FMS contractor. new text end

new text begin (e) The FMS contractor shall: new text end

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

new text begin (2) provide the participant and the targeted case manager, if applicable, with a monthly written summary of the spending for services and supports that were billed against the spending budget; new text end

new text begin (3) be knowledgeable of state and federal employment regulations, including those under the Fair Labor Standards Act of 1938, and comply with the requirements under the Internal Revenue Service Revenue Code Procedure 70-6, Section 35-4, Agency Employer Tax Liability for vendor or fiscal employer agent, and any requirements necessary to process employer and employee deductions, provide appropriate and timely submission of employer tax liabilities, and maintain documentation to support medical assistance claims; new text end

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

new text begin (5) assume fiscal accountability for state funds designated for the program; and new text end

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

new text begin (f) The commissioner of human services shall: new text end

new text begin (1) establish rates and payment methodology for the FMS contractor; new text end

new text begin (2) identify a process to ensure quality and performance standards for the FMS contractor and ensure statewide access to FMS contractors; and new text end

new text begin (3) establish a uniform protocol for delivering and administering CFSS services to be used by eligible FMS contractors. new text end

new text begin (g) The commissioner of human services shall disenroll or exclude participants from the budget model and transfer them to the agency-provider model under the following circumstances that include but are not limited to: new text end

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

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

new text begin (3) when the department determines that the participant or participant's representative or legal representative cannot manage participant responsibilities under the budget model. The commissioner must develop policies for determining if a participant is unable to manage responsibilities under a budget model. new text end

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

new text begin Subd. 14. new text end

new text begin Participant's responsibilities under budget model. new text end

new text begin (a) A participant using the budget model must use an FMS contractor or vendor that is under contract with the department. Upon a determination of eligibility and completion of the assessment and community support plan, the participant shall choose a FMS contractor from a list of eligible vendors maintained by the department. new text end

new text begin (b) When the participant, participant's representative, or legal representative chooses to be the employer of the support worker, they are responsible for the hiring and supervision of the support worker, including, but not limited to, recruiting, interviewing, training, scheduling, and discharging the support worker consistent with federal and state laws and regulations. new text end

new text begin (c) In addition to the employer responsibilities in paragraph (b), the participant, participant's representative, or legal representative is responsible for: new text end

new text begin (1) tracking the services provided and all expenditures for goods or other supports; new text end

new text begin (2) preparing and submitting time sheets, signed by both the participant and support worker, to the FMS contractor on a regular basis and in a timely manner according to the FMS contractor's procedures; new text end

new text begin (3) notifying the FMS contractor within ten days of any changes in circumstances affecting the CFSS service plan or in the participant's place of residence including, but not limited to, any hospitalization of the participant or change in the participant's address, telephone number, or employment; new text end

new text begin (4) notifying the FMS contractor of any changes in the employment status of each participant support worker; and new text end

new text begin (5) reporting any problems resulting from the quality of services rendered by the support worker to the FMS contractor. If the participant is unable to resolve any problems resulting from the quality of service rendered by the support worker with the assistance of the FMS contractor, the participant shall report the situation to the department. new text end

new text begin Subd. 15. new text end

new text begin Documentation of support services provided. new text end

new text begin (a) Support services provided to a participant by a support worker employed by either an agency-provider or the participant acting as the employer must be documented daily by each support worker, 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 or the participant and the FMS contractor selected by the participant to provide assistance with meeting the participant's employer obligations and kept in the recipient's health record. new text end

new text begin (b) The activity documentation must correspond to the written service delivery plan and be reviewed by the agency provider or the participant and the FMS contractor when the participant is acting as the employer of the support worker. new text end

new text begin (c) The time sheet must be on a form approved by the commissioner documenting time the support worker provides services in the home. The following criteria must be included in the time sheet: new text end

new text begin (1) full name of the support worker and individual provider number; new text end

new text begin (2) provider name and telephone numbers, if an agency-provider is responsible for delivery services under the written service plan; new text end

new text begin (3) full name of the participant; new text end

new text begin (4) consecutive dates, including month, day, and year, and arrival and departure times with a.m. or p.m. notations; new text end

new text begin (5) signatures of the participant or the participant's representative; new text end

new text begin (6) personal signature of the support worker; new text end

new text begin (7) any shared care provided, if applicable; new text end

new text begin (8) a statement that it is a federal crime to provide false information on CFSS billings for medical assistance payments; and new text end

new text begin (9) dates and location of recipient stays in a hospital, care facility, or incarceration. new text end

new text begin Subd. 16. new text end

new text begin Support workers requirements. new text end

new text begin (a) Support workers shall: new text end

new text begin (1) enroll with the department as a support worker after a background study under chapter 245C has been completed and the support worker has received a notice from the commissioner that: new text end

new text begin (i) the support worker is not disqualified under section 245C.14; or new text end

new text begin (ii) is disqualified, but the support worker has received a set-aside of the disqualification under section 245C.22; new text end

new text begin (2) have the ability to effectively communicate with the participant or the participant's representative; new text end

new text begin (3) have the skills and ability to provide the services and supports according to the person's CFSS service delivery plan and respond appropriately to the participant's needs; new text end

new text begin (4) not be a participant of CFSS, unless the support services provided by the support worker differ from those provided to the support worker; new text end

new text begin (5) complete the basic standardized training as determined by the commissioner before completing enrollment. The training must be available in languages other than English and to those who need accommodations due to disabilities. Support worker training must include successful completion of the following training components: basic first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic roles and responsibilities of support workers including information about basic body mechanics, emergency preparedness, orientation to positive behavioral practices, orientation to responding to a mental health crisis, fraud issues, time cards and documentation, and an overview of person-centered planning and self-direction. Upon completion of the training components, the support worker must pass the certification test to provide assistance to participants; new text end

new text begin (6) complete training and orientation on the participant's individual needs; and new text end

new text begin (7) maintain the privacy and confidentiality of the participant, and not independently determine the medication dose or time for medications for the participant. new text end

new text begin (b) The commissioner may deny or terminate a support worker's provider enrollment and provider number if the support worker: new text end

new text begin (1) lacks the skills, knowledge, or ability to adequately or safely perform the required work; new text end

new text begin (2) fails to provide the authorized services required by the participant employer; new text end

new text begin (3) has been intoxicated by alcohol or drugs while providing authorized services to the participant or while in the participant's home; new text end

new text begin (4) has manufactured or distributed drugs while providing authorized services to the participant or while in the participant's home; or new text end

new text begin (5) has been excluded as a provider by the commissioner of human services, or the United States Department of Health and Human Services, Office of Inspector General, from participation in Medicaid, Medicare, or any other federal health care program. new text end

new text begin (c) A support worker may appeal in writing to the commissioner to contest the decision to terminate the support worker's provider enrollment and provider number. new text end

new text begin Subd. 17. new text end

new text begin Support specialist requirements and payments. new text end

new text begin The commissioner shall develop qualifications, scope of functions, and payment rates and service limits for a support specialist that may provide additional or specialized assistance necessary to plan, implement, arrange, augment, or evaluate services and supports. new text end

new text begin Subd. 18. new text end

new text begin Service unit and budget allocation requirements and limits. new text end

new text begin (a) For the agency-provider model, services will be authorized in units of service. The total service unit amount must be established based upon the assessed need for CFSS services, and must not exceed the maximum number of units available as determined under subdivision 8. new text end

new text begin (b) For the budget model, the budget allocation allowed for services and supports is established by multiplying the number of units authorized under subdivision 8 by the payment rate established by the commissioner. new text end

new text begin Subd. 19. new text end

new text begin Support system. new text end

new text begin (a) The commissioner shall provide information, consultation, training, and assistance to ensure the participant is able to manage the services and supports and budgets, if applicable. This support shall include individual consultation on how to select and employ workers, manage responsibilities under CFSS, and evaluate personal outcomes. new text end

new text begin (b) The commissioner shall provide assistance with the development of risk management agreements. new text end

new text begin Subd. 20. new text end

new text begin Service-related rights. new text end

new text begin (a) Participants must be provided with adequate information, counseling, training, and assistance, as needed, to ensure that the participant is able to choose and manage services, models, and budgets. This support shall include information regarding: new text end

new text begin (1) person-centered planning; new text end

new text begin (2) the range and scope of individual choices; new text end

new text begin (3) the process for changing plans, services and budgets; new text end

new text begin (4) the grievance process; new text end

new text begin (5) individual rights; new text end

new text begin (6) identifying and assessing appropriate services; new text end

new text begin (7) risks and responsibilities; and new text end

new text begin (8) risk management. new text end

new text begin (b) The commissioner must ensure that the participant has a copy of the most recent community support plan and service delivery plan. new text end

new text begin (c) A participant who appeals a reduction in previously authorized CFSS services may continue previously authorized services pending an appeal in accordance with section 256.045. new text end

new text begin (d) If the units of service or budget allocation for CFSS are reduced, denied, or terminated, the commissioner must provide notice of the reasons for the reduction in the participant's notice of denial, termination, or reduction. new text end

new text begin (e) If all or part of a service delivery plan is denied approval, the commissioner must provide a notice that describes the basis of the denial. new text end

new text begin Subd. 21. new text end

new text begin Development and Implementation Council. new text end

new text begin The commissioner shall establish a Development and Implementation Council of which the majority of members are individuals with disabilities, elderly individuals, and their representatives. The commissioner shall consult and collaborate with the council when developing and implementing this section for at least the first five years of operation. The commissioner, in consultation with the council, shall provide recommendations on how to improve the quality and integrity of CFSS, reduce the paper documentation required in subdivisions 10, 12, and 15, make use of electronic means of documentation and online reporting in order to reduce administrative costs and improve training to the legislative chairs of the health and human services policy and finance committees by February 1, 2014. new text end

new text begin Subd. 22. new text end

new text begin Quality assurance and risk management system. new text end

new text begin (a) The commissioner shall establish quality assurance and risk management measures for use in developing and implementing CFSS, including those that (1) recognize the roles and responsibilities of those involved in obtaining CFSS, and (2) ensure the appropriateness of such plans and budgets based upon a recipient's resources and capabilities. Risk management measures must include background studies, and backup and emergency plans, including disaster planning. new text end

new text begin (b) The commissioner shall provide ongoing technical assistance and resource and educational materials for CFSS participants. new text end

new text begin (c) Performance assessment measures, such as a participant's satisfaction with the services and supports, and ongoing monitoring of health and well-being shall be identified in consultation with the council established in subdivision 21. new text end

new text begin (d) Data reporting requirements will be developed in consultation with the council established in subdivision 21. new text end

new text begin Subd. 23. new text end

new text begin Commissioner's access. new text end

new text begin When the commissioner is investigating a possible overpayment of Medicaid funds, the commissioner must be given immediate access without prior notice to the agency provider or FMS contractor's office during regular business hours and to documentation and records related to services provided and submission of claims for services provided. Denying the commissioner access to records is cause for immediate suspension of payment and terminating the agency provider's enrollment according to section 256B.064 or terminating the FMS contract. new text end

new text begin Subd. 24. new text end

new text begin CFSS agency-providers; background studies. new text end

new text begin CFSS agency-providers enrolled to provide personal care assistance services under the medical assistance program shall comply with the following: new text end

new text begin (1) owners who have a five percent interest or more and all managing employees are subject to a background study as provided in chapter 245C. This applies to currently enrolled CFSS agency-providers and those agencies seeking enrollment as a CFSS agency-provider. "Managing employee" has the same meaning as Code of Federal Regulations, title 42, section 455. An organization is barred from enrollment if: new text end

new text begin (i) the organization has not initiated background studies on owners managing employees; or new text end

new text begin (ii) the organization has initiated background studies on owners and managing employees, but the commissioner has sent the organization a notice that an owner or managing employee of the organization has been disqualified under section 245C.14, and the owner or managing employee has not received a set-aside of the disqualification under section 245C.22; new text end

new text begin (2) a background study must be initiated and completed for all support specialists; and new text end

new text begin (3) a background study must be initiated and completed for all support workers. new text end

new text begin Subd. 25. new text end

new text begin Commissioner recommendations required. new text end

new text begin In consultation with the Development and Implementation Council described in subdivision 21 and other stakeholders, the commissioner shall develop recommendations for revisions to subdivisions 12, 15, and 16, that promote self-direction in the following areas: new text end

new text begin (1) CFSS provider and support worker enrollment, qualification, and disqualification criteria; new text end

new text begin (2) documentation requirements that are consistent with state and federal requirements; and new text end

new text begin (3) provisions to maintain program integrity and assure fiscal accountability for goods and services purchased through CFSS. new text end

new text begin The recommendations shall be provided to the chairs and ranking minority members of the legislative committees and divisions with jurisdiction over health and human services policy and finance by November 15, 2013. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval but no earlier than April 1, 2014. The service will begin 90 days after federal approval or April 1, 2014, whichever is later. The commissioner of human services shall notify the revisor of statutes when this occurs. new text end

Sec. 50.

Minnesota Statutes 2012, section 256D.44, subdivision 5, is amended to read:

Subd. 5.

Special needs.

In addition to the state standards of assistance established in subdivisions 1 to 4, payments are allowed for the following special needs of recipients of Minnesota supplemental aid who are not residents of a nursing home, a regional treatment center, or a group residential housing facility.

(a) The county agency shall pay a monthly allowance for medically prescribed diets if the cost of those additional dietary needs cannot be met through some other maintenance benefit. The need for special diets or dietary items must be prescribed by a licensed physician. Costs for special diets shall be determined as percentages of the allotment for a one-person household under the thrifty food plan as defined by the United States Department of Agriculture. The types of diets and the percentages of the thrifty food plan that are covered are as follows:

(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;

(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent of thrifty food plan;

(3) controlled protein diet, less than 40 grams and requires special products, 125 percent of thrifty food plan;

(4) low cholesterol diet, 25 percent of thrifty food plan;

(5) high residue diet, 20 percent of thrifty food plan;

(6) pregnancy and lactation diet, 35 percent of thrifty food plan;

(7) gluten-free diet, 25 percent of thrifty food plan;

(8) lactose-free diet, 25 percent of thrifty food plan;

(9) antidumping diet, 15 percent of thrifty food plan;

(10) hypoglycemic diet, 15 percent of thrifty food plan; or

(11) ketogenic diet, 25 percent of thrifty food plan.

(b) Payment for nonrecurring special needs must be allowed for necessary home repairs or necessary repairs or replacement of household furniture and appliances using the payment standard of the AFDC program in effect on July 16, 1996, for these expenses, as long as other funding sources are not available.

(c) A fee for guardian or conservator service is allowed at a reasonable rate negotiated by the county or approved by the court. This rate shall not exceed five percent of the assistance unit's gross monthly income up to a maximum of $100 per month. If the guardian or conservator is a member of the county agency staff, no fee is allowed.

(d) The county agency shall continue to pay a monthly allowance of $68 for restaurant meals for a person who was receiving a restaurant meal allowance on June 1, 1990, and who eats two or more meals in a restaurant daily. The allowance must continue until the person has not received Minnesota supplemental aid for one full calendar month or until the person's living arrangement changes and the person no longer meets the criteria for the restaurant meal allowance, whichever occurs first.

(e) A fee of ten percent of the recipient's gross income or $25, whichever is less, is allowed for representative payee services provided by an agency that meets the requirements under SSI regulations to charge a fee for representative payee services. This special need is available to all recipients of Minnesota supplemental aid regardless of their living arrangement.

(f)(1) Notwithstanding the language in this subdivision, an amount equal to the maximum allotment authorized by the federal Food Stamp Program for a single individual which is in effect on the first day of July of each year will be added to the standards of assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify as shelter needy and are: (i) relocating from an institution, or an adult mental health residential treatment program under section 256B.0622; (ii) eligible for the self-directed supports option as defined under section 256B.0657, subdivision 2; or (iii) home and community-based waiver recipients living in their own home or rented or leased apartment which is not owned, operated, or controlled by a provider of service not related by blood or marriage, unless allowed under paragraph (g).

(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the shelter needy benefit under this paragraph is considered a household of one. An eligible individual who receives this benefit prior to age 65 may continue to receive the benefit after the age of 65.

(3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that exceed 40 percent of the assistance unit's gross income before the application of this special needs standard. "Gross income" for the purposes of this section is the applicant's or recipient's income as defined in section 256D.35, subdivision 10, or the standard specified in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be considered shelter needy for purposes of this paragraph.

(g) Notwithstanding this subdivision, to access housing and services as provided in paragraph (f), the recipient may choose housing that may be owned, operated, or controlled by the recipient's service provider. In a multifamily building of more than four units, the maximum number of units that may be used by recipients of this program shall be the greater of four units or 25 percent of the units in the buildingnew text begin , unless required by the Housing Opportunities for Persons with AIDS Programnew text end . In multifamily buildings of four or fewer units, all of the units may be used by recipients of this program. When housing is controlled by the service provider, the individual may choose the individual's own service provider as provided in section 256B.49, subdivision 23, clause (3). When the housing is controlled by the service provider, the service provider shall implement a plan with the recipient to transition the lease to the recipient's name. Within two years of signing the initial lease, the service provider shall transfer the lease entered into under this subdivision to the recipient. In the event the landlord denies this transfer, the commissioner may approve an exception within sufficient time to ensure the continued occupancy by the recipient. This paragraph expires June 30, 2016.

Sec. 51.

Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision 3, as amended by Laws 2012, chapter 247, article 4, section 43, is amended to read:

Subd. 3.

Forecasted Programs

The amounts that may be spent from this appropriation for each purpose are as follows:

(a) MFIP/DWP Grants
Appropriations by Fund
General 84,680,000 91,978,000
Federal TANF 84,425,000 75,417,000
(b) MFIP Child Care Assistance Grants 55,456,000 30,923,000
(c) General Assistance Grants 49,192,000 46,938,000

General Assistance Standard. The commissioner shall set the monthly standard of assistance for general assistance units consisting of an adult recipient who is childless and unmarried or living apart from parents or a legal guardian at $203. The commissioner may reduce this amount according to Laws 1997, chapter 85, article 3, section 54.

Emergency General Assistance. The amount appropriated for emergency general assistance funds is limited to no more than $6,689,812 in fiscal year 2012 and $6,729,812 in fiscal year 2013. Funds to counties shall be allocated by the commissioner using the allocation method specified in Minnesota Statutes, section 256D.06.

(d) Minnesota Supplemental Aid Grants 38,095,000 39,120,000
(e) Group Residential Housing Grants 121,080,000 129,238,000
(f) MinnesotaCare Grants 295,046,000 317,272,000

This appropriation is from the health care access fund.

(g) Medical Assistance Grants 4,501,582,000 4,437,282,000

Managed Care Incentive Payments. The commissioner shall not make managed care incentive payments for expanding preventive services during fiscal years beginning July 1, 2011, and July 1, 2012.

Reduction of Rates for Congregate Living for Individuals with Lower Needs. Beginning October 1, 2011, lead agencies must reduce rates in effect on January 1, 2011, by ten percent for individuals with lower needs living in foster care settings where the license holder does not share the residence with recipients on the CADI and DD waivers and customized living settings for CADI. Lead agencies shall consult with providers to review individual service plans and identify changes or modifications to reduce the utilization of services while maintaining the health and safety of the individual receiving services. Lead agencies must adjust contracts within 60 days of the effective date. If federal waiver approval is obtained under the long-term care realignment waiver application submitted on February 13, 2012, and federal financial participation is authorized for the alternative care program, the commissioner shall adjust this payment rate reduction from ten to five percent for services rendered on or after July 1, 2012, or the first day of the month following federal approval, whichever is later.new text begin Effective August 1, 2013, this provision does not apply to individuals whose primary diagnosis is mental illness and who are living in foster care settings where the license holder is also (1) a provider of assertive community treatment (ACT) or adult rehabilitative mental health services (ARMHS) as defined in Minnesota Statutes, section 256B.0623; (2) a mental health center or mental health clinic certified under Minnesota Rules, parts 9520.0750 to 9520.0870; or (3) a provider of intensive residential treatment services (IRTS) licensed under Minnesota Rules, parts 9520.0500 to 9520.0670.new text end

Reduction of Lead Agency Waiver Allocations to Implement Rate Reductions for Congregate Living for Individuals with Lower Needs. Beginning October 1, 2011, the commissioner shall reduce lead agency waiver allocations to implement the reduction of rates for individuals with lower needs living in foster care settings where the license holder does not share the residence with recipients on the CADI and DD waivers and customized living settings for CADI.

Reduce customized living and 24-hour customized living component rates. Effective July 1, 2011, the commissioner shall reduce elderly waiver customized living and 24-hour customized living component service spending by five percent through reductions in component rates and service rate limits. The commissioner shall adjust the elderly waiver capitation payment rates for managed care organizations paid under Minnesota Statutes, section 256B.69, subdivisions 6a and 23, to reflect reductions in component spending for customized living services and 24-hour customized living services under Minnesota Statutes, section 256B.0915, subdivisions 3e and 3h, for the contract period beginning January 1, 2012. To implement the reduction specified in this provision, capitation rates paid by the commissioner to managed care organizations under Minnesota Statutes, section 256B.69, shall reflect a ten percent reduction for the specified services for the period January 1, 2012, to June 30, 2012, and a five percent reduction for those services on or after July 1, 2012.

Limit Growth in the Developmental Disability Waiver. The commissioner shall limit growth in the developmental disability waiver to six diversion allocations per month beginning July 1, 2011, through June 30, 2013, and 15 diversion allocations per month beginning July 1, 2013, through June 30, 2015. Waiver allocations shall be targeted to individuals who meet the priorities for accessing waiver services identified in Minnesota Statutes, 256B.092, subdivision 12. The limits do not include conversions from intermediate care facilities for persons with developmental disabilities. Notwithstanding any contrary provisions in this article, this paragraph expires June 30, 2015.

Limit Growth in the Community Alternatives for Disabled Individuals Waiver. The commissioner shall limit growth in the community alternatives for disabled individuals waiver to 60 allocations per month beginning July 1, 2011, through June 30, 2013, and 85 allocations per month beginning July 1, 2013, through June 30, 2015. Waiver allocations must be targeted to individuals who meet the priorities for accessing waiver services identified in Minnesota Statutes, section 256B.49, subdivision 11a. The limits include conversions and diversions, unless the commissioner has approved a plan to convert funding due to the closure or downsizing of a residential facility or nursing facility to serve directly affected individuals on the community alternatives for disabled individuals waiver. Notwithstanding any contrary provisions in this article, this paragraph expires June 30, 2015.

Personal Care Assistance Relative Care. The commissioner shall adjust the capitation payment rates for managed care organizations paid under Minnesota Statutes, section 256B.69, to reflect the rate reductions for personal care assistance provided by a relative pursuant to Minnesota Statutes, section 256B.0659, subdivision 11. This rate reduction is effective July 1, 2013.

(h) Alternative Care Grants 46,421,000 46,035,000

Alternative Care Transfer. Any money allocated to the alternative care program that is not spent for the purposes indicated does not cancel but shall be transferred to the medical assistance account.

(i) Chemical Dependency Entitlement Grants 94,675,000 93,298,000

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2013. new text end

Sec. 52.

Laws 2012, chapter 247, article 6, section 4, is amended to read:

Sec. 4.

BOARD OF NURSING HOME ADMINISTRATORS

$ -0- $ 10,000

Administrative Services Unit. This appropriation is to provide a grant to the Minnesota Ambulance Association to coordinate and prepare an assessment of the extent and costs of uncompensated care as a direct result of emergency responses on interstate highways in Minnesota. The study will collect appropriate information from medical response units and ambulance services regulated under Minnesota Statutes, chapter 144E, and to the extent possible, firefighting agencies. In preparing the assessment, the Minnesota Ambulance Association shall consult with its membership, the Minnesota Fire Chiefs Association, the Office of the State Fire Marshal, and the Emergency Medical Services Regulatory Board. The findings of the assessment will be reported to the chairs and ranking minority members of the legislative committees with jurisdiction over health and public safety by January 1, 2013.new text begin This is a onetime appropriation.new text end

Sec. 53.

new text begin RECOMMENDATIONS FOR CONCENTRATION LIMITS ON HOME AND COMMUNITY-BASED SETTINGS. new text end

new text begin The commissioner of human services shall consult with the Minnesota Olmstead subcabinet, advocates, providers, and city representatives to develop recommendations on concentration limits on home and community-based settings, as defined in Minnesota Statutes, section 256B.492, as well as any other exceptions to the definition. The recommendations must be consistent with Minnesota's Olmstead plan. The recommendations and proposed legislation must be submitted to the chairs and ranking minority members of the legislative committees with jurisdiction over health and human services policy and finance by February 1, 2014. new text end

Sec. 54.

new text begin TRAINING OF AUTISM SERVICE PROVIDERS. new text end

new text begin The commissioners of health and human services shall ensure that the departments' autism-related service providers receive training in culturally appropriate approaches to serving the Somali, Latino, Hmong, and Indigenous American Indian communities, and other cultural groups experiencing a disproportionate incidence of autism. new text end

Sec. 55.

new text begin DIRECTION TO COMMISSIONER; SPOUSAL DISREGARD. new text end

new text begin The commissioner of human services shall request authority, in whatever form is necessary, from the federal Centers for Medicare and Medicaid Services to allow persons under age 65 participating in the home and community-based services waivers to continue to use the disregard of the nonassisted spouse's income and assets instead of the spousal impoverishment provisions under the federal Patient Protection and Affordable Care Act, Public Law 111-148, section 2404, as amended by the federal Health Care and Education Reconciliation Act of 2010, Public Law 111-152, and any amendments to, or regulations or guidance issued under, those acts. new text end

Sec. 56.

new text begin DIRECTION TO COMMISSIONER; ABA. new text end

new text begin By January 1, 2014, the commissioner of human services shall apply to the federal Centers for Medicare and Medicaid Services for a waiver or other authority to provide applied behavioral analysis services to children with autism spectrum disorder and related conditions under the medical assistance program. 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. 57.

new text begin RECOMMENDATIONS ON RAISING THE ASSET LIMITS FOR SENIORS AND PERSONS WITH DISABILITIES. new text end

new text begin The commissioner of human services shall consult with interested stakeholders to develop recommendations and a request for a federal 1115 demonstration waiver in order to increase the asset limit for individuals eligible for medical assistance due to disability or age who are not residing in a nursing facility, intermediate care facility for persons with developmental disabilities, or other institution whose costs for room and board are covered by medical assistance or state funds. The recommendations must be provided to the legislative committees and divisions with jurisdiction over health and human services policy and finance by February 1, 2014. new text end

Sec. 58.

new text begin NURSING HOME LEVEL OF CARE REPORT. new text end

new text begin (a) The commissioner of human services shall report on the impact of the modification to the nursing facility level of care to be implemented January 1, 2014, including the following: new text end

new text begin (1) the number of individuals who lose eligibility for home and community-based services waivers under Minnesota Statutes, sections 256B.0915 and 256B.49, and alternative care under Minnesota Statutes, section 256B.0913; new text end

new text begin (2) the number of individuals who lose eligibility for medical assistance; and new text end

new text begin (3) for individuals reported under clauses (1) and (2), and to the extent possible: new text end

new text begin (i) their living situation before and after nursing facility level of care implementation; and new text end

new text begin (ii) the programs or services they received before and after nursing facility level of care implementation, including, but not limited to, personal care assistant services and essential community supports. new text end

new text begin (b) The commissioner of human services shall report to the chairs and ranking minority members of the legislative committees and divisions with jurisdiction over health and human services policy and finance with the information required under paragraph (a). A preliminary report shall be submitted on October 1, 2014, and a final report shall be submitted February 15, 2015. new text end

Sec. 59.

new text begin ASSISTIVE TECHNOLOGY EQUIPMENT FOR HOME AND COMMUNITY-BASED SERVICES WAIVERS FUNDING DEVELOPMENT. new text end

new text begin (a) For the purposes of this section, "assistive technology equipment" includes computer tablets, passive sensors, and other forms of technology allowing increased safety and independence, and used by those receiving services through a home and community-based services waiver under Minnesota Statutes, sections 256B.0915, 256B.092, and 256B.49. new text end

new text begin (b) The commissioner of human services shall develop recommendations for assistive technology equipment funding to enable individuals receiving services identified in paragraph (a) to live in the least restrictive setting possible. In developing the funding, the commissioner shall examine funding for the following: new text end

new text begin (1) an assessment process to match the appropriate assistive technology equipment with the waiver recipient, including when the recipient's condition changes or progresses; new text end

new text begin (2) the use of monitoring services, if applicable, to the assistive technology equipment identified in clause (1); new text end

new text begin (3) the leasing of assistive technology equipment as a possible alternative to purchasing the equipment; and new text end

new text begin (4) ongoing support services, such as technological support. new text end

new text begin (c) The commissioner shall provide the chairs and ranking minority members of the legislative committees and divisions with jurisdiction over health and human services policy and finance a recommendation for implementing an assistive technology equipment program as developed in paragraph (b) by February 1, 2014. new text end

Sec. 60.

new text begin PROVIDER RATE AND GRANT INCREASE EFFECTIVE APRIL 1, 2014. new text end

new text begin (a) The commissioner of human services shall increase reimbursement rates, grants, allocations, individual limits, and rate limits, as applicable, by one percent for the rate period beginning April 1, 2014, for services rendered on or after those dates. County or tribal contracts for services specified in this section must be amended to pass through these rate increases within 60 days of the effective date. new text end

new text begin (b) The rate changes described in this section must be provided to: new text end

new text begin (1) home and community-based waivered services for persons with developmental disabilities or related conditions, including consumer-directed community supports, under Minnesota Statutes, section 256B.501; new text end

new text begin (2) waivered services under community alternatives for disabled individuals, including consumer-directed community supports, under Minnesota Statutes, section 256B.49; new text end

new text begin (3) community alternative care waivered services, including consumer-directed community supports, under Minnesota Statutes, section 256B.49; new text end

new text begin (4) brain injury waivered services, including consumer-directed community supports, under Minnesota Statutes, section 256B.49; new text end

new text begin (5) home and community-based waivered services for the elderly under Minnesota Statutes, section 256B.0915; new text end

new text begin (6) nursing services and home health services under Minnesota Statutes, section 256B.0625, subdivision 6a; new text end

new text begin (7) personal care services and qualified professional supervision of personal care services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a; new text end

new text begin (8) private duty nursing services under Minnesota Statutes, section 256B.0625, subdivision 7; new text end

new text begin (9) day training and habilitation services for adults with developmental disabilities or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the additional cost of rate adjustments on day training and habilitation services, provided as a social service, formerly funded under Minnesota Statutes 2010, chapter 256M; new text end

new text begin (10) alternative care services under Minnesota Statutes, section 256B.0913; new text end

new text begin (11) living skills training programs for persons with intractable epilepsy who need assistance in the transition to independent living under Laws 1988, chapter 689; new text end

new text begin (12) semi-independent living services (SILS) under Minnesota Statutes, section 252.275, including SILS funding under county social services grants formerly funded under Minnesota Statutes, chapter 256M; new text end

new text begin (13) consumer support grants under Minnesota Statutes, section 256.476; new text end

new text begin (14) family support grants under Minnesota Statutes, section 252.32; new text end

new text begin (15) housing access grants under Minnesota Statutes, sections 256B.0658 and 256B.0917, subdivision 14; new text end

new text begin (16) self-advocacy grants under Laws 2009, chapter 101; new text end

new text begin (17) technology grants under Laws 2009, chapter 79; new text end

new text begin (18) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917, and 256B.0928; and new text end

new text begin (19) community support services for deaf and hard-of-hearing adults with mental illness who use or wish to use sign language as their primary means of communication under Minnesota Statutes, section 256.01, subdivision 2; and deaf and hard-of-hearing grants under Minnesota Statutes, sections 256C.233 and 256C.25; Laws 1985, chapter 9; and Laws 1997, First Special Session chapter 5, section 20. new text end

new text begin (c) A managed care plan receiving state payments for the services in this section must include these increases in their payments to providers. To implement the rate increase in this section, capitation rates paid by the commissioner to managed care organizations under Minnesota Statutes, section 256B.69, shall reflect a one percent increase for the specified services for the period beginning April 1, 2014. new text end

new text begin (d) Counties shall increase the budget for each recipient of consumer-directed community supports by the amounts in paragraph (a) on the effective dates in paragraph (a). new text end

Sec. 61.

new text begin SAFETY NET FOR HOME AND COMMUNITY-BASED SERVICES WAIVERS. new text end

new text begin The commissioner of human services shall submit a request by December 31, 2013, to the federal government to amend the home and community-based services waivers for individuals with disabilities authorized under Minnesota Statutes, section 256B.49, to modify the financial management of the home and community-based services waivers to provide a state-administered safety net when costs for an individual increase above an identified threshold. The implementation of the safety net may result in a decreased allocation for individual counties, tribes, or collaboratives of counties or tribes, but must not result in a net decreased statewide allocation. new text end

Sec. 62.

new text begin SHARED LIVING MODEL. new text end

new text begin The commissioner of human services shall develop and promote a shared living model option for individuals receiving services through the home and community-based services waivers for individuals with disabilities, authorized under Minnesota Statutes, section 256B.092 or 256B.49, as an option for individuals who require 24-hour assistance. The option must be a companion model with a limit of one or two individuals receiving support in the home, planned respite for the caregiver, and the availability of intensive training and support on the needs of the individual or individuals. Any necessary amendments to implement the model must be submitted to the federal government by December 31, 2013. new text end

Sec. 63.

new text begin MONEY FOLLOWS THE PERSON GRANT. new text end

new text begin The commissioner of human services shall submit to the federal government all necessary waiver amendments to implement the Money Follows the Person federal grant by December 31, 2013. new text end

Sec. 64.

new text begin REPEALER. new text end

new text begin Minnesota Statutes 2012, sections 256B.0917, subdivision 14; 256B.096, subdivisions 1, 2, 3, and 4; 256B.14, subdivision 3a; and 256B.5012, subdivision 13, new text end new text begin and new text end new text begin Laws 2011, First Special Session chapter 9, article 7, section 54, as amended by Laws 2012, chapter 247, article 4, section 42, and Laws 2012, chapter 298, section 3, new text end new text begin are repealed. new text end

ARTICLE 8

WAIVER PROVIDER STANDARDS

Section 1.

Minnesota Statutes 2012, section 13.461, is amended by adding a subdivision to read:

new text begin Subd. 7c. new text end

new text begin Human services license holders. new text end

new text begin Section 245D.095, subdivision 3, requires certain license holders to protect service recipient records in accordance with specified provisions of this chapter. new text end

Sec. 2.

Minnesota Statutes 2012, section 145C.01, subdivision 7, is amended to read:

Subd. 7.

Health care facility.

"Health care facility" means a hospital or other entity licensed under sections 144.50 to 144.58, a nursing home licensed to serve adults under section 144A.02, a home care provider licensed under sections 144A.43 to 144A.47, an adult foster care provider licensed under chapter 245A and Minnesota Rules, parts 9555.5105 to 9555.6265,new text begin a community residential setting licensed under chapter 245D,new text end or a hospice provider licensed under sections 144A.75 to 144A.755.

Sec. 3.

Minnesota Statutes 2012, section 243.166, subdivision 4b, is amended to read:

Subd. 4b.

Health care facility; notice of status.

(a) For the purposes of this subdivision, "health care facility" means a facility:

(1) licensed by the commissioner of health as a hospital, boarding care home or supervised living facility under sections 144.50 to 144.58, or a nursing home under chapter 144A;

(2) registered by the commissioner of health as a housing with services establishment as defined in section 144D.01; or

(3) licensed by the commissioner of human services as a residential facility under chapter 245A to provide adult foster care, adult mental health treatment, chemical dependency treatment to adults, or residential services to persons with deleted text begin developmentaldeleted text end disabilities.

(b) Prior to admission to a health care facility, a person required to register under this section shall disclose to:

(1) the health care facility employee processing the admission the person's status as a registered predatory offender under this section; and

(2) the person's corrections agent, or if the person does not have an assigned corrections agent, the law enforcement authority with whom the person is currently required to register, that inpatient admission will occur.

(c) A law enforcement authority or corrections agent who receives notice under paragraph (b) or who knows that a person required to register under this section is planning to be admitted and receive, or has been admitted and is receiving health care at a health care facility shall notify the administrator of the facility and deliver a fact sheet to the administrator containing the following information: (1) name and physical description of the offender; (2) the offender's conviction history, including the dates of conviction; (3) the risk level classification assigned to the offender under section 244.052, if any; and (4) the profile of likely victims.

(d) Except for a hospital licensed under sections 144.50 to 144.58, if a health care facility receives a fact sheet under paragraph (c) that includes a risk level classification for the offender, and if the facility admits the offender, the facility shall distribute the fact sheet to all residents at the facility. If the facility determines that distribution to a resident is not appropriate given the resident's medical, emotional, or mental status, the facility shall distribute the fact sheet to the patient's next of kin or emergency contact.

Sec. 4.

new text begin [245.8251] POSITIVE SUPPORT STRATEGIES AND EMERGENCY MANUAL RESTRAINT; LICENSED FACILITIES AND PROGRAMS. new text end

new text begin Subdivision 1. new text end

new text begin Rules. new text end

new text begin The commissioner of human services shall, within 24 months of enactment of this section, adopt rules governing the use of positive support strategies, safety interventions, and emergency use of manual restraint in facilities and services licensed under chapter 245D. new text end

new text begin Subd. 2. new text end

new text begin Data collection. new text end

new text begin (a) The commissioner shall, with stakeholder input, develop data collection elements specific to incidents of emergency use of manual restraint and positive support transition plans for persons receiving services from providers governed under chapter 245D effective January 1, 2014. Providers shall report the data in a format and at a frequency determined by the commissioner of human services. Providers shall submit the data to the commissioner and the Office of the Ombudsman for Mental Health and Developmental Disabilities. new text end

new text begin (b) Beginning July 1, 2013, providers regulated under Minnesota Rules, parts 9525.2700 to 9525.2810, shall submit data regarding the use of all controlled procedures identified in Minnesota Rules, part 9525.2740, in a format and at a frequency determined by the commissioner. Providers shall submit the data to the commissioner and the Office of the Ombudsman for Mental Health and Developmental Disabilities. new text end

Sec. 5.

Minnesota Statutes 2012, section 245.91, is amended by adding a subdivision to read:

new text begin Subd. 3a. new text end

new text begin Emergency use of manual restraint. new text end

new text begin "Emergency use of manual restraint" has the meaning given in section 245D.02, subdivision 8a, and applies to services licensed under chapter 245D. new text end

Sec. 6.

Minnesota Statutes 2012, section 245.94, subdivision 2, is amended to read:

Subd. 2.

Matters appropriate for review.

(a) In selecting matters for review by the office, the ombudsman shall give particular attention to unusual deaths or injuries of a client new text begin or reports of emergency use of manual restraint as identified in section 245D.061, new text end served by an agency, facility, or program, or actions of an agency, facility, or program that:

(1) may be contrary to law or rule;

(2) may be unreasonable, unfair, oppressive, or inconsistent with a policy or order of an agency, facility, or program;

(3) may be mistaken in law or arbitrary in the ascertainment of facts;

(4) may be unclear or inadequately explained, when reasons should have been revealed;

(5) may result in abuse or neglect of a person receiving treatment;

(6) may disregard the rights of a client or other individual served by an agency or facility;

(7) may impede or promote independence, community integration, and productivity for clients; or

(8) may impede or improve the monitoring or evaluation of services provided to clients.

(b) The ombudsman shall, in selecting matters for review and in the course of the review, avoid duplicating other investigations or regulatory efforts.

Sec. 7.

Minnesota Statutes 2012, section 245.94, subdivision 2a, is amended to read:

Subd. 2a.

Mandatory reporting.

Within 24 hours after a client suffers death or serious injury, the agency, facility, or program director shall notify the ombudsman of the death or serious injury. new text begin The emergency use of manual restraint must be reported to the ombudsman as required under section 245D.061, subdivision 10. new text end The ombudsman is authorized to receive identifying information about a deceased client according to Code of Federal Regulations, title 42, section 2.15, paragraph (b).

Sec. 8.

Minnesota Statutes 2012, section 245A.02, subdivision 10, is amended to read:

Subd. 10.

Nonresidential program.

"Nonresidential program" means care, supervision, rehabilitation, training or habilitation of a person provided outside the person's own home and provided for fewer than 24 hours a day, including adult day care programs; and chemical dependency or chemical abuse programs that are located in a nursing home or hospital and receive public funds for providing chemical abuse or chemical dependency treatment services under chapter 254B. Nonresidential programs include home and community-based services deleted text begin and semi-independent living servicesdeleted text end for persons with deleted text begin developmentaldeleted text end disabilitiesnew text begin or persons age 65 and oldernew text end that are provided in or outside of a person's own homenew text begin under chapter 245Dnew text end .

Sec. 9.

Minnesota Statutes 2012, section 245A.02, subdivision 14, is amended to read:

Subd. 14.

Residential program.

"Residential program" means a program that provides 24-hour-a-day care, supervision, food, lodging, rehabilitation, training, education, habilitation, or treatment outside a person's own home, including a program in an intermediate care facility for four or more persons with developmental disabilities; and chemical dependency or chemical abuse programs that are located in a hospital or nursing home and receive public funds for providing chemical abuse or chemical dependency treatment services under chapter 254B. Residential programs include home and community-based services for persons with deleted text begin developmentaldeleted text end disabilitiesnew text begin or persons age 65 and oldernew text end that are provided in or outside of a person's own homenew text begin under chapter 245Dnew text end .

Sec. 10.

Minnesota Statutes 2012, 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. new text begin The commissioner shall not issue an initial license for a community residential setting licensed under chapter 245D. new text end 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,new text begin or community residential setting licenses replacing adult foster care licenses in existence on December 31, 2013,new text end and determined to be needed by the commissioner under paragraph (b);

(3) new foster care licensesnew text begin or community residential setting licensesnew text end determined to be needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, or restructuring of state-operated services that limits the capacity of state-operated facilities;

(4) new foster care licensesnew text begin or community residential setting licensesnew text end determined to be needed by the commissioner under paragraph (b) for persons requiring hospital level care; or

(5) new foster care licensesnew text begin or community residential setting licensesnew text end determined to be needed by the commissioner for the transition of people from personal care assistance to the home and community-based services.

(b) The commissioner shall determine the need for newly licensed foster care homesnew text begin or community residential settingsnew text end 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) The commissioner shall study the effects of the license moratorium under this subdivision and shall report back to the legislature by January 15, 2011. This study shall include, but is not limited to the following:

(1) the overall capacity and utilization of foster care beds where the physical location is not the primary residence of the license holder prior to and after implementation of the moratorium;

(2) the overall capacity and utilization of foster care beds where the physical location is the primary residence of the license holder prior to and after implementation of the moratorium; and

(3) the number of licensed and occupied ICF/MR beds prior to and after implementation of the moratorium.

(d) When deleted text begin a foster care recipientdeleted text end new text begin an adult resident served by the programnew text end 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)new text begin , or the adult community residential settingnew text end , the county shall immediately inform the Department of Human Services Licensing Division. The department shall decrease the statewide licensed capacity fornew text begin adultnew text end foster care settings where the physical location is not the primary residence of the license holdernew text begin , or for adult community residential settingsnew text end , if the voluntary changes described in paragraph (f) 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. Under this paragraph, the commissioner has the authority to reduce unused licensed capacity of a current foster care programnew text begin , or the community residential settings,new text end to accomplish the consolidation or closure of settings. A decreased licensed capacity according to this paragraph is not subject to appeal under this chapter.

(e) Residential settings that would otherwise be subject to the decreased license capacity established in paragraph (d) shall be exempt under the following circumstances:

(1) until August 1, 2013, the license holder's beds occupied by residents whose primary diagnosis is mental illness and the license holder is:

(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental health services (ARMHS) as defined in section 256B.0623;

(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to 9520.0870;

(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to 9520.0870; or

(iv) a provider of intensive residential treatment services (IRTS) licensed under Minnesota Rules, parts 9520.0500 to 9520.0670; or

(2) the license holder is certified under the requirements in subdivision 6anew text begin or section 245D.33new text end .

(f) 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 (d) 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 of each 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.

(g) 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.

(h) License holders of foster care homes identified under paragraph (g) 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. deleted text begin These license holders must be considered registered under deleted text end deleted text begin section 256B.092, subdivision 11, paragraph (c), and this registration status must be identified on their license certificates.deleted text end

Sec. 11.

Minnesota Statutes 2012, section 245A.03, subdivision 8, is amended to read:

Subd. 8.

Excluded providers seeking licensure.

Nothing in this section shall prohibit a program that is excluded from licensure under subdivision 2, paragraph (a), clause deleted text begin (28)deleted text end new text begin (26)new text end , from seeking licensure. The commissioner shall ensure that any application received from such an excluded provider is processed in the same manner as all other applications for child care center licensure.

Sec. 12.

Minnesota Statutes 2012, section 245A.03, subdivision 9, is amended to read:

Subd. 9.

Permitted services by an individual who is related.

Notwithstanding subdivision 2, paragraph (a), clause (1), and subdivision 7, an individual who is related to a person receiving supported living services may provide licensed services to that person if:

(1) the person who receives supported living services received these services in a residential site on July 1, 2005;

(2) the services under clause (1) were provided in a corporate foster care setting for adults and were funded by the developmental disabilities home and community-based services waiver defined in section 256B.092;

(3) the individual who is related obtains and maintains both a license under chapter 245B new text begin or successor licensing requirements for the provision of supported living services new text end and an adult foster care license under Minnesota Rules, parts 9555.5105 to 9555.6265; and

(4) the individual who is related is not the guardian of the person receiving supported living services.

Sec. 13.

Minnesota Statutes 2012, section 245A.042, subdivision 3, is amended to read:

Subd. 3.

Implementation.

(a) The commissioner shall implement the responsibilities of this chapter according to the timelines in paragraphs (b) and (c) only within the limits of available appropriations or other administrative cost recovery methodology.

(b) The licensure of home and community-based services according to this section shall be implemented January 1, 2014. License applications shall be received and processed on a phased-in schedule as determined by the commissioner beginning July 1, 2013. Licenses will be issued thereafter upon the commissioner's determination that the application is complete according to section 245A.04.

(c) Within the limits of available appropriations or other administrative cost recovery methodology, implementation of compliance monitoring must be phased in after January 1, 2014.

(1) Applicants who do not currently hold a license issued under deleted text begin thisdeleted text end chapternew text begin 245Bnew text end must receive an initial compliance monitoring visit after 12 months of the effective date of the initial license for the purpose of providing technical assistance on how to achieve and maintain compliance with the applicable law or rules governing the provision of home and community-based services under chapter 245D. If during the review the commissioner finds that the license holder has failed to achieve compliance with an applicable law or rule and this failure does not imminently endanger the health, safety, or rights of the persons served by the program, the commissioner may issue a licensing review report with recommendations for achieving and maintaining compliance.

(2) Applicants who do currently hold a license issued under this chapter must receive a compliance monitoring visit after 24 months of the effective date of the initial license.

(d) Nothing in this subdivision shall be construed to limit the commissioner's authority to suspend or revoke a license or issue a fine at any time under section 245A.07, or deleted text begin makedeleted text end new text begin issuenew text end correction orders and make a license conditional for failure to comply with applicable laws or rules under section 245A.06, based on the nature, chronicity, or severity of the violation of law or rule and the effect of the violation on the health, safety, or rights of persons served by the program.

Sec. 14.

Minnesota Statutes 2012, section 245A.08, subdivision 2a, is amended to read:

Subd. 2a.

Consolidated contested case hearings.

(a) When a denial of a license under section 245A.05 or a licensing sanction under section 245A.07, subdivision 3, is based on a disqualification for which reconsideration was requested and which was not set aside under section 245C.22, the scope of the contested case hearing shall include the disqualification and the licensing sanction or denial of a license, unless otherwise specified in this subdivision. When the licensing sanction or denial of a license is based on a determination of maltreatment under section 626.556 or 626.557, or a disqualification for serious or recurring maltreatment which was not set aside, the scope of the contested case hearing shall include the maltreatment determination, disqualification, and the licensing sanction or denial of a license, unless otherwise specified in this subdivision. In such cases, a fair hearing under section 256.045 shall not be conducted as provided for in sections 245C.27, 626.556, subdivision 10i, and 626.557, subdivision 9d.

(b) Except for family child care and child foster care, reconsideration of a maltreatment determination under sections 626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of a disqualification under section 245C.22, shall not be conducted when:

(1) a denial of a license under section 245A.05, or a licensing sanction under section 245A.07, is based on a determination that the license holder is responsible for maltreatment or the disqualification of a license holder is based on serious or recurring maltreatment;

(2) the denial of a license or licensing sanction is issued at the same time as the maltreatment determination or disqualification; and

(3) the license holder appeals the maltreatment determination or disqualification, and denial of a license or licensing sanction. In these cases, a fair hearing shall not be conducted under sections 245C.27, 626.556, subdivision 10i, and 626.557, subdivision 9d. The scope of the contested case hearing must include the maltreatment determination, disqualification, and denial of a license or licensing sanction.

Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment determination or disqualification, but does not appeal the denial of a license or a licensing sanction, reconsideration of the maltreatment determination shall be conducted under sections 626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the disqualification shall be conducted under section 245C.22. In such cases, a fair hearing shall also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and 626.557, subdivision 9d.

(c) In consolidated contested case hearings regarding sanctions issued in family child care, child foster care, family adult day services, deleted text begin anddeleted text end adult foster care,new text begin and community residential settings,new text end the county attorney shall defend the commissioner's orders in accordance with section 245A.16, subdivision 4.

(d) The commissioner's final order under subdivision 5 is the final agency action on the issue of maltreatment and disqualification, including for purposes of subsequent background studies under chapter 245C and is the only administrative appeal of the final agency determination, specifically, including a challenge to the accuracy and completeness of data under section 13.04.

(e) When consolidated hearings under this subdivision involve a licensing sanction based on a previous maltreatment determination for which the commissioner has issued a final order in an appeal of that determination under section 256.045, or the individual failed to exercise the right to appeal the previous maltreatment determination under section 626.556, subdivision 10i, or 626.557, subdivision 9d, the commissioner's order is conclusive on the issue of maltreatment. In such cases, the scope of the administrative law judge's review shall be limited to the disqualification and the licensing sanction or denial of a license. In the case of a denial of a license or a licensing sanction issued to a facility based on a maltreatment determination regarding an individual who is not the license holder or a household member, the scope of the administrative law judge's review includes the maltreatment determination.

(f) The hearings of all parties may be consolidated into a single contested case hearing upon consent of all parties and the administrative law judge, if:

(1) a maltreatment determination or disqualification, which was not set aside under section 245C.22, is the basis for a denial of a license under section 245A.05 or a licensing sanction under section 245A.07;

(2) the disqualified subject is an individual other than the license holder and upon whom a background study must be conducted under section 245C.03; and

(3) the individual has a hearing right under section 245C.27.

(g) When a denial of a license under section 245A.05 or a licensing sanction under section 245A.07 is based on a disqualification for which reconsideration was requested and was not set aside under section 245C.22, and the individual otherwise has no hearing right under section 245C.27, the scope of the administrative law judge's review shall include the denial or sanction and a determination whether the disqualification should be set aside, unless section 245C.24 prohibits the set-aside of the disqualification. In determining whether the disqualification should be set aside, the administrative law judge shall consider the factors under section 245C.22, subdivision 4, to determine whether the individual poses a risk of harm to any person receiving services from the license holder.

(h) Notwithstanding section 245C.30, subdivision 5, when a licensing sanction under section 245A.07 is based on the termination of a variance under section 245C.30, subdivision 4, the scope of the administrative law judge's review shall include the sanction and a determination whether the disqualification should be set aside, unless section 245C.24 prohibits the set-aside of the disqualification. In determining whether the disqualification should be set aside, the administrative law judge shall consider the factors under section 245C.22, subdivision 4, to determine whether the individual poses a risk of harm to any person receiving services from the license holder.

Sec. 15.

Minnesota Statutes 2012, section 245A.10, is amended to read:

245A.10 FEES.

Subdivision 1.

Application or license fee required, programs exempt from fee.

(a) Unless exempt under paragraph (b), the commissioner shall charge a fee for evaluation of applications and inspection of programs which are licensed under this chapter.

(b) Except as provided under subdivision 2, no application or license fee shall be charged for child foster care, adult foster care, deleted text begin ordeleted text end family and group family child carenew text begin , or a community residential settingnew text end .

Subd. 2.

County fees for background studies and licensing inspections.

(a) For purposes of family and group family child care licensing under this chapter, a county agency may charge a fee to an applicant or license holder to recover the actual cost of background studies, but in any case not to exceed $100 annually. A county agency may also charge a license fee to an applicant or license holder not to exceed $50 for a one-year license or $100 for a two-year license.

(b) A county agency may charge a fee to a legal nonlicensed child care provider or applicant for authorization to recover the actual cost of background studies completed under section 119B.125, but in any case not to exceed $100 annually.

(c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):

(1) in cases of financial hardship;

(2) if the county has a shortage of providers in the county's area;

(3) for new providers; or

(4) for providers who have attained at least 16 hours of training before seeking initial licensure.

(d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on an installment basis for up to one year. If the provider is receiving child care assistance payments from the state, the provider may have the fees under paragraph (a) or (b) deducted from the child care assistance payments for up to one year and the state shall reimburse the county for the county fees collected in this manner.

(e) For purposes of adult foster care and child foster care licensingnew text begin , and licensing the physical plant of a community residential setting,new text end under this chapter, a county agency may charge a fee to a corporate applicant or corporate license holder to recover the actual cost of licensing inspections, not to exceed $500 annually.

(f) Counties may elect to reduce or waive the fees in paragraph (e) under the following circumstances:

(1) in cases of financial hardship;

(2) if the county has a shortage of providers in the county's area; or

(3) for new providers.

Subd. 3.

Application fee for initial license or certification.

(a) For fees required under subdivision 1, an applicant for an initial license or certification issued by the commissioner shall submit a $500 application fee with each new application required under this subdivision. new text begin An applicant for an initial day services facility license under chapter 245D shall submit a $250 application fee with each new application. new text end The application fee shall not be prorated, is nonrefundable, and is in lieu of the annual license or certification fee that expires on December 31. The commissioner shall not process an application until the application fee is paid.

(b) Except as provided in clauses (1) to deleted text begin (4)deleted text end new text begin (3)new text end , an applicant shall apply for a license to provide services at a specific location.

(1) deleted text begin For a license to provide residential-based habilitation services to persons with developmental disabilities under chapter 245B, an applicant shall submit an application for each county in which the services will be provided. Upon licensure, the license holder may provide services to persons in that county plus no more than three persons at any one time in each of up to ten additional counties. A license holder in one county may not provide services under the home and community-based waiver for persons with developmental disabilities to more than three people in a second county without holding a separate license for that second county. Applicants or licensees providing services under this clause to not more than three persons remain subject to the inspection fees established in section 245A.10, subdivision 2, for each location. The license issued by the commissioner must state the name of each additional county where services are being provided to persons with developmental disabilities. A license holder must notify the commissioner before making any changes that would alter the license information listed under section 245A.04, subdivision 7, paragraph (a), including any additional counties where persons with developmental disabilities are being served.deleted text end new text begin For a license to provide home and community-based services to persons with disabilities or age 65 and older under chapter 245D, an applicant shall submit an application to provide services statewide. Notwithstanding paragraph (a), applications received by the commissioner between July 1, 2013, and December 31, 2013, for licensure of services provided under chapter 245D must include an application fee that is equal to the annual license renewal fee under subdivision 4, paragraph (b), or $500, whichever is less. Applications received by the commissioner after January 1, 2014, must include the application fee required under paragraph (a). Applicants who meet the modified application criteria identified in section 245A.042, subdivision 2, are exempt from paying an application fee.new text end

(2) deleted text begin For a license to provide supported employment, crisis respite, or semi-independent living services to persons with developmental disabilities under chapter 245B, an applicant shall submit a single application to provide services statewide.deleted text end

deleted text begin (3)deleted text end For a license to provide independent living assistance for youth under section 245A.22, an applicant shall submit a single application to provide services statewide.

deleted text begin (4)deleted text end new text begin (3)new text end For a license for a private agency to provide foster care or adoption services under Minnesota Rules, parts 9545.0755 to 9545.0845, an applicant shall submit a single application to provide services statewide.

new text begin (c) The initial application fee charged under this subdivision does not include the temporary license surcharge under section 16E.22. new text end

Subd. 4.

License or certification fee for certain programs.

(a) Child care centers shall pay an annual nonrefundable license fee based on the following schedule:

Licensed Capacity Child Care Center
License Fee
1 to 24 persons $200
25 to 49 persons $300
50 to 74 persons $400
75 to 99 persons $500
100 to 124 persons $600
125 to 149 persons $700
150 to 174 persons $800
175 to 199 persons $900
200 to 224 persons $1,000
225 or more persons $1,100

deleted text begin (b) A day training and habilitation program serving persons with developmental disabilities or related conditions shall pay an annual nonrefundable license fee based on the following schedule: deleted text end

deleted text begin Licensed Capacity deleted text end deleted text begin License Fee deleted text end
deleted text begin 1 to 24 persons deleted text end deleted text begin $800 deleted text end
deleted text begin 25 to 49 persons deleted text end deleted text begin $1,000 deleted text end
deleted text begin 50 to 74 persons deleted text end deleted text begin $1,200 deleted text end
deleted text begin 75 to 99 persons deleted text end deleted text begin $1,400 deleted text end
deleted text begin 100 to 124 persons deleted text end deleted text begin $1,600 deleted text end
deleted text begin 125 to 149 persons deleted text end deleted text begin $1,800 deleted text end
deleted text begin 150 or more persons deleted text end deleted text begin $2,000 deleted text end

deleted text begin Except as provided in paragraph (c), when a day training and habilitation program serves more than 50 percent of the same persons in two or more locations in a community, the day training and habilitation program shall pay a license fee based on the licensed capacity of the largest facility and the other facility or facilities shall be charged a license fee based on a licensed capacity of a residential program serving one to 24 persons. deleted text end

deleted text begin (c) When a day training and habilitation program serving persons with developmental disabilities or related conditions seeks a single license allowed under section 245B.07, subdivision 12, clause (2) or (3), the licensing fee must be based on the combined licensed capacity for each location. deleted text end

deleted text begin (d) A program licensed to provide supported employment services to persons with developmental disabilities under chapter 245B shall pay an annual nonrefundable license fee of $650. deleted text end

deleted text begin (e) A program licensed to provide crisis respite services to persons with developmental disabilities under chapter 245B shall pay an annual nonrefundable license fee of $700. deleted text end

deleted text begin (f) A program licensed to provide semi-independent living services to persons with developmental disabilities under chapter 245B shall pay an annual nonrefundable license fee of $700. deleted text end

deleted text begin (g) A program licensed to provide residential-based habilitation services under the home and community-based waiver for persons with developmental disabilities shall pay an annual license fee that includes a base rate of $690 plus $60 times the number of clients served on the first day of July of the current license year. deleted text end

deleted text begin (h) A residential program certified by the Department of Health as an intermediate care facility for persons with developmental disabilities (ICF/MR) and a noncertified residential program licensed to provide health or rehabilitative services for persons with developmental disabilities shall pay an annual nonrefundable license fee based on the following schedule: deleted text end

deleted text begin Licensed Capacity deleted text end deleted text begin License Fee deleted text end
deleted text begin 1 to 24 persons deleted text end deleted text begin $535 deleted text end
deleted text begin 25 to 49 persons deleted text end deleted text begin $735 deleted text end
deleted text begin 50 or more persons deleted text end deleted text begin $935 deleted text end

new text begin (b)(1) A program licensed to provide one or more of the home and community-based services and supports identified under chapter 245D to persons with disabilities or age 65 and older, shall pay an annual nonrefundable license fee based on revenues derived from the provision of services that would require licensure under chapter 245D during the calendar year immediately preceding the year in which the license fee is paid, according to the following schedule: new text end

new text begin License Holder Annual Revenue new text end new text begin License Fee new text end
new text begin less than or equal to $10,000 new text end new text begin $200 new text end
new text begin greater than $10,000 but less than or equal to $25,000 new text end new text begin $300 new text end
new text begin greater than $25,000 but less than or equal to $50,000 new text end new text begin $400 new text end
new text begin greater than $50,000 but less than or equal to $100,000 new text end new text begin $500 new text end
new text begin greater than $100,000 but less than or equal to $150,000 new text end new text begin $600 new text end
new text begin greater than $150,000 but less than or equal to $200,000 new text end new text begin $800 new text end
new text begin greater than $200,000 but less than or equal to $250,000 new text end new text begin $1,000 new text end
new text begin greater than $250,000 but less than or equal to $300,000 new text end new text begin $1,200 new text end
new text begin greater than $300,000 but less than or equal to $350,000 new text end new text begin $1,400 new text end
new text begin greater than $350,000 but less than or equal to $400,000 new text end new text begin $1,600 new text end
new text begin greater than $400,000 but less than or equal to $450,000 new text end new text begin $1,800 new text end
new text begin greater than $450,000 but less than or equal to $500,000 new text end new text begin $2,000 new text end
new text begin greater than $500,000 but less than or equal to $600,000 new text end new text begin $2,250 new text end
new text begin greater than $600,000 but less than or equal to $700,000 new text end new text begin $2,500 new text end
new text begin greater than $700,000 but less than or equal to $800,000 new text end new text begin $2,750 new text end
new text begin greater than $800,000 but less than or equal to $900,000 new text end new text begin $3,000 new text end
new text begin greater than $900,000 but less than or equal to $1,000,000 new text end new text begin $3,250 new text end
new text begin greater than $1,000,000 but less than or equal to $1,250,000 new text end new text begin $3,500 new text end
new text begin greater than $1,250,000 but less than or equal to $1,500,000 new text end new text begin $3,750 new text end
new text begin greater than $1,500,000 but less than or equal to $1,750,000 new text end new text begin $4,000 new text end
new text begin greater than $1,750,000 but less than or equal to $2,000,000 new text end new text begin $4,250 new text end
new text begin greater than $2,000,000 but less than or equal to $2,500,000 new text end new text begin $4,500 new text end
new text begin greater than $2,500,000 but less than or equal to $3,000,000 new text end new text begin $4,750 new text end
new text begin greater than $3,000,000 but less than or equal to $3,500,000 new text end new text begin $5,000 new text end
new text begin greater than $3,500,000 but less than or equal to $4,000,000 new text end new text begin $5,500 new text end
new text begin greater than $4,000,000 but less than or equal to $4,500,000 new text end new text begin $6,000 new text end
new text begin greater than $4,500,000 but less than or equal to $5,000,000 new text end new text begin $6,500 new text end
new text begin greater than $5,000,000 but less than or equal to $7,500,000 new text end new text begin $7,000 new text end
new text begin greater than $7,500,000 but less than or equal to $10,000,000 new text end new text begin $8,500 new text end
new text begin greater than $10,000,000 but less than or equal to $12,500,000 new text end new text begin $10,000 new text end
new text begin greater than $12,500,000 but less than or equal to $15,000,000 new text end new text begin $14,000 new text end
new text begin greater than $15,000,000 new text end new text begin $18,000 new text end

new text begin (2) If requested, the license holder shall provide the commissioner information to verify the license holder's annual revenues or other information as needed, including copies of documents submitted to the Department of Revenue. new text end

new text begin (3) At each annual renewal, a license holder may elect to pay the highest renewal fee, and not provide annual revenue information to the commissioner. new text end

new text begin (4) A license holder that knowingly provides the commissioner incorrect revenue amounts for the purpose of paying a lower license fee shall be subject to a civil penalty in the amount of double the fee the provider should have paid. new text end

new text begin (5) Notwithstanding clause (1), a license holder providing services under one or more licenses under chapter 245B that are in effect on May 15, 2013, shall pay an annual license fee for calendar years 2014, 2015, and 2016, equal to the total license fees paid by the license holder for all licenses held under chapter 245B for calendar year 2013. For calendar year 2017 and thereafter, the license holder shall pay an annual license fee according to clause (1). new text end

deleted text begin (i)deleted text end new text begin (c)new text end A chemical dependency treatment program licensed under Minnesota Rules, parts 9530.6405 to 9530.6505, to provide chemical dependency treatment shall pay an annual nonrefundable license fee based on the following schedule:

Licensed Capacity License Fee
1 to 24 persons $600
25 to 49 persons $800
50 to 74 persons $1,000
75 to 99 persons $1,200
100 or more persons $1,400

deleted text begin (j)deleted text end new text begin (d)new text end A chemical dependency program licensed under Minnesota Rules, parts 9530.6510 to 9530.6590, to provide detoxification services shall pay an annual nonrefundable license fee based on the following schedule:

Licensed Capacity License Fee
1 to 24 persons $760
25 to 49 persons $960
50 or more persons $1,160

deleted text begin (k)deleted text end new text begin (e)new text end Except for child foster care, a residential facility licensed under Minnesota Rules, chapter 2960, to serve children shall pay an annual nonrefundable license fee based on the following schedule:

Licensed Capacity License Fee
1 to 24 persons $1,000
25 to 49 persons $1,100
50 to 74 persons $1,200
75 to 99 persons $1,300
100 or more persons $1,400

deleted text begin (l)deleted text end new text begin (f)new text end A residential facility licensed under Minnesota Rules, parts 9520.0500 to 9520.0670, to serve persons with mental illness shall pay an annual nonrefundable license fee based on the following schedule:

Licensed Capacity License Fee
1 to 24 persons $2,525
25 or more persons $2,725

deleted text begin (m)deleted text end new text begin (g)new text end A residential facility licensed under Minnesota Rules, parts 9570.2000 to 9570.3400, to serve persons with physical disabilities shall pay an annual nonrefundable license fee based on the following schedule:

Licensed Capacity License Fee
1 to 24 persons $450
25 to 49 persons $650
50 to 74 persons $850
75 to 99 persons $1,050
100 or more persons $1,250

deleted text begin (n)deleted text end new text begin (h)new text end A program licensed to provide independent living assistance for youth under section 245A.22 shall pay an annual nonrefundable license fee of $1,500.

deleted text begin (o)deleted text end new text begin (i)new text end A private agency licensed to provide foster care and adoption services under Minnesota Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable license fee of $875.

deleted text begin (p)deleted text end new text begin (j)new text end A program licensed as an adult day care center licensed under Minnesota Rules, parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based on the following schedule:

Licensed Capacity License Fee
1 to 24 persons $500
25 to 49 persons $700
50 to 74 persons $900
75 to 99 persons $1,100
100 or more persons $1,300

deleted text begin (q)deleted text end new text begin (k)new text end A program licensed to provide treatment services to persons with sexual psychopathic personalities or sexually dangerous persons under Minnesota Rules, parts 9515.3000 to 9515.3110, shall pay an annual nonrefundable license fee of $20,000.

deleted text begin (r)deleted text end new text begin (l)new text end A mental health center or mental health clinic requesting certification for purposes of insurance and subscriber contract reimbursement under Minnesota Rules, parts 9520.0750 to 9520.0870, shall pay a certification fee of $1,550 per year. If the mental health center or mental health clinic provides services at a primary location with satellite facilities, the satellite facilities shall be certified with the primary location without an additional charge.

Subd. 6.

License not issued until license or certification fee is paid.

The commissioner shall not issue a license or certification until the license or certification fee is paid. The commissioner shall send a bill for the license or certification fee to the billing address identified by the license holder. If the license holder does not submit the license or certification fee payment by the due date, the commissioner shall send the license holder a past due notice. If the license holder fails to pay the license or certification fee by the due date on the past due notice, the commissioner shall send a final notice to the license holder informing the license holder that the program license will expire on December 31 unless the license fee is paid before December 31. If a license expires, the program is no longer licensed and, unless exempt from licensure under section 245A.03, subdivision 2, must not operate after the expiration date. After a license expires, if the former license holder wishes to provide licensed services, the former license holder must submit a new license application and application fee under subdivision 3.

Subd. 7.

Human services licensing fees to recover expenditures.

Notwithstanding section 16A.1285, subdivision 2, related to activities for which the commissioner charges a fee, the commissioner must plan to fully recover direct expenditures for licensing activities under this chapter over a five-year period. The commissioner may have anticipated expenditures in excess of anticipated revenues in a biennium by using surplus revenues accumulated in previous bienniums.

Subd. 8.

Deposit of license fees.

A human services licensing account is created in the state government special revenue fund. Fees collected under subdivisions 3 and 4 must be deposited in the human services licensing account and are annually appropriated to the commissioner for licensing activities authorized under this chapter.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2013. new text end

Sec. 16.

Minnesota Statutes 2012, section 245A.11, subdivision 2a, is amended to read:

Subd. 2a.

Adult foster carenew text begin and community residential settingnew text end license capacity.

(a) The commissioner shall issue adult foster carenew text begin and community residential settingnew text end licenses with a maximum licensed capacity of four beds, including nonstaff roomers and boarders, except that the commissioner may issue a license with a capacity of five beds, including roomers and boarders, according to paragraphs (b) to (f).

(b) deleted text begin An adult foster caredeleted text end new text begin Thenew text end license holder may have a maximum license capacity of five if all persons in care are age 55 or over and do not have a serious and persistent mental illness or a developmental disability.

(c) The commissioner may grant variances to paragraph (b) to allow a deleted text begin foster care providerdeleted text end new text begin facilitynew text end with a licensed capacity of five persons to admit an individual under the age of 55 if the variance complies with section 245A.04, subdivision 9, and approval of the variance is recommended by the county in which the licensed deleted text begin foster care providerdeleted text end new text begin facilitynew text end is located.

(d) The commissioner may grant variances to paragraph (b) to allow the use of a fifth bed for emergency crisis services for a person with serious and persistent mental illness or a developmental disability, regardless of age, if the variance complies with section 245A.04, subdivision 9, and approval of the variance is recommended by the county in which the licensed deleted text begin foster care providerdeleted text end new text begin facilitynew text end is located.

(e) The commissioner may grant a variance to paragraph (b) to allow for the use of a fifth bed for respite services, as defined in section 245A.02, for persons with disabilities, regardless of age, if the variance complies with sections 245A.03, subdivision 7, and 245A.04, subdivision 9, and approval of the variance is recommended by the county in which the licensed deleted text begin foster care providerdeleted text end new text begin facilitynew text end is deleted text begin licenseddeleted text end new text begin locatednew text end . Respite care may be provided under the following conditions:

(1) staffing ratios cannot be reduced below the approved level for the individuals being served in the home on a permanent basis;

(2) no more than two different individuals can be accepted for respite services in any calendar month and the total respite days may not exceed 120 days per program in any calendar year;

(3) the person receiving respite services must have his or her own bedroom, which could be used for alternative purposes when not used as a respite bedroom, and cannot be the room of another person who lives in the deleted text begin foster care homedeleted text end new text begin facilitynew text end ; and

(4) individuals living in the deleted text begin foster care homedeleted text end new text begin facilitynew text end must be notified when the variance is approved. The provider must give 60 days' notice in writing to the residents and their legal representatives prior to accepting the first respite placement. Notice must be given to residents at least two days prior to service initiation, or as soon as the license holder is able if they receive notice of the need for respite less than two days prior to initiation, each time a respite client will be served, unless the requirement for this notice is waived by the resident or legal guardian.

(f) The commissioner may issue an adult foster carenew text begin or community residential settingnew text end license with a capacity of five adults if the fifth bed does not increase the overall statewide capacity of licensed adult foster carenew text begin or community residential settingnew text end beds in homes that are not the primary residence of the license holder, as identified in a plan submitted to the commissioner by the county, when the capacity is recommended by the county licensing agency of the county in which the facility is located and if the recommendation verifies that:

(1) the facility meets the physical environment requirements in the adult foster care licensing rule;

(2) the five-bed living arrangement is specified for each resident in the resident's:

(i) individualized plan of care;

(ii) individual service plan under section 256B.092, subdivision 1b, if required; or

(iii) individual resident placement agreement under Minnesota Rules, part 9555.5105, subpart 19, if required;

(3) the license holder obtains written and signed informed consent from each resident or resident's legal representative documenting the resident's informed choice to remain living in the home and that the resident's refusal to consent would not have resulted in service termination; and

(4) the facility was licensed for adult foster care before March 1, 2011.

(g) The commissioner shall not issue a new adult foster care license under paragraph (f) after June 30, 2016. The commissioner shall allow a facility with an adult foster care license issued under paragraph (f) before June 30, 2016, to continue with a capacity of five adults if the license holder continues to comply with the requirements in paragraph (f).

Sec. 17.

Minnesota Statutes 2012, section 245A.11, subdivision 7, is amended to read:

Subd. 7.

Adult foster care; variance for alternate overnight supervision.

(a) The commissioner may grant a variance under section 245A.04, subdivision 9, to rule parts requiring a caregiver to be present in an adult foster care home during normal sleeping hours to allow for alternative methods of overnight supervision. The commissioner may grant the variance if the local county licensing agency recommends the variance and the county recommendation includes documentation verifying that:

(1) the county has approved the license holder's plan for alternative methods of providing overnight supervision and determined the plan protects the residents' health, safety, and rights;

(2) the license holder has obtained written and signed informed consent from each resident or each resident's legal representative documenting the resident's or legal representative's agreement with the alternative method of overnight supervision; and

(3) the alternative method of providing overnight supervision, which may include the use of technology, is specified for each resident in the resident's: (i) individualized plan of care; (ii) individual service plan under section 256B.092, subdivision 1b, if required; or (iii) individual resident placement agreement under Minnesota Rules, part 9555.5105, subpart 19, if required.

(b) To be eligible for a variance under paragraph (a), the adult foster care license holder must not have had a conditional license issued under section 245A.06, or any other licensing sanction issued under section 245A.07 during the prior 24 months based on failure to provide adequate supervision, health care services, or resident safety in the adult foster care home.

(c) A license holder requesting a variance under this subdivision to utilize technology as a component of a plan for alternative overnight supervision may request the commissioner's review in the absence of a county recommendation. Upon receipt of such a request from a license holder, the commissioner shall review the variance request with the county.

new text begin (d) A variance granted by the commissioner according to this subdivision before January 1, 2014, to a license holder for an adult foster care home must transfer with the license when the license converts to a community residential setting license under chapter 245D. The terms and conditions of the variance remain in effect as approved at the time the variance was granted. new text end

Sec. 18.

Minnesota Statutes 2012, section 245A.11, subdivision 7a, is amended to read:

Subd. 7a.

Alternate overnight supervision technology; adult foster care deleted text begin licensedeleted text end new text begin and community residential setting licensesnew text end .

(a) The commissioner may grant an applicant or license holder an adult foster carenew text begin or community residential settingnew text end license for a residence that does not have a caregiver in the residence during normal sleeping hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B,new text begin or section 245D.02, subdivision 33b,new text end but uses monitoring technology to alert the license holder when an incident occurs that may jeopardize the health, safety, or rights of a foster care recipient. The applicant or license holder must comply with all other requirements under Minnesota Rules, parts 9555.5105 to 9555.6265,new text begin or applicable requirements under chapter 245D,new text end and the requirements under this subdivision. The license printed by the commissioner must state in bold and large font:

(1) that the facility is under electronic monitoring; and

(2) the telephone number of the county's common entry point for making reports of suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.

(b) Applications for a license under this section must be submitted directly to the Department of Human Services licensing division. The licensing division must immediately notify the deleted text begin host county and lead county contract agency and the hostdeleted text end county licensing agency. The licensing division must collaborate with the county licensing agency in the review of the application and the licensing of the program.

(c) Before a license is issued by the commissioner, and for the duration of the license, the applicant or license holder must establish, maintain, and document the implementation of written policies and procedures addressing the requirements in paragraphs (d) through (f).

(d) The applicant or license holder must have policies and procedures that:

(1) establish characteristics of target populations that will be admitted into the home, and characteristics of populations that will not be accepted into the home;

(2) explain the discharge process when a deleted text begin foster care recipientdeleted text end new text begin resident served by the programnew text end requires overnight supervision or other services that cannot be provided by the license holder due to the limited hours that the license holder is on site;

(3) describe the types of events to which the program will respond with a physical presence when those events occur in the home during time when staff are not on site, and how the license holder's response plan meets the requirements in paragraph (e), clause (1) or (2);

(4) establish a process for documenting a review of the implementation and effectiveness of the response protocol for the response required under paragraph (e), clause (1) or (2). The documentation must include:

(i) a description of the triggering incident;

(ii) the date and time of the triggering incident;

(iii) the time of the response or responses under paragraph (e), clause (1) or (2);

(iv) whether the response met the resident's needs;

(v) whether the existing policies and response protocols were followed; and

(vi) whether the existing policies and protocols are adequate or need modification.

When no physical presence response is completed for a three-month period, the license holder's written policies and procedures must require a physical presence response drill to be conducted for which the effectiveness of the response protocol under paragraph (e), clause (1) or (2), will be reviewed and documented as required under this clause; and

(5) establish that emergency and nonemergency phone numbers are posted in a prominent location in a common area of the home where they can be easily observed by a person responding to an incident who is not otherwise affiliated with the home.

(e) The license holder must document and include in the license application which response alternative under clause (1) or (2) is in place for responding to situations that present a serious risk to the health, safety, or rights of deleted text begin people receiving foster care services in the homedeleted text end new text begin residents served by the programnew text end :

(1) response alternative (1) requires only the technology to provide an electronic notification or alert to the license holder that an event is underway that requires a response. Under this alternative, no more than ten minutes will pass before the license holder will be physically present on site to respond to the situation; or

(2) response alternative (2) requires the electronic notification and alert system under alternative (1), but more than ten minutes may pass before the license holder is present on site to respond to the situation. Under alternative (2), all of the following conditions are met:

(i) the license holder has a written description of the interactive technological applications that will assist the license holder in communicating with and assessing the needs related to the care, health, and safety of the foster care recipients. This interactive technology must permit the license holder to remotely assess the well being of the deleted text begin foster care recipientdeleted text end new text begin resident served by the programnew text end without requiring the initiation of the foster care recipient. Requiring the foster care recipient to initiate a telephone call does not meet this requirement;

(ii) the license holder documents how the remote license holder is qualified and capable of meeting the needs of the foster care recipients and assessing foster care recipients' needs under item (i) during the absence of the license holder on site;

(iii) the license holder maintains written procedures to dispatch emergency response personnel to the site in the event of an identified emergency; and

(iv) each deleted text begin foster care recipient'sdeleted text end new text begin resident'snew text end individualized plan of care, deleted text begin individual service plandeleted text end new text begin coordinated service and support plannew text end under deleted text begin sectiondeleted text end new text begin sections 256B.0913, subdivision 8; 256B.0915, subdivision 6; new text end 256B.092, subdivision 1bnew text begin ; and 256B.49, subdivision 15new text end , if required, or individual resident placement agreement under Minnesota Rules, part 9555.5105, subpart 19, if required, identifies the maximum response time, which may be greater than ten minutes, for the license holder to be on site for that deleted text begin foster care recipientdeleted text end new text begin residentnew text end .

(f) Each deleted text begin foster care recipient'sdeleted text end new text begin resident'snew text end placement agreement, individual service agreement, and plan must clearly state that the adult foster carenew text begin or community residential settingnew text end license category is a program without the presence of a caregiver in the residence during normal sleeping hours; the protocols in place for responding to situations that present a serious risk to the health, safety, or rights of deleted text begin foster care recipientsdeleted text end new text begin residents served by the programnew text end under paragraph (e), clause (1) or (2); and a signed informed consent from each deleted text begin foster care recipientdeleted text end new text begin resident served by the programnew text end or the person's legal representative documenting the person's or legal representative's agreement with placement in the program. If electronic monitoring technology is used in the home, the informed consent form must also explain the following:

(1) how any electronic monitoring is incorporated into the alternative supervision system;

(2) the backup system for any electronic monitoring in times of electrical outages or other equipment malfunctions;

(3) how the caregiversnew text begin or direct support staffnew text end are trained on the use of the technology;

(4) the event types and license holder response times established under paragraph (e);

(5) how the license holder protects deleted text begin the foster care recipient'sdeleted text end new text begin each resident'snew text end privacy related to electronic monitoring and related to any electronically recorded data generated by the monitoring system. A deleted text begin foster care recipientdeleted text end new text begin resident served by the programnew text end may not be removed from a program under this subdivision for failure to consent to electronic monitoring. The consent form must explain where and how the electronically recorded data is stored, with whom it will be shared, and how long it is retained; and

(6) the risks and benefits of the alternative overnight supervision system.

The written explanations under clauses (1) to (6) may be accomplished through cross-references to other policies and procedures as long as they are explained to the person giving consent, and the person giving consent is offered a copy.

(g) Nothing in this section requires the applicant or license holder to develop or maintain separate or duplicative policies, procedures, documentation, consent forms, or individual plans that may be required for other licensing standards, if the requirements of this section are incorporated into those documents.

(h) The commissioner may grant variances to the requirements of this section according to section 245A.04, subdivision 9.

(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and contractors affiliated with the license holder.

(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to remotely determine what action the license holder needs to take to protect the well-being of the foster care recipient.

(k) The commissioner shall evaluate license applications using the requirements in paragraphs (d) to (f). The commissioner shall provide detailed application forms, including a checklist of criteria needed for approval.

(l) To be eligible for a license under paragraph (a), the adult foster carenew text begin or community residential settingnew text end license holder must not have had a conditional license issued under section 245A.06 or any licensing sanction under section 245A.07 during the prior 24 months based on failure to provide adequate supervision, health care services, or resident safety in the adult foster care homenew text begin or community residential settingnew text end .

(m) The commissioner shall review an application for an alternative overnight supervision license within 60 days of receipt of the application. When the commissioner receives an application that is incomplete because the applicant failed to submit required documents or that is substantially deficient because the documents submitted do not meet licensing requirements, the commissioner shall provide the applicant written notice that the application is incomplete or substantially deficient. In the written notice to the applicant, the commissioner shall identify documents that are missing or deficient and give the applicant 45 days to resubmit a second application that is substantially complete. An applicant's failure to submit a substantially complete application after receiving notice from the commissioner is a basis for license denial under section 245A.05. The commissioner shall complete subsequent review within 30 days.

(n) Once the application is considered complete under paragraph (m), the commissioner will approve or deny an application for an alternative overnight supervision license within 60 days.

(o) For the purposes of this subdivision, "supervision" means:

(1) oversight by a caregivernew text begin or direct support staffnew text end as specified in the individual resident's place agreementnew text begin or coordinated service and support plannew text end and awareness of the resident's needs and activities; and

(2) the presence of a caregivernew text begin or direct support staffnew text end in a residence during normal sleeping hours, unless a determination has been made and documented in the individual'snew text begin coordinated service andnew text end support plan that the individual does not require the presence of a caregivernew text begin or direct support staffnew text end during normal sleeping hours.

Sec. 19.

Minnesota Statutes 2012, section 245A.11, subdivision 7b, is amended to read:

Subd. 7b.

Adult foster care data privacy and security.

(a) An adult foster carenew text begin or community residential settingnew text end license holder who creates, collects, records, maintains, stores, or discloses any individually identifiable recipient data, whether in an electronic or any other format, must comply with the privacy and security provisions of applicable privacy laws and regulations, including:

(1) the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-1; and the HIPAA Privacy Rule, Code of Federal Regulations, title 45, part 160, and subparts A and E of part 164; and

(2) the Minnesota Government Data Practices Act as codified in chapter 13.

(b) For purposes of licensure, the license holder shall be monitored for compliance with the following data privacy and security provisions:

(1) the license holder must control access to data on deleted text begin foster care recipientsdeleted text end new text begin residents served by the programnew text end according to the definitions of public and private data on individuals under section 13.02; classification of the data on individuals as private under section 13.46, subdivision 2; and control over the collection, storage, use, access, protection, and contracting related to data according to section 13.05, in which the license holder is assigned the duties of a government entity;

(2) the license holder must provide each deleted text begin foster care recipientdeleted text end new text begin resident served by the programnew text end with a notice that meets the requirements under section 13.04, in which the license holder is assigned the duties of the government entity, and that meets the requirements of Code of Federal Regulations, title 45, part 164.52. The notice shall describe the purpose for collection of the data, and to whom and why it may be disclosed pursuant to law. The notice must inform the deleted text begin recipientdeleted text end new text begin individualnew text end that the license holder uses electronic monitoring and, if applicable, that recording technology is used;

(3) the license holder must not install monitoring cameras in bathrooms;

(4) electronic monitoring cameras must not be concealed from the deleted text begin foster care recipientsdeleted text end new text begin residents served by the programnew text end ; and

(5) electronic video and audio recordings of deleted text begin foster care recipientsdeleted text end new text begin residents served by the programnew text end shall be stored by the license holder for five days unless: (i) a deleted text begin foster care recipientdeleted text end new text begin resident served by the programnew text end or legal representative requests that the recording be held longer based on a specific report of alleged maltreatment; or (ii) the recording captures an incident or event of alleged maltreatment under section 626.556 or 626.557 or a crime under chapter 609. When requested by a deleted text begin recipientdeleted text end new text begin resident served by the programnew text end or when a recording captures an incident or event of alleged maltreatment or a crime, the license holder must maintain the recording in a secured area for no longer than 30 days to give the investigating agency an opportunity to make a copy of the recording. The investigating agency will maintain the electronic video or audio recordings as required in section 626.557, subdivision 12b.

(c) The commissioner shall develop, and make available to license holders and county licensing workers, a checklist of the data privacy provisions to be monitored for purposes of licensure.

Sec. 20.

Minnesota Statutes 2012, section 245A.11, subdivision 8, is amended to read:

Subd. 8.

Community residential setting license.

(a) The commissioner shall establish provider standards for residential support services that integrate service standards and the residential setting under one license. The commissioner shall propose statutory language and an implementation plan for licensing requirements for residential support services to the legislature by January 15, 2012, as a component of the quality outcome standards recommendations required by Laws 2010, chapter 352, article 1, section 24.

(b) Providers licensed under chapter 245B, and providing, contracting, or arranging for services in settings licensed as adult foster care under Minnesota Rules, parts 9555.5105 to 9555.6265deleted text begin , or child foster care under Minnesota Rules, parts 2960.3000 to 2960.3340deleted text end ; and meeting the provisions of deleted text begin section 256B.092, subdivision 11, paragraph (b)deleted text end new text begin section 245D.02, subdivision 4anew text end , must be required to obtain a community residential setting license.

Sec. 21.

Minnesota Statutes 2012, section 245A.16, subdivision 1, is amended to read:

Subdivision 1.

Delegation of authority to agencies.

(a) County agencies and private agencies that have been designated or licensed by the commissioner to perform licensing functions and activities under section 245A.04 and background studies for family child care under chapter 245C; to recommend denial of applicants under section 245A.05; to issue correction orders, to issue variances, and recommend a conditional license under section 245A.06, or to recommend suspending or revoking a license or issuing a fine under section 245A.07, shall comply with rules and directives of the commissioner governing those functions and with this section. The following variances are excluded from the delegation of variance authority and may be issued only by the commissioner:

(1) dual licensure of family child care and child foster care, dual licensure of child and adult foster care, and adult foster care and family child care;

(2) adult foster care maximum capacity;

(3) adult foster care minimum age requirement;

(4) child foster care maximum age requirement;

(5) variances regarding disqualified individuals except that county agencies may issue variances under section 245C.30 regarding disqualified individuals when the county is responsible for conducting a consolidated reconsideration according to sections 245C.25 and 245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination and a disqualification based on serious or recurring maltreatment; deleted text begin anddeleted text end

(6) the required presence of a caregiver in the adult foster care residence during normal sleeping hoursnew text begin ; andnew text end

new text begin (7) variances for community residential setting licenses under chapter 245Dnew text end .

Except as provided in section 245A.14, subdivision 4, paragraph (e), a county agency must not grant a license holder a variance to exceed the maximum allowable family child care license capacity of 14 children.

(b) County agencies must report information about disqualification reconsiderations under sections 245C.25 and 245C.27, subdivision 2, paragraphs (a) and (b), and variances granted under paragraph (a), clause (5), to the commissioner at least monthly in a format prescribed by the commissioner.

(c) For family day care programs, the commissioner may authorize licensing reviews every two years after a licensee has had at least one annual review.

(d) For family adult day services programs, the commissioner may authorize licensing reviews every two years after a licensee has had at least one annual review.

(e) A license issued under this section may be issued for up to two years.

new text begin (f) During implementation of chapter 245D, the commissioner shall consider: new text end

new text begin (1) the role of counties in quality assurance; new text end

new text begin (2) the duties of county licensing staff; and new text end

new text begin (3) the possible use of joint powers agreements, according to section 471.59, with counties through which some licensing duties under chapter 245D may be delegated by the commissioner to the counties. new text end

new text begin Any consideration related to this paragraph must meet all of the requirements of the corrective action plan ordered by the federal Centers for Medicare and Medicaid Services. new text end

Sec. 22.

Minnesota Statutes 2012, section 245D.02, is amended to read:

245D.02 DEFINITIONS.

Subdivision 1.

Scope.

The terms used in this chapter have the meanings given them in this section.

Subd. 2.

Annual and annually.

"Annual" and "annually" have the meaning given in section 245A.02, subdivision 2b.

new text begin Subd. 2a. new text end

new text begin Authorized representative. new text end

new text begin "Authorized representative" means a parent, family member, advocate, or other adult authorized by the person or the person's legal representative, to serve as a representative in connection with the provision of services licensed under this chapter. This authorization must be in writing or by another method that clearly indicates the person's free choice. The authorized representative must have no financial interest in the provision of any services included in the person's service delivery plan and must be capable of providing the support necessary to assist the person in the use of home and community-based services licensed under this chapter. new text end

new text begin Subd. 2b. new text end

new text begin Aversive procedure. new text end

new text begin "Aversive procedure" means the application of an aversive stimulus contingent upon the occurrence of a behavior for the purposes of reducing or eliminating the behavior. new text end

new text begin Subd. 2c. new text end

new text begin Aversive stimulus. new text end

new text begin "Aversive stimulus" means an object, event, or situation that is presented immediately following a behavior in an attempt to suppress the behavior. Typically, an aversive stimulus is unpleasant and penalizes or confines. new text end

Subd. 3.

Case manager.

"Case manager" means the individual designated to provide waiver case management services, care coordination, or long-term care consultation, as specified in sections 256B.0913, 256B.0915, 256B.092, and 256B.49, or successor provisions.

new text begin Subd. 3a. new text end

new text begin Certification. new text end

new text begin "Certification" means the commissioner's written authorization for a license holder to provide specialized services based on certification standards in section 245D.33. The term certification and its derivatives have the same meaning and may be substituted for the term licensure and its derivatives in this chapter and chapter 245A. new text end

new text begin Subd. 3b. new text end

new text begin Chemical restraint. new text end

new text begin "Chemical restraint" means the administration of a drug or medication to control the person's behavior or restrict the person's freedom of movement and is not a standard treatment or dosage for the person's medical or psychological condition. new text end

Subd. 4.

Commissioner.

"Commissioner" means the commissioner of the Department of Human Services or the commissioner's designated representative.

new text begin Subd. 4a. new text end

new text begin Community residential setting. new text end

new text begin "Community residential setting" means a residential program as identified in section 245A.11, subdivision 8, where residential supports and services identified in section 245D.03, subdivision 1, paragraph (c), clause (3), items (i) and (ii), are provided and the license holder is the owner, lessor, or tenant of the facility licensed according to this chapter, and the license holder does not reside in the facility. new text end

new text begin Subd. 4b. new text end

new text begin Coordinated service and support plan. new text end

new text begin "Coordinated service and support plan" has the meaning given in sections 256B.0913, subdivision 8; 256B.0915, subdivision 6; 256B.092, subdivision 1b; and 256B.49, subdivision 15, or successor provisions. new text end

new text begin Subd. 4c. new text end

new text begin Coordinated service and support plan addendum. new text end

new text begin "Coordinated service and support plan addendum" means the documentation that this chapter requires of the license holder for each person receiving services. new text end

new text begin Subd. 4d. new text end

new text begin Corporate foster care. new text end

new text begin "Corporate foster care" means a child foster residence setting licensed according to Minnesota Rules, parts 2960.0010 to 2960.3340, or an adult foster care home licensed according to Minnesota Rules, parts 9555.5105 to 9555.6265, where the license holder does not live in the home. new text end

new text begin Subd. 4e. new text end

new text begin Cultural competence or culturally competent. new text end

new text begin "Cultural competence" or "culturally competent" means the ability and the will to respond to the unique needs of a person that arise from the person's culture and the ability to use the person's culture as a resource or tool to assist with the intervention and help meet the person's needs. new text end

new text begin Subd. 4f. new text end

new text begin Day services facility. new text end

new text begin "Day services facility" means a facility licensed according to this chapter at which persons receive day services licensed under this chapter from the license holder's direct support staff for a cumulative total of more than 30 days within any 12-month period and the license holder is the owner, lessor, or tenant of the facility. new text end

Subd. 5.

Department.

"Department" means the Department of Human Services.

new text begin Subd. 5a. new text end

new text begin Deprivation procedure. new text end

new text begin "Deprivation procedure" means the removal of a positive reinforcer following a response resulting in, or intended to result in, a decrease in the frequency, duration, or intensity of that response. Oftentimes the positive reinforcer available is goods, services, or activities to which the person is normally entitled. The removal is often in the form of a delay or postponement of the positive reinforcer. new text end

Subd. 6.

Direct contact.

"Direct contact" has the meaning given in section 245C.02, subdivision 11, and is used interchangeably with the term "direct new text begin support new text end service."

new text begin Subd. 6a. new text end

new text begin Direct support staff or staff. new text end

new text begin "Direct support staff" or "staff" means employees of the license holder who have direct contact with persons served by the program and includes temporary staff or subcontractors, regardless of employer, providing program services for hire under the control of the license holder who have direct contact with persons served by the program. new text end

Subd. 7.

Drug.

"Drug" has the meaning given in section 151.01, subdivision 5.

Subd. 8.

Emergency.

"Emergency" means any event that affects the ordinary daily operation of the program including, but not limited to, fires, severe weather, natural disasters, power failures, or other events that threaten the immediate health and safety of a person receiving services and that require calling 911, emergency evacuation, moving to an emergency shelter, or temporary closure or relocation of the program to another facility or service sitenew text begin for more than 24 hoursnew text end .

new text begin Subd. 8a. new text end

new text begin Emergency use of manual restraint. new text end

new text begin "Emergency use of manual restraint" means using a manual restraint when a person poses an imminent risk of physical harm to self or others and is the least restrictive intervention that would achieve safety. Property damage, verbal aggression, or a person's refusal to receive or participate in treatment or programming on their own, do not constitute an emergency. new text end

new text begin Subd. 8b. new text end

new text begin Expanded support team. new text end

new text begin "Expanded support team" means the members of the support team defined in subdivision 46, and a licensed health or mental health professional or other licensed, certified, or qualified professionals or consultants working with the person and included in the team at the request of the person or the person's legal representative. new text end

new text begin Subd. 8c. new text end

new text begin Family foster care. new text end

new text begin "Family foster care" means a child foster family setting licensed according to Minnesota Rules, parts 2960.0010 to 2960.3340, or an adult foster care home licensed according to Minnesota Rules, parts 9555.5105 to 9555.6265, where the license holder lives in the home. new text end

Subd. 9.

Health services.

"Health services" means any service or treatment consistent with the physical and mental health needs of the person, such as medication administration and monitoring, medical, dental, nutritional, health monitoring, wellness education, and exercise.

Subd. 10.

Home and community-based services.

"Home and community-based services" means the services deleted text begin subject to the provisions of this chapterdeleted text end new text begin identified in section 245D.03, subdivision 1,new text end and new text begin as new text end defined innew text begin :new text end

new text begin (1)new text end the deleted text begin federaldeleted text end new text begin federally approvednew text end waiver plans governed by United States Code, title 42, sections 1396 et seq., deleted text begin or the state's alternative care program according to section 256B.0913,deleted text end including new text begin the waivers for persons with disabilities under section 256B.49, subdivision 11, including new text end the brain injury (BI) waiverdeleted text begin ,deleted text end new text begin plan;new text end the community alternative care (CAC) waiverdeleted text begin ,deleted text end new text begin plan;new text end the community alternatives for disabled individuals (CADI) waiverdeleted text begin ,deleted text end new text begin plan;new text end the developmental disability (DD) waiverdeleted text begin ,deleted text end new text begin plan under section 256B.092, subdivision 5;new text end the elderly waiver (EW)deleted text begin , anddeleted text end new text begin plan under section 256B.0915, subdivision 1; or successor plans respective to each waiver;new text end new text begin ornew text end

new text begin (2) new text end the alternative care (AC) programnew text begin under section 256B.0913new text end .

Subd. 11.

Incident.

"Incident" means an occurrence deleted text begin that affects thedeleted text end new text begin which involves a person and requires the program to make a response that is not a part of the program's new text end ordinary provision of services to deleted text begin adeleted text end new text begin thatnew text end personnew text begin ,new text end and includes deleted text begin any of the followingdeleted text end :

(1) serious injury new text begin of a person new text end as determined by section 245.91, subdivision 6;

(2) a person's death;

(3) any medical emergency, unexpected serious illness, or significant unexpected change in an illness or medical conditiondeleted text begin , or the mental health statusdeleted text end of a person that requires deleted text begin callingdeleted text end new text begin the program to callnew text end 911 deleted text begin or a mental health crisis intervention teamdeleted text end , physician treatment, or hospitalization;

new text begin (4) any mental health crisis that requires the program to call 911 or a mental health crisis intervention team; new text end

new text begin (5) an act or situation involving a person that requires the program to call 911, law enforcement, or the fire department; new text end

deleted text begin (4)deleted text end new text begin (6)new text end a person's unauthorized or unexplained absence from a program;

deleted text begin (5)deleted text end new text begin (7)new text end deleted text begin physical aggressiondeleted text end new text begin conductnew text end by a person receiving services against another person receiving services that deleted text begin causes physical pain, injury, or persistent emotional distress, including, but not limited to, hitting, slapping, kicking, scratching, pinching, biting, pushing, and spitting;deleted text end new text begin :new text end

new text begin (i) is so severe, pervasive, or objectively offensive that it substantially interferes with a person's opportunities to participate in or receive service or support; new text end

new text begin (ii) places the person in actual and reasonable fear of harm; new text end

new text begin (iii) places the person in actual and reasonable fear of damage to property of the person; or new text end

new text begin (iv) substantially disrupts the orderly operation of the program; new text end

deleted text begin (6)deleted text end new text begin (8)new text end any sexual activity between persons receiving services involving force or coercion as defined under section 609.341, subdivisions 3 and 14; deleted text begin ordeleted text end

new text begin (9) any emergency use of manual restraint as identified in section 245D.061; or new text end

deleted text begin (7)deleted text end new text begin (10)new text end a report of alleged or suspected child or vulnerable adult maltreatment under section 626.556 or 626.557.

new text begin Subd. 11a. new text end

new text begin Intermediate care facility for persons with developmental disabilities or ICF/DD. new text end

new text begin "Intermediate care facility for persons with developmental disabilities" or "ICF/DD" means a residential program licensed to serve four or more persons with developmental disabilities under section 252.28 and chapter 245A and licensed as a supervised living facility under chapter 144, which together are certified by the Department of Health as an intermediate care facility for persons with developmental disabilities. new text end

new text begin Subd. 11b. new text end

new text begin Least restrictive alternative. new text end

new text begin "Least restrictive alternative" means the alternative method for providing supports and services that is the least intrusive and most normalized given the level of supervision and protection required for the person. This level of supervision and protection allows risk taking to the extent that there is no reasonable likelihood that serious harm will happen to the person or others. new text end

Subd. 12.

Legal representative.

"Legal representative" means the parent of a person who is under 18 years of age, a court-appointed guardian, or other representative with legal authority to make decisions about services for a person. new text begin Other representatives with legal authority to make decisions include but are not limited to a health care agent or an attorney-in-fact authorized through a health care directive or power of attorney.new text end

Subd. 13.

License.

"License" has the meaning given in section 245A.02, subdivision 8.

Subd. 14.

Licensed health professional.

"Licensed health professional" means a person licensed in Minnesota to practice those professions described in section 214.01, subdivision 2.

Subd. 15.

License holder.

"License holder" has the meaning given in section 245A.02, subdivision 9.

new text begin Subd. 15a. new text end

new text begin Manual restraint. new text end

new text begin "Manual restraint" means physical intervention intended to hold a person immobile or limit a person's voluntary movement by using body contact as the only source of physical restraint. new text end

new text begin Subd. 15b. new text end

new text begin Mechanical restraint. new text end

new text begin Except for devices worn by the person that trigger electronic alarms to warn staff that a person is leaving a room or area, which do not, in and of themselves, restrict freedom of movement, or the use of adaptive aids or equipment or orthotic devices ordered by a health care professional used to treat or manage a medical condition, "mechanical restraint" means the use of devices, materials, or equipment attached or adjacent to the person's body, or the use of practices that are intended to restrict freedom of movement or normal access to one's body or body parts, or limits a person's voluntary movement or holds a person immobile as an intervention precipitated by a person's behavior. The term applies to the use of mechanical restraint used to prevent injury with persons who engage in self-injurious behaviors, such as head-banging, gouging, or other actions resulting in tissue damage that have caused or could cause medical problems resulting from the self-injury. new text end

Subd. 16.

Medication.

"Medication" means a prescription drug or over-the-counter drug. For purposes of this chapter, "medication" includes dietary supplements.

deleted text begin Subd. 17. deleted text end

deleted text begin Medication administration. deleted text end

deleted text begin "Medication administration" means performing the following set of tasks to ensure a person takes both prescription and over-the-counter medications and treatments according to orders issued by appropriately licensed professionals, and includes the following: deleted text end

deleted text begin (1) checking the person's medication record; deleted text end

deleted text begin (2) preparing the medication for administration; deleted text end

deleted text begin (3) administering the medication to the person; deleted text end

deleted text begin (4) documenting the administration of the medication or the reason for not administering the medication; and deleted text end

deleted text begin (5) reporting to the prescriber or a nurse any concerns about the medication, including side effects, adverse reactions, effectiveness, or the person's refusal to take the medication or the person's self-administration of the medication. deleted text end

deleted text begin Subd. 18. deleted text end

deleted text begin Medication assistance. deleted text end

deleted text begin "Medication assistance" means providing verbal or visual reminders to take regularly scheduled medication, which includes either of the following: deleted text end

deleted text begin (1) bringing to the person and opening a container of previously set up medications and emptying the container into the person's hand or opening and giving the medications in the original container to the person, or bringing to the person liquids or food to accompany the medication; or deleted text end

deleted text begin (2) providing verbal or visual reminders to perform regularly scheduled treatments and exercises. deleted text end

deleted text begin Subd. 19. deleted text end

deleted text begin Medication management. deleted text end

deleted text begin "Medication management" means the provision of any of the following: deleted text end

deleted text begin (1) medication-related services to a person; deleted text end

deleted text begin (2) medication setup; deleted text end

deleted text begin (3) medication administration; deleted text end

deleted text begin (4) medication storage and security; deleted text end

deleted text begin (5) medication documentation and charting; deleted text end

deleted text begin (6) verification and monitoring of effectiveness of systems to ensure safe medication handling and administration; deleted text end

deleted text begin (7) coordination of medication refills; deleted text end

deleted text begin (8) handling changes to prescriptions and implementation of those changes; deleted text end

deleted text begin (9) communicating with the pharmacy; or deleted text end

deleted text begin (10) coordination and communication with prescriber. deleted text end

deleted text begin For the purposes of this chapter, medication management does not mean "medication therapy management services" as identified in section 256B.0625, subdivision 13h. deleted text end

Subd. 20.

Mental health crisis intervention team.

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

new text begin Subd. 20a. new text end

new text begin Most integrated setting. new text end

new text begin "Most integrated setting" means a setting that enables individuals with disabilities to interact with nondisabled persons to the fullest extent possible. new text end

Subd. 21.

Over-the-counter drug.

"Over-the-counter drug" means a drug that is not required by federal law to bear the statement "Caution: Federal law prohibits dispensing without prescription."

new text begin Subd. 21a. new text end

new text begin Outcome. new text end

new text begin "Outcome" means the behavior, action, or status attained by the person that can be observed, measured, and determined reliable and valid. new text end

Subd. 22.

Person.

"Person" has the meaning given in section 245A.02, subdivision 11.

Subd. 23.

Person with a disability.

"Person with a disability" means a person determined to have a disability by the commissioner's state medical review team as identified in section 256B.055, subdivision 7, the Social Security Administration, or the person is determined to have a developmental disability as defined in Minnesota Rules, part 9525.0016, subpart 2, item B, or a related condition as defined in section 252.27, subdivision 1a.

new text begin Subd. 23a. new text end

new text begin Physician. new text end

new text begin "Physician" means a person who is licensed under chapter 147. new text end

new text begin Subd. 23b. new text end

new text begin Positive support transition plan. new text end

new text begin "Positive support transition plan" means the plan required in section 245D.06, subdivision 5, paragraph (b), to be developed by the expanded support team to implement positive support strategies to: new text end

new text begin (1) eliminate the use of prohibited procedures as identified in section 245D.06, subdivision 5, paragraph (a); new text end

new text begin (2) avoid the emergency use of manual restraint as identified in section 245D.061; and new text end

new text begin (3) prevent the person from physically harming self or others. new text end

Subd. 24.

Prescriber.

"Prescriber" means a deleted text begin licensed practitioner as defined in section 151.01, subdivision 23,deleted text end new text begin personnew text end who is authorized under sectionnew text begin 148.235; 151.01, subdivision 23; ornew text end 151.37 to prescribe drugs. deleted text begin For the purposes of this chapter, the term "prescriber" is used interchangeably with "physician."deleted text end

Subd. 25.

Prescription drug.

"Prescription drug" has the meaning given in section 151.01, subdivision deleted text begin 17deleted text end new text begin 16new text end .

Subd. 26.

Program.

"Program" means either the nonresidential or residential program as defined in section 245A.02, subdivisions 10 and 14.

Subd. 27.

Psychotropic medication.

"Psychotropic medication" means any medication prescribed to treat the symptoms of mental illness that affect thought processes, mood, sleep, or behavior. The major classes of psychotropic medication are antipsychotic (neuroleptic), antidepressant, antianxiety, mood stabilizers, anticonvulsants, and stimulants and nonstimulants for the treatment of attention deficit/hyperactivity disorder. Other miscellaneous medications are considered to be a psychotropic medication when they are specifically prescribed to treat a mental illness or to control or alter behavior.

Subd. 28.

Restraint.

"Restraint" means deleted text begin physical or mechanicaldeleted text end new text begin manual restraint as defined in subdivision 15a or mechanical restraint as defined in subdivision 15b, or any other form of restraint that results innew text end limiting of the free and normal movement of body or limbs.

Subd. 29.

Seclusion.

"Seclusion" means deleted text begin separating a person from others in a way that prevents social contact and prevents the person from leaving the situation if he or she choosesdeleted text end new text begin the placement of a person alone in a room from which exit is prohibited by a staff person or a mechanism such as a lock, a device, or an object positioned to hold the door closed or otherwise prevent the person from leaving the roomnew text end .

new text begin Subd. 29a. new text end

new text begin Self-determination. new text end

new text begin "Self-determination" means the person makes decisions independently, plans for the person's own future, determines how money is spent for the person's supports, and takes responsibility for making these decisions. If a person has a legal representative, the legal representative's decision-making authority is limited to the scope of authority granted by the court or allowed in the document authorizing the legal representative to act. new text end

new text begin Subd. 29b. new text end

new text begin Semi-independent living services. new text end

new text begin "Semi-independent living services" has the meaning given in section 252.275. new text end

Subd. 30.

Service.

"Service" means care, training, supervision, counseling, consultation, or medication assistance assigned to the license holder in the new text begin coordinated new text end service new text begin and support new text end plan.

deleted text begin Subd. 31. deleted text end

deleted text begin Service plan. deleted text end

deleted text begin "Service plan" means the individual service plan or individual care plan identified in sections 256B.0913, 256B.0915, 256B.092, and 256B.49, or successor provisions, and includes any support plans or service needs identified as a result of long-term care consultation, or a support team meeting that includes the participation of the person, the person's legal representative, and case manager, or assigned to a license holder through an authorized service agreement. deleted text end

Subd. 32.

Service site.

"Service site" means the location where the service is provided to the person, including, but not limited to, a facility licensed according to chapter 245A; a location where the license holder is the owner, lessor, or tenant; a person's own home; or a community-based location.

deleted text begin Subd. 33. deleted text end

deleted text begin Staff. deleted text end

deleted text begin "Staff" means an employee who will have direct contact with a person served by the facility, agency, or program. deleted text end

new text begin Subd. 33a. new text end

new text begin Supervised living facility. new text end

new text begin "Supervised living facility" has the meaning given in Minnesota Rules, part 4665.0100, subpart 10. new text end

new text begin Subd. 33b. new text end

new text begin Supervision. new text end

new text begin (a) "Supervision" means: new text end

new text begin (1) oversight by direct support staff as specified in the person's coordinated service and support plan or coordinated service and support plan addendum and awareness of the person's needs and activities; new text end

new text begin (2) responding to situations that present a serious risk to the health, safety, or rights of the person while services are being provided; and new text end

new text begin (3) the presence of direct support staff at a service site while services are being provided, unless a determination has been made and documented in the person's coordinated service and support plan or coordinated service and support plan addendum that the person does not require the presence of direct support staff while services are being provided. new text end

new text begin (b) For the purposes of this definition, "while services are being provided," means any period of time during which the license holder will seek reimbursement for services. new text end

Subd. 34.

Support team.

"Support team" means the service planning team identified in section 256B.49, subdivision 15, or the interdisciplinary team identified in Minnesota Rules, part 9525.0004, subpart 14.

new text begin Subd. 34a. new text end

new text begin Time out. new text end

new text begin "Time out" means removing a person involuntarily from an ongoing activity to a room, either locked or unlocked, or otherwise separating a person from others in a way that prevents social contact and prevents the person from leaving the situation if the person chooses. For the purpose of chapter 245D, "time out" does not mean voluntary removal or self-removal for the purpose of calming, prevention of escalation, or de-escalation of behavior for a period of up to 15 minutes. "Time out" does not include a person voluntarily moving from an ongoing activity to an unlocked room or otherwise separating from a situation or social contact with others if the person chooses. For the purposes of this definition, "voluntarily" means without being forced, compelled, or coerced. new text end

deleted text begin Subd. 35. deleted text end

deleted text begin Unit of government. deleted text end

deleted text begin "Unit of government" means every city, county, town, school district, other political subdivisions of the state, and any agency of the state or the United States, and includes any instrumentality of a unit of government. deleted text end

new text begin Subd. 35a. new text end

new text begin Treatment. new text end

new text begin "Treatment" means the provision of care, other than medications, ordered or prescribed by a licensed health or mental health professional, provided to a person to cure, rehabilitate, or ease symptoms. new text end

Subd. 36.

Volunteer.

"Volunteer" means an individual who, under the direction of the license holder, provides direct services without pay to a person served by the license holder.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 23.

Minnesota Statutes 2012, section 245D.03, is amended to read:

245D.03 APPLICABILITY AND EFFECT.

Subdivision 1.

Applicability.

new text begin (a) new text end 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 deleted text begin the followingdeleted text end new text begin basic supportnew text end servicesdeleted text begin :deleted text end new text begin and intensive support services.new text end

deleted text begin (1) housing access coordination as defined under the current BI, CADI, and DD waiver plans or successor plans; deleted text end

deleted text begin (2) respite services as defined under the current CADI, BI, CAC, DD, and EW waiver plans or successor plans when the provider is an individual who is not an employee of a residential or nonresidential program licensed by the Department of Human Services or the Department of Health that is otherwise providing the respite service; deleted text end

deleted text begin (3) behavioral programming as defined under the current BI and CADI waiver plans or successor plans; deleted text end

deleted text begin (4) specialist services as defined under the current DD waiver plan or successor plans; deleted text end

deleted text begin (5) companion services as defined under the current BI, CADI, and EW waiver plans or successor plans, excluding 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; deleted text end

deleted text begin (6) personal support as defined under the current DD waiver plan or successor plans; deleted text end

deleted text begin (7) 24-hour emergency assistance, on-call and personal emergency response as defined under the current CADI and DD waiver plans or successor plans; deleted text end

deleted text begin (8) night supervision services as defined under the current BI waiver plan or successor plans; deleted text end

deleted text begin (9) homemaker services as defined under the current CADI, BI, CAC, DD, and EW waiver plans or successor plans, excluding providers licensed by the Department of Health under chapter 144A and those providers providing cleaning services only; deleted text end

deleted text begin (10) independent living skills training as defined under the current BI and CADI waiver plans or successor plans; deleted text end

deleted text begin (11) prevocational services as defined under the current BI and CADI waiver plans or successor plans; deleted text end

deleted text begin (12) structured day services as defined under the current BI waiver plan or successor plans; or deleted text end

deleted text begin (13) supported employment as defined under the current BI and CADI waiver plans or successor plans. deleted text end

new text begin (b) Basic support services provide the level of assistance, supervision, and care that is necessary to ensure the health and safety 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: new text end

new text begin (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 alternatives for disabled individuals, developmental disability, and elderly waiver plans; new text end

new text begin (2) companion services as defined under the brain injury, community alternatives for disabled individuals, and elderly waiver plans, excluding 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; new text end

new text begin (3) personal support as defined under the developmental disability waiver plan; new text end

new text begin (4) 24-hour emergency assistance, personal emergency response as defined under the community alternatives for disabled individuals and developmental disability waiver plans; new text end

new text begin (5) night supervision services as defined under the brain injury waiver plan; and new text end

new text begin (6) homemaker services as defined under the community alternatives for disabled individuals, 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. new text end

new text begin (c) Intensive support services provide assistance, supervision, and care that is necessary to ensure the health and safety of the person and services specifically directed toward the training, habilitation, or rehabilitation of the person. Intensive support services include: new text end

new text begin (1) intervention services, including: new text end

new text begin (i) behavioral support services as defined under the brain injury and community alternatives for disabled individuals waiver plans; new text end

new text begin (ii) in-home or out-of-home crisis respite services as defined under the developmental disability waiver plan; and new text end

new text begin (iii) specialist services as defined under the current developmental disability waiver plan; new text end

new text begin (2) in-home support services, including: new text end

new text begin (i) in-home family support and supported living services as defined under the developmental disability waiver plan; new text end

new text begin (ii) independent living services training as defined under the brain injury and community alternatives for disabled individuals waiver plans; and new text end

new text begin (iii) semi-independent living services; new text end

new text begin (3) residential supports and services, including: new text end

new text begin (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; new text end

new text begin (ii) foster care services as defined in the brain injury, community alternative care, and community alternatives for disabled individuals waiver plans provided in a family or corporate child foster care residence, a family adult foster care residence, or a community residential setting; and new text end

new text begin (iii) residential services provided in a supervised living facility that is certified by the Department of Health as an ICF/DD; new text end

new text begin (4) day services, including: new text end

new text begin (i) structured day services as defined under the brain injury waiver plan; new text end

new text begin (ii) day training and habilitation services under sections 252.40 to 252.46, and as defined under the developmental disability waiver plan; and new text end

new text begin (iii) prevocational services as defined under the brain injury and community alternatives for disabled individuals waiver plans; and new text end

new text begin (5) supported employment as defined under the brain injury, developmental disability, and community alternatives for disabled individuals waiver plans. new text end

Subd. 2.

Relationship to other standards governing home and community-based services.

(a) A license holder governed by this chapter is also subject to the licensure requirements under chapter 245A.

(b) deleted text begin A license holder concurrently providing child foster care services licensed according to Minnesota Rules, chapter 2960, to the same person receiving a service licensed under this chapter is exempt from section 245D.04 as it applies to the person.deleted text end new text begin A corporate or family child foster care site controlled by a license holder and providing services governed by this chapter is exempt from compliance with section 245D.04. This exemption applies to foster care homes where at least one resident is receiving residential supports and services licensed according to this chapter. This chapter does not apply to corporate or family child foster care homes that do not provide services licensed under this chapter.new text end

new text begin (c) A family adult foster care site controlled by a license holder and providing services governed by this chapter is exempt from compliance with Minnesota Rules, parts 9555.6185; 9555.6225; 9555.6245; 9555.6255; and 9555.6265. These exemptions apply to family adult foster care homes where at least one resident is receiving residential supports and services licensed according to this chapter. This chapter does not apply to family adult foster care homes that do not provide services licensed under this chapter. new text end

new text begin (d) A license holder providing services licensed according to this chapter in a supervised living facility is exempt from compliance with sections 245D.04; 245D.05, subdivision 2; and 245D.06, subdivision 2, clauses (1), (4), and (5). new text end

new text begin (e) A license holder providing residential services to persons in an ICF/DD is exempt from compliance with sections 245D.04; 245D.05, subdivision 1b; 245D.06, subdivision 2, clauses (4) and (5); 245D.071, subdivisions 4 and 5; 245D.081, subdivision 2; 245D.09, subdivision 7; 245D.095, subdivision 2; and 245D.11, subdivision 3. new text end

deleted text begin (c)deleted text end new text begin (f)new text end A license holder deleted text begin concurrentlydeleted text end providing deleted text begin home caredeleted text end new text begin homemakernew text end services deleted text begin registereddeleted text end new text begin licensednew text end according to deleted text begin sections 144A.43 to 144A.49 to the same person receiving home management services licensed underdeleted text end this chapter new text begin and registered according to chapter 144A new text end is exempt from new text begin compliance with new text end section 245D.04 deleted text begin as it applies to the persondeleted text end .

deleted text begin (d) A license holder identified in subdivision 1, clauses (1), (5), and (9), is exempt from compliance with sections 245A.65, subdivision 2, paragraph (a), and 626.557, subdivision 14, paragraph (b). deleted text end

deleted text begin (e) Notwithstanding section 245D.06, subdivision 5, a license holder providing structured day, prevocational, or supported employment services under this chapter and day training and habilitation or supported employment services licensed under chapter 245B within the same program is exempt from compliance with this chapter when the license holder notifies the commissioner in writing that the requirements under chapter 245B will be met for all persons receiving these services from the program. For the purposes of this paragraph, if the license holder has obtained approval from the commissioner for an alternative inspection status according to section 245B.031, that approval will apply to all persons receiving services in the program. deleted text end

new text begin (g) Nothing in this chapter prohibits a license holder from concurrently serving persons without disabilities or people who are or are not age 65 and older, provided this chapter's standards are met as well as other relevant standards. new text end

new text begin (h) The documentation required under sections 245D.07 and 245D.071 must meet the individual program plan requirements identified in section 256B.092 or successor provisions. new text end

Subd. 3.

Variance.

If the conditions in section 245A.04, subdivision 9, are met, the commissioner may grant a variance to any of the requirements in this chapter, except sections 245D.04, deleted text begin and 245D.10, subdivision 4, paragraph (b)deleted text end new text begin 245D.06, subdivision 4, paragraph (b), and 245D.061, subdivision 3new text end , or provisions governing data practices and information rights of persons.

deleted text begin Subd. 4. deleted text end

deleted text begin License holders with multiple 245D licenses. deleted text end

deleted text begin (a) When a person changes service from one license to a different license held by the same license holder, the license holder is exempt from the requirements in section 245D.10, subdivision 4, paragraph (b). deleted text end

deleted text begin (b) When a staff person begins providing direct service under one or more licenses held by the same license holder, other than the license for which staff orientation was initially provided according to section 245D.09, subdivision 4, the license holder is exempt from those staff orientation requirements, except the staff person must review each person's service plan and medication administration procedures in accordance with section 245D.09, subdivision 4, paragraph (c), if not previously reviewed by the staff person. deleted text end

new text begin Subd. 5. new text end

new text begin Program certification. new text end

new text begin An applicant or a license holder may apply for program certification as identified in section 245D.33. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 24.

Minnesota Statutes 2012, section 245D.04, is amended to read:

245D.04 SERVICE RECIPIENT RIGHTS.

Subdivision 1.

License holder responsibility for individual rights of persons served by the program.

The license holder must:

(1) provide each person or each person's legal representative with a written notice that identifies the service recipient rights in subdivisions 2 and 3, and an explanation of those rights within five working days of service initiation and annually thereafter;

(2) make reasonable accommodations to provide this information in other formats or languages as needed to facilitate understanding of the rights by the person and the person's legal representative, if any;

(3) maintain documentation of the person's or the person's legal representative's receipt of a copy and an explanation of the rights; and

(4) ensure the exercise and protection of the person's rights in the services provided by the license holder and as authorized in the new text begin coordinated new text end service new text begin and support new text end plan.

Subd. 2.

Service-related rights.

A person's service-related rights include the right to:

(1) participate in the development and evaluation of the services provided to the person;

(2) have services new text begin and supports new text end identified in the new text begin coordinated new text end service new text begin and support new text end plan new text begin and the coordinated service and support plan addendum new text end provided in a manner that respects and takes into consideration the person's preferencesnew text begin according to the requirements in sections 245D.07 and 245D.071new text end ;

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

(4) know, in advance, limits to the services available from the license holdernew text begin , including the license holder's knowledge, skill, and ability to meet the person's service and support needsnew text end ;

(5) know conditions and terms governing the provision of services, including the license holder's new text begin admission criteria and new text end policies and procedures related to temporary service suspension and service termination;

(6) new text begin a coordinated transfer to ensure continuity of care when there will be a change in the provider;new text end

new text begin (7) new text end know what the charges are for services, regardless of who will be paying for the services, and be notified of changes in those charges;

deleted text begin (7)deleted text end new text begin (8)new text end know, in advance, whether services are covered by insurance, government funding, or other sources, and be told of any charges the person or other private party may have to pay; and

deleted text begin (8)deleted text end new text begin (9)new text end receive services from an individual who is competent and trained, who has professional certification or licensure, as required, and who meets additional qualifications identified in the person's new text begin coordinated new text end service new text begin and support new text end plandeleted text begin .deleted text end new text begin or coordinated service and support plan addendum.new text end

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 restraintnew text begin , time out,new text end or seclusion deleted text begin used for a purpose other thandeleted text end new text begin except for emergency use of manual restraintnew text end to protect the person from imminent danger to self or othersnew text begin according to the requirements in section 245D.06new text end ;

(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 privacy; and

(15) engage in chosen activities.

(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; deleted text begin anddeleted text end

(3) new text begin have use of and free access to common areas in the residence; and new text end

new text begin (4) new text end privacy for visits with the person's spouse, next of kin, legal counsel, religious advisor, or others, in accordance with section 363A.09 of the Human Rights Act, including privacy in the person's bedroom.

(c) Restriction of a person's rights under new text begin subdivision 2, clause (10), or new text end paragraph (a), clauses (13) to (15), 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 new text begin person's coordinated new text end service new text begin and support new text end plan deleted text begin for the person anddeleted text end new text begin 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 documentationnew text end 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 occurdeleted text begin , at a minimum, every three months for persons who do not have a legal representative and annually for persons who do have a legal representativedeleted text end new text begin semiannually new text end from the date of initial approvalnew text begin , at a minimum, or more frequently if requested by the person, the person's legal representative, if any, and case managernew text end ; 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 January 1, 2014. new text end

Sec. 25.

Minnesota Statutes 2012, section 245D.05, is amended to read:

245D.05 HEALTH SERVICES.

Subdivision 1.

Health needs.

(a) The license holder is responsible for deleted text begin providingdeleted text end new text begin meetingnew text end health deleted text begin servicesdeleted text end new text begin service needsnew text end assigned in the new text begin coordinated new text end service new text begin and support new text end plan deleted text begin anddeleted text end new text begin or the coordinated service and support plan addendum, new text end consistent with the person's health needs. The license holder is responsible for promptly notifying deleted text begin the person ordeleted text end the person's legal representativenew text begin , if any,new text end and the case manager of changes in a person's physical and mental health needs affecting deleted text begin assigneddeleted text end health deleted text begin servicesdeleted text end new text begin service needs assigned to the license holder in the coordinated service and support plan or the coordinated service and support plan addendumnew text end , when discovered by the license holder, unless the license holder has reason to know the change has already been reported. The license holder must document when the notice is provided.

(b) deleted text begin When assigned in the service plan,deleted text end new text begin If responsibility for meeting the person's health service needs has been assigned to the license holder in the coordinated service and support plan or the coordinated service and support plan addendum,new text end the license holder deleted text begin is required todeleted text end new text begin mustnew text end maintain documentation on how the person's health needs will be met, including a description of the procedures the license holder will follow in order to:

(1) provide medication deleted text begin administration,deleted text end new text begin assistance or new text end medication deleted text begin assistance, or medication managementdeleted text end new text begin administrationnew text end according to this chapter;

(2) monitor health conditions according to written instructions from deleted text begin the person's physician odeleted text end r a licensed health professional;

(3) assist with or coordinate medical, dental, and other health service appointments; or

(4) use medical equipment, devices, or adaptive aides or technology safely and correctly according to written instructions from deleted text begin the person's physician ordeleted text end a licensed health professional.

new text begin Subd. 1a. new text end

new text begin Medication setup. new text end

new text begin For the purposes of this subdivision, "medication setup" means the arranging of medications according to instructions from the pharmacy, the prescriber, or a licensed nurse, for later administration when the license holder is assigned responsibility for medication assistance or medication administration in the coordinated service and support plan or the coordinated service and support plan addendum. A prescription label or the prescriber's written or electronically recorded order for the prescription is sufficient to constitute written instructions from the prescriber. The license holder must document in the person's medication administration record: dates of setup, name of medication, quantity of dose, times to be administered, and route of administration at time of setup; and, when the person will be away from home, to whom the medications were given. new text end

new text begin Subd. 1b. new text end

new text begin Medication assistance. new text end

new text begin If responsibility for medication assistance is assigned to the license holder in the coordinated service and support plan or the coordinated service and support plan addendum, the license holder must ensure that the requirements of subdivision 2, paragraph (b), have been met when staff provides medication assistance to enable a person to self-administer medication or treatment when the person is capable of directing the person's own care, or when the person's legal representative is present and able to direct care for the person. For the purposes of this subdivision, "medication assistance" means any of the following: new text end

new text begin (1) bringing to the person and opening a container of previously set up medications, emptying the container into the person's hand, or opening and giving the medications in the original container to the person; new text end

new text begin (2) bringing to the person liquids or food to accompany the medication; or new text end

new text begin (3) providing reminders to take regularly scheduled medication or perform regularly scheduled treatments and exercises. new text end

Subd. 2.

Medication administration.

(a) new text begin If responsibility for medication administration is assigned to the license holder in the coordinated service and support plan or the coordinated service and support plan addendum, the license holder must implement the following medication administration procedures to ensure a person takes medications and treatments as prescribed:new text end

new text begin (1) checking the person's medication record; new text end

new text begin (2) preparing the medication as necessary; new text end

new text begin (3) administering the medication or treatment to the person; new text end

new text begin (4) documenting the administration of the medication or treatment or the reason for not administering the medication or treatment; and new text end

new text begin (5) reporting to the prescriber or a nurse any concerns about the medication or treatment, including side effects, effectiveness, or a pattern of the person refusing to take the medication or treatment as prescribed. Adverse reactions must be immediately reported to the prescriber or a nurse. new text end

new text begin (b)(1) new text end The license holder must ensure that the deleted text begin following criteriadeleted text end new text begin requirements in clauses (2) to (4)new text end have been met before deleted text begin staff that is not a licensed health professional administersdeleted text end new text begin administering new text end medication or treatmentdeleted text begin :deleted text end new text begin .new text end

deleted text begin (1)deleted text end new text begin (2) The license holder must obtainnew text end written authorization deleted text begin has been obtaineddeleted text end from the person or the person's legal representative to administer medication or treatment deleted text begin orders;deleted text end new text begin and must obtain reauthorization annually as needed. If the person or the person's legal representative refuses to authorize the license holder to administer medication, the medication must not be administered. The refusal to authorize medication administration must be reported to the prescriber as expediently as possible.new text end

deleted text begin (2)deleted text end new text begin (3)new text end The staff person deleted text begin has completeddeleted text end new text begin responsible for administering the medication or treatment must completenew text end medication administration training according to section 245D.09, subdivision deleted text begin 4deleted text end deleted text begin , paragraphdeleted text end new text begin 4a, paragraphs (a) andnew text end (c), deleted text begin clause (2);deleted text end andnew text begin , as applicable to the person, paragraph (d).new text end

deleted text begin (3) The medication or treatment will be administered under administration procedures established for the person in consultation with a licensed health professional. written instruction from the person's physician may constitute the medication administration procedures. A prescription label or the prescriber's order for the prescription is sufficient to constitute written instructions from the prescriber. A licensed health professional may delegate medication administration procedures. deleted text end

new text begin (4) For a license holder providing intensive support services, the medication or treatment must be administered according to the license holder's medication administration policy and procedures as required under section 245D.11, subdivision 2, clause (3). new text end

deleted text begin (b)deleted text end new text begin (c)new text end The license holder must ensure the following information is documented in the person's medication administration record:

(1) the information on the new text begin current new text end prescription label or the prescriber's new text begin current written or electronically recorded new text end order new text begin or prescription new text end that includes deleted text begin directions fordeleted text end new text begin the person's name, description of the medication or treatment to be provided, and the frequency and other information needed tonew text end safely and correctly deleted text begin administeringdeleted text end new text begin administernew text end the medication new text begin or treatment new text end to ensure effectiveness;

(2) information on any deleted text begin discomforts,deleted text end risksdeleted text begin ,deleted text end or other side effects that are reasonable to expect, and any contraindications to its usenew text begin . This information must be readily available to all staff administering the medicationnew text end ;

(3) the possible consequences if the medication or treatment is not taken or administered as directed;

(4) instruction deleted text begin from the prescriberdeleted text end on when and to whom to report the following:

(i) if deleted text begin thedeleted text end new text begin a dose ofnew text end medication deleted text begin or treatmentdeleted text end is not administered new text begin or treatment is not performed new text end as prescribed, whether by error by the staff or the person or by refusal by the person; and

(ii) the occurrence of possible adverse reactions to the medication or treatment;

(5) notation of any occurrence of new text begin a dose of new text end medication not being administered new text begin or treatment not performed new text end as prescribednew text begin , whether by error by the staff or the person or by refusal by the person,new text end or of adverse reactions, and when and to whom the report was made; and

(6) notation of when a medication or treatment is started, new text begin administered, new text end changed, or discontinued.

deleted text begin (c) The license holder must ensure that the information maintained in the medication administration record is current and is regularly reviewed with the person or the person's legal representative and the staff administering the medication to identify medication administration issues or errors. At a minimum, the review must be conducted every three months or more often if requested by the person or the person's legal representative. Based on the review, the license holder must develop and implement a plan to correct medication administration issues or errors. If issues or concerns are identified related to the medication itself, the license holder must report those as required under subdivision 4. deleted text end

deleted text begin Subd. 3. deleted text end

deleted text begin Medication assistance. deleted text end

deleted text begin The license holder must ensure that the requirements of subdivision 2, paragraph (a), have been met when staff provides assistance to enable a person to self-administer medication when the person is capable of directing the person's own care, or when the person's legal representative is present and able to direct care for the person. deleted text end

Subd. 4.

new text begin Reviewing and new text end reporting medication and treatment issues.

deleted text begin The following medication administration issues must be reported to the person or the person's legal representative and case manager as they occur or following timelines established in the person's service plan or as requested in writing by the person or the person's legal representative, or the case manager: deleted text end new text begin (a) When assigned responsibility for medication administration, the license holder must ensure that the information maintained in the medication administration record is current and is regularly reviewed to identify medication administration errors. At a minimum, the review must be conducted every three months, or more frequently as directed in the coordinated service and support plan or coordinated service and support plan addendum or as requested by the person or the person's legal representative. Based on the review, the license holder must develop and implement a plan to correct patterns of medication administration errors when identified. new text end

new text begin (b) If assigned responsibility for medication assistance or medication administration, the license holder must report the following to the person's legal representative and case manager as they occur or as otherwise directed in the coordinated service and support plan or the coordinated service and support plan addendum: new text end

(1) any reports made to the person's physician or prescriber required under subdivision 2, paragraph deleted text begin (b)deleted text end new text begin (c)new text end , clause (4);

(2) a person's refusal or failure to take new text begin or receive new text end medication or treatment as prescribed; or

(3) concerns about a person's self-administration of medicationnew text begin or treatmentnew text end .

Subd. 5.

Injectable medications.

Injectable medications may be administered according to a prescriber's order and written instructions when one of the following conditions has been met:

(1) a registered nurse or licensed practical nurse will administer the subcutaneous or intramuscular injection;

(2) a supervising registered nurse with a physician's order has delegated the administration of subcutaneous injectable medication to an unlicensed staff member and has provided the necessary training; or

(3) there is an agreement signed by the license holder, the prescriber, and the person or the person's legal representative specifying what subcutaneous injections may be given, when, how, and that the prescriber must retain responsibility for the license holder's giving the injections. A copy of the agreement must be placed in the person's service recipient record.

Only licensed health professionals are allowed to administer psychotropic medications by injection.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 26.

new text begin [245D.051] PSYCHOTROPIC MEDICATION USE AND MONITORING. new text end

new text begin Subdivision 1. new text end

new text begin Conditions for psychotropic medication administration. new text end

new text begin (a) When a person is prescribed a psychotropic medication and the license holder is assigned responsibility for administration of the medication in the person's coordinated service and support plan or the coordinated service and support plan addendum, the license holder must ensure that the requirements in paragraphs (b) to (d) and section 245D.05, subdivision 2, are met. new text end

new text begin (b) Use of the medication must be included in the person's coordinated service and support plan or in the coordinated service and support plan addendum and based on a prescriber's current written or electronically recorded prescription. new text end

new text begin (c) The license holder must develop, implement, and maintain the following documentation in the person's coordinated service and support plan addendum according to the requirements in sections 245D.07 and 245D.071: new text end

new text begin (1) a description of the target symptoms that the psychotropic medication is to alleviate; and new text end

new text begin (2) documentation methods the license holder will use to monitor and measure changes in the target symptoms that are to be alleviated by the psychotropic medication if required by the prescriber. The license holder must collect and report on medication and symptom-related data as instructed by the prescriber. The license holder must provide the monitoring data to the expanded support team for review every three months, or as otherwise requested by the person or the person's legal representative. new text end

new text begin For the purposes of this section, "target symptom" refers to any perceptible diagnostic criteria for a person's diagnosed mental disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR) or successive editions that has been identified for alleviation. new text end

new text begin Subd. 2. new text end

new text begin Refusal to authorize psychotropic medication. new text end

new text begin If the person or the person's legal representative refuses to authorize the administration of a psychotropic medication as ordered by the prescriber, the license holder must follow the requirement in section 245D.05, subdivision 2, paragraph (b), clause (2). After reporting the refusal to the prescriber, the license holder must follow any directives or orders given by the prescriber. A court order must be obtained to override the refusal. Refusal to authorize administration of a specific psychotropic medication is not grounds for service termination and does not constitute an emergency. A decision to terminate services must be reached in compliance with section 245D.10, subdivision 3. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 27.

Minnesota Statutes 2012, section 245D.06, is amended to read:

245D.06 PROTECTION STANDARDS.

Subdivision 1.

Incident response and reporting.

(a) The license holder must respond to deleted text begin alldeleted text end incidents under section 245D.02, subdivision 11, that occur while providing services to protect the health and safety of and minimize risk of harm to the person.

(b) The license holder must maintain information about and report incidents to the person's legal representative or designated emergency contact and case manager within 24 hours of an incident occurring while services are being provided, deleted text begin ordeleted text end within 24 hours of discovery or receipt of information that an incident occurred, unless the license holder has reason to know that the incident has already been reportednew text begin , or as otherwise directed in a person's coordinated service and support plan or coordinated service and support plan addendumnew text end . An incident of suspected or alleged maltreatment must be reported as required under paragraph (d), and an incident of serious injury or death must be reported as required under paragraph (e).

(c) When the incident involves more than one person, the license holder must not disclose personally identifiable information about any other person when making the report to each person and case manager unless the license holder has the consent of the person.

(d) Within 24 hours of reporting maltreatment as required under section 626.556 or 626.557, the license holder must inform the case manager of the report unless there is reason to believe that the case manager is involved in the suspected maltreatment. The license holder must disclose the nature of the activity or occurrence reported and the agency that received the report.

(e) The license holder must report the death or serious injury of the person deleted text begin to the legal representative, if any, and case manager,deleted text end new text begin as required in paragraph (b) and to new text end the Department of Human Services Licensing Division, and the Office of Ombudsman for Mental Health and Developmental Disabilities as required under section 245.94, subdivision 2a, within 24 hours of the death, or receipt of information that the death occurred, unless the license holder has reason to know that the death has already been reported.

new text begin (f) When a death or serious injury occurs in a facility certified as an intermediate care facility for persons with developmental disabilities, the death or serious injury must be reported to the Department of Health, Office of Health Facility Complaints, and the Office of Ombudsman for Mental Health and Developmental Disabilities, as required under sections 245.91 and 245.94, subdivision 2a, unless the license holder has reason to know that the death has already been reported. new text end

deleted text begin (f)deleted text end new text begin (g)new text end The license holder must conduct deleted text begin adeleted text end new text begin an internalnew text end review of incident reportsnew text begin of deaths and serious injuries that occurred while services were being provided and that were not reported by the program as alleged or suspected maltreatmentnew text end , for identification of incident patterns, and implementation of corrective action as necessary to reduce occurrences.new text begin The review must include an evaluation of whether related policies and procedures were followed, whether the policies and procedures were adequate, whether there is a need for additional staff training, whether the reported event is similar to past events with the persons or the services involved, and whether there is a need for corrective action by the license holder to protect the health and safety of persons receiving services. Based on the results of this review, the license holder must develop, document, and implement a corrective action plan designed to correct current lapses and prevent future lapses in performance by staff or the license holder, if any.new text end

new text begin (h) The license holder must verbally report the emergency use of manual restraint of a person as required in paragraph (b), within 24 hours of the occurrence. The license holder must ensure the written report and internal review of all incident reports of the emergency use of manual restraints are completed according to the requirements in section 245D.061. new text end

Subd. 2.

Environment and safety.

The license holder must:

(1) ensure the following when the license holder is the owner, lessor, or tenant of the service site:

(i) the service site is a safe and hazard-free environment;

(ii) deleted text begin doors are locked ordeleted text end new text begin thatnew text end toxic substances or dangerous items deleted text begin normally accessibledeleted text end new text begin are inaccessiblenew text end to persons served by the program deleted text begin are stored in locked cabinets, drawers, or containersdeleted text end only to protect the safety of a person receiving services and not as a substitute for staff supervision or interactions with a person who is receiving services. If deleted text begin doors are locked ordeleted text end toxic substances or dangerous items deleted text begin normally accessible to persons served by the program are stored in locked cabinets, drawers, or containersdeleted text end new text begin are made inaccessiblenew text end , the license holder must deleted text begin justify and document how this determination was made in consultation with the person or person's legal representative, and how access will otherwise be provided to the person and all other affected persons receiving services; anddeleted text end new text begin document an assessment of the physical plant, its environment, and its population identifying the risk factors which require toxic substances or dangerous items to be inaccessible and a statement of specific measures to be taken to minimize the safety risk to persons receiving services;new text end

new text begin (iii) doors are locked from the inside to prevent a person from exiting only when necessary to protect the safety of a person receiving services and not as a substitute for staff supervision or interactions with the person. If doors are locked from the inside, the license holder must document an assessment of the physical plant, the environment and the population served, identifying the risk factors which require the use of locked doors, and a statement of specific measures to be taken to minimize the safety risk to persons receiving services at the service site; and new text end

deleted text begin (iii)deleted text end new text begin (iv)new text end a staff person is available deleted text begin ondeleted text end new text begin at the servicenew text end site who is trained in basic first aidnew text begin and, when required in a person's coordinated service and support plan or coordinated service and support plan addendum, cardiopulmonary resuscitation, "CPR,"new text end whenever persons are present and staff are required to be at the site to provide direct servicenew text begin . The CPR training must include in-person instruction, hands-on practice, and an observed skills assessment under the direct supervision of a CPR instructornew text end ;

(2) maintain equipment, vehicles, supplies, and materials owned or leased by the license holder in good condition when used to provide services;

(3) follow procedures to ensure safe transportation, handling, and transfers of the person and any equipment used by the person, when the license holder is responsible for transportation of a person or a person's equipment;

(4) be prepared for emergencies and follow emergency response procedures to ensure the person's safety in an emergency; and

(5) follow new text begin universal precautions and new text end sanitary practicesnew text begin , including hand washing,new text end for infection new text begin prevention and new text end controlnew text begin ,new text end and to prevent communicable diseases.

deleted text begin Subd. 3. deleted text end

deleted text begin Compliance with fire and safety codes. deleted text end

deleted text begin When services are provided at deleted text end deleted text begin a deleted text end deleted text begin service site deleted text end deleted text begin licensed according to chapter 245A or deleted text end deleted text begin where the license deleted text end deleted text begin holder is the owner, lessor, or tenant of the service site, the license holder must document deleted text end deleted text begin compliance with applicable building codes, fire and safety codes, health rules, and zoning deleted text end deleted text begin ordinances, or document that an appropriate waiver has been granted. deleted text end

Subd. 4.

Funds and property.

(a) Whenever the license holder assists a person with the safekeeping of funds or other property according to section 245A.04, subdivision 13, the license holder must deleted text begin havedeleted text end new text begin obtainnew text end written authorization to do so from the person new text begin or the person's legal representative new text end and the case manager.new text begin Authorization must be obtained within five working days of service initiation and renewed annually thereafter. At the time initial authorization is obtained, the license holder must survey, document, and implement the preferences of the person or the person's legal representative and the case manager for frequency of receiving a statement that itemizes receipts and disbursements of funds or other property. The license holder must document changes to these preferences when they are requested.new text end

(b) A license holder or staff person may not accept powers-of-attorney from a person receiving services from the license holder for any purposedeleted text begin , and may not accept an appointment as guardian or conservator of a person receiving services from the license holderdeleted text end . This does not apply to license holders that are Minnesota counties or other units of government or to staff persons employed by license holders who were acting as deleted text begin power-of-attorney, guardian, or conservatordeleted text end new text begin attorney-in-factnew text end for specific individuals prior to deleted text begin April 23, 2012deleted text end new text begin implementation of this chapternew text end . The license holder must maintain documentation of the power-of-attorneydeleted text begin , guardianship, or conservatorshipdeleted text end in the service recipient record.

new text begin (c) Upon the transfer or death of a person, any funds or other property of the person must be surrendered to the person or the person's legal representative, or given to the executor or administrator of the estate in exchange for an itemized receipt. new text end

Subd. 5.

deleted text begin Prohibitionsdeleted text end new text begin Prohibited proceduresnew text end .

deleted text begin (a)deleted text end The license holder is prohibited from using deleted text begin psychotropic medicationdeleted text end new text begin chemical restraints, mechanical restraints, manual restraints, time out, seclusion, or any other aversive or deprivation procedure,new text end as a substitute for adequate staffingnew text begin , for a behavioral or therapeutic program to reduce or eliminate behaviornew text end , as punishment, new text begin or new text end for staff conveniencedeleted text begin , or for any reason other than as prescribeddeleted text end .

deleted text begin (b) The license holder is prohibited from using restraints or seclusion under any circumstance, unless the commissioner has approved a variance request from the license holder that allows for the emergency use of restraints and seclusion according to terms and conditions approved in the variance. Applicants and license holders who have reason to believe they may be serving an individual who will need emergency use of restraints or seclusion may request a variance on the application or reapplication, and the commissioner shall automatically review the request for a variance as part of the application or reapplication process. License holders may also request the variance any time after issuance of a license. In the event a license holder uses restraint or seclusion for any reason without first obtaining a variance as required, the license holder must report the unauthorized use of restraint or seclusion to the commissioner within 24 hours of the occurrence and request the required variance. deleted text end

new text begin Subd. 6. new text end

new text begin Restricted procedures. new text end

new text begin The following procedures are allowed when the procedures are implemented in compliance with the standards governing their use as identified in clauses (1) to (3). Allowed but restricted procedures include: new text end

new text begin (1) permitted actions and procedures subject to the requirements in subdivision 7; new text end

new text begin (2) procedures identified in a positive support transition plan subject to the requirements in subdivision 8; or new text end

new text begin (3) emergency use of manual restraint subject to the requirements in section 245D.061. new text end

new text begin For purposes of this chapter, this section supersedes the requirements identified in Minnesota Rules, part 9525.2740. new text end

new text begin Subd. 7. new text end

new text begin Permitted actions and procedures. new text end

new text begin (a) Use of the instructional techniques and intervention procedures as identified in paragraphs (b) and (c), is permitted when used on an intermittent or continuous basis. When used on a continuous basis, it must be addressed in a person's coordinated service and support plan addendum as identified in sections 245D.07 and 245D.071. For purposes of this chapter, the requirements of this subdivision supersede the requirements identified in Minnesota Rules, part 9525.2720. new text end

new text begin (b) Physical contact or instructional techniques must use the least restrictive alternative possible to meet the needs of the person and may be used: new text end

new text begin (1) to calm or comfort a person by holding that person with no resistance from that person; new text end

new text begin (2) to protect a person known to be at risk or injury due to frequent falls as a result of a medical condition; new text end

new text begin (3) to facilitate the person's completion of a task or response when the person does not resist or the person's resistance is minimal in intensity and duration; or new text end

new text begin (4) to briefly block or redirect a person's limbs or body without holding the person or limiting the person's movement to interrupt the person's behavior that may result in injury to self or others. new text end

new text begin (c) Restraint may be used as an intervention procedure to: new text end

new text begin (1) allow a licensed health care professional to safely conduct a medical examination or to provide medical treatment ordered by a licensed health care professional to a person necessary to promote healing or recovery from an acute, meaning short-term, medical condition; new text end

new text begin (2) assist in the safe evacuation or redirection of a person in the event of an emergency and the person is at imminent risk of harm. new text end

new text begin Any use of manual restraint as allowed in this paragraph must comply with the restrictions identified in section 245D.061, subdivision 3; or new text end

new text begin (3) to position a person with physical disabilities in a manner specified in the person's coordinated service and support plan addendum. new text end

new text begin (d) Use of adaptive aids or equipment, orthotic devices, or other medical equipment ordered by a licensed health professional to treat a diagnosed medical condition do not in and of themselves constitute the use of mechanical restraint. new text end

new text begin Subd. 8. new text end

new text begin Positive support transition plan. new text end

new text begin License holders must develop a positive support transition plan on the forms and in the manner prescribed by the commissioner for a person who requires intervention in order to maintain safety when it is known that the person's behavior poses an immediate risk of physical harm to self or others. The positive support transition plan forms and instructions will supersede the requirements in Minnesota Rules, parts 9525.2750; 9525.2760; and 9525.2780. The positive support transition plan must phase out any existing plans for the emergency or programmatic use of aversive or deprivation procedures prohibited under this chapter within the following timelines: new text end

new text begin (1) for persons receiving services from the license holder before January 1, 2014, the plan must be developed and implemented by February 1, 2014, and phased out no later than December 31, 2014; and new text end

new text begin (2) for persons admitted to the program on or after January 1, 2014, the plan must be developed and implemented within 30 calendar days of service initiation and phased out no later than 11 months from the date of plan implementation. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 28.

new text begin [245D.061] EMERGENCY USE OF MANUAL RESTRAINTS. new text end

new text begin Subdivision 1. new text end

new text begin Standards for emergency use of manual restraints. new text end

new text begin The license holder must ensure that emergency use of manual restraints complies with the requirements of this chapter and the license holder's policy and procedures as required under subdivision 10. For the purposes of persons receiving services governed by this chapter, this section supersedes the requirements identified in Minnesota Rules, part 9525.2770. new text end

new text begin Subd. 2. new text end

new text begin Conditions for emergency use of manual restraint. new text end

new text begin Emergency use of manual restraint must meet the following conditions: new text end

new text begin (1) immediate intervention must be needed to protect the person or others from imminent risk of physical harm; and new text end

new text begin (2) the type of manual restraint used must be the least restrictive intervention to eliminate the immediate risk of harm and effectively achieve safety. The manual restraint must end when the threat of harm ends. new text end

new text begin Subd. 3. new text end

new text begin Restrictions when implementing emergency use of manual restraint. new text end

new text begin (a) Emergency use of manual restraint procedures must not: new text end

new text begin (1) be implemented with a child in a manner that constitutes sexual abuse, neglect, physical abuse, or mental injury, as defined in section 626.556, subdivision 2; new text end

new text begin (2) be implemented with an adult in a manner that constitutes abuse or neglect as defined in section 626.5572, subdivisions 2 and 17; new text end

new text begin (3) be implemented in a manner that violates a person's rights and protections identified in section 245D.04; new text end

new text begin (4) restrict a person's normal access to a nutritious diet, drinking water, adequate ventilation, necessary medical care, ordinary hygiene facilities, normal sleeping conditions, or necessary clothing, or to any protection required by state licensing standards and federal regulations governing the program; new text end

new text begin (5) deny the person visitation or ordinary contact with legal counsel, a legal representative, or next of kin; new text end

new text begin (6) be used as a substitute for adequate staffing, for the convenience of staff, as punishment, or as a consequence if the person refuses to participate in the treatment or services provided by the program; or new text end

new text begin (7) use prone restraint. For the purposes of this section, "prone restraint" means use of manual restraint that places a person in a face-down position. This does not include brief physical holding of a person who, during an emergency use of manual restraint, rolls into a prone position, and the person is restored to a standing, sitting, or side-lying position as quickly as possible. Applying back or chest pressure while a person is in the prone or supine position or face-up is prohibited. new text end

new text begin Subd. 4. new text end

new text begin Monitoring emergency use of manual restraint. new text end

new text begin The license holder shall monitor a person's health and safety during an emergency use of a manual restraint. Staff monitoring the procedure must not be the staff implementing the procedure when possible. The license holder shall complete a monitoring form, approved by the commissioner, for each incident involving the emergency use of a manual restraint. new text end

new text begin Subd. 5. new text end

new text begin Reporting emergency use of manual restraint incident. new text end

new text begin (a) Within three calendar days after an emergency use of a manual restraint, the staff person who implemented the emergency use must report in writing to the designated coordinator the following information about the emergency use: new text end

new text begin (1) the staff and persons receiving services who were involved in the incident leading up to the emergency use of manual restraint; new text end

new text begin (2) a description of the physical and social environment, including who was present before and during the incident leading up to the emergency use of manual restraint; new text end

new text begin (3) a description of what less restrictive alternative measures were attempted to de-escalate the incident and maintain safety before the manual restraint was implemented that identifies when, how, and how long the alternative measures were attempted before manual restraint was implemented; new text end

new text begin (4) a description of the mental, physical, and emotional condition of the person who was restrained, and other persons involved in the incident leading up to, during, and following the manual restraint; new text end

new text begin (5) whether there was any injury to the person who was restrained or other persons involved in the incident, including staff, before or as a result of the use of manual restraint; new text end

new text begin (6) whether there was a debriefing with the staff, and, if not contraindicated, with the person who was restrained and other persons who were involved in or who witnessed the restraint, following the incident and the outcome of the debriefing. If the debriefing was not conducted at the time the incident report was made, the report should identify whether a debriefing is planned; and new text end

new text begin (7) a copy of the report must be maintained in the person's service recipient record. new text end

new text begin (b) Each single incident of emergency use of manual restraint must be reported separately. For the purposes of this subdivision, an incident of emergency use of manual restraint is a single incident when the following conditions have been met: new text end

new text begin (1) after implementing the manual restraint, staff attempt to release the person at the moment staff believe the person's conduct no longer poses an imminent risk of physical harm to self or others and less restrictive strategies can be implemented to maintain safety; new text end

new text begin (2) upon the attempt to release the restraint, the person's behavior immediately re-escalates; and new text end

new text begin (3) staff must immediately reimplement the restraint in order to maintain safety. new text end

new text begin Subd. 6. new text end

new text begin Internal review of emergency use of manual restraint. new text end

new text begin (a) Within five working days of the emergency use of manual restraint, the license holder must complete and document an internal review of each report of emergency use of manual restraint. The review must include an evaluation of whether: new text end

new text begin (1) the person's service and support strategies developed according to sections 245D.07 and 245D.071 need to be revised; new text end

new text begin (2) related policies and procedures were followed; new text end

new text begin (3) the policies and procedures were adequate; new text end

new text begin (4) there is a need for additional staff training; new text end

new text begin (5) the reported event is similar to past events with the persons, staff, or the services involved; and new text end

new text begin (6) there is a need for corrective action by the license holder to protect the health and safety of persons. new text end

new text begin (b) Based on the results of the internal review, the license holder must develop, document, and implement a corrective action plan for the program designed to correct current lapses and prevent future lapses in performance by individuals or the license holder, if any. The corrective action plan, if any, must be implemented within 30 days of the internal review being completed. new text end

new text begin (c) The license holder must maintain a copy of the internal review and the corrective action plan, if any, in the person's service recipient record. new text end

new text begin Subd. 7. new text end

new text begin Expanded support team review. new text end

new text begin (a) Within five working days after the completion of the internal review required in subdivision 8, the license holder must consult with the expanded support team following the emergency use of manual restraint to: new text end

new text begin (1) discuss the incident reported in subdivision 7, to define the antecedent or event that gave rise to the behavior resulting in the manual restraint and identify the perceived function the behavior served; and new text end

new text begin (2) determine whether the person's coordinated service and support plan addendum needs to be revised according to sections 245D.07 and 245D.071 to positively and effectively help the person maintain stability and to reduce or eliminate future occurrences requiring emergency use of manual restraint. new text end

new text begin (b) The license holder must maintain a written summary of the expanded support team's discussion and decisions required in paragraph (a) in the person's service recipient record. new text end

new text begin Subd. 8. new text end

new text begin External review and reporting. new text end

new text begin Within five working days of the expanded support team review, the license holder must submit the following to the Department of Human Services, and the Office of the Ombudsman for Mental Health and Developmental Disabilities, as required under section 245.94, subdivision 2a: new text end

new text begin (1) the report required under subdivision 7; new text end

new text begin (2) the internal review and the corrective action plan required under subdivision 8; and new text end

new text begin (3) the summary of the expanded support team review required under subdivision 9. new text end

new text begin Subd. 9. new text end

new text begin Emergency use of manual restraints policy and procedures. new text end

new text begin The license holder must develop, document, and implement a policy and procedures that promote service recipient rights and protect health and safety during the emergency use of manual restraints. The policy and procedures must comply with the requirements of this section and must specify the following: new text end

new text begin (1) a description of the positive support strategies and techniques staff must use to attempt to de-escalate a person's behavior before it poses an imminent risk of physical harm to self or others; new text end

new text begin (2) a description of the types of manual restraints the license holder allows staff to use on an emergency basis, if any. If the license holder will not allow the emergency use of manual restraint, the policy and procedure must identify the alternative measures the license holder will require staff to use when a person's conduct poses an imminent risk of physical harm to self or others and less restrictive strategies would not achieve safety; new text end

new text begin (3) instructions for safe and correct implementation of the allowed manual restraint procedures; new text end

new text begin (4) the training that staff must complete and the timelines for completion, before they may implement an emergency use of manual restraint. In addition to the training on this policy and procedure and the orientation and annual training required in section 245D.09, subdivision 4, the training for emergency use of manual restraint must incorporate the following subjects: new text end

new text begin (i) alternatives to manual restraint procedures, including techniques to identify events and environmental factors that may escalate conduct that poses an imminent risk of physical harm to self or others; new text end

new text begin (ii) de-escalation methods, positive support strategies, and how to avoid power struggles; new text end

new text begin (iii) simulated experiences of administering and receiving manual restraint procedures allowed by the license holder on an emergency basis; new text end

new text begin (iv) how to properly identify thresholds for implementing and ceasing restrictive procedures; new text end

new text begin (v) how to recognize, monitor, and respond to the person's physical signs of distress, including positional asphyxia; new text end

new text begin (vi) the physiological and psychological impact on the person and the staff when restrictive procedures are used; new text end

new text begin (vii) the communicative intent of behaviors; and new text end

new text begin (viii) relationship building; new text end

new text begin (5) the procedures and forms to be used to monitor the emergency use of manual restraints, including what must be monitored and the frequency of monitoring per each incident of emergency use of manual restraint, and the person or position who is responsible for monitoring the use; new text end

new text begin (6) the instructions, forms, and timelines required for completing and submitting an incident report by the person or persons who implemented the manual restraint; and new text end

new text begin (7) the procedures and timelines for conducting the internal review and the expanded support team review, and the person or position responsible for completing the reviews and for ensuring that corrective action is taken or the person's coordinated service and support plan addendum is revised, when determined necessary. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 29.

Minnesota Statutes 2012, section 245D.07, is amended to read:

245D.07 SERVICE deleted text begin NEEDSdeleted text end new text begin PLANNING AND DELIVERYnew text end .

Subdivision 1.

Provision of services.

The license holder must provide services as deleted text begin specifieddeleted text end new text begin assignednew text end in thenew text begin coordinatednew text end servicenew text begin and supportnew text end plan deleted text begin and assigned to the license holderdeleted text end . The provision of services must comply with the requirements of this chapter and the federal waiver plans.

new text begin Subd. 1a. new text end

new text begin Person-centered planning and service delivery. new text end

new text begin (a) The license holder must provide services in response to the person's identified needs, interests, preferences, and desired outcomes as specified in the coordinated service and support plan and the coordinated service and support plan addendum, and in compliance with the requirements of this chapter. License holders providing intensive support services must also provide outcome-based services according to the requirements in section 245D.071. new text end

new text begin (b) Services must be provided in a manner that supports the person's preferences, daily needs, and activities and accomplishment of the person's personal goals and service outcomes, consistent with the principles of: new text end

new text begin (1) person-centered service planning and delivery that: new text end

new text begin (i) identifies and supports what is important to the person as well as what is important for the person, including preferences for when, how, and by whom direct support service is provided; new text end

new text begin (ii) uses that information to identify outcomes the person desires; and new text end

new text begin (iii) respects each person's history, dignity, and cultural background; new text end

new text begin (2) self-determination that supports and provides: new text end

new text begin (i) opportunities for the development and exercise of functional and age-appropriate skills, decision making and choice, personal advocacy, and communication; and new text end

new text begin (ii) the affirmation and protection of each person's civil and legal rights; and new text end

new text begin (3) providing the most integrated setting and inclusive service delivery that supports, promotes, and allows: new text end

new text begin (i) inclusion and participation in the person's community as desired by the person in a manner that enables the person to interact with nondisabled persons to the fullest extent possible and supports the person in developing and maintaining a role as a valued community member; new text end

new text begin (ii) opportunities for self-sufficiency as well as developing and maintaining social relationships and natural supports; and new text end

new text begin (iii) a balance between risk and opportunity, meaning the least restrictive supports or interventions necessary are provided in the most integrated settings in the most inclusive manner possible to support the person to engage in activities of the person's own choosing that may otherwise present a risk to the person's health, safety, or rights. new text end

Subd. 2.

Service planning new text begin requirements for basic support servicesnew text end .

new text begin (a) License holders providing basic support services must meet the requirements of this subdivision. new text end

new text begin (b) 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. new text end

new text begin (c) Within 60 days of service initiation the license holder must review and revise as needed the preliminary coordinated service and support plan addendum to document the services that will be provided including how, when, and by whom services will be provided, and the person responsible for overseeing the delivery and coordination of services. new text end

new text begin (d) new text end The license holder must participate in new text begin service planning and new text end support team meetings deleted text begin related todeleted text end new text begin fornew text end the person following stated timelines established in the person'snew text begin coordinatednew text end servicenew text begin and supportnew text end plan or as requested by deleted text begin the support team,deleted text end the persondeleted text begin ,deleted text end or the person's legal representativenew text begin , the support team or the expanded support teamnew text end .

Subd. 3.

Reports.

The license holder must provide written reports regarding the person's progress or status as requested by the person, the person's legal representative, the case manager, or the team.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 30.

new text begin [245D.071] SERVICE PLANNING AND DELIVERY; INTENSIVE SUPPORT SERVICES. new text end

new text begin Subdivision 1. new text end

new text begin Requirements for intensive support services. new text end

new text begin A license holder providing intensive support services identified in section 245D.03, subdivision 1, paragraph (c), must comply with the requirements in section 245D.07, subdivisions 1 and 3, and this section. new text end

new text begin Subd. 2. new text end

new text begin Abuse prevention. new text end

new text begin Prior to or upon initiating services, the license holder must develop, document, and implement an abuse prevention plan according to section 245A.65, subdivision 2. new text end

new text begin Subd. 3. new text end

new text begin Assessment and initial service planning. new text end

new text begin (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. new text end

new text begin (b) 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 assess and determine the following based on the person's coordinated service and support plan and the requirements in subdivision 4 and section 245D.07, subdivision 1a: new text end

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

new text begin (2) the person's desired outcomes and the supports necessary to accomplish the person's desired outcomes; new text end

new text begin (3) the person's preferences for how services and supports are provided; new text end

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

new text begin (5) how services must be coordinated across other providers licensed under this chapter serving the same person to ensure continuity of care for the person. new text end

new text begin (c) Within the scope of services, the license holder must, at a minimum, assess the following areas: new text end

new text begin (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; new text end

new text begin (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 new text end

new text begin (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 safety of the person or others. The assessments must produce information about the person that is descriptive of the person's overall strengths, functional skills and abilities, and behaviors or symptoms. new text end

new text begin Subd. 4. new text end

new text begin Service outcomes and supports. new text end

new text begin (a) Within ten working days of the 45-day meeting, the license holder must develop and document the service outcomes and supports based on the assessments completed under subdivision 3 and the requirements in section 245D.07, subdivision 1a. The outcomes and supports must be included in the coordinated service and support plan addendum. new text end

new text begin (b) The license holder must document the supports and methods to be implemented to support the accomplishment of outcomes related to acquiring, retaining, or improving skills. The documentation must include: new text end

new text begin (1) the methods or actions that will be used to support the person and to accomplish the service outcomes, including information about: new text end

new text begin (i) any changes or modifications to the physical and social environments necessary when the service supports are provided; new text end

new text begin (ii) any equipment and materials required; and new text end

new text begin (iii) techniques that are consistent with the person's communication mode and learning style; new text end

new text begin (2) the measurable and observable criteria for identifying when the desired outcome has been achieved and how data will be collected; new text end

new text begin (3) the projected starting date for implementing the supports and methods and the date by which progress towards accomplishing the outcomes will be reviewed and evaluated; and new text end

new text begin (4) the names of the staff or position responsible for implementing the supports and methods. new text end

new text begin (c) Within 20 working days of the 45-day meeting, the license holder must obtain dated signatures from the person or the person's legal representative and case manager to document completion and approval of the assessment and coordinated service and support plan addendum. new text end

new text begin Subd. 5. new text end

new text begin Progress reviews. new text end

new text begin (a) The license holder must give the person or the person's legal representative and case manager an opportunity to participate in the ongoing review and development of the methods used to support the person and accomplish outcomes identified in subdivisions 3 and 4. The license holder, in coordination with the person's support team or expanded support team, must meet with the person, the person's legal representative, and the case manager, and participate in progress review meetings following stated timelines established in the person's coordinated service and support plan or coordinated service and support plan addendum or within 30 days of a written request by the person, the person's legal representative, or the case manager, at a minimum of once per year. new text end

new text begin (b) The license holder must summarize the person's progress toward achieving the identified outcomes and make recommendations and identify the rationale for changing, continuing, or discontinuing implementation of supports and methods identified in subdivision 4 in a written report sent to the person or the person's legal representative and case manager five working days prior to the review meeting, unless the person, the person's legal representative, or the case manager requests to receive the report at the time of the meeting. new text end

new text begin (c) Within ten working days of the progress review meeting, the license holder must obtain dated signatures from the person or the person's legal representative and the case manager to document approval of any changes to the coordinated service and support plan addendum. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 31.

new text begin [245D.081] PROGRAM COORDINATION, EVALUATION, AND OVERSIGHT. new text end

new text begin Subdivision 1. new text end

new text begin Program coordination and evaluation. new text end

new text begin (a) The license holder is responsible for: new text end

new text begin (1) coordination of service delivery and evaluation for each person served by the program as identified in subdivision 2; and new text end

new text begin (2) program management and oversight that includes evaluation of the program quality and program improvement for services provided by the license holder as identified in subdivision 3. new text end

new text begin (b) The same person may perform the functions in paragraph (a) if the work and education qualifications are met in subdivisions 2 and 3. new text end

new text begin Subd. 2. new text end

new text begin Coordination and evaluation of individual service delivery. new text end

new text begin (a) Delivery and evaluation of services provided by the license holder must be coordinated by a designated staff person. The designated coordinator must provide supervision, support, and evaluation of activities that include: new text end

new text begin (1) oversight of the license holder's responsibilities assigned in the person's coordinated service and support plan and the coordinated service and support plan addendum; new text end

new text begin (2) taking the action necessary to facilitate the accomplishment of the outcomes according to the requirements in section 245D.07; new text end

new text begin (3) instruction and assistance to direct support staff implementing the coordinated service and support plan and the service outcomes, including direct observation of service delivery sufficient to assess staff competency; and new text end

new text begin (4) evaluation of the effectiveness of service delivery, methodologies, and progress on the person's outcomes based on the measurable and observable criteria for identifying when the desired outcome has been achieved according to the requirements in section 245D.07. new text end

new text begin (b) The license holder must ensure that the designated coordinator is competent to perform the required duties identified in paragraph (a) through education and training in human services and disability-related fields, and work experience in providing direct care services and supports to persons with disabilities. The designated coordinator must have the skills and ability necessary to develop effective plans and to design and use data systems to measure effectiveness of services and supports. The license holder must verify and document competence according to the requirements in section 245D.09, subdivision 3. The designated coordinator must minimally have: new text end

new text begin (1) a baccalaureate degree in a field related to human services, and one year of full-time work experience providing direct care services to persons with disabilities or persons age 65 and older; new text end

new text begin (2) an associate degree in a field related to human services, and two years of full-time work experience providing direct care services to persons with disabilities or persons age 65 and older; new text end

new text begin (3) a diploma in a field related to human services from an accredited postsecondary institution and three years of full-time work experience providing direct care services to persons with disabilities or persons age 65 and older; or new text end

new text begin (4) a minimum of 50 hours of education and training related to human services and disabilities; and new text end

new text begin (5) four years of full-time work experience providing direct care services to persons with disabilities or persons age 65 and older under the supervision of a staff person who meets the qualifications identified in clauses (1) to (3). new text end

new text begin Subd. 3. new text end

new text begin Program management and oversight. new text end

new text begin (a) The license holder must designate a managerial staff person or persons to provide program management and oversight of the services provided by the license holder. The designated manager is responsible for the following: new text end

new text begin (1) maintaining a current understanding of the licensing requirements sufficient to ensure compliance throughout the program as identified in section 245A.04, subdivision 1, paragraph (e), and when applicable, as identified in section 256B.04, subdivision 21, paragraph (b); new text end

new text begin (2) ensuring the duties of the designated coordinator are fulfilled according to the requirements in subdivision 2; new text end

new text begin (3) ensuring the program implements corrective action identified as necessary by the program following review of incident and emergency reports according to the requirements in section 245D.11, subdivision 2, clause (7). An internal review of incident reports of alleged or suspected maltreatment must be conducted according to the requirements in section 245A.65, subdivision 1, paragraph (b); new text end

new text begin (4) evaluation of satisfaction of persons served by the program, the person's legal representative, if any, and the case manager, with the service delivery and progress towards accomplishing outcomes identified in sections 245D.07 and 245D.071, and ensuring and protecting each person's rights as identified in section 245D.04; new text end

new text begin (5) ensuring staff competency requirements are met according to the requirements in section 245D.09, subdivision 3, and ensuring staff orientation and training is provided according to the requirements in section 245D.09, subdivisions 4, 4a, and 5; new text end

new text begin (6) ensuring corrective action is taken when ordered by the commissioner and that the terms and condition of the license and any variances are met; and new text end

new text begin (7) evaluating the information identified in clauses (1) to (6) to develop, document, and implement ongoing program improvements. new text end

new text begin (b) The designated manager must be competent to perform the duties as required and must minimally meet the education and training requirements identified in subdivision 2, paragraph (b), and have a minimum of three years of supervisory level experience in a program providing direct support services to persons with disabilities or persons age 65 and older. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 32.

Minnesota Statutes 2012, section 245D.09, is amended to read:

245D.09 STAFFING STANDARDS.

Subdivision 1.

Staffing requirements.

The license holder must providenew text begin the level ofnew text end direct servicenew text begin supportnew text end staff deleted text begin sufficientdeleted text end new text begin supervision, assistance, and training necessary:new text end

new text begin (1)new text end to ensure the health, safety, and protection of rights of each personnew text begin ;new text end and

new text begin (2)new text end to be able to implement the responsibilities assigned to the license holder in each person'snew text begin coordinatednew text end servicenew text begin and supportnew text end plannew text begin or identified in the coordinated service and support plan addendum, according to the requirements of this chapternew text end .

Subd. 2.

Supervision of staff having direct contact.

Except for a license holder who is the sole direct deleted text begin servicedeleted text end new text begin supportnew text end staff, the license holder must provide adequate supervision of staff providing direct deleted text begin servicedeleted text end new text begin supportnew text end to ensure the health, safety, and protection of rights of each person and implementation of the responsibilities assigned to the license holder in each person's deleted text begin service plandeleted text end new text begin coordinated service and support plan or coordinated service and support plan addendumnew text end .

Subd. 3.

Staff qualifications.

(a) The license holder must ensure that staff deleted text begin isdeleted text end new text begin providing direct support, or staff who have responsibilities related to supervising or managing the provision of direct support service, arenew text end competentnew text begin as demonstratednew text end throughnew text begin skills and knowledgenew text end training, experience, and education to meet the person's needs and additional requirements as written in thenew text begin coordinatednew text end servicenew text begin and supportnew text end plan new text begin or coordinated service and support plan addendumnew text end , or when otherwise required by the case manager or the federal waiver plan. The license holder must verify and maintain evidence of staff competency, including documentation of:

(1) education and experience qualificationsnew text begin relevant to the job responsibilities assigned to the staff and the needs of the general population of persons served by the programnew text end , including a valid degree and transcript, or a current license, registration, or certification, when a degree or licensure, registration, or certification is requirednew text begin by this chapter or in the coordinated service and support plan or coordinated service and support plan addendumnew text end ;

(2) deleted text begin completion of requireddeleted text end new text begin demonstrated competency in thenew text end orientation and trainingnew text begin areas required under this chapternew text end , deleted text begin includingdeleted text end new text begin and when applicable,new text end completion of continuing education required to maintain professional licensure, registration, or certification requirementsnew text begin . Competency in these areas is determined by the license holder through knowledge testing and observed skill assessment conducted by the trainer or instructornew text end ; and

(3) except for a license holder who is the sole direct deleted text begin servicedeleted text end new text begin supportnew text end staff,new text begin periodicnew text end performance evaluations completed by the license holder of the direct deleted text begin servicedeleted text end new text begin supportnew text end staff person's ability to perform the job functions based on direct observation.

(b) Staff under 18 years of age may not perform overnight duties or administer medication.

Subd. 4.

Orientationnew text begin to program requirementsnew text end .

deleted text begin (a)deleted text end Except for a license holder who does not supervise any direct deleted text begin servicedeleted text end new text begin supportnew text end staff, within deleted text begin 90 days of hiring direct service staffdeleted text end new text begin 60 days of hire, unless stated otherwisenew text end , the license holder must provide and ensure completion of new text begin 30 hours ofnew text end orientationnew text begin for direct support staffnew text end that combines supervised on-the-job training with review of and instruction deleted text begin ondeleted text end new text begin innew text end the followingnew text begin areasnew text end :

(1) the job description and how to complete specific job functions, including:

(i) responding to and reporting incidents as required under section 245D.06, subdivision 1; and

(ii) following safety practices established by the license holder and as required in section 245D.06, subdivision 2;

(2) the license holder's current policies and procedures required under this chapter, including their location and access, and staff responsibilities related to implementation of those policies and procedures;

(3) data privacy requirements according to sections 13.01 to 13.10 and 13.46, the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), and staff responsibilities related to complying with data privacy practices;

(4) the service recipient rights deleted text begin under section 245D.04deleted text end , and staff responsibilities related to ensuring the exercise and protection of those rightsnew text begin according to the requirements in section 245D.04new text end ;

(5) sections 245A.65, 245A.66, 626.556, and 626.557, governing maltreatment reporting and service planning for children and vulnerable adults, and staff responsibilities related to protecting persons from maltreatment and reporting maltreatmentnew text begin . This orientation must be provided within 72 hours of first providing direct contact services and annually thereafter according to section 245A.65, subdivision 3new text end ;

(6) deleted text begin what constitutes use of restraints, seclusion, and psychotropic medications, and staff responsibilities related to the prohibitions of their usedeleted text end new text begin the principles of person-centered service planning and delivery as identified in section 245D.07, subdivision 1a, and how they apply to direct support service provided by the staff personnew text end ; and

(7) other topics as determined necessary in the person'snew text begin coordinatednew text end servicenew text begin and supportnew text end plan by the case manager or other areas identified by the license holder.

deleted text begin (b) License holders who provide direct service themselves must complete the orientation required in paragraph (a), clauses (3) to (7). deleted text end

new text begin Subd. 4a. new text end

new text begin Orientation to individual service recipient needs. new text end

deleted text begin (c)deleted text end new text begin (a)new text end Before deleted text begin providingdeleted text end new text begin havingnew text end unsupervised direct deleted text begin service todeleted text end new text begin contact withnew text end a person served by the program, or for whom the staff person has not previously provided direct deleted text begin servicedeleted text end new text begin supportnew text end , or any time the plans or procedures identified in deleted text begin clauses (1) and (2)deleted text end new text begin paragraphs (b) to (f)new text end are revised, the staff person must review and receive instruction on the deleted text begin following as it relatesdeleted text end new text begin requirements in paragraphs (b) to (f) as they relatenew text end to the staff person's job functions for that persondeleted text begin :deleted text end new text begin .new text end

new text begin (b) Training and competency evaluations must include the following: new text end

new text begin (1) appropriate and safe techniques in personal hygiene and grooming, including hair care; bathing; care of teeth, gums, and oral prosthetic devices; and other activities of daily living (ADLs) as defined under section 256B.0659, subdivision 1; new text end

new text begin (2) an understanding of what constitutes a healthy diet according to data from the Centers for Disease Control and Prevention and the skills necessary to prepare that diet; new text end

new text begin (3) skills necessary to provide appropriate support in instrumental activities of daily living (IADLs) as defined under section 256B.0659, subdivision 1; and new text end

new text begin (4) demonstrated competence in providing first aid. new text end

deleted text begin (1)deleted text end new text begin (c) The staff person must review and receive instruction onnew text end the person'snew text begin coordinatednew text end servicenew text begin and supportnew text end plan new text begin or coordinated service and support plan addendumnew text end as it relates to the responsibilities assigned to the license holder, and when applicable, the person's individual abuse prevention plan deleted text begin according to section 245A.65deleted text end , to achievenew text begin and demonstratenew text end an understanding of the person as a unique individual, and how to implement those plansdeleted text begin ; anddeleted text end new text begin .new text end

deleted text begin (2)deleted text end new text begin (d) The staff person must review and receive instruction onnew text end medication administration procedures established for the person whennew text begin medication administration isnew text end assigned to the license holder according to section 245D.05, subdivision 1, paragraph (b). Unlicensed staff may administer medications only after successful completion of a medication administration training, from a training curriculum developed by a registered nurse, clinical nurse specialist in psychiatric and mental health nursing, certified nurse practitioner, physician's assistant, or physician deleted text begin incorporatingdeleted text end new text begin . The training curriculum must incorporatenew text end an observed skill assessment conducted by the trainer to ensure staff demonstrate the ability to safely and correctly follow medication procedures.

Medication administration must be taught by a registered nurse, clinical nurse specialist, certified nurse practitioner, physician's assistant, or physician if, at the time of service initiation or any time thereafter, the person has or develops a health care condition that affects the service options available to the person because the condition requires:

deleted text begin (i)deleted text end new text begin (1)new text end specialized or intensive medical or nursing supervision;new text begin andnew text end

deleted text begin (ii)deleted text end new text begin (2)new text end nonmedical service providers to adapt their services to accommodate the health and safety needs of the persondeleted text begin ; anddeleted text end new text begin .new text end

deleted text begin (iii) necessary training in order to meet the health service needs of the person as determined by the person's physician. deleted text end

new text begin (e) The staff person must review and receive instruction on the safe and correct operation of medical equipment used by the person to sustain life, including but not limited to ventilators, feeding tubes, or endotracheal tubes. The training must be provided by a licensed health care professional or a manufacturer's representative and incorporate an observed skill assessment to ensure staff demonstrate the ability to safely and correctly operate the equipment according to the treatment orders and the manufacturer's instructions. new text end

new text begin (f) The staff person must review and receive instruction on what constitutes use of restraints, time out, and seclusion, including chemical restraint, and staff responsibilities related to the prohibitions of their use according to the requirements in section 245D.06, subdivision 5, why such procedures are not effective for reducing or eliminating symptoms or undesired behavior and why they are not safe, and the safe and correct use of manual restraint on an emergency basis according to the requirements in section 245D.061. new text end

new text begin (g) In the event of an emergency service initiation, the license holder must ensure the training required in this subdivision occurs within 72 hours of the direct support staff person first having unsupervised contact with the person receiving services. The license holder must document the reason for the unplanned or emergency service initiation and maintain the documentation in the person's service recipient record. new text end

new text begin (h) License holders who provide direct support services themselves must complete the orientation required in subdivision 4, clauses (3) to (7). new text end

Subd. 5.

new text begin Annual new text end training.

deleted text begin (a)deleted text end A license holder must provide annual training to direct deleted text begin servicedeleted text end new text begin supportnew text end staff on the topics identified in subdivision 4, deleted text begin paragraph (a),deleted text end clauses (3) to deleted text begin (6)deleted text end new text begin (7), and subdivision 4a. A license holder must provide a minimum of 24 hours of annual training to direct service staff with fewer than five years of documented experience and 12 hours of annual training to direct service staff with five or more years of documented experience in topics described in subdivisions 4 and 4a, paragraphs (a) to (h). Training on relevant topics received from sources other than the license holder may count toward training requirementsnew text end .

deleted text begin (b) A license holder providing behavioral programming, specialist services, personal support, 24-hour emergency assistance, night supervision, independent living skills, structured day, prevocational, or supported employment services must provide a minimum of eight hours of annual training to direct service staff that addresses: deleted text end

deleted text begin (1) topics related to the general health, safety, and service needs of the population served by the license holder; and deleted text end

deleted text begin (2) other areas identified by the license holder or in the person's current service plan. deleted text end

deleted text begin Training on relevant topics received from sources other than the license holder may count toward training requirements. deleted text end

deleted text begin (c) When the license holder is the owner, lessor, or tenant of the service site and whenever a person receiving services is present at the site, the license holder must have a staff person available on site who is trained in basic first aid and, when required in a person's service plan, cardiopulmonary resuscitation. deleted text end

new text begin Subd. 5a. new text end

new text begin Alternative sources of training. new text end

new text begin 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 end

Subd. 6.

Subcontractorsnew text begin and temporary staffnew text end .

If the license holder uses a subcontractornew text begin or temporary staffnew text end to perform services licensed under this chapter on the license holder's behalf, the license holder must ensure that the subcontractornew text begin or temporary staffnew text end meets and maintains compliance with all requirements under this chapter that apply to the services to be providednew text begin , including training, orientation, and supervision necessary to fulfill their responsibilities. The license holder must ensure that a background study has been completed according to the requirements in sections 245C.03, subdivision 1, and 245C.04. Subcontractors and temporary staff hired by the license holder must meet the Minnesota licensing requirements applicable to the disciplines in which they are providing services. The license holder must maintain documentation that the applicable requirements have been metnew text end .

Subd. 7.

Volunteers.

The license holder must ensure that volunteers who provide direct new text begin support new text end services to persons served by the program receive the training, orientation, and supervision necessary to fulfill their responsibilities.new text begin The license holder must ensure that a background study has been completed according to the requirements in sections 245C.03, subdivision 1, and 245C.04. The license holder must maintain documentation that the applicable requirements have been met.new text end

new text begin Subd. 8. new text end

new text begin Staff orientation and training plan. new text end

new text begin The license holder must develop a staff orientation and training plan documenting when and how compliance with subdivisions 4, 4a, and 5 will be met. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 33.

new text begin [245D.091] INTERVENTION SERVICES. new text end

new text begin Subdivision 1. new text end

new text begin Licensure requirements. new text end

new text begin An individual meeting the staff qualification requirements of this section who is an employee of a program licensed according to this chapter and providing behavioral support services, specialist services, or crisis respite services is not required to hold a separate license under this chapter. An individual meeting the staff qualifications of this section who is not providing these services as an employee of a program licensed according to this chapter must obtain a license according to this chapter. new text end

new text begin Subd. 2. new text end

new text begin Behavior professional qualifications. new text end

new text begin A behavior professional, as defined in the brain injury and community alternatives for disabled individuals waiver plans or successor plans, must have competencies in areas related to: new text end

new text begin (1) ethical considerations; new text end

new text begin (2) functional assessment; new text end

new text begin (3) functional analysis; new text end

new text begin (4) measurement of behavior and interpretation of data; new text end

new text begin (5) selecting intervention outcomes and strategies; new text end

new text begin (6) behavior reduction and elimination strategies that promote least restrictive approved alternatives; new text end

new text begin (7) data collection; new text end

new text begin (8) staff and caregiver training; new text end

new text begin (9) support plan monitoring; new text end

new text begin (10) co-occurring mental disorders or neuro-cognitive disorder; new text end

new text begin (11) demonstrated expertise with populations being served; and new text end

new text begin (12) must be a: new text end

new text begin (i) psychologist licensed under sections 148.88 to 148.98, who has stated to the Board of Psychology competencies in the above identified areas; new text end

new text begin (ii) clinical social worker licensed as an independent clinical social worker under chapter 148D, or a person with a master's degree in social work from an accredited college or university, with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services in the areas identified in clauses (1) to (11); new text end

new text begin (iii) physician licensed under chapter 147 and certified by the American Board of Psychiatry and Neurology or eligible for board certification in psychiatry with competencies in the areas identified in clauses (1) to (11); new text end

new text begin (iv) licensed professional clinical counselor licensed under sections 148B.29 to 148B.39 with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services who has demonstrated competencies in the areas identified in clauses (1) to (11); new text end

new text begin (v) person with a master's degree from an accredited college or university in one of the behavioral sciences or related fields, with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services with demonstrated competencies in the areas identified in clauses (1) to (11); or new text end

new text begin (vi) registered nurse who is licensed under sections 148.171 to 148.285, and who is certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric and mental health nursing by a national nurse certification organization, or who has a master's degree in nursing or one of the behavioral sciences or related fields from an accredited college or university or its equivalent, with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services. new text end

new text begin Subd. 3. new text end

new text begin Behavior analyst qualifications. new text end

new text begin (a) A behavior analyst, as defined in the brain injury and community alternatives for disabled individuals waiver plans or successor plans, must: new text end

new text begin (1) have obtained a baccalaureate degree, master's degree, or PhD in a social services discipline; or new text end

new text begin (2) meet the qualifications of a mental health practitioner as defined in section 245.462, subdivision 17. new text end

new text begin (b) In addition, a behavior analyst must: new text end

new text begin (1) have four years of supervised experience working with individuals who exhibit challenging behaviors as well as co-occurring mental disorders or neuro-cognitive disorder; new text end

new text begin (2) have received ten hours of instruction in functional assessment and functional analysis; new text end

new text begin (3) have received 20 hours of instruction in the understanding of the function of behavior; new text end

new text begin (4) have received ten hours of instruction on design of positive practices behavior support strategies; new text end

new text begin (5) have received 20 hours of instruction on the use of behavior reduction approved strategies used only in combination with behavior positive practices strategies; new text end

new text begin (6) be determined by a behavior professional to have the training and prerequisite skills required to provide positive practice strategies as well as behavior reduction approved and permitted intervention to the person who receives behavioral support; and new text end

new text begin (7) be under the direct supervision of a behavior professional. new text end

new text begin Subd. 4. new text end

new text begin Behavior specialist qualifications. new text end

new text begin (a) A behavior specialist, as defined in the brain injury and community alternatives for disabled individuals waiver plans or successor plans, must meet the following qualifications: new text end

new text begin (1) have an associate's degree in a social services discipline; or new text end

new text begin (2) have two years of supervised experience working with individuals who exhibit challenging behaviors as well as co-occurring mental disorders or neuro-cognitive disorder. new text end

new text begin (b) In addition, a behavior specialist must: new text end

new text begin (1) have received a minimum of four hours of training in functional assessment; new text end

new text begin (2) have received 20 hours of instruction in the understanding of the function of behavior; new text end

new text begin (3) have received ten hours of instruction on design of positive practices behavioral support strategies; new text end

new text begin (4) be determined by a behavior professional to have the training and prerequisite skills required to provide positive practices strategies as well as behavior reduction approved intervention to the person who receives behavioral support; and new text end

new text begin (5) be under the direct supervision of a behavior professional. new text end

new text begin Subd. 5. new text end

new text begin Specialist services qualifications. new text end

new text begin An individual providing specialist services, as defined in the developmental disabilities waiver plan or successor plan, must have: new text end

new text begin (1) the specific experience and skills required of the specialist to meet the needs of the person identified by the person's service planning team; and new text end

new text begin (2) the qualifications of the specialist identified in the person's coordinated service and support plan. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 34.

new text begin [245D.095] RECORD REQUIREMENTS. new text end

new text begin Subdivision 1. new text end

new text begin Record-keeping systems. new text end

new text begin The license holder must ensure that the content and format of service recipient, personnel, and program records are uniform and legible according to the requirements of this chapter. new text end

new text begin Subd. 2. new text end

new text begin Admission and discharge register. new text end

new text begin The license holder must keep a written or electronic register, listing in chronological order the dates and names of all persons served by the program who have been admitted, discharged, or transferred, including service terminations initiated by the license holder and deaths. new text end

new text begin Subd. 3. new text end

new text begin Service recipient record. new text end

new text begin (a) The license holder must maintain a record of current services provided to each person on the premises where the services are provided or coordinated. When the services are provided in a licensed facility, the records must be maintained at the facility, otherwise the records must be maintained at the license holder's program office. new text end new text begin The license holder must protect service recipient records against loss, tampering, or unauthorized disclosure according to the requirements in sections 13.01 to 13.10 and 13.46. new text end

new text begin (b) The license holder must maintain the following information for each person: new text end

new text begin (1) an admission form signed by the person or the person's legal representative that includes: new text end

new text begin (i) identifying information, including the person's name, date of birth, address, and telephone number; and new text end

new text begin (ii) the name, address, and telephone number of the person's legal representative, if any, and a primary emergency contact, the case manager, and family members or others as identified by the person or case manager; new text end

new text begin (2) service information, including service initiation information, verification of the person's eligibility for services, documentation verifying that services have been provided as identified in the coordinated service and support plan or coordinated service and support plan addendum according to paragraph (a), and date of admission or readmission; new text end

new text begin (3) health information, including medical history, special dietary needs, and allergies, and when the license holder is assigned responsibility for meeting the person's health service needs according to section 245D.05: new text end

new text begin (i) current orders for medication, treatments, or medical equipment and a signed authorization from the person or the person's legal representative to administer or assist in administering the medication or treatments, if applicable; new text end

new text begin (ii) a signed statement authorizing the license holder to act in a medical emergency when the person's legal representative, if any, cannot be reached or is delayed in arriving; new text end

new text begin (iii) medication administration procedures; new text end

new text begin (iv) a medication administration record documenting the implementation of the medication administration procedures, and the medication administration record reviews, including any agreements for administration of injectable medications by the license holder according to the requirements in section 245D.05; and new text end

new text begin (v) a medical appointment schedule when the license holder is assigned responsibility for assisting with medical appointments; new text end

new text begin (4) the person's current coordinated service and support plan or that portion of the plan assigned to the license holder; new text end

new text begin (5) copies of the individual abuse prevention plan and assessments as required under section 245D.071, subdivisions 2 and 3; new text end

new text begin (6) a record of other service providers serving the person when the person's coordinated service and support plan or coordinated service and support plan addendum identifies the need for coordination between the service providers, that includes a contact person and telephone numbers, services being provided, and names of staff responsible for coordination; new text end

new text begin (7) documentation of orientation to service recipient rights according to section 245D.04, subdivision 1, and maltreatment reporting policies and procedures according to section 245A.65, subdivision 1, paragraph (c); new text end

new text begin (8) copies of authorizations to handle a person's funds, according to section 245D.06, subdivision 4, paragraph (a); new text end

new text begin (9) documentation of complaints received and grievance resolution; new text end

new text begin (10) incident reports involving the person, required under section 245D.06, subdivision 1; new text end

new text begin (11) copies of written reports regarding the person's status when requested according to section 245D.07, subdivision 3, progress review reports as required under section 245D.071, subdivision 5, progress or daily log notes that are recorded by the program, and reports received from other agencies involved in providing services or care to the person; and new text end

new text begin (12) discharge summary, including service termination notice and related documentation, when applicable. new text end

new text begin Subd. 4. new text end

new text begin Access to service recipient records. new text end

new text begin The license holder must ensure that the following people have access to the information in subdivision 1 in accordance with applicable state and federal laws, regulations, or rules: new text end

new text begin (1) the person, the person's legal representative, and anyone properly authorized by the person; new text end

new text begin (2) the person's case manager; new text end

new text begin (3) staff providing services to the person unless the information is not relevant to carrying out the coordinated service and support plan or coordinated service and support plan addendum; and new text end

new text begin (4) the county child or adult foster care licensor, when services are also licensed as child or adult foster care. new text end

new text begin Subd. 5. new text end

new text begin Personnel records. new text end

new text begin (a) The license holder must maintain a personnel record of each employee to document and verify staff qualifications, orientation, and training. The personnel record must include: new text end

new text begin (1) the employee's date of hire, completed application, an acknowledgement signed by the employee that job duties were reviewed with the employee and the employee understands those duties, and documentation that the employee meets the position requirements as determined by the license holder; new text end

new text begin (2) documentation of staff qualifications, orientation, training, and performance evaluations as required under section 245D.09, subdivisions 3 to 5, including the date the training was completed, the number of hours per subject area, and the name of the trainer or instructor; and new text end

new text begin (3) a completed background study as required under chapter 245C. new text end

new text begin (b) For employees hired after January 1, 2014, the license holder must maintain documentation in the personnel record or elsewhere, sufficient to determine the date of the employee's first supervised direct contact with a person served by the program, and the date of first unsupervised direct contact with a person served by the program. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 35.

Minnesota Statutes 2012, section 245D.10, is amended to read:

245D.10 POLICIES AND PROCEDURES.

Subdivision 1.

Policy and procedure requirements.

deleted text begin Thedeleted text end new text begin Anew text end license holdernew text begin providing either basic or intensive supports and servicesnew text end must establish, enforce, and maintain policies and procedures as required in this chapternew text begin , chapter 245A, and other applicable state and federal laws and regulations governing the provision of home and community-based services licensed according to this chapternew text end .

Subd. 2.

Grievances.

The license holder must establish policies and procedures that deleted text begin providedeleted text end new text begin promote service recipient rights by providingnew text end a simple complaint process for persons served by the program and their authorized representatives to bring a grievance that:

(1) provides staff assistance with the complaint process when requested, and the addresses and telephone numbers of outside agencies to assist the person;

(2) allows the person to bring the complaint to the highest level of authority in the program if the grievance cannot be resolved by other staff members, and that provides the name, address, and telephone number of that person;

(3) requires the license holder to promptly respond to all complaints affecting a person's health and safety. For all other complaints, the license holder must provide an initial response within 14 calendar days of receipt of the complaint. All complaints must be resolved within 30 calendar days of receipt or the license holder must document the reason for the delay and a plan for resolution;

(4) requires a complaint review that includes an evaluation of whether:

(i) related policies and procedures were followed and adequate;

(ii) there is a need for additional staff training;

(iii) the complaint is similar to past complaints with the persons, staff, or services involved; and

(iv) there is a need for corrective action by the license holder to protect the health and safety of persons receiving services;

(5) based on the review in clause (4), requires the license holder to develop, document, and implement a corrective action plan designed to correct current lapses and prevent future lapses in performance by staff or the license holder, if any;

(6) provides a written summary of the complaint and a notice of the complaint resolution to the person and case manager that:

(i) identifies the nature of the complaint and the date it was received;

(ii) includes the results of the complaint review;

(iii) identifies the complaint resolution, including any corrective action; and

(7) requires that the complaint summary and resolution notice be maintained in the service recipient record.

Subd. 3.

Service suspension and service termination.

(a) The license holder must establish policies and procedures for temporary service suspension and service termination that promote continuity of care and service coordination with the person and the case manager and with other licensed caregivers, if any, who also provide support to the person.

(b) The policy must include the following requirements:

(1) the license holder must notify the person new text begin or the person's legal representative new text end and case manager in writing of the intended termination or temporary service suspension, and the person's right to seek a temporary order staying the termination of service according to the procedures in section 256.045, subdivision 4a, or 6, paragraph (c);

(2) notice of the proposed termination of services, including those situations that began with a temporary service suspension, must be given at least 60 days before the proposed termination is to become effective when a license holder is providing deleted text begin independent living skills training, structured day, prevocational or supported employment services to the persondeleted text end new text begin intensive supports and services identified in section 245D.03, subdivision 1, paragraph (c)new text end , and 30 days prior to termination for all other services licensed under this chapter;

(3) the license holder must provide information requested by the person or case manager when services are temporarily suspended or upon notice of termination;

(4) prior to giving notice of service termination or temporary service suspension, the license holder must document actions taken to minimize or eliminate the need for service suspension or termination;

(5) during the temporary service suspension or service termination notice period, the license holder will work with the appropriate county agency to develop reasonable alternatives to protect the person and others;

(6) the license holder must maintain information about the service suspension or termination, including the written termination notice, in the service recipient record; and

(7) the license holder must restrict temporary service suspension to situations in which the person's deleted text begin behavior causes immediate and serious danger to the health and safety of the person or othersdeleted text end new text begin conduct poses an imminent risk of physical harm to self or others and less restrictive or positive support strategies would not achieve safetynew text end .

Subd. 4.

Availability of current written policies and procedures.

(a) The license holder must review and update, as needed, the written policies and procedures required under this chapter.

(b)new text begin (1)new text end The license holder must inform the person and case manager of the policies and procedures affecting a person's rights under section 245D.04, and provide copies of those policies and procedures, within five working days of service initiation.

new text begin (2) If a license holder only provides basic services and supports, this includes the: new text end

new text begin (i) grievance policy and procedure required under subdivision 2; and new text end

new text begin (ii) service suspension and termination policy and procedure required under subdivision 3. new text end

new text begin (3) For all other license holders this includes the: new text end

new text begin (i) policies and procedures in clause (2); new text end

new text begin (ii) emergency use of manual restraints policy and procedure required under section 245D.061, subdivision 10; and new text end

new text begin (iii) data privacy requirements under section 245D.11, subdivision 3. new text end

(c) The license holder must provide a written notice new text begin to all persons or their legal representatives and case managersnew text end at least 30 days before implementing any deleted text begin revised policies and proceduresdeleted text end new text begin procedural revisions to policiesnew text end affecting a person's new text begin service-related or protection-relatednew text end rights under section 245D.04new text begin and maltreatment reporting policies and proceduresnew text end . The notice must explain the revision that was made and include a copy of the revised policy and procedure. The license holder must document the deleted text begin reasondeleted text end new text begin reasonable causenew text end for not providing the notice at least 30 days before implementing the revisions.

(d) Before implementing revisions to required policies and procedures, the license holder must inform all employees of the revisions and provide training on implementation of the revised policies and procedures.

new text begin (e) The license holder must annually notify all persons, or their legal representatives, and case managers of any procedural revisions to policies required under this chapter, other than those in paragraph (c). Upon request, the license holder must provide the person, or the person's legal representative, and case manager with copies of the revised policies and procedures. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 36.

new text begin [245D.11] POLICIES AND PROCEDURES; INTENSIVE SUPPORT SERVICES. new text end

new text begin Subdivision 1. new text end

new text begin Policy and procedure requirements. new text end

new text begin A license holder providing intensive support services as identified in section 245D.03, subdivision 1, paragraph (c), must establish, enforce, and maintain policies and procedures as required in this section. new text end

new text begin Subd. 2. new text end

new text begin Health and safety. new text end

new text begin The license holder must establish policies and procedures that promote health and safety by ensuring: new text end

new text begin (1) use of universal precautions and sanitary practices in compliance with section 245D.06, subdivision 2, clause (5); new text end

new text begin (2) if the license holder operates a residential program, health service coordination and care according to the requirements in section 245D.05, subdivision 1; new text end

new text begin (3) safe medication assistance and administration according to the requirements in sections 245D.05, subdivisions 1a, 2, and 5, and 245D.051, that are established in consultation with a registered nurse, nurse practitioner, physician's assistant, or medical doctor and require completion of medication administration training according to the requirements in section 245D.09, subdivision 4a, paragraph (d). Medication assistance and administration includes, but is not limited to: new text end

new text begin (i) providing medication-related services for a person; new text end

new text begin (ii) medication setup; new text end

new text begin (iii) medication administration; new text end

new text begin (iv) medication storage and security; new text end

new text begin (v) medication documentation and charting; new text end

new text begin (vi) verification and monitoring of effectiveness of systems to ensure safe medication handling and administration; new text end

new text begin (vii) coordination of medication refills; new text end

new text begin (viii) handling changes to prescriptions and implementation of those changes; new text end

new text begin (ix) communicating with the pharmacy; and new text end

new text begin (x) coordination and communication with prescriber; new text end

new text begin (4) safe transportation, when the license holder is responsible for transportation of persons, with provisions for handling emergency situations according to the requirements in section 245D.06, subdivision 2, clauses (2) to (4); new text end

new text begin (5) a plan for ensuring the safety of persons served by the program in emergencies as defined in section 245D.02, subdivision 8, and procedures for staff to report emergencies to the license holder. A license holder with a community residential setting or a day service facility license must ensure the policy and procedures comply with the requirements in section 245D.22, subdivision 4; new text end

new text begin (6) a plan for responding to all incidents as defined in section 245D.02, subdivision 11; and reporting all incidents required to be reported according to section 245D.06, subdivision 1. The plan must: new text end

new text begin (i) provide the contact information of a source of emergency medical care and transportation; and new text end

new text begin (ii) require staff to first call 911 when the staff believes a medical emergency may be life threatening, or to call the mental health crisis intervention team when the person is experiencing a mental health crisis; and new text end

new text begin (7) a procedure for the review of incidents and emergencies to identify trends or patterns, and corrective action if needed. The license holder must establish and maintain a record-keeping system for the incident and emergency reports. Each incident and emergency report file must contain a written summary of the incident. The license holder must conduct a review of incident reports for identification of incident patterns, and implementation of corrective action as necessary to reduce occurrences. Each incident report must include: new text end

new text begin (i) the name of the person or persons involved in the incident. It is not necessary to identify all persons affected by or involved in an emergency unless the emergency resulted in an incident; new text end

new text begin (ii) the date, time, and location of the incident or emergency; new text end

new text begin (iii) a description of the incident or emergency; new text end

new text begin (iv) a description of the response to the incident or emergency and whether a person's coordinated service and support plan addendum or program policies and procedures were implemented as applicable; new text end

new text begin (v) the name of the staff person or persons who responded to the incident or emergency; and new text end

new text begin (vi) the determination of whether corrective action is necessary based on the results of the review. new text end

new text begin Subd. 3. new text end

new text begin Data privacy. new text end

new text begin The license holder must establish policies and procedures that promote service recipient rights by ensuring data privacy according to the requirements in: new text end

new text begin (1) the Minnesota Government Data Practices Act, section 13.46, and all other applicable Minnesota laws and rules in handling all data related to the services provided; and new text end

new text begin (2) the Health Insurance Portability and Accountability Act of 1996 (HIPAA), to the extent that the license holder performs a function or activity involving the use of protected health information as defined under Code of Federal Regulations, title 45, section 164.501, including, but not limited to, providing health care services; health care claims processing or administration; data analysis, processing, or administration; utilization review; quality assurance; billing; benefit management; practice management; repricing; or as otherwise provided by Code of Federal Regulations, title 45, section 160.103. The license holder must comply with the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations, Code of Federal Regulations, title 45, parts 160 to 164, and all applicable requirements. new text end

new text begin Subd. 4. new text end

new text begin Admission criteria. new text end

new text begin The license holder must establish policies and procedures that promote continuity of care by ensuring that admission or service initiation criteria: new text end

new text begin (1) is consistent with the license holder's registration information identified in the requirements in section 245D.031, subdivision 2, and with the service-related rights identified in section 245D.04, subdivisions 2, clauses (4) to (7), and 3, clause (8); new text end

new text begin (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; new text end

new text begin (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; and new text end

new text begin (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 request. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 37.

new text begin [245D.21] FACILITY LICENSURE REQUIREMENTS AND APPLICATION PROCESS. new text end

new text begin Subdivision 1. new text end

new text begin Community residential settings and day service facilities. new text end

new text begin For purposes of this section, "facility" means both a community residential setting and day service facility and the physical plant. new text end

new text begin Subd. 2. new text end

new text begin Inspections and code compliance. new text end

new text begin (a) Physical plants must comply with applicable state and local fire, health, building, and zoning codes. new text end

new text begin (b)(1) The facility must be inspected by a fire marshal or their delegate within 12 months before initial licensure to verify that it meets the applicable occupancy requirements as defined in the State Fire Code and that the facility complies with the fire safety standards for that occupancy code contained in the State Fire Code. new text end

new text begin (2) The fire marshal inspection of a community residential setting must verify the residence is a dwelling unit within a residential occupancy as defined in section 9.117 of the State Fire Code. A home safety checklist, approved by the commissioner, must be completed for a community residential setting by the license holder and the commissioner before the satellite license is reissued. new text end

new text begin (3) The facility shall be inspected according to the facility capacity specified on the initial application form. new text end

new text begin (4) If the commissioner has reasonable cause to believe that a potentially hazardous condition may be present or the licensed capacity is increased, the commissioner shall request a subsequent inspection and written report by a fire marshal to verify the absence of hazard. new text end

new text begin (5) Any condition cited by a fire marshal, building official, or health authority as hazardous or creating an immediate danger of fire or threat to health and safety must be corrected before a license is issued by the department, and for community residential settings, before a license is reissued. new text end

new text begin (c) The facility must maintain in a permanent file the reports of health, fire, and other safety inspections. new text end

new text begin (d) The facility's plumbing, ventilation, heating, cooling, lighting, and other fixtures and equipment, including elevators or food service, if provided, must conform to applicable health, sanitation, and safety codes and regulations. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 38.

new text begin [245D.22] FACILITY SANITATION AND HEALTH. new text end

new text begin Subdivision 1. new text end

new text begin General maintenance. new text end

new text begin The license holder must maintain the interior and exterior of buildings, structures, or enclosures used by the facility, including walls, floors, ceilings, registers, fixtures, equipment, and furnishings in good repair and in a sanitary and safe condition. The facility must be clean and free from accumulations of dirt, grease, garbage, peeling paint, mold, vermin, and insects. The license holder must correct building and equipment deterioration, safety hazards, and unsanitary conditions. new text end

new text begin Subd. 2. new text end

new text begin Hazards and toxic substances. new text end

new text begin The license holder must ensure that service sites owned or leased by the license holder are free from hazards that would threaten the health or safety of a person receiving services by ensuring the requirements in paragraphs (a) to (g) are met. new text end

new text begin (a) Chemicals, detergents, and other hazardous or toxic substances must not be stored with food products or in any way that poses a hazard to persons receiving services. new text end

new text begin (b) The license holder must install handrails and nonslip surfaces on interior and exterior runways, stairways, and ramps according to the applicable building code. new text end

new text begin (c) If there are elevators in the facility, the license holder must have elevators inspected each year. The date of the inspection, any repairs needed, and the date the necessary repairs were made must be documented. new text end

new text begin (d) The license holder must keep stairways, ramps, and corridors free of obstructions. new text end

new text begin (e) Outside property must be free from debris and safety hazards. Exterior stairs and walkways must be kept free of ice and snow. new text end

new text begin (f) Heating, ventilation, air conditioning units, and other hot surfaces and moving parts of machinery must be shielded or enclosed. new text end

new text begin (g) Use of dangerous items or equipment by persons served by the program must be allowed in accordance with the person's coordinated service and support plan addendum or the program abuse prevention plan, if not addressed in the coordinated service and support plan addendum. new text end

new text begin Subd. 3. new text end

new text begin Storage and disposal of medication. new text end

new text begin Schedule II controlled substances in the facility that are named in section 152.02, subdivision 3, must be stored in a locked storage area permitting access only by persons and staff authorized to administer the medication. This must be incorporated into the license holder's medication administration policy and procedures required under section 245D.11, subdivision 2, clause (3). Medications must be disposed of according to the Environmental Protection Agency recommendations. new text end

new text begin Subd. 4. new text end

new text begin First aid must be available on site. new text end

new text begin (a) A staff person trained in first aid must be available on site and, when required in a person's coordinated service and support plan or coordinated service and support plan addendum, be able to provide cardiopulmonary resuscitation, whenever persons are present and staff are required to be at the site to provide direct service. The CPR training must include in-person instruction, hands-on practice, and an observed skills assessment under the direct supervision of a CPR instructor. new text end

new text begin (b) A facility must have first aid kits readily available for use by, and that meet the needs of, persons receiving services and staff. At a minimum, the first aid kit must be equipped with accessible first aid supplies including bandages, sterile compresses, scissors, an ice bag or cold pack, an oral or surface thermometer, mild liquid soap, adhesive tape, and first aid manual. new text end

new text begin Subd. 5. new text end

new text begin Emergencies. new text end

new text begin (a) The license holder must have a written plan for responding to emergencies as defined in section 245D.02, subdivision 8, to ensure the safety of persons served in the facility. The plan must include: new text end

new text begin (1) procedures for emergency evacuation and emergency sheltering, including: new text end

new text begin (i) how to report a fire or other emergency; new text end

new text begin (ii) procedures to notify, relocate, and evacuate occupants, including use of adaptive procedures or equipment to assist with the safe evacuation of persons with physical or sensory disabilities; and new text end

new text begin (iii) instructions on closing off the fire area, using fire extinguishers, and activating and responding to alarm systems; new text end

new text begin (2) a floor plan that identifies: new text end

new text begin (i) the location of fire extinguishers; new text end

new text begin (ii) the location of audible or visual alarm systems, including but not limited to manual fire alarm boxes, smoke detectors, fire alarm enunciators and controls, and sprinkler systems; new text end

new text begin (iii) the location of exits, primary and secondary evacuation routes, and accessible egress routes, if any; and new text end

new text begin (iv) the location of emergency shelter within the facility; new text end

new text begin (3) a site plan that identifies: new text end

new text begin (i) designated assembly points outside the facility; new text end

new text begin (ii) the locations of fire hydrants; and new text end

new text begin (iii) the routes of fire department access; new text end

new text begin (4) the responsibilities each staff person must assume in case of emergency; new text end

new text begin (5) procedures for conducting quarterly drills each year and recording the date of each drill in the file of emergency plans; new text end

new text begin (6) procedures for relocation or service suspension when services are interrupted for more than 24 hours; new text end

new text begin (7) for a community residential setting with three or more dwelling units, a floor plan that identifies the location of enclosed exit stairs; and new text end

new text begin (8) an emergency escape plan for each resident. new text end

new text begin (b) The license holder must: new text end

new text begin (1) maintain a log of quarterly fire drills on file in the facility; new text end

new text begin (2) provide an emergency response plan that is readily available to staff and persons receiving services; new text end

new text begin (3) inform each person of a designated area within the facility where the person should go for emergency shelter during severe weather and the designated assembly points outside the facility; and new text end

new text begin (4) maintain emergency contact information for persons served at the facility that can be readily accessed in an emergency. new text end

new text begin Subd. 6. new text end

new text begin Emergency equipment. new text end

new text begin The facility must have a flashlight and a portable radio or television set that do not require electricity and can be used if a power failure occurs. new text end

new text begin Subd. 7. new text end

new text begin Telephone and posted numbers. new text end

new text begin A facility must have a non-coin operated telephone that is readily accessible. A list of emergency numbers must be posted in a prominent location. When an area has a 911 number or a mental health crisis intervention team number, both numbers must be posted and the emergency number listed must be 911. In areas of the state without a 911 number, the numbers listed must be those of the local fire department, police department, emergency transportation, and poison control center. The names and telephone numbers of each person's representative, physician, and dentist must be readily available. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 39.

new text begin [245D.23] COMMUNITY RESIDENTIAL SETTINGS; SATELLITE LICENSURE REQUIREMENTS AND APPLICATION PROCESS. new text end

new text begin Subdivision 1. new text end

new text begin Separate satellite license required for separate sites. new text end

new text begin (a) A license holder providing residential support services must obtain a separate satellite license for each community residential setting located at separate addresses when the community residential settings are to be operated by the same license holder. For purposes of this chapter, a community residential setting is a satellite of the home and community-based services license. new text end

new text begin (b) Community residential settings are permitted single-family use homes. After a license has been issued, the commissioner shall notify the local municipality where the residence is located of the approved license. new text end

new text begin Subd. 2. new text end

new text begin Notification to local agency. new text end

new text begin The license holder must notify the local agency within 24 hours of the onset of changes in a residence resulting from construction, remodeling, or damages requiring repairs that require a building permit or may affect a licensing requirement in this chapter. new text end

new text begin Subd. 3. new text end

new text begin Alternate overnight supervision. new text end

new text begin A license holder granted an alternate overnight supervision technology adult foster care license according to section 245A.11, subdivision 7a, that converts to a community residential setting satellite license according to this chapter, must retain that designation. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 40.

new text begin [245D.24] COMMUNITY RESIDENTIAL SETTINGS; PHYSICAL PLANT AND ENVIRONMENT. new text end

new text begin Subdivision 1. new text end

new text begin Occupancy. new text end

new text begin The residence must meet the definition of a dwelling unit in a residential occupancy. new text end

new text begin Subd. 2. new text end

new text begin Common area requirements. new text end

new text begin The living area must be provided with an adequate number of furnishings for the usual functions of daily living and social activities. The dining area must be furnished to accommodate meals shared by all persons living in the residence. These furnishings must be in good repair and functional to meet the daily needs of the persons living in the residence. new text end

new text begin Subd. 3. new text end

new text begin Bedrooms. new text end

new text begin (a) People receiving services must mutually consent, in writing, to sharing a bedroom with one another. No more than two people receiving services may share one bedroom. new text end

new text begin (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. new text end

new text begin (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. new text end

new text begin (d) Unless otherwise documented through assessment as a safety concern for the person, each person must be provided with the following furnishings: new text end

new text begin (1) a separate bed of proper size and height for the convenience and comfort of the person, with a clean mattress in good repair; new text end

new text begin (2) clean bedding appropriate for the season for each person; new text end

new text begin (3) an individual cabinet, or dresser, shelves, and a closet, for storage of personal possessions and clothing; and new text end

new text begin (4) a mirror for grooming. new text end

new text begin (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. new text end

new text begin (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 end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 41.

new text begin [245D.25] COMMUNITY RESIDENTIAL SETTINGS; FOOD AND WATER. new text end

new text begin Subdivision 1. new text end

new text begin Water. new text end

new text begin Potable water from privately owned wells must be tested annually by a Department of Health-certified laboratory for coliform bacteria and nitrate nitrogens to verify safety. The health authority may require retesting and corrective measures if results exceed state water standards in Minnesota Rules, chapter 4720, or in the event of flooding or an incident which may put the well at risk of contamination. To prevent scalding, the water temperature of faucets must not exceed 120 degrees Fahrenheit. new text end

new text begin Subd. 2. new text end

new text begin Food. new text end

new text begin Food served must meet any special dietary needs of a person as prescribed by the person's physician or dietitian. Three nutritionally balanced meals a day must be served or made available to persons, and nutritious snacks must be available between meals. new text end

new text begin Subd. 3. new text end

new text begin Food safety. new text end

new text begin Food must be obtained, handled, and properly stored to prevent contamination, spoilage, or a threat to the health of a person. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 42.

new text begin [245D.26] COMMUNITY RESIDENTIAL SETTINGS; SANITATION AND HEALTH. new text end

new text begin Subdivision 1. new text end

new text begin Goods provided by the license holder. new text end

new text begin Individual clean bed linens appropriate for the season and the person's comfort, including towels and wash cloths, must be available for each person. Usual or customary goods for the operation of a residence which are communally used by all persons receiving services living in the residence must be provided by the license holder, including household items for meal preparation, cleaning supplies to maintain the cleanliness of the residence, window coverings on windows for privacy, toilet paper, and hand soap. new text end

new text begin Subd. 2. new text end

new text begin Personal items. new text end

new text begin Personal health and hygiene items must be stored in a safe and sanitary manner. new text end

new text begin Subd. 3. new text end

new text begin Pets and service animals. new text end

new text begin Pets and service animals housed within the residence must be immunized and maintained in good health as required by local ordinances and state law. The license holder must ensure that the person and the person's representative are notified before admission of the presence of pets in the residence. new text end

new text begin Subd. 4. new text end

new text begin Smoking in the residence. new text end

new text begin License holders must comply with the requirements of the Minnesota Clean Indoor Air Act, sections 144.411 to 144.417, when smoking is permitted in the residence. new text end

new text begin Subd. 5. new text end

new text begin Weapons. new text end

new text begin Weapons and ammunition must be stored separately in locked areas that are inaccessible to a person receiving services. For purposes of this subdivision, "weapons" means firearms and other instruments or devices designed for and capable of producing bodily harm. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 43.

new text begin [245D.27] DAY SERVICES FACILITIES; SATELLITE LICENSURE REQUIREMENTS AND APPLICATION PROCESS. new text end

new text begin Except for day service facilities on the same or adjoining lot, the license holder providing day services must apply for a separate license for each facility-based service site when the license holder is the owner, lessor, or tenant of the service site at which persons receive day services and the license holder's employees who provide day services are present for a cumulative total of more than 30 days within any 12-month period. For purposes of this chapter, a day services facility license is a satellite license of the day services program. A day services program may operate multiple licensed day service facilities in one or more counties in the state. For the purposes of this section, "adjoining lot" means day services facilities that are next door to or across the street from one another. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 44.

new text begin [245D.28] DAY SERVICES FACILITIES; PHYSICAL PLANT AND SPACE REQUIREMENTS. new text end

new text begin Subdivision 1. new text end

new text begin Facility capacity and useable space requirements. new text end

new text begin (a) The facility capacity of each day service facility must be determined by the amount of primary space available, the scheduling of activities at other service sites, and the space requirements of all persons receiving services at the facility, not just the licensed services. The facility capacity must specify the maximum number of persons that may receive services on site at any one time. new text end

new text begin (b) When a facility is located in a multifunctional organization, the facility may share common space with the multifunctional organization if the required available primary space for use by persons receiving day services is maintained while the facility is operating. The license holder must comply at all times with all applicable fire and safety codes under section 245A.04, subdivision 2a, and adequate supervision requirements under section 245D.31 for all persons receiving day services. new text end

new text begin (c) A day services facility must have a minimum of 40 square feet of primary space available for each person receiving services who is present at the site at any one time. Primary space does not include: new text end

new text begin (1) common areas, such as hallways, stairways, closets, utility areas, bathrooms, and kitchens; new text end

new text begin (2) floor areas beneath stationary equipment; or new text end

new text begin (3) any space occupied by persons associated with the multifunctional organization while persons receiving day services are using common space. new text end

new text begin Subd. 2. new text end

new text begin Individual personal articles. new text end

new text begin Each person must be provided space in a closet, cabinet, on a shelf, or a coat hook for storage of personal items for the person's own use while receiving services at the facility, unless doing so would interfere with safety precautions, another person's work space, or violate a building or fire code. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 45.

new text begin [245D.29] DAY SERVICES FACILITIES; HEALTH AND SAFETY REQUIREMENTS. new text end

new text begin Subdivision 1. new text end

new text begin Refrigeration. new text end

new text begin If the license holder provides refrigeration at service sites owned or leased by the license holder for storing perishable foods and perishable portions of bag lunches, whether the foods are supplied by the license holder or the persons receiving services, the refrigeration must have a temperature of 40 degrees Fahrenheit or less. new text end

new text begin Subd. 2. new text end

new text begin Drinking water. new text end

new text begin Drinking water must be available to all persons receiving services. If a person is unable to request or obtain drinking water, it must be provided according to that person's individual needs. Drinking water must be provided in single-service containers or from drinking fountains accessible to all persons. new text end

new text begin Subd. 3. new text end

new text begin Individuals who become ill during the day. new text end

new text begin There must be an area in which a person receiving services can rest if: new text end

new text begin (1) the person becomes ill during the day; new text end

new text begin (2) the person does not live in a licensed residential site; new text end

new text begin (3) the person requires supervision; and new text end

new text begin (4) there is not a caretaker immediately available. Supervision must be provided until the caretaker arrives to bring the person home. new text end

new text begin Subd. 4. new text end

new text begin Safety procedures. new text end

new text begin The license holder must establish general written safety procedures that include criteria for selecting, training, and supervising persons who work with hazardous machinery, tools, or substances. Safety procedures specific to each person's activities must be explained and be available in writing to all staff members and persons receiving services. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 46.

new text begin [245D.31] DAY SERVICES FACILITIES; STAFF RATIO AND FACILITY COVERAGE. new text end

new text begin Subdivision 1. new text end

new text begin Scope. new text end

new text begin This section applies only to facility-based day services. new text end

new text begin Subd. 2. new text end

new text begin Factors. new text end

new text begin (a) The number of direct support service staff members that a license holder must have on duty at the facility at a given time to meet the minimum staffing requirements established in this section varies according to: new text end

new text begin (1) the number of persons who are enrolled and receiving direct support services at that given time; new text end

new text begin (2) the staff ratio requirement established under subdivision 3 for each person who is present; and new text end

new text begin (3) whether the conditions described in subdivision 8 exist and warrant additional staffing beyond the number determined to be needed under subdivision 7. new text end

new text begin (b) The commissioner must consider the factors in paragraph (a) in determining a license holder's compliance with the staffing requirements and must further consider whether the staff ratio requirement established under subdivision 3 for each person receiving services accurately reflects the person's need for staff time. new text end

new text begin Subd. 3. new text end

new text begin Staff ratio requirement for each person receiving services. new text end

new text begin The case manager, in consultation with the interdisciplinary team, must determine at least once each year which of the ratios in subdivisions 4, 5, and 6 is appropriate for each person receiving services on the basis of the characteristics described in subdivisions 4, 5, and 6. The ratio assigned each person and the documentation of how the ratio was arrived at must be kept in each person's individual service plan. Documentation must include an assessment of the person with respect to the characteristics in subdivisions 4, 5, and 6 recorded on a standard assessment form required by the commissioner. new text end

new text begin Subd. 4. new text end

new text begin Person requiring staff ratio of one to four. new text end

new text begin A person must be assigned a staff ratio requirement of one to four if: new text end

new text begin (1) on a daily basis the person requires total care and monitoring or constant hand-over-hand physical guidance to successfully complete at least three of the following activities: toileting, communicating basic needs, eating, ambulating; or is not capable of taking appropriate action for self-preservation under emergency conditions; or new text end

new text begin (2) the person engages in conduct that poses an imminent risk of physical harm to self or others at a documented level of frequency, intensity, or duration requiring frequent daily ongoing intervention and monitoring as established in the person's coordinated service and support plan or coordinated service and support plan addendum. new text end

new text begin Subd. 5. new text end

new text begin Person requiring staff ratio of one to eight. new text end

new text begin A person must be assigned a staff ratio requirement of one to eight if: new text end

new text begin (1) the person does not meet the requirements in subdivision 4; and new text end

new text begin (2) on a daily basis the person requires verbal prompts or spot checks and minimal or no physical assistance to successfully complete at least four of the following activities: toileting, communicating basic needs, eating, ambulating, or taking appropriate action for self-preservation under emergency conditions. new text end

new text begin Subd. 6. new text end

new text begin Person requiring staff ratio of one to six. new text end

new text begin A person who does not have any of the characteristics described in subdivision 4 or 5 must be assigned a staff ratio requirement of one to six. new text end

new text begin Subd. 7. new text end

new text begin Determining number of direct support service staff required. new text end

new text begin The minimum number of direct support service staff members required at any one time to meet the combined staff ratio requirements of the persons present at that time can be determined by the following steps: new text end

new text begin (1) assign to each person in attendance the three-digit decimal below that corresponds to the staff ratio requirement assigned to that person. A staff ratio requirement of one to four equals 0.250. A staff ratio requirement of one to eight equals 0.125. A staff ratio requirement of one to six equals 0.166. A staff ratio requirement of one to ten equals 0.100; new text end

new text begin (2) add all of the three-digit decimals (one three-digit decimal for every person in attendance) assigned in clause (1); new text end

new text begin (3) when the sum in clause (2) falls between two whole numbers, round off the sum to the larger of the two whole numbers; and new text end

new text begin (4) the larger of the two whole numbers in clause (3) equals the number of direct support service staff members needed to meet the staff ratio requirements of the persons in attendance. new text end

new text begin Subd. 8. new text end

new text begin Staff to be included in calculating minimum staffing requirement. new text end

new text begin Only staff providing direct support must be counted as staff members in calculating the staff-to-participant ratio. A volunteer may be counted as a direct support staff in calculating the staff-to-participant ratio if the volunteer meets the same standards and requirements as paid staff. No person receiving services must be counted as or be substituted for a staff member in calculating the staff-to-participant ratio. new text end

new text begin Subd. 9. new text end

new text begin Conditions requiring additional direct support staff. new text end

new text begin The license holder must increase the number of direct support staff members present at any one time beyond the number arrived at in subdivision 4 if necessary when any one or combination of the following circumstances can be documented by the commissioner as existing: new text end

new text begin (1) the health and safety needs of the persons receiving services cannot be met by the number of staff members available under the staffing pattern in effect even though the number has been accurately calculated under subdivision 7; or new text end

new text begin (2) the person's conduct frequently presents an imminent risk of physical harm to self or others. new text end

new text begin Subd. 10. new text end

new text begin Supervision requirements. new text end

new text begin (a) At no time must one direct support staff member be assigned responsibility for supervision and training of more than ten persons receiving supervision and training, except as otherwise stated in each person's risk management plan. new text end

new text begin (b) In the temporary absence of the director or a supervisor, a direct support staff member must be designated to supervise the center. new text end

new text begin Subd. 11. new text end

new text begin Multifunctional programs. new text end

new text begin A multifunctional program may count other employees of the organization besides direct support staff of the day service facility in calculating the staff-to-participant ratio if the employee is assigned to the day services facility for a specified amount of time, during which the employee is not assigned to another organization or program. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 47.

new text begin [245D.32] ALTERNATIVE LICENSING INSPECTIONS. new text end

new text begin Subdivision 1. new text end

new text begin Eligibility for an alternative licensing inspection. new text end

new text begin (a) A license holder providing services licensed under this chapter, with a qualifying accreditation and meeting the eligibility criteria in paragraphs (b) and (c), may request approval for an alternative licensing inspection when all services provided under the license holder's license are accredited. A license holder with a qualifying accreditation and meeting the eligibility criteria in paragraphs (b) and (c) may request approval for an alternative licensing inspection for individual community residential settings or day services facilities licensed under this chapter. new text end

new text begin (b) In order to be eligible for an alternative licensing inspection, the program must have had at least one inspection by the commissioner following issuance of the initial license. For programs operating a day services facility, each facility must have had at least one on-site inspection by the commissioner following issuance of the initial license. new text end

new text begin (c) In order to be eligible for an alternative licensing inspection, the program must have been in substantial and consistent compliance at the time of the last licensing inspection and during the current licensing period. For purposes of this section, "substantial and consistent compliance" means: new text end

new text begin (1) the license holder's license was not made conditional, suspended, or revoked; new text end

new text begin (2) there have been no substantiated allegations of maltreatment against the license holder; new text end

new text begin (3) there were no program deficiencies identified that would jeopardize the health, safety, or rights of persons being served; and new text end

new text begin (4) the license holder maintained substantial compliance with the other requirements of chapters 245A and 245C and other applicable laws and rules. new text end

new text begin (d) For the purposes of this section, the license holder's license includes services licensed under this chapter that were previously licensed under chapter 245B until December 31, 2013. new text end

new text begin Subd. 2. new text end

new text begin Qualifying accreditation. new text end

new text begin The commissioner must accept a three-year accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF) as a qualifying accreditation. new text end

new text begin Subd. 3. new text end

new text begin Request for approval of an alternative inspection status. new text end

new text begin (a) A request for an alternative inspection must be made on the forms and in the manner prescribed by the commissioner. When submitting the request, the license holder must submit all documentation issued by the accrediting body verifying that the license holder has obtained and maintained the qualifying accreditation and has complied with recommendations or requirements from the accrediting body during the period of accreditation. Based on the request and the additional required materials, the commissioner may approve an alternative inspection status. new text end

new text begin (b) The commissioner must notify the license holder in writing that the request for an alternative inspection status has been approved. Approval must be granted until the end of the qualifying accreditation period. new text end

new text begin (c) The license holder must submit a written request for approval to be renewed one month before the end of the current approval period according to the requirements in paragraph (a). If the license holder does not submit a request to renew approval as required, the commissioner must conduct a licensing inspection. new text end

new text begin Subd. 4. new text end

new text begin Programs approved for alternative licensing inspection; deemed compliance licensing requirements. new text end

new text begin (a) A license holder approved for alternative licensing inspection under this section is required to maintain compliance with all licensing standards according to this chapter. new text end

new text begin (b) A license holder approved for alternative licensing inspection under this section must be deemed to be in compliance with all the requirements of this chapter, and the commissioner must not perform routine licensing inspections. new text end

new text begin (c) Upon receipt of a complaint regarding the services of a license holder approved for alternative licensing inspection under this section, the commissioner must investigate the complaint and may take any action as provided under section 245A.06 or 245A.07. new text end

new text begin Subd. 5. new text end

new text begin Investigations of alleged or suspected maltreatment. new text end

new text begin Nothing in this section changes the commissioner's responsibilities to investigate alleged or suspected maltreatment of a minor under section 626.556 or a vulnerable adult under section 626.557. new text end

new text begin Subd. 6. new text end

new text begin Termination or denial of subsequent approval. new text end

new text begin Following approval of an alternative licensing inspection, the commissioner may terminate or deny subsequent approval of an alternative licensing inspection if the commissioner determines that: new text end

new text begin (1) the license holder has not maintained the qualifying accreditation; new text end

new text begin (2) the commissioner has substantiated maltreatment for which the license holder or facility is determined to be responsible during the qualifying accreditation period; or new text end

new text begin (3) during the qualifying accreditation period, the license holder has been issued an order for conditional license, fine, suspension, or license revocation that has not been reversed upon appeal. new text end

new text begin Subd. 7. new text end

new text begin Appeals. new text end

new text begin The commissioner's decision that the conditions for approval for an alternative licensing inspection have not been met is final and not subject to appeal under the provisions of chapter 14. new text end

new text begin Subd. 8. new text end

new text begin Commissioner's programs. new text end

new text begin Home and community-based services licensed under this chapter for which the commissioner is the license holder with a qualifying accreditation are excluded from being approved for an alternative licensing inspection. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 48.

new text begin [245D.33] ADULT MENTAL HEALTH CERTIFICATION STANDARDS. new text end

new text begin (a) The commissioner of human services shall issue a mental health certification for services licensed under this chapter when a license holder is determined to have met the requirements under paragraph (b). This certification is voluntary for license holders. The certification shall be printed on the license and identified on the commissioner's public Web site. new text end

new text begin (b) The requirements for certification are: new text end

new text begin (1) all staff have received at least seven hours of annual training covering all of the following topics: new text end

new text begin (i) mental health diagnoses; new text end

new text begin (ii) mental health crisis response and de-escalation techniques; new text end

new text begin (iii) recovery from mental illness; new text end

new text begin (iv) treatment options, including evidence-based practices; new text end

new text begin (v) medications and their side effects; new text end

new text begin (vi) co-occurring substance abuse and health conditions; and new text end

new text begin (vii) community resources; new text end

new text begin (2) a mental health professional, as defined in section 245.462, subdivision 18, or a mental health practitioner as defined in section 245.462, subdivision 17, is available for consultation and assistance; new text end

new text begin (3) there is a plan and protocol in place to address a mental health crisis; and new text end

new text begin (4) each person's individual service and support plan identifies who is providing clinical services and their contact information, and includes an individual crisis prevention and management plan developed with the person. new text end

new text begin (c) License holders seeking certification under this section must request this certification on forms and in the manner prescribed by the commissioner. new text end

new text begin (d) If the commissioner finds that the license holder has failed to comply with the certification requirements under paragraph (b), the commissioner may issue a correction order and an order of conditional license in accordance with section 245A.06 or may issue a sanction in accordance with section 245A.07, including and up to removal of the certification. new text end

new text begin (e) A denial of the certification or the removal of the certification based on a determination that the requirements under paragraph (b) have not been met is not subject to appeal. A license holder that has been denied a certification or that has had a certification removed may again request certification when the license holder is in compliance with the requirements of paragraph (b). new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 49.

Minnesota Statutes 2012, 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 providers;

(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.

new text begin (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: new text end

new text begin (1) phasing out the use of prohibited procedures; new text end

new text begin (2) acquisition of skills needed to eliminate the prohibited procedures within the plan's timeline; and new text end

new text begin (3) accomplishment of identified outcomes. new text end

new text begin 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 end

deleted text begin (e)deleted text end new text begin (f)new text end 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 January 1, 2014. new text end

Sec. 50.

Minnesota Statutes 2012, section 256B.092, subdivision 11, is amended to read:

Subd. 11.

Residential support services.

(a) Upon federal approval, there is established a new service called residential support that is available on the community alternative care, community alternatives for disabled individuals, developmental disabilities, and brain injury waivers. Existing waiver service descriptions must be modified to the extent necessary to ensure there is no duplication between other services. Residential support services must be provided by vendors licensed as a community residential setting as defined in section 245A.11, subdivision 8new text begin , a foster care setting licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or an adult foster care setting licensed under Minnesota Rules, parts 9555.5105 to 9555.6265new text end .

(b) Residential support services must meet the following criteria:

deleted text begin (1) providers of residential support services must own or control the residential site; deleted text end

deleted text begin (2) the residential site must not be the primary residence of the license holder; deleted text end

deleted text begin (3)deleted text end new text begin (1)new text end the residential site must have a designated deleted text begin program supervisordeleted text end new text begin personnew text end responsible for programnew text begin management,new text end oversight, development, and implementation of policies and procedures;

deleted text begin (4)deleted text end new text begin (2)new text end the provider of residential support services must provide supervision, training, and assistance as described in the person's coordinated service and support plan; and

deleted text begin (5)deleted text end new text begin (3)new text end the provider of residential support services must meet the requirements of licensure and additional requirements of the person's coordinated service and support plan.

(c) Providers of residential support services that meet the definition in paragraph (a) deleted text begin must be registered using a process determined by the commissioner beginning July 1, 2009deleted text end new text begin must be licensed according to chapter 245Dnew text end . Providers licensed to provide child foster care under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, and that meet the requirements in section 245A.03, subdivision 7, paragraph (g), are considered registered under this section.

Sec. 51.

Minnesota Statutes 2012, 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 providers;

(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).

new text begin (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: new text end

new text begin (1) phasing out the use of prohibited procedures; new text end

new text begin (2) acquisition of skills needed to eliminate the prohibited procedures within the plan's timeline; and new text end

new text begin (3) accomplishment of identified outcomes. new text end

new text begin 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 end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 52.

Minnesota Statutes 2012, section 256B.4912, subdivision 1, is amended to read:

Subdivision 1.

Provider qualifications.

new text begin (a) new text end For the home and community-based waivers providing services to seniors and individuals with disabilitiesnew text begin under sections 256B.0913, 256B.0915, 256B.092, and 256B.49new text end , the commissioner shall establish:

(1) agreements with enrolled waiver service providers to ensure providers meet Minnesota health care program requirements;

(2) regular reviews of provider qualifications, and including requests of proof of documentation; and

(3) processes to gather the necessary information to determine provider qualifications.

new text begin (b) new text end Beginning July 1, 2012, staff that provide direct contact, as defined in section 245C.02, subdivision 11, for services specified in the federally approved waiver plans must meet the requirements of chapter 245C prior to providing waiver services and as part of ongoing enrollment. Upon federal approval, this requirement must also apply to consumer-directed community supports.

new text begin (c) Beginning January 1, 2014, service owners and managerial officials overseeing the management or policies of services that provide direct contact as specified in the federally approved waiver plans must meet the requirements of chapter 245C prior to reenrollment or, for new providers, prior to initial enrollment if they have not already done so as a part of service licensure requirements. new text end

Sec. 53.

Minnesota Statutes 2012, section 256B.4912, subdivision 7, is amended to read:

Subd. 7.

Applicant and license holder training.

An applicant or license holder new text begin for the home and community-based waivers providing services to seniors and individuals with disabilities under sections 256B.0913, 256B.0915, 256B.092, and 256B.49 new text end that is not enrolled as a Minnesota health care program home and community-based services waiver provider at the time of application must ensure that at least one controlling individual completes a onetime training on the requirements for providing home and community-based services deleted text begin from a qualified sourcedeleted text end as determined by the commissioner, before a provider is enrolled or license is issued.new text begin Within six months of enrollment, a newly enrolled home and community-based waiver service provider must ensure that at least one controlling individual has completed training on waiver and related program billing. Exemptions to new waiver provider training requirements may be granted, as determined by the commissioner.new text end

Sec. 54.

Minnesota Statutes 2012, section 256B.4912, is amended by adding a subdivision to read:

new text begin Subd. 8. new text end

new text begin Data on use of emergency use of manual restraint. new text end

new text begin Beginning July 1, 2013, facilities and services to be licensed under chapter 245D shall submit data regarding the use of emergency use of manual restraint as identified in section 245D.061 in a format and at a frequency identified by the commissioner. new text end

Sec. 55.

Minnesota Statutes 2012, section 256B.4912, is amended by adding a subdivision to read:

new text begin Subd. 9. new text end

new text begin Definitions. new text end

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

new text begin (b) "Controlling individual" means 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. new text end

new text begin (c) "Managerial official" means an individual who has decision-making authority related to the operation of the program and responsibility for the ongoing management of or direction of the policies, services, or employees of the program. new text end

new text begin (d) "Owner" means an individual who has direct or indirect ownership interest in a corporation or partnership, or business association enrolling with the Department of Human Services as a provider of waiver services. new text end

Sec. 56.

Minnesota Statutes 2012, section 256B.4912, is amended by adding a subdivision to read:

new text begin Subd. 10. new text end

new text begin Enrollment requirements. new text end

new text begin All home and community-based waiver providers must provide, at the time of enrollment and within 30 days of a request, in a format determined by the commissioner, information and documentation that includes, but is not limited to, the following: new text end

new text begin (1) proof of surety bond coverage in the amount of $50,000 or ten percent of the provider's payments from Medicaid in the previous calendar year, whichever is greater; new text end

new text begin (2) proof of fidelity bond coverage in the amount of $20,000; and new text end

new text begin (3) proof of liability insurance. new text end

Sec. 57.

Minnesota Statutes 2012, section 626.557, subdivision 9a, is amended to read:

Subd. 9a.

Evaluation and referral of reports made to common entry point unit.

The common entry point must screen the reports of alleged or suspected maltreatment for immediate risk and make all necessary referrals as follows:

(1) if the common entry point determines that there is an immediate need for adult protective services, the common entry point agency shall immediately notify the appropriate county agency;

(2) if the report contains suspected criminal activity against a vulnerable adult, the common entry point shall immediately notify the appropriate law enforcement agency;

(3) the common entry point shall refer all reports of alleged or suspected maltreatment to the appropriate lead investigative agency as soon as possible, but in any event no longer than two working days;new text begin andnew text end

deleted text begin (4) if the report involves services licensed by the Department of Human Services and subject to chapter 245D, the common entry point shall refer the report to the county as the lead agency according to clause (3), but shall also notify the Department of Human Services of the report; and deleted text end

deleted text begin (5)deleted text end new text begin (4)new text end if the report contains information about a suspicious death, the common entry point shall immediately notify the appropriate law enforcement agencies, the local medical examiner, and the ombudsman for mental health and developmental disabilities established under section 245.92. Law enforcement agencies shall coordinate with the local medical examiner and the ombudsman as provided by law.

Sec. 58.

Minnesota Statutes 2012, section 626.5572, subdivision 13, is amended to read:

Subd. 13.

Lead investigative agency.

"Lead investigative agency" is the primary administrative agency responsible for investigating reports made under section 626.557.

(a) The Department of Health is the lead investigative agency for facilities or services licensed or required to be licensed as hospitals, home care providers, nursing homes, boarding care homes, hospice providers, residential facilities that are also federally certified as intermediate care facilities that serve people with developmental disabilities, or any other facility or service not listed in this subdivision that is licensed or required to be licensed by the Department of Health for the care of vulnerable adults. "Home care provider" has the meaning provided in section 144A.43, subdivision 4, and applies when care or services are delivered in the vulnerable adult's home, whether a private home or a housing with services establishment registered under chapter 144D, including those that offer assisted living services under chapter 144G.

(b) deleted text begin Except as provided under paragraph (c), for services licensed according to chapter 245D,deleted text end The Department of Human Services is the lead investigative agency for facilities or services licensed or required to be licensed as adult day care, adult foster care, new text begin community residential settings, new text end programs for people with deleted text begin developmentaldeleted text end disabilities, family adult day services, mental health programs, mental health clinics, chemical dependency programs, the Minnesota sex offender program, or any other facility or service not listed in this subdivision that is licensed or required to be licensed by the Department of Human Services.

(c) The county social service agency or its designee is the lead investigative agency for all other reports, including, but not limited to, reports involving vulnerable adults receiving services from a personal care provider organization under section 256B.0659deleted text begin , or receiving home and community-based services licensed by the Department of Human Services and subject to chapter 245Ddeleted text end .

Sec. 59.

new text begin REPORT ON TRANSFER OF VULNERABLE ADULT MALTREATMENT INVESTIGATION DUTIES. new text end

new text begin (a) The commissioner of human services shall provide a follow-up report on the collection of fees and actual licensing and maltreatment investigation costs resulting from the reform of the standards and oversight for home and community-based services as adopted and funded by the 2013 legislature. new text end

new text begin (b) The report must identify actual fees collected based on provider revenue, distinguish the amount of fees collected based on non-medical assistance revenue, and determine the impact of the non-medical assistance revenue on future licensing fees. new text end

new text begin (c) The report must recommend how maltreatment investigations, when conducted by the commissioner of human services, should be funded and at what amount. The recommendation must identify whether maltreatment investigation costs should be recovered through licensure fees, an appropriation from the general fund, provider fines for substantiated maltreatment, licensing fee surcharges related to substantiated maltreatment, or a combination of these sources. new text end

new text begin (d) The report must contain a cost comparison between similar maltreatment investigations completed by the Minnesota Department of Health and the Department of Human Services, and describe the method of funding for the investigations conducted by the Department of Health. new text end

new text begin (e) The report must make recommendations for changes that the commissioner determines are appropriate to reduce the costs of maltreatment investigations. new text end

new text begin (f) The commissioner must submit the report with draft legislation proposing alternative fees, if necessary, to the chairs and ranking minority members of the legislative committees with jurisdiction over health and human services policy and finance by July 1, 2015. new text end

Sec. 60.

new text begin INTEGRATED LICENSING SYSTEM FOR HOME CARE AND HOME AND COMMUNITY-BASED SERVICES. new text end

new text begin (a) The Department of Health Compliance Monitoring Division and the Department of Human Services Licensing Division shall jointly develop an integrated licensing system for providers of both home care services subject to licensure under Minnesota Statutes, chapter 144A, and for home and community-based services subject to licensure under Minnesota Statutes, chapter 245D. The integrated licensing system shall: new text end

new text begin (1) require only one license of any provider of services under Minnesota Statutes, sections 144A.43 to 144A.482, and 245D.03, subdivision 1; new text end

new text begin (2) promote quality services that recognize a person's individual needs and protect the person's health, safety, rights, and well-being; new text end

new text begin (3) promote provider accountability through application requirements, compliance inspections, investigations, and enforcement actions; new text end

new text begin (4) reference other applicable requirements in existing state and federal laws, including the federal Affordable Care Act; new text end

new text begin (5) establish internal procedures to facilitate ongoing communications between the agencies and with providers and services recipients about the regulatory activities; new text end

new text begin (6) create a link between the agency Web sites so that providers and the public can access the same information regardless of which Web site is accessed initially; and new text end

new text begin (7) collect data on identified outcome measures as necessary for the agencies to report to the Centers for Medicare and Medicaid Services. new text end

new text begin (b) The joint recommendations for legislative changes to implement the integrated licensing system are due to the legislature by February 15, 2014. new text end

new text begin (c) Before implementation of the integrated licensing system, providers licensed as home care providers under Minnesota Statutes, chapter 144A, may also provide home and community-based services subject to licensure under Minnesota Statutes, chapter 245D, without obtaining a home and community-based services license under Minnesota Statutes, chapter 245D. During this time, the conditions under clauses (1) to (3) shall apply to these providers: new text end

new text begin (1) the provider must comply with all requirements under Minnesota Statutes, chapter 245D, for services otherwise subject to licensure under Minnesota Statutes, chapter 245D; new text end

new text begin (2) a violation of requirements under Minnesota Statutes, chapter 245D, may be enforced by the Department of Health under the enforcement authority set forth in Minnesota Statutes, section 144A.475; and new text end

new text begin (3) the Department of Health will provide information to the Department of Human Services about each provider licensed under this section, including the provider's license application, licensing documents, inspections, information about complaints received, and investigations conducted for possible violations of Minnesota Statutes, chapter 245D. new text end

Sec. 61.

new text begin REPEALER. new text end

new text begin (a) new text end new text begin Minnesota Statutes 2012, sections 245B.01; 245B.02; 245B.03; 245B.031; 245B.04; 245B.05, subdivisions 1, 2, 3, 5, 6, and 7; 245B.055; 245B.06; 245B.07; and 245B.08, new text end new text begin are repealed effective January 1, 2014. new text end

new text begin (b) new text end new text begin Minnesota Statutes 2012, section 245D.08, new text end new text begin is repealed. new text end

ARTICLE 9

WAIVER PROVIDER STANDARDS TECHNICAL CHANGES

Section 1.

Minnesota Statutes 2012, section 16C.10, subdivision 5, is amended to read:

Subd. 5.

Specific purchases.

The solicitation process described in this chapter is not required for acquisition of the following:

(1) merchandise for resale purchased under policies determined by the commissioner;

(2) farm and garden products which, as determined by the commissioner, may be purchased at the prevailing market price on the date of sale;

(3) goods and services from the Minnesota correctional facilities;

(4) goods and services from rehabilitation facilities and extended employment providers that are certified by the commissioner of employment and economic development, and day deleted text begin training and habilitationdeleted text end services licensed under deleted text begin sections 245B.01 to 245B.08deleted text end new text begin chapter 245Dnew text end ;

(5) goods and services for use by a community-based facility operated by the commissioner of human services;

(6) goods purchased at auction or when submitting a sealed bid at auction provided that before authorizing such an action, the commissioner consult with the requesting agency to determine a fair and reasonable value for the goods considering factors including, but not limited to, costs associated with submitting a bid, travel, transportation, and storage. This fair and reasonable value must represent the limit of the state's bid;

(7) utility services where no competition exists or where rates are fixed by law or ordinance; and

(8) goods and services from Minnesota sex offender program facilities.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 2.

Minnesota Statutes 2012, section 16C.155, subdivision 1, is amended to read:

Subdivision 1.

Service contracts.

The commissioner of administration shall ensure that a portion of all contracts for janitorial services; document imaging; document shredding; and mailing, collating, and sorting services be awarded by the state to rehabilitation programs and extended employment providers that are certified by the commissioner of employment and economic development, and day deleted text begin training and habilitationdeleted text end services licensed under deleted text begin sections 245B.01 to 245B.08deleted text end new text begin chapter 245Dnew text end . The amount of each contract awarded under this section may exceed the estimated fair market price as determined by the commissioner for the same goods and services by up to six percent. The aggregate value of the contracts awarded to eligible providers under this section in any given year must exceed 19 percent of the total value of all contracts for janitorial services; document imaging; document shredding; and mailing, collating, and sorting services entered into in the same year. For the 19 percent requirement to be applicable in any given year, the contract amounts proposed by eligible providers must be within six percent of the estimated fair market price for at least 19 percent of the contracts awarded for the corresponding service area.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 3.

Minnesota Statutes 2012, section 144D.01, subdivision 4, is amended to read:

Subd. 4.

Housing with services establishment or establishment.

(a) "Housing with services establishment" or "establishment" means:

(1) an establishment providing sleeping accommodations to one or more adult residents, at least 80 percent of which are 55 years of age or older, and offering or providing, for a fee, one or more regularly scheduled health-related services or two or more regularly scheduled supportive services, whether offered or provided directly by the establishment or by another entity arranged for by the establishment; or

(2) an establishment that registers under section 144D.025.

(b) Housing with services establishment does not include:

(1) a nursing home licensed under chapter 144A;

(2) a hospital, certified boarding care home, or supervised living facility licensed under sections 144.50 to 144.56;

(3) a board and lodging establishment licensed under chapter 157 and Minnesota Rules, parts 9520.0500 to 9520.0670, 9525.0215 to 9525.0355, 9525.0500 to 9525.0660, or 9530.4100 to 9530.4450, or under chapter deleted text begin 245Bdeleted text end new text begin 245Dnew text end ;

(4) a board and lodging establishment which serves as a shelter for battered women or other similar purpose;

(5) a family adult foster care home licensed by the Department of Human Services;

(6) private homes in which the residents are related by kinship, law, or affinity with the providers of services;

(7) residential settings for persons with developmental disabilities in which the services are licensed under Minnesota Rules, parts 9525.2100 to 9525.2140, or applicable successor rules or laws;

(8) a home-sharing arrangement such as when an elderly or disabled person or single-parent family makes lodging in a private residence available to another person in exchange for services or rent, or both;

(9) a duly organized condominium, cooperative, common interest community, or owners' association of the foregoing where at least 80 percent of the units that comprise the condominium, cooperative, or common interest community are occupied by individuals who are the owners, members, or shareholders of the units; or

(10) services for persons with developmental disabilities that are provided under a license according to Minnesota Rules, parts 9525.2000 to 9525.2140 in effect until January 1, 1998, or under chapter deleted text begin 245Bdeleted text end new text begin 245Dnew text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 4.

Minnesota Statutes 2012, section 174.30, subdivision 1, is amended to read:

Subdivision 1.

Applicability.

(a) The operating standards for special transportation service adopted under this section do not apply to special transportation provided by:

(1) a common carrier operating on fixed routes and schedules;

(2) a volunteer driver using a private automobile;

(3) a school bus as defined in section 169.011, subdivision 71; or

(4) an emergency ambulance regulated under chapter 144.

(b) The operating standards adopted under this section only apply to providers of special transportation service who receive grants or other financial assistance from either the state or the federal government, or both, to provide or assist in providing that service; except that the operating standards adopted under this section do not apply to any nursing home licensed under section 144A.02, to any board and care facility licensed under section 144.50, or to any day training and habilitation services, day care, or group home facility licensed under sections 245A.01 to 245A.19 unless the facility or program provides transportation to nonresidents on a regular basis and the facility receives reimbursement, other than per diem payments, for that service under rules promulgated by the commissioner of human services.

(c) Notwithstanding paragraph (b), the operating standards adopted under this section do not apply to any vendor of services licensed under chapter deleted text begin 245Bdeleted text end new text begin 245Dnew text end that provides transportation services to consumers or residents of other vendors licensed under chapter deleted text begin 245Bdeleted text end new text begin 245Dnew text end and transports 15 or fewer persons, including consumers or residents and the driver.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 5.

Minnesota Statutes 2012, section 245A.02, subdivision 1, is amended to read:

Subdivision 1.

Scope.

The terms used in this chapter deleted text begin and chapter 245Bdeleted text end have the meanings given them in this section.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 6.

Minnesota Statutes 2012, section 245A.02, subdivision 9, is amended to read:

Subd. 9.

License holder.

"License holder" means an individual, corporation, partnership, voluntary association, or other organization that is legally responsible for the operation of the program, has been granted a license by the commissioner under this chapter or chapter deleted text begin 245Bdeleted text end new text begin 245D new text end and the rules of the commissioner, and is a controlling individual.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 7.

Minnesota Statutes 2012, section 245A.03, subdivision 9, is amended to read:

Subd. 9.

Permitted services by an individual who is related.

Notwithstanding subdivision 2, paragraph (a), clause (1), and subdivision 7, an individual who is related to a person receiving supported living services may provide licensed services to that person if:

(1) the person who receives supported living services received these services in a residential site on July 1, 2005;

(2) the services under clause (1) were provided in a corporate foster care setting for adults and were funded by the developmental disabilities home and community-based services waiver defined in section 256B.092;

(3) the individual who is related obtains and maintains both a license under chapter deleted text begin 245Bdeleted text end new text begin 245Dnew text end and an adult foster care license under Minnesota Rules, parts 9555.5105 to 9555.6265; and

(4) the individual who is related is not the guardian of the person receiving supported living services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 8.

Minnesota Statutes 2012, section 245A.04, subdivision 13, is amended to read:

Subd. 13.

Funds and property; other requirements.

(a) A license holder must ensure that persons served by the program retain the use and availability of personal funds or property unless restrictions are justified in the person's individual plan. deleted text begin This subdivision does not apply to programs governed by the provisions in section 245B.07, subdivision 10.deleted text end

(b) The license holder must ensure separation of funds of persons served by the program from funds of the license holder, the program, or program staff.

(c) Whenever the license holder assists a person served by the program with the safekeeping of funds or other property, the license holder must:

(1) immediately document receipt and disbursement of the person's funds or other property at the time of receipt or disbursement, including the person's signature, or the signature of the conservator or payee; and

(2) return to the person upon the person's request, funds and property in the license holder's possession subject to restrictions in the person's treatment plan, as soon as possible, but no later than three working days after the date of request.

(d) License holders and program staff must not:

(1) borrow money from a person served by the program;

(2) purchase personal items from a person served by the program;

(3) sell merchandise or personal services to a person served by the program;

(4) require a person served by the program to purchase items for which the license holder is eligible for reimbursement; or

(5) use funds of persons served by the program to purchase items for which the facility is already receiving public or private payments.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 9.

Minnesota Statutes 2012, section 245A.07, subdivision 3, is amended to read:

Subd. 3.

License suspension, revocation, or fine.

(a) The commissioner may suspend or revoke a license, or impose a fine if:

(1) a license holder fails to comply fully with applicable laws or rules;

(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 which has not been set aside under section 245C.22;

(3) a license holder knowingly withholds relevant information from or gives false or misleading information to the commissioner in connection with an application for a license, in connection with the background study status of an individual, during an investigation, or regarding compliance with applicable laws or rules; or

(4) after July 1, 2012, and upon request by the commissioner, a license holder fails to submit the information required of an applicant under section 245A.04, subdivision 1, paragraph (f) or (g).

A license holder who has had a license suspended, revoked, or has been ordered to pay a fine must be given notice of the action by certified mail or personal service. 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 reasons the license was suspended, revoked, or a fine was ordered.

(b) If the license was suspended or 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 an order suspending or revoking a license. The appeal of an order suspending or revoking a license 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 that the license has been suspended or revoked. If a request is made by personal service, it must be received by the commissioner within ten calendar days after the license holder received the order. Except as provided in subdivision 2a, paragraph (c), if a license holder submits a timely appeal of an order suspending or revoking a license, the license holder may continue to operate the program as provided in section 245A.04, subdivision 7, paragraphs (g) and (h), until the commissioner issues a final order on the suspension or revocation.

(c)(1) If the license holder was ordered to pay a fine, the notice must inform the license holder of the responsibility for payment of fines and the right to a contested case hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal of an order to pay a fine 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 that the fine has been ordered. If a request is made by personal service, it must be received by the commissioner within ten calendar days after the license holder received the order.

(2) The license holder shall pay the fines assessed on or before the payment date specified. If the license holder fails to fully comply with the order, the commissioner may issue a second fine or suspend the license until the license holder complies. If the license holder receives state funds, the state, county, or municipal agencies or departments responsible for administering the funds shall withhold payments and recover any payments made while the license is suspended for failure to pay a fine. A timely appeal shall stay payment of the fine until the commissioner issues a final order.

(3) A license holder shall promptly notify the commissioner of human services, in writing, when a violation specified in the order to forfeit a fine is corrected. If upon reinspection the commissioner determines that a violation has not been corrected as indicated by the order to forfeit a fine, the commissioner may issue a second fine. The commissioner shall notify the license holder by certified mail or personal service that a second fine has been assessed. The license holder may appeal the second fine as provided under this subdivision.

(4) Fines shall be assessed as follows: the license holder shall forfeit $1,000 for each determination of maltreatment of a child under section 626.556 or the maltreatment of a vulnerable adult under section 626.557 for which the license holder is determined responsible for the maltreatment under section 626.556, subdivision 10e, paragraph (i), or 626.557, subdivision 9c, paragraph (c); the license holder shall forfeit $200 for each occurrence of a violation of law or rule governing matters of health, safety, or supervision, including but not limited to the provision of adequate staff-to-child or adult ratios, and failure to comply with background study requirements under chapter 245C; and the license holder shall forfeit $100 for each occurrence of a violation of law or rule other than those subject to a $1,000 or $200 fine above. For purposes of this section, "occurrence" means each violation identified in the commissioner's fine order. Fines assessed against a license holder that holds a license to provide deleted text begin the residential-based habilitationdeleted text end new text begin home and community-based new text end services, as deleted text begin defined underdeleted text end new text begin identified innew text end section deleted text begin 245B.02, subdivision 20deleted text end new text begin 245D.03, subdivision 1new text end , and a new text begin community residential setting or day services facility new text end license deleted text begin to provide foster caredeleted text end new text begin under chapter 245D where the services are providednew text end , may be assessed against both licenses for the same occurrence, but the combined amount of the fines shall not exceed the amount specified in this clause for that occurrence.

(5) When a fine has been assessed, the license holder may not avoid payment by closing, selling, or otherwise transferring the licensed program to a third party. In such an event, the license holder will be personally liable for payment. In the case of a corporation, each controlling individual is personally and jointly liable for payment.

(d) Except for background study violations involving the failure to comply with an order to immediately remove an individual or an order to provide continuous, direct supervision, the commissioner shall not issue a fine under paragraph (c) relating to a background study violation to a license holder who self-corrects a background study violation before the commissioner discovers the violation. A license holder who has previously exercised the provisions of this paragraph to avoid a fine for a background study violation may not avoid a fine for a subsequent background study violation unless at least 365 days have passed since the license holder self-corrected the earlier background study violation.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 10.

Minnesota Statutes 2012, section 256B.0625, subdivision 19c, is amended to read:

Subd. 19c.

Personal care.

Medical assistance covers personal care assistance services provided by an individual who is qualified to provide the services according to subdivision 19a and sections 256B.0651 to 256B.0656, provided in accordance with a plan, and supervised by a qualified professional.

"Qualified professional" means a mental health professional as defined in section 245.462, subdivision 18, clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6); deleted text begin ordeleted text end a registered nurse as defined in sections 148.171 to 148.285, a licensed social worker as defined in sections 148E.010 and 148E.055, or a qualified deleted text begin developmental disabilities deleted text end deleted text begin specialist under section 245B.07, subdivision 4deleted text end new text begin designated coordinator under section 245D.081, subdivision 2new text end . The qualified professional shall perform the duties required in section 256B.0659.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 11.

Minnesota Statutes 2012, section 256B.5011, subdivision 2, is amended to read:

Subd. 2.

Contract provisions.

(a) The service contract with each intermediate care facility must include provisions for:

(1) modifying payments when significant changes occur in the needs of the consumers;

(2) appropriate and necessary statistical information required by the commissioner;

(3) annual aggregate facility financial information; and

(4) additional requirements for intermediate care facilities not meeting the standards set forth in the service contract.

(b) The commissioner of human services and the commissioner of health, in consultation with representatives from counties, advocacy organizations, and the provider community, shall review deleted text begin the consolidated standards under chapter 245B anddeleted text end new text begin the home and community-based services standards under chapter 245D and new text end the supervised living facility rule under Minnesota Rules, chapter 4665, to determine what provisions in Minnesota Rules, chapter 4665, may be waived by the commissioner of health for intermediate care facilities in order to enable facilities to implement the performance measures in their contract and provide quality services to residents without a duplication of or increase in regulatory requirements.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 12.

Minnesota Statutes 2012, section 471.59, subdivision 1, is amended to read:

Subdivision 1.

Agreement.

Two or more governmental units, by agreement entered into through action of their governing bodies, may jointly or cooperatively exercise any power common to the contracting parties or any similar powers, including those which are the same except for the territorial limits within which they may be exercised. The agreement may provide for the exercise of such powers by one or more of the participating governmental units on behalf of the other participating units. The term "governmental unit" as used in this section includes every city, county, town, school district, independent nonprofit firefighting corporation, other political subdivision of this or another state, another state, federally recognized Indian tribe, the University of Minnesota, the Minnesota Historical Society, nonprofit hospitals licensed under sections 144.50 to 144.56, rehabilitation facilities and extended employment providers that are certified by the commissioner of employment and economic development, deleted text begin day training and habilitation services licensed under sections 245B.01 to 245B.08,deleted text end new text begin day and supported employment services licensed under chapter 245D, new text end and any agency of the state of Minnesota or the United States, and includes any instrumentality of a governmental unit. For the purpose of this section, an instrumentality of a governmental unit means an instrumentality having independent policy-making and appropriating authority.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 13.

Minnesota Statutes 2012, section 626.556, subdivision 2, is amended to read:

Subd. 2.

Definitions.

As used in this section, the following terms have the meanings given them unless the specific content indicates otherwise:

(a) "Family assessment" means a comprehensive assessment of child safety, risk of subsequent child maltreatment, and family strengths and needs that is applied to a child maltreatment report that does not allege substantial child endangerment. Family assessment does not include a determination as to whether child maltreatment occurred but does determine the need for services to address the safety of family members and the risk of subsequent maltreatment.

(b) "Investigation" means fact gathering related to the current safety of a child and the risk of subsequent maltreatment that determines whether child maltreatment occurred and whether child protective services are needed. An investigation must be used when reports involve substantial child endangerment, and for reports of maltreatment in facilities required to be licensed under chapter 245A or 245B; under sections 144.50 to 144.58 and 241.021; in a school as defined in sections 120A.05, subdivisions 9, 11, and 13, and 124D.10; or in a nonlicensed personal care provider association as defined in sections 256B.04, subdivision 16, and 256B.0625, subdivision 19a.

(c) "Substantial child endangerment" means a person responsible for a child's care, and in the case of sexual abuse includes a person who has a significant relationship to the child as defined in section 609.341, or a person in a position of authority as defined in section 609.341, who by act or omission commits or attempts to commit an act against a child under their care that constitutes any of the following:

(1) egregious harm as defined in section 260C.007, subdivision 14;

(2) sexual abuse as defined in paragraph (d);

(3) abandonment under section 260C.301, subdivision 2;

(4) neglect as defined in paragraph (f), clause (2), that substantially endangers the child's physical or mental health, including a growth delay, which may be referred to as failure to thrive, that has been diagnosed by a physician and is due to parental neglect;

(5) murder in the first, second, or third degree under section 609.185, 609.19, or 609.195;

(6) manslaughter in the first or second degree under section 609.20 or 609.205;

(7) assault in the first, second, or third degree under section 609.221, 609.222, or 609.223;

(8) solicitation, inducement, and promotion of prostitution under section 609.322;

(9) criminal sexual conduct under sections 609.342 to 609.3451;

(10) solicitation of children to engage in sexual conduct under section 609.352;

(11) malicious punishment or neglect or endangerment of a child under section 609.377 or 609.378;

(12) use of a minor in sexual performance under section 617.246; or

(13) parental behavior, status, or condition which mandates that the county attorney file a termination of parental rights petition under section 260C.301, subdivision 3, paragraph (a).

(d) "Sexual abuse" means the subjection of a child by a person responsible for the child's care, by a person who has a significant relationship to the child, as defined in section 609.341, or by a person in a position of authority, as defined in section 609.341, subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual conduct in the first degree), 609.343 (criminal sexual conduct in the second degree), 609.344 (criminal sexual conduct in the third degree), 609.345 (criminal sexual conduct in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual abuse also includes any act which involves a minor which constitutes a violation of prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes threatened sexual abuse which includes the status of a parent or household member who has committed a violation which requires registration as an offender under section 243.166, subdivision 1b, paragraph (a) or (b), or required registration under section 243.166, subdivision 1b, paragraph (a) or (b).

(e) "Person responsible for the child's care" means (1) an individual functioning within the family unit and having responsibilities for the care of the child such as a parent, guardian, or other person having similar care responsibilities, or (2) an individual functioning outside the family unit and having responsibilities for the care of the child such as a teacher, school administrator, other school employees or agents, or other lawful custodian of a child having either full-time or short-term care responsibilities including, but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching, and coaching.

(f) "Neglect" means the commission or omission of any of the acts specified under clauses (1) to (9), other than by accidental means:

(1) failure by a person responsible for a child's care to supply a child with necessary food, clothing, shelter, health, medical, or other care required for the child's physical or mental health when reasonably able to do so;

(2) failure to protect a child from conditions or actions that seriously endanger the child's physical or mental health when reasonably able to do so, including a growth delay, which may be referred to as a failure to thrive, that has been diagnosed by a physician and is due to parental neglect;

(3) failure to provide for necessary supervision or child care arrangements appropriate for a child after considering factors as the child's age, mental ability, physical condition, length of absence, or environment, when the child is unable to care for the child's own basic needs or safety, or the basic needs or safety of another child in their care;

(4) failure to ensure that the child is educated as defined in sections 120A.22 and 260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's child with sympathomimetic medications, consistent with section 125A.091, subdivision 5;

(5) nothing in this section shall be construed to mean that a child is neglected solely because the child's parent, guardian, or other person responsible for the child's care in good faith selects and depends upon spiritual means or prayer for treatment or care of disease or remedial care of the child in lieu of medical care; except that a parent, guardian, or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report if a lack of medical care may cause serious danger to the child's health. This section does not impose upon persons, not otherwise legally responsible for providing a child with necessary food, clothing, shelter, education, or medical care, a duty to provide that care;

(6) prenatal exposure to a controlled substance, as defined in section 253B.02, subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal symptoms in the child at birth, results of a toxicology test performed on the mother at delivery or the child at birth, medical effects or developmental delays during the child's first year of life that medically indicate prenatal exposure to a controlled substance, or the presence of a fetal alcohol spectrum disorder;

(7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);

(8) chronic and severe use of alcohol or a controlled substance by a parent or person responsible for the care of the child that adversely affects the child's basic needs and safety; or

(9) emotional harm from a pattern of behavior which contributes to impaired emotional functioning of the child which may be demonstrated by a substantial and observable effect in the child's behavior, emotional response, or cognition that is not within the normal range for the child's age and stage of development, with due regard to the child's culture.

(g) "Physical abuse" means any physical injury, mental injury, or threatened injury, inflicted by a person responsible for the child's care on a child other than by accidental means, or any physical or mental injury that cannot reasonably be explained by the child's history of injuries, or any aversive or deprivation procedures, or regulated interventions, that have not been authorized under section 121A.67 or 245.825.

Abuse does not include reasonable and moderate physical discipline of a child administered by a parent or legal guardian which does not result in an injury. Abuse does not include the use of reasonable force by a teacher, principal, or school employee as allowed by section 121A.582. Actions which are not reasonable and moderate include, but are not limited to, any of the following that are done in anger or without regard to the safety of the child:

(1) throwing, kicking, burning, biting, or cutting a child;

(2) striking a child with a closed fist;

(3) shaking a child under age three;

(4) striking or other actions which result in any nonaccidental injury to a child under 18 months of age;

(5) unreasonable interference with a child's breathing;

(6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;

(7) striking a child under age one on the face or head;

(8) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled substances which were not prescribed for the child by a practitioner, in order to control or punish the child; or other substances that substantially affect the child's behavior, motor coordination, or judgment or that results in sickness or internal injury, or subjects the child to medical procedures that would be unnecessary if the child were not exposed to the substances;

(9) unreasonable physical confinement or restraint not permitted under section 609.379, including but not limited to tying, caging, or chaining; or

(10) in a school facility or school zone, an act by a person responsible for the child's care that is a violation under section 121A.58.

(h) "Report" means any report received by the local welfare agency, police department, county sheriff, or agency responsible for assessing or investigating maltreatment pursuant to this section.

(i) "Facility" means:

(1) a licensed or unlicensed day care facility, residential facility, agency, hospital, sanitarium, or other facility or institution required to be licensed under sections 144.50 to 144.58, 241.021, or 245A.01 to 245A.16, or chapter deleted text begin 245Bdeleted text end new text begin 245Dnew text end ;

(2) a school as defined in sections 120A.05, subdivisions 9, 11, and 13; and 124D.10; or

(3) a nonlicensed personal care provider organization as defined in sections 256B.04, subdivision 16, and 256B.0625, subdivision 19a.

(j) "Operator" means an operator or agency as defined in section 245A.02.

(k) "Commissioner" means the commissioner of human services.

(l) "Practice of social services," for the purposes of subdivision 3, includes but is not limited to employee assistance counseling and the provision of guardian ad litem and parenting time expeditor services.

(m) "Mental injury" means an injury to the psychological capacity or emotional stability of a child as evidenced by an observable or substantial impairment in the child's ability to function within a normal range of performance and behavior with due regard to the child's culture.

(n) "Threatened injury" means a statement, overt act, condition, or status that represents a substantial risk of physical or sexual abuse or mental injury. Threatened injury includes, but is not limited to, exposing a child to a person responsible for the child's care, as defined in paragraph (e), clause (1), who has:

(1) subjected a child to, or failed to protect a child from, an overt act or condition that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a similar law of another jurisdiction;

(2) been found to be palpably unfit under section 260C.301, paragraph (b), clause (4), or a similar law of another jurisdiction;

(3) committed an act that has resulted in an involuntary termination of parental rights under section 260C.301, or a similar law of another jurisdiction; or

(4) committed an act that has resulted in the involuntary transfer of permanent legal and physical custody of a child to a relative under Minnesota Statutes 2010, section 260C.201, subdivision 11, paragraph (d), clause (1), section 260C.515, subdivision 4, or a similar law of another jurisdiction.

A child is the subject of a report of threatened injury when the responsible social services agency receives birth match data under paragraph (o) from the Department of Human Services.

(o) Upon receiving data under section 144.225, subdivision 2b, contained in a birth record or recognition of parentage identifying a child who is subject to threatened injury under paragraph (n), the Department of Human Services shall send the data to the responsible social services agency. The data is known as "birth match" data. Unless the responsible social services agency has already begun an investigation or assessment of the report due to the birth of the child or execution of the recognition of parentage and the parent's previous history with child protection, the agency shall accept the birth match data as a report under this section. The agency may use either a family assessment or investigation to determine whether the child is safe. All of the provisions of this section apply. If the child is determined to be safe, the agency shall consult with the county attorney to determine the appropriateness of filing a petition alleging the child is in need of protection or services under section 260C.007, subdivision 6, clause (16), in order to deliver needed services. If the child is determined not to be safe, the agency and the county attorney shall take appropriate action as required under section 260C.301, subdivision 3.

(p) Persons who conduct assessments or investigations under this section shall take into account accepted child-rearing practices of the culture in which a child participates and accepted teacher discipline practices, which are not injurious to the child's health, welfare, and safety.

(q) "Accidental" means a sudden, not reasonably foreseeable, and unexpected occurrence or event which:

(1) is not likely to occur and could not have been prevented by exercise of due care; and

(2) if occurring while a child is receiving services from a facility, happens when the facility and the employee or person providing services in the facility are in compliance with the laws and rules relevant to the occurrence or event.

(r) "Nonmaltreatment mistake" means:

(1) at the time of the incident, the individual was performing duties identified in the center's child care program plan required under Minnesota Rules, part 9503.0045;

(2) the individual has not been determined responsible for a similar incident that resulted in a finding of maltreatment for at least seven years;

(3) the individual has not been determined to have committed a similar nonmaltreatment mistake under this paragraph for at least four years;

(4) any injury to a child resulting from the incident, if treated, is treated only with remedies that are available over the counter, whether ordered by a medical professional or not; and

(5) except for the period when the incident occurred, the facility and the individual providing services were both in compliance with all licensing requirements relevant to the incident.

This definition only applies to child care centers licensed under Minnesota Rules, chapter 9503. If clauses (1) to (5) apply, rather than making a determination of substantiated maltreatment by the individual, the commissioner of human services shall determine that a nonmaltreatment mistake was made by the individual.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 14.

Minnesota Statutes 2012, section 626.556, subdivision 3, is amended to read:

Subd. 3.

Persons mandated to report.

(a) A person who knows or has reason to believe a child is being neglected or physically or sexually abused, as defined in subdivision 2, or has been neglected or physically or sexually abused within the preceding three years, shall immediately report the information to the local welfare agency, agency responsible for assessing or investigating the report, police department, or the county sheriff if the person is:

(1) a professional or professional's delegate who is engaged in the practice of the healing arts, social services, hospital administration, psychological or psychiatric treatment, child care, education, correctional supervision, probation and correctional services, or law enforcement; or

(2) employed as a member of the clergy and received the information while engaged in ministerial duties, provided that a member of the clergy is not required by this subdivision to report information that is otherwise privileged under section 595.02, subdivision 1, paragraph (c).

The police department or the county sheriff, upon receiving a report, shall immediately notify the local welfare agency or agency responsible for assessing or investigating the report, orally and in writing. The local welfare agency, or agency responsible for assessing or investigating the report, upon receiving a report, shall immediately notify the local police department or the county sheriff orally and in writing. The county sheriff and the head of every local welfare agency, agency responsible for assessing or investigating reports, and police department shall each designate a person within their agency, department, or office who is responsible for ensuring that the notification duties of this paragraph and paragraph (b) are carried out. Nothing in this subdivision shall be construed to require more than one report from any institution, facility, school, or agency.

(b) Any person may voluntarily report to the local welfare agency, agency responsible for assessing or investigating the report, police department, or the county sheriff if the person knows, has reason to believe, or suspects a child is being or has been neglected or subjected to physical or sexual abuse. The police department or the county sheriff, upon receiving a report, shall immediately notify the local welfare agency or agency responsible for assessing or investigating the report, orally and in writing. The local welfare agency or agency responsible for assessing or investigating the report, upon receiving a report, shall immediately notify the local police department or the county sheriff orally and in writing.

(c) A person mandated to report physical or sexual child abuse or neglect occurring within a licensed facility shall report the information to the agency responsible for licensing the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or chapter deleted text begin 245Bdeleted text end new text begin 245Dnew text end ; or a nonlicensed personal care provider organization as defined in sections 256B.04, subdivision 16; and 256B.0625, subdivision 19. A health or corrections agency receiving a report may request the local welfare agency to provide assistance pursuant to subdivisions 10, 10a, and 10b. A board or other entity whose licensees perform work within a school facility, upon receiving a complaint of alleged maltreatment, shall provide information about the circumstances of the alleged maltreatment to the commissioner of education. Section 13.03, subdivision 4, applies to data received by the commissioner of education from a licensing entity.

(d) Any person mandated to report shall receive a summary of the disposition of any report made by that reporter, including whether the case has been opened for child protection or other services, or if a referral has been made to a community organization, unless release would be detrimental to the best interests of the child. Any person who is not mandated to report shall, upon request to the local welfare agency, receive a concise summary of the disposition of any report made by that reporter, unless release would be detrimental to the best interests of the child.

(e) For purposes of this section, "immediately" means as soon as possible but in no event longer than 24 hours.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 15.

Minnesota Statutes 2012, section 626.556, subdivision 10d, is amended to read:

Subd. 10d.

Notification of neglect or abuse in facility.

(a) When a report is received that alleges neglect, physical abuse, sexual abuse, or maltreatment of a child while in the care of a licensed or unlicensed day care facility, residential facility, agency, hospital, sanitarium, or other facility or institution required to be licensed according to sections 144.50 to 144.58; 241.021; or 245A.01 to 245A.16; or chapter deleted text begin 245Bdeleted text end new text begin 245Dnew text end , or a school as defined in sections 120A.05, subdivisions 9, 11, and 13; and 124D.10; or a nonlicensed personal care provider organization as defined in section 256B.04, subdivision 16, and 256B.0625, subdivision 19a, the commissioner of the agency responsible for assessing or investigating the report or local welfare agency investigating the report shall provide the following information to the parent, guardian, or legal custodian of a child alleged to have been neglected, physically abused, sexually abused, or the victim of maltreatment of a child in the facility: the name of the facility; the fact that a report alleging neglect, physical abuse, sexual abuse, or maltreatment of a child in the facility has been received; the nature of the alleged neglect, physical abuse, sexual abuse, or maltreatment of a child in the facility; that the agency is conducting an assessment or investigation; any protective or corrective measures being taken pending the outcome of the investigation; and that a written memorandum will be provided when the investigation is completed.

(b) The commissioner of the agency responsible for assessing or investigating the report or local welfare agency may also provide the information in paragraph (a) to the parent, guardian, or legal custodian of any other child in the facility if the investigative agency knows or has reason to believe the alleged neglect, physical abuse, sexual abuse, or maltreatment of a child in the facility has occurred. In determining whether to exercise this authority, the commissioner of the agency responsible for assessing or investigating the report or local welfare agency shall consider the seriousness of the alleged neglect, physical abuse, sexual abuse, or maltreatment of a child in the facility; the number of children allegedly neglected, physically abused, sexually abused, or victims of maltreatment of a child in the facility; the number of alleged perpetrators; and the length of the investigation. The facility shall be notified whenever this discretion is exercised.

(c) When the commissioner of the agency responsible for assessing or investigating the report or local welfare agency has completed its investigation, every parent, guardian, or legal custodian previously notified of the investigation by the commissioner or local welfare agency shall be provided with the following information in a written memorandum: the name of the facility investigated; the nature of the alleged neglect, physical abuse, sexual abuse, or maltreatment of a child in the facility; the investigator's name; a summary of the investigation findings; a statement whether maltreatment was found; and the protective or corrective measures that are being or will be taken. The memorandum shall be written in a manner that protects the identity of the reporter and the child and shall not contain the name, or to the extent possible, reveal the identity of the alleged perpetrator or of those interviewed during the investigation. If maltreatment is determined to exist, the commissioner or local welfare agency shall also provide the written memorandum to the parent, guardian, or legal custodian of each child in the facility who had contact with the individual responsible for the maltreatment. When the facility is the responsible party for maltreatment, the commissioner or local welfare agency shall also provide the written memorandum to the parent, guardian, or legal custodian of each child who received services in the population of the facility where the maltreatment occurred. This notification must be provided to the parent, guardian, or legal custodian of each child receiving services from the time the maltreatment occurred until either the individual responsible for maltreatment is no longer in contact with a child or children in the facility or the conclusion of the investigation. In the case of maltreatment within a school facility, as defined in sections 120A.05, subdivisions 9, 11, and 13, and 124D.10, the commissioner of education need not provide notification to parents, guardians, or legal custodians of each child in the facility, but shall, within ten days after the investigation is completed, provide written notification to the parent, guardian, or legal custodian of any student alleged to have been maltreated. The commissioner of education may notify the parent, guardian, or legal custodian of any student involved as a witness to alleged maltreatment.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 16.

new text begin REPEALER. new text end

new text begin Minnesota Statutes 2012, section 256B.49, subdivision 16a, new text end new text begin is repealed effective January 1, 2014. new text end

ARTICLE 10

HEALTH-RELATED LICENSING BOARDS

Section 1.

Minnesota Statutes 2012, section 148B.17, subdivision 2, is amended to read:

Subd. 2.

Licensure and application fees.

Nonrefundable licensure and application fees deleted text begin chargeddeleted text end new text begin establishednew text end by the board deleted text begin are as followsdeleted text end new text begin shall not exceed the following amountsnew text end :

(1) application fee for national examination is deleted text begin $220deleted text end new text begin $110new text end ;

(2) application fee for Licensed Marriage and Family Therapist (LMFT) state examination is $110;

(3) initial LMFT license fee is prorated, but cannot exceed $125;

(4) annual renewal fee for LMFT license is $125;

(5) late fee for deleted text begin initial Licensed Associate Marriage and Family Therapist LAMFTdeleted text end new text begin LMFT new text end license renewal is $50;

(6) application fee for LMFT licensure by reciprocity is deleted text begin $340deleted text end new text begin $220new text end ;

(7) fee for initial Licensed Associate Marriage and Family Therapist (LAMFT) license is $75;

(8) annual renewal fee for LAMFT license is $75;

(9) late fee for LAMFT renewal is deleted text begin $50deleted text end new text begin $25new text end ;

(10) fee for reinstatement of license is $150; and

(11) fee for emeritus status is $125.

Sec. 2.

Minnesota Statutes 2012, section 151.19, subdivision 1, is amended to read:

Subdivision 1.

Pharmacy deleted text begin registrationdeleted text end new text begin licensure requirementsnew text end .

deleted text begin The board shall require and provide for the annual registration of every pharmacy now or hereafter doing business within this state. Upon the payment of any applicable fee specified in section 151.065, the board shall issue a registration certificate in such form as it may prescribe to such persons as may be qualified by law to conduct a pharmacy. Such certificate shall be displayed in a conspicuous place in the pharmacy for which it is issued and expire on the 30th day of June following the date of issue. It shall be unlawful for any person to conduct a pharmacy unless such certificate has been issued to the person by the board. deleted text end new text begin (a) No person shall operate a pharmacy without first obtaining a license from the board and paying any applicable fee specified in section 151.065. The license shall be displayed in a conspicuous place in the pharmacy for which it is issued and expires on June 30 following the date of issue. It is unlawful for any person to operate a pharmacy unless the license has been issued to the person by the board. new text end

new text begin (b) Application for a pharmacy license under this section shall be made in a manner specified by the board. new text end

new text begin (c) No license shall be issued or renewed for a pharmacy located within the state unless the applicant agrees to operate the pharmacy in a manner prescribed by federal and state law and according to rules adopted by the board. No license shall be issued for a pharmacy located outside of the state unless the applicant agrees to operate the pharmacy in a manner prescribed by federal law and, when dispensing medications for residents of this state, the laws of this state, and Minnesota Rules. new text end

new text begin (d) No license shall be issued or renewed for a pharmacy that is required to be licensed or registered by the state in which it is physically located unless the applicant supplies the board with proof of such licensure or registration. new text end

new text begin (e) The board shall require a separate license for each pharmacy located within the state and for each pharmacy located outside of the state at which any portion of the dispensing process occurs for drugs dispensed to residents of this state. new text end

new text begin (f) The board shall not issue an initial or renewed license for a pharmacy unless the pharmacy passes an inspection conducted by an authorized representative of the board. In the case of a pharmacy located outside of the state, the board may require the applicant to pay the cost of the inspection, in addition to the license fee in section 151.065, unless the applicant furnishes the board with a report, issued by the appropriate regulatory agency of the state in which the facility is located, of an inspection that has occurred within the 24 months immediately preceding receipt of the license application by the board. The board may deny licensure unless the applicant submits documentation satisfactory to the board that any deficiencies noted in an inspection report have been corrected. new text end

new text begin (g) The board shall not issue an initial or renewed license for a pharmacy located outside of the state unless the applicant discloses and certifies: new text end

new text begin (1) the location, names, and titles of all principal corporate officers and all pharmacists who are involved in dispensing drugs to residents of this state; new text end

new text begin (2) that it maintains its records of drugs dispensed to residents of this state so that the records are readily retrievable from the records of other drugs dispensed; new text end

new text begin (3) that it agrees to cooperate with, and provide information to, the board concerning matters related to dispensing drugs to residents of this state; new text end

new text begin (4) that, during its regular hours of operation, but no less than six days per week, for a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate communication between patients in this state and a pharmacist at the pharmacy who has access to the patients' records; the toll-free number must be disclosed on the label affixed to each container of drugs dispensed to residents of this state; and new text end

new text begin (5) that, upon request of a resident of a long-term care facility located in this state, the resident's authorized representative, or a contract pharmacy or licensed health care facility acting on behalf of the resident, the pharmacy will dispense medications prescribed for the resident in unit-dose packaging or, alternatively, comply with section 151.415, subdivision 5. new text end

Sec. 3.

Minnesota Statutes 2012, section 151.19, subdivision 3, is amended to read:

Subd. 3.

Sale of federally restricted medical gases.

deleted text begin The board shall require and provide for the annual registration of every person or establishment not licensed as a pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted medical gases. Upon the payment of any applicable fee specified in section 151.065, the board shall issue a registration certificate in such form as it may prescribe to those persons or places that may be qualified to sell or distribute federally restricted medical gases. The certificate shall be displayed in a conspicuous place in the business for which it is issued and expire on the date set by the board. It is unlawful for a person to sell or distribute federally restricted medical gases unless a certificate has been issued to that person by the board. deleted text end new text begin (a) A person or establishment not licensed as a pharmacy or a practitioner shall not engage in the retail sale or distribution of federally restricted medical gases without first obtaining a registration from the board and paying the applicable fee specified in section 151.065. The registration shall be displayed in a conspicuous place in the business for which it is issued and expires on the date set by the board. It is unlawful for a person to sell or distribute federally restricted medical gases unless a certificate has been issued to that person by the board. new text end

new text begin (b) Application for a medical gas distributor registration under this section shall be made in a manner specified by the board. new text end

new text begin (c) No registration shall be issued or renewed for a medical gas distributor located within the state unless the applicant agrees to operate in a manner prescribed by federal and state law and according to the rules adopted by the board. No license shall be issued for a medical gas distributor located outside of the state unless the applicant agrees to operate in a manner prescribed by federal law and, when distributing medical gases for residents of this state, the laws of this state and Minnesota Rules. new text end

new text begin (d) No registration shall be issued or renewed for a medical gas distributor that is required to be licensed or registered by the state in which it is physically located unless the applicant supplies the board with proof of the licensure or registration. The board may, by rule, establish standards for the registration of a medical gas distributor that is not required to be licensed or registered by the state in which it is physically located. new text end

new text begin (e) The board shall require a separate registration for each medical gas distributor located within the state and for each facility located outside of the state from which medical gases are distributed to residents of this state. new text end

new text begin (f) The board shall not issue an initial or renewed registration for a medical gas distributor unless the medical gas distributor passes an inspection conducted by an authorized representative of the board. In the case of a medical gas distributor located outside of the state, the board may require the applicant to pay the cost of the inspection, in addition to the license fee in section 151.065, unless the applicant furnishes the board with a report, issued by the appropriate regulatory agency of the state in which the facility is located, of an inspection that has occurred within the 24 months immediately preceding receipt of the license application by the board. The board may deny licensure unless the applicant submits documentation satisfactory to the board that any deficiencies noted in an inspection report have been corrected. new text end

Sec. 4.

new text begin [151.252] LICENSING OF DRUG MANUFACTURERS; FEES; PROHIBITIONS. new text end

new text begin Subdivision 1. new text end

new text begin Requirements. new text end

new text begin (a) No person shall act as a drug manufacturer without first obtaining a license from the board and paying any applicable fee specified in section 151.065. new text end

new text begin (b) Application for a drug manufacturer license under this section shall be made in a manner specified by the board. new text end

new text begin (c) No license shall be issued or renewed for a drug manufacturer unless the applicant agrees to operate in a manner prescribed by federal and state law and according to Minnesota Rules. new text end

new text begin (d) No license shall be issued or renewed for a drug manufacturer that is required to be registered pursuant to United State Code, title 21, section 360, unless the applicant supplies the board with proof of registration. The board may establish by rule the standards for licensure of drug manufacturers that are not required to be registered under United States Code, title 21, section 360. new text end

new text begin (e) No license shall be issued or renewed for a drug manufacturer that is required to be licensed or registered by the state in which it is physically located unless the applicant supplies the board with proof of licensure or registration. The board may establish, by rule, standards for the licensure of a drug manufacturer that is not required to be licensed or registered by the state in which it is physically located. new text end

new text begin (f) The board shall require a separate license for each facility located within the state at which drug manufacturing occurs and for each facility located outside of the state at which drugs that are shipped into the state are manufactured. new text end

new text begin (g) The board shall not issue an initial or renewed license for a drug manufacturing facility unless the facility passes an inspection conducted by an authorized representative of the board. In the case of a drug manufacturing facility located outside of the state, the board may require the applicant to pay the cost of the inspection, in addition to the license fee in section 151.065, unless the applicant furnishes the board with a report, issued by the appropriate regulatory agency of the state in which the facility is located or by the United States Food and Drug Administration, of an inspection that has occurred within the 24 months immediately preceding receipt of the license application by the board. The board may deny licensure unless the applicant submits documentation satisfactory to the board that any deficiencies noted in an inspection report have been corrected. new text end

new text begin Subd. 2. new text end

new text begin Prohibition. new text end

new text begin It is unlawful for any person engaged in drug manufacturing to sell legend drugs to anyone located in this state except as provided in this chapter. new text end

new text begin Subd. 3. new text end

new text begin Payment to practitioner; reporting. new text end

new text begin Unless prohibited by United States Code, title 42, section 1320a-7h, a drug manufacturer shall file with the board an annual report, in a form and on the date prescribed by the board, identifying all payments, honoraria, reimbursement, or other compensation authorized under section 151.461, clauses (4) and (5), paid to practitioners in Minnesota during the preceding calendar year. The report shall identify the nature and value of any payments totaling $100 or more to a particular practitioner during the year, and shall identify the practitioner. Reports filed under this subdivision are public data. new text end

Sec. 5.

Minnesota Statutes 2012, section 151.37, subdivision 4, is amended to read:

Subd. 4.

Research.

new text begin (a) new text end Any qualified person may use legend drugs in the course of a bona fide research project, but cannot administer or dispense such drugs to human beings unless such drugs are prescribed, dispensed, and administered by a person lawfully authorized to do so.

new text begin (b) Drugs may be dispensed or distributed by a pharmacy licensed by the board for use by, or administration to, patients enrolled in a bona fide research study that is being conducted pursuant to either an investigational new drug application approved by the United States Food and Drug Administration or that has been approved by an institutional review board. For the purposes of this subdivision only: new text end

new text begin (1) a prescription drug order is not required for a pharmacy to dispense a research drug, unless the study protocol requires the pharmacy to receive such an order; new text end

new text begin (2) notwithstanding the prescription labeling requirements found in this chapter or the rules promulgated by the board, a research drug may be labeled as required by the study protocol; and new text end

new text begin (3) dispensing and distribution of research drugs by pharmacies shall not be considered compounding, manufacturing, or wholesaling under this chapter. new text end

new text begin (c) An entity that is under contract to a federal agency for the purpose of distributing drugs for bona fide research studies is exempt from the drug wholesaler licensing requirements of this chapter. Any other entity is exempt from the drug wholesaler licensing requirements of this chapter if the board finds that the entity is licensed or registered according to the laws of the state in which it is physically located and it is distributing drugs for use by, or administration to, patients enrolled in a bona fide research study that is being conducted pursuant to either an investigational new drug application approved by the United States Food and Drug Administration or that has been approved by an institutional review board. 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 2012, section 151.47, subdivision 1, is amended to read:

Subdivision 1.

Requirements.

new text begin (a) new text end All wholesale drug distributors are subject to the requirements deleted text begin in paragraphs (a) to (f)deleted text end new text begin of this subdivisionnew text end .

deleted text begin (a)deleted text end new text begin (b)new text end No person or distribution outlet shall act as a wholesale drug distributor without first obtaining a license from the board and paying any applicable fee specified in section 151.065.

new text begin (c) Application for a wholesale drug distributor license under this section shall be made in a manner specified by the board. new text end

deleted text begin (b)deleted text end new text begin (d)new text end No license shall be issued or renewed for a wholesale drug distributor to operate unless the applicant agrees to operate in a manner prescribed by federal and state law and according to the rules adopted by the board.

deleted text begin (c) The board may require a separate license for each facility directly or indirectly owned or operated by the same business entity within the state, or for a parent entity with divisions, subsidiaries, or affiliate companies within the state, when operations are conducted at more than one location and joint ownership and control exists among all the entities. deleted text end

new text begin (e) No license may be issued or renewed for a drug wholesale distributor that is required to be licensed or registered by the state in which it is physically located unless the applicant supplies the board with proof of licensure or registration. The board may establish, by rule, standards for the licensure of a drug wholesale distributor that is not required to be licensed or registered by the state in which it is physically located. new text end

new text begin (f) The board shall require a separate license for each drug wholesale distributor facility located within the state and for each drug wholesale distributor facility located outside of the state from which drugs are shipped into the state or to which drugs are reverse distributed. new text end

new text begin (g) The board shall not issue an initial or renewed license for a drug wholesale distributor facility unless the facility passes an inspection conducted by an authorized representative of the board, or is accredited by an accreditation program approved by the board. In the case of a drug wholesale distributor facility located outside of the state, the board may require the applicant to pay the cost of the inspection, in addition to the license fee in section 151.065, unless the applicant furnishes the board with a report, issued by the appropriate regulatory agency of the state in which the facility is located, of an inspection that has occurred within the 24 months immediately preceding receipt of the license application by the board, or furnishes the board with proof of current accreditation. The board may deny licensure unless the applicant submits documentation satisfactory to the board that any deficiencies noted in an inspection report have been corrected. new text end

deleted text begin (d)deleted text end new text begin (h)new text end As a condition for receiving and retaining a wholesale drug distributor license issued under sections 151.42 to 151.51, an applicant shall satisfy the board that it has and will continuously maintain:

(1) adequate storage conditions and facilities;

(2) minimum liability and other insurance as may be required under any applicable federal or state law;

(3) a viable security system that includes an after hours central alarm, or comparable entry detection capability; restricted access to the premises; comprehensive employment applicant screening; and safeguards against all forms of employee theft;

(4) a system of records describing all wholesale drug distributor activities set forth in section 151.44 for at least the most recent two-year period, which shall be reasonably accessible as defined by board regulations in any inspection authorized by the board;

(5) principals and persons, including officers, directors, primary shareholders, and key management executives, who must at all times demonstrate and maintain their capability of conducting business in conformity with sound financial practices as well as state and federal law;

(6) complete, updated information, to be provided to the board as a condition for obtaining and retaining a license, about each wholesale drug distributor to be licensed, including all pertinent corporate licensee information, if applicable, or other ownership, principal, key personnel, and facilities information found to be necessary by the board;

(7) written policies and procedures that assure reasonable wholesale drug distributor preparation for, protection against, and handling of any facility security or operation problems, including, but not limited to, those caused by natural disaster or government emergency, inventory inaccuracies or product shipping and receiving, outdated product or other unauthorized product control, appropriate disposition of returned goods, and product recalls;

(8) sufficient inspection procedures for all incoming and outgoing product shipments; and

(9) operations in compliance with all federal requirements applicable to wholesale drug distribution.

deleted text begin (e)deleted text end new text begin (i) new text end An agent or employee of any licensed wholesale drug distributor need not seek licensure under this section.

deleted text begin (f) A wholesale drug distributor shall file with the board an annual report, in a form and on the date prescribed by the board, identifying all payments, honoraria, reimbursement or other compensation authorized under section 151.461, clauses (3) to (5), paid to practitioners in Minnesota during the preceding calendar year. The report shall identify the nature and value of any payments totaling $100 or more, to a particular practitioner during the year, and shall identify the practitioner. Reports filed under this provision are public data. deleted text end

Sec. 7.

Minnesota Statutes 2012, section 151.47, is amended by adding a subdivision to read:

new text begin Subd. 3. new text end

new text begin Prohibition. new text end

new text begin It is unlawful for any person engaged in wholesale drug distribution to sell drugs to a person located within the state or to receive drugs in reverse distribution from a person located within the state except as provided in this chapter. new text end

Sec. 8.

Minnesota Statutes 2012, section 151.49, is amended to read:

151.49 LICENSE RENEWAL APPLICATION PROCEDURES.

Application blanks new text begin or notices new text end for renewal of a license required by sections 151.42 to 151.51 shall be mailednew text begin or otherwise providednew text end to each licensee on or before the first day of the month prior to the month in which the license expires and, if application for renewal of the license with the required feenew text begin and supporting documentsnew text end is not made before the expiration date, the existing license or renewal shall lapse and become null and void upon the date of expiration.

Sec. 9.

new text begin [214.075] HEALTH-RELATED LICENSING BOARDS; CRIMINAL BACKGROUND CHECKS. new text end

new text begin Subdivision 1. new text end

new text begin Applications. new text end

new text begin (a) By January 1, 2018, each health-related licensing board, as defined in section 214.01, subdivision 2, shall require applicants for initial licensure, licensure by endorsement, or reinstatement or other relicensure after a lapse in licensure, as defined by the individual health-related licensing boards, to submit to a criminal history records check of state data completed by the Bureau of Criminal Apprehension (BCA) and a national criminal history records check, including a search of the records of the Federal Bureau of Investigation (FBI). new text end

new text begin (b) An applicant must complete a criminal background check if more than one year has elapsed since the applicant last submitted a background check to the board. new text end

new text begin Subd. 2. new text end

new text begin Investigations. new text end

new text begin If a health-related licensing board has reasonable cause to believe a licensee has been charged with or convicted of a crime in this or any other jurisdiction, the health-related licensing board may require the licensee to submit to a criminal history records check of state data completed by the BCA and a national criminal history records check, including a search of the records of the FBI. new text end

new text begin Subd. 3. new text end

new text begin Consent form; fees; fingerprints. new text end

new text begin (a) In order to effectuate the federal and state level, fingerprint-based criminal background check, the applicant or licensee must submit a completed criminal history records check consent form and a full set of fingerprints to the respective health-related licensing board or a designee in the manner and form specified by the board. new text end

new text begin (b) The applicant or licensee is responsible for all fees associated with preparation of the fingerprints, the criminal records check consent form, and the criminal background check. The fees for the criminal records background check shall be set by the BCA and the FBI and are not refundable. The fees shall be submitted to the respective health-related licensing board by the applicant or licensee as prescribed by the respective board. new text end

new text begin (c) All fees received by the health-related licensing boards under this subdivision shall be deposited in a dedicated account in the special revenue fund and are appropriated to the Board of Nursing Home Administrators for the administrative services unit to pay for the criminal background checks conducted by the Bureau of Criminal Apprehension and Federal Bureau of Investigation. new text end

new text begin Subd. 4. new text end

new text begin Refusal to consent. new text end

new text begin (a) The health-related licensing boards shall not issue a license to any applicant who refuses to consent to a criminal background check or fails to submit fingerprints within 90 days after submission of an application for licensure. Any fees paid by the applicant to the board shall be forfeited if the applicant refuses to consent to the criminal background check or fails to submit the required fingerprints. new text end

new text begin (b) The failure of a licensee to submit to a criminal background check as provided in subdivision 3 is grounds for disciplinary action by the respective health licensing board. new text end

new text begin Subd. 5. new text end

new text begin Submission of fingerprints to the Bureau of Criminal Apprehension. new text end

new text begin The health-related licensing board or designee shall submit applicant or licensee fingerprints to the BCA. The BCA shall perform a check for state criminal justice information and shall forward the applicant's or licensee's fingerprints to the FBI to perform a check for national criminal justice information regarding the applicant or licensee. The BCA shall report to the board the results of the state and national criminal justice information checks. new text end

new text begin Subd. 6. new text end

new text begin Alternatives to fingerprint-based criminal background checks. new text end

new text begin The health-related licensing board may require an alternative method of criminal history checks for an applicant or licensee who has submitted at least three sets of fingerprints in accordance with this section that have been unreadable by the BCA or the FBI. new text end

new text begin Subd. 7. new text end

new text begin Opportunity to challenge accuracy of report. new text end

new text begin Prior to taking disciplinary action against an applicant or a licensee based on a criminal conviction, the health-related licensing board shall provide the applicant or the licensee an opportunity to complete or challenge the accuracy of the criminal history information reported to the board. The applicant or licensee shall have 30 calendar days following notice from the board of the intent to deny licensure or to take disciplinary action to request an opportunity to correct or complete the record prior to the board taking disciplinary action based on the information reported to the board. The board shall provide the applicant up to 180 days to challenge the accuracy or completeness of the report with the agency responsible for the record. This subdivision does not affect the right of the subject of the data to contest the accuracy or completeness under section 13.04, subdivision 4. new text end

new text begin Subd. 8. new text end

new text begin Instructions to the board; plans. new text end

new text begin The health-related licensing boards, in collaboration with the commissioner of human services and the BCA, shall establish a plan for completing criminal background checks of all licensees who were licensed before the effective date requirement under subdivision 1. The plan must seek to minimize duplication of requirements for background checks of licensed health professionals. The plan for background checks of current licensees shall be developed no later than January 1, 2017, and may be contingent upon the implementation of a system by the BCA or FBI in which any new crimes that an applicant or licensee commits after an initial background check are flagged in the BCA's or FBI's database and reported back to the board. The plan shall include recommendations for any necessary statutory changes. new text end

Sec. 10.

Minnesota Statutes 2012, section 214.12, is amended by adding a subdivision to read:

new text begin Subd. 4. new text end

new text begin Parental depression. new text end

new text begin The health-related licensing boards that regulate professions that serve caregivers at risk of depression, or their children, including behavioral health and therapy, chiropractic, marriage and family therapy, medical practice, nursing, psychology, and social work, shall provide educational materials to licensees on the subject of parental depression and its potential effects on children if unaddressed, including how to: new text end

new text begin (1) screen mothers for depression; new text end

new text begin (2) identify children who are affected by their mother's depression; and new text end

new text begin (3) provide treatment or referral information on needed services. new text end

Sec. 11.

Minnesota Statutes 2012, section 214.40, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

(a) The definitions in this subdivision apply to this section.

(b) "Administrative services unit" means the administrative services unit for the health-related licensing boards.

(c) "Charitable organization" means a charitable organization within the meaning of section 501(c)(3) of the Internal Revenue Code that has as a purpose the sponsorship or support of programs designed to improve the quality, awareness, and availability of health care services and that serves as a funding mechanism for providing those services.

(d) "Health care facility or organization" means a health care facility licensed under chapter 144 or 144A, or a charitable organization.

(e) "Health care provider" means a physician licensed under chapter 147, physician assistant deleted text begin registereddeleted text end new text begin licensednew text end and practicing under chapter 147A, nurse licensed and registered to practice under chapter 148, deleted text begin ordeleted text end dentist deleted text begin ordeleted text end new text begin ,new text end dental hygienistnew text begin , or dental therapistnew text end licensed under chapter 150Anew text begin , or an advanced dental therapist licensed and certified under chapter 150Anew text end .

(f) "Health care services" means health promotion, health monitoring, health education, diagnosis, treatment, minor surgical procedures, the administration of local anesthesia for the stitching of wounds, and primary dental services, including preventive, diagnostic, restorative, and emergency treatment. Health care services do not include the administration of general anesthesia or surgical procedures other than minor surgical procedures.

(g) "Medical professional liability insurance" means medical malpractice insurance as defined in section 62F.03.

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 INCLUSION OF OTHER HEALTH-RELATED OCCUPATIONS TO CRIMINAL BACKGROUND CHECKS. new text end

new text begin (a) If the Department of Health is not reviewed by the Sunset Advisory Commission according to the schedule in Minnesota Statutes, section 3D.21, the commissioner of health, as the regulator for occupational therapy practitioners, speech-language pathologists, audiologists, and hearing instrument dispensers, shall require applicants for licensure or renewal to submit to a criminal history records check as required under Minnesota Statutes, section 214.075, for other health-related licensed occupations regulated by the health-related licensing boards. new text end

new text begin (b) Any statutory changes necessary to include the commissioner of health to Minnesota Statutes, section 214.075, shall be included in the plan required in Minnesota Statutes, section 214.075, subdivision 8. new text end

Sec. 13.

new text begin REPEALER. new text end

new text begin Minnesota Statutes 2012, sections 151.19, subdivision 2; 151.25; 151.45; 151.47, subdivision 2; and 151.48, new text end new text begin are repealed. new text end

ARTICLE 11

HOME CARE PROVIDERS

Section 1.

Minnesota Statutes 2012, section 13.381, subdivision 2, is amended to read:

Subd. 2.

Health occupations data.

(a) Health-related licensees and registrants. The collection, analysis, reporting, and use of data on individuals licensed or registered by the commissioner of health or health-related licensing boards are governed by sections 144.051, deleted text begin subdivision 2deleted text end new text begin subdivisions 2 to 6new text end , and 144.052.

(b) Health services personnel. Data collected by the commissioner of health for the database on health services personnel are classified under section 144.1485.

Sec. 2.

Minnesota Statutes 2012, section 13.381, subdivision 10, is amended to read:

Subd. 10.

Home care and hospice provider.

Data regarding a home care provider under sections 144A.43 to 144A.47 are governed by section 144A.45. new text begin Data regarding home care provider background studies are governed by section 144A.476, subdivision 1. new text end Data regarding a hospice provider under sections 144A.75 to 144A.755 are governed by sections 144A.752 and 144A.754.

Sec. 3.

Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision to read:

new text begin Subd. 3. new text end

new text begin Data classification; private data. new text end

new text begin For providers regulated pursuant to sections 144A.43 to 144A.482, the following data collected, created, or maintained by the commissioner are classified as private data on individuals as defined in section 13.02, subdivision 12: new text end

new text begin (1) data submitted by or on behalf of applicants for licenses prior to issuance of the license; new text end

new text begin (2) the identity of complainants who have made reports concerning licensees or applicants unless the complainant consents to the disclosure; new text end

new text begin (3) the identity of individuals who provide information as part of surveys and investigations; new text end

new text begin (4) Social Security numbers; and new text end

new text begin (5) health record data. new text end

Sec. 4.

Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision to read:

new text begin Subd. 4. new text end

new text begin Data classification; public data. new text end

new text begin For providers regulated pursuant to sections 144A.43 to 144A.482, the following data collected, created, or maintained by the commissioner are classified as public data as defined in section 13.02, subdivision 15: new text end

new text begin (1) all application data on licensees, license numbers, license status; new text end

new text begin (2) licensing information about licenses previously held under this chapter; new text end

new text begin (3) correction orders, including information about compliance with the order and whether the fine was paid; new text end

new text begin (4) final enforcement actions pursuant to chapter 14; new text end

new text begin (5) orders for hearing, findings of fact and conclusions of law; and new text end

new text begin (6) when the licensee and department agree to resolve the matter without a hearing, the agreement and specific reasons for the agreement are public data. new text end

Sec. 5.

Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision to read:

new text begin Subd. 5. new text end

new text begin Data classification; confidential data. new text end

new text begin For providers regulated pursuant to sections 144A.43 to 144A.482, the following data collected, created, or maintained by the Department of Health are classified as confidential data on individuals as defined in section 13.02, subdivision 3: active investigative data relating to the investigation of potential violations of law by a licensee including data from the survey process before the correction order is issued by the department. new text end

Sec. 6.

Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision to read:

new text begin Subd. 6. new text end

new text begin Release of private or confidential data. new text end

new text begin For providers regulated pursuant to sections 144A.43 to 144A.482, the department may release private or confidential data, except Social Security numbers, to the appropriate state, federal, or local agency and law enforcement office to enhance investigative or enforcement efforts or further a public health protective process. Types of offices include Adult Protective Services, Office of the Ombudsman for Long-Term Care and Office of the Ombudsman for Mental Health and Developmental Disabilities, the health licensing boards, Department of Human Services, county or city attorney's offices, police, and local or county public health offices. new text end

Sec. 7.

Minnesota Statutes 2012, section 144A.43, is amended to read:

144A.43 DEFINITIONS.

Subdivision 1.

Applicability.

The definitions in this section apply to sections 144.699, subdivision 2, and 144A.43 to deleted text begin 144A.47deleted text end new text begin 144A.482new text end .

new text begin Subd. 1a. new text end

new text begin Agent. new text end

new text begin "Agent" means the person upon whom all notices and orders shall be served and who is authorized to accept service of notices and orders on behalf of the home care provider. new text end

new text begin Subd. 1b. new text end

new text begin Applicant. new text end

new text begin "Applicant" means an individual, organization, association, corporation, unit of government, or other entity that applies for a temporary license, license, or renewal of the applicant's home care provider license under section 144A.472. new text end

new text begin Subd. 1c. new text end

new text begin Client. new text end

new text begin "Client" means a person to whom home care services are provided. new text end

new text begin Subd. 1d. new text end

new text begin Client record. new text end

new text begin "Client record" means all records that document information about the home care services provided to the client by the home care provider. new text end

new text begin Subd. 1e. new text end

new text begin Client representative. new text end

new text begin "Client representative" means a person who, because of the client's needs, makes decisions about the client's care on behalf of the client. A client representative may be a guardian, health care agent, family member, or other agent of the client. Nothing in this section expands or diminishes the rights of persons to act on behalf of clients under other law. new text end

Subd. 2.

Commissioner.

"Commissioner" means the commissioner of health.

new text begin Subd. 2a. new text end

new text begin Controlled substance. new text end

new text begin "Controlled substance" has the meaning given in section 152.01, subdivision 4. new text end

new text begin Subd. 2b. new text end

new text begin Department. new text end

new text begin "Department" means the Minnesota Department of Health. new text end

new text begin Subd. 2c. new text end

new text begin Dietary supplement. new text end

new text begin "Dietary supplement" means a product taken by mouth that contains a dietary ingredient intended to supplement the diet. Dietary ingredients may include vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissue, glandulars, or metabolites. new text end

new text begin Subd. 2d. new text end

new text begin Dietitian. new text end

new text begin "Dietitian" is a person licensed under sections 148.621 to 148.633. new text end

new text begin Subd. 2e. new text end

new text begin Dietetics or nutrition practice. new text end

new text begin "Dietetics or nutrition practice" is performed by a licensed dietitian or licensed nutritionist and includes the activities of assessment, setting priorities and objectives, providing nutrition counseling, developing and implementing nutrition care services, and evaluating and maintaining appropriate standards of quality of nutrition care under sections 148.621 to 148.633. new text end

Subd. 3.

Home care service.

"Home care service" means any of the following services deleted text begin whendeleted text end delivered in deleted text begin a place of residence todeleted text end new text begin the home of new text end a person whose illness, disability, or physical condition creates a need for the service:

deleted text begin (1) nursing services, including the services of a home health aide; deleted text end

deleted text begin (2) personal care services not included under sections 148.171 to 148.285;deleted text end

deleted text begin (3) physical therapy; deleted text end

deleted text begin (4) speech therapy; deleted text end

deleted text begin (5) respiratory therapy; deleted text end

deleted text begin (6) occupational therapy; deleted text end

deleted text begin (7) nutritional services; deleted text end

deleted text begin (8) home management services when provided to a person who is unable to perform these activities due to illness, disability, or physical condition. Home management services include at least two of the following services: housekeeping, meal preparation, and shopping; deleted text end

deleted text begin (9) medical social services; deleted text end

deleted text begin (10) the provision of medical supplies and equipment when accompanied by the provision of a home care service; and deleted text end

deleted text begin (11) other similar medical services and health-related support services identified by the commissioner in rule. deleted text end

deleted text begin "Home care service" does not include the following activities conducted by the commissioner of health or a board of health as defined in section 145A.02, subdivision 2: communicable disease investigations or testing; administering or monitoring a prescribed therapy necessary to control or prevent a communicable disease; or the monitoring of an individual's compliance with a health directive as defined in section 144.4172, subdivision 6. deleted text end

new text begin (1) assistive tasks provided by unlicensed personnel; new text end

new text begin (2) services provided by a registered nurse or licensed practical nurse, physical therapist, respiratory therapist, occupational therapist, speech-language pathologist, dietitian or nutritionist, or social worker; new text end

new text begin (3) medication and treatment management services; or new text end

new text begin (4) the provision of durable medical equipment services when provided with any of the home care services listed in clauses (1) to (3). new text end

new text begin Subd. 3a. new text end

new text begin Hands-on assistance. new text end

new text begin "Hands-on assistance" means physical help by another person without which the client is not able to perform the activity. new text end

new text begin Subd. 3b. new text end

new text begin Home. new text end

new text begin "Home" means the client's temporary or permanent place of residence. new text end

Subd. 4.

Home care provider.

"Home care provider" means an individual, organization, association, corporation, unit of government, or other entity that is regularly engaged in the deliverynew text begin of at least one home care servicenew text end , directly deleted text begin or by contractual arrangement, of home care servicesdeleted text end new text begin in a client's homenew text end for a feenew text begin and who has a valid current temporary license or license issued under sections 144A.43 to 144A.482new text end . deleted text begin At least one home care service must be provided directly, although additional home care services may be provided by contractual arrangements. "Home care provider" does not include:deleted text end

deleted text begin (1) any home care or nursing services conducted by and for the adherents of any recognized church or religious denomination for the purpose of providing care and services for those who depend upon spiritual means, through prayer alone, for healing; deleted text end

deleted text begin (2) an individual who only provides services to a relative; deleted text end

deleted text begin (3) an individual not connected with a home care provider who provides assistance with home management services or personal care needs if the assistance is provided primarily as a contribution and not as a business; deleted text end

deleted text begin (4) an individual not connected with a home care provider who shares housing with and provides primarily housekeeping or homemaking services to an elderly or disabled person in return for free or reduced-cost housing; deleted text end

deleted text begin (5) an individual or agency providing home-delivered meal services; deleted text end

deleted text begin (6) an agency providing senior companion services and other older American volunteer programs established under the Domestic Volunteer Service Act of 1973, Public Law 98-288; deleted text end

deleted text begin (7) an employee of a nursing home licensed under this chapter or an employee of a boarding care home licensed under sections 144.50 to 144.56 who responds to occasional emergency calls from individuals residing in a residential setting that is attached to or located on property contiguous to the nursing home or boarding care home; deleted text end

deleted text begin (8) a member of a professional corporation organized under chapter 319B that does not regularly offer or provide home care services as defined in subdivision 3; deleted text end

deleted text begin (9) the following organizations established to provide medical or surgical services that do not regularly offer or provide home care services as defined in subdivision 3: a business trust organized under sections 318.01 to 318.04, a nonprofit corporation organized under chapter 317A, a partnership organized under chapter 323, or any other entity determined by the commissioner; deleted text end

deleted text begin (10) an individual or agency that provides medical supplies or durable medical equipment, except when the provision of supplies or equipment is accompanied by a home care service; deleted text end

deleted text begin (11) an individual licensed under chapter 147; or deleted text end

deleted text begin (12) an individual who provides home care services to a person with a developmental disability who lives in a place of residence with a family, foster family, or primary caregiver. deleted text end

deleted text begin Subd. 5. deleted text end

deleted text begin Medication reminder. deleted text end

deleted text begin "Medication reminder" means providing a verbal or visual reminder to a client to take medication. This includes bringing the medication to the client and providing liquids or nutrition to accompany medication that a client is self-administering. deleted text end

new text begin Subd. 6. new text end

new text begin License. new text end

new text begin "License" means a basic or comprehensive home care license issued by the commissioner to a home care provider. new text end

new text begin Subd. 7. new text end

new text begin Licensed health professional. new text end

new text begin "Licensed health professional" means a person, other than a registered nurse or licensed practical nurse, who provides home care services within the scope of practice of the person's health occupation license, registration, or certification as regulated and who is licensed by the appropriate Minnesota state board or agency. new text end

new text begin Subd. 8. new text end

new text begin Licensee. new text end

new text begin "Licensee" means a home care provider that is licensed under this chapter. new text end

new text begin Subd. 9. new text end

new text begin Managerial official. new text end

new text begin "Managerial official" means an administrator, director, officer, trustee, or employee of a home care provider, however designated, who has the authority to establish or control business policy. new text end

new text begin Subd. 10. new text end

new text begin Medication. new text end

new text begin "Medication" means a prescription or over-the-counter drug. For purposes of this chapter only, medication includes dietary supplements. new text end

new text begin Subd. 11. new text end

new text begin Medication administration. new text end

new text begin "Medication administration" means performing a set of tasks to ensure a client takes medications, and includes the following: new text end

new text begin (1) checking the client's medication record; new text end

new text begin (2) preparing the medication as necessary; new text end

new text begin (3) administering the medication to the client; new text end

new text begin (4) documenting the administration or reason for not administering the medication; and new text end

new text begin (5) reporting to a nurse any concerns about the medication, the client, or the client's refusal to take the medication. new text end

new text begin Subd. 12. new text end

new text begin Medication management. new text end

new text begin "Medication management" means the provision of any of the following medication-related services to a client: new text end

new text begin (1) performing medication setup; new text end

new text begin (2) administering medication; new text end

new text begin (3) storing and securing medications; new text end

new text begin (4) documenting medication activities; new text end

new text begin (5) verifying and monitoring effectiveness of systems to ensure safe handling and administration; new text end

new text begin (6) coordinating refills; new text end

new text begin (7) handling and implementing changes to prescriptions; new text end

new text begin (8) communicating with the pharmacy about the client's medications; and new text end

new text begin (9) coordinating and communicating with the prescriber. new text end

new text begin Subd. 13. new text end

new text begin Medication setup. new text end

new text begin "Medication setup" means arranging medications by a nurse, pharmacy, or authorized prescriber for later administration by the client or by comprehensive home care staff. new text end

new text begin Subd. 14. new text end

new text begin Nurse. new text end

new text begin "Nurse" means a person who is licensed under sections 148.171 to 148.285. new text end

new text begin Subd. 15. new text end

new text begin Occupational therapist. new text end

new text begin "Occupational therapist" means a person who is licensed under sections 148.6401 to 148.6450. new text end

new text begin Subd. 16. new text end

new text begin Over-the-counter drug. new text end

new text begin "Over-the-counter drug" means a drug that is not required by federal law to bear the symbol "Rx only." new text end

new text begin Subd. 17. new text end

new text begin Owner. new text end

new text begin "Owner" means a proprietor, general partner, limited partner who has five percent or more equity interest in a limited partnership, a person who owns or controls voting stock in a corporation in an amount equal to or greater than five percent of the shares issued and outstanding, or a corporation that owns equity interest in a licensee or applicant for a license. new text end

new text begin Subd. 18. new text end

new text begin Pharmacist. new text end

new text begin "Pharmacist" has the meaning given in section 151.01, subdivision 3. new text end

new text begin Subd. 19. new text end

new text begin Physical therapist. new text end

new text begin "Physical therapist" means a person who is licensed under sections 148.65 to 148.78. new text end

new text begin Subd. 20. new text end

new text begin Physician. new text end

new text begin "Physician" means a person who is licensed under chapter 147. new text end

new text begin Subd. 21. new text end

new text begin Prescriber. new text end

new text begin "Prescriber" means a person who is authorized by sections 148.235; 151.01, subdivision 23; and 151.37 to prescribe prescription drugs. new text end

new text begin Subd. 22. new text end

new text begin Prescription. new text end

new text begin "Prescription" has the meaning given in section 151.01, subdivision 16. new text end

new text begin Subd. 23. new text end

new text begin Regularly scheduled. new text end

new text begin "Regularly scheduled" means ordered or planned to be completed at predetermined times or according to a predetermined routine. new text end

new text begin Subd. 24. new text end

new text begin Reminder. new text end

new text begin "Reminder" means providing a verbal or visual reminder to a client. new text end

new text begin Subd. 25. new text end

new text begin Respiratory therapist. new text end

new text begin "Respiratory therapist" means a person who is licensed under chapter 147C. new text end

new text begin Subd. 26. new text end

new text begin Revenues. new text end

new text begin "Revenues" means all money received by a licensee derived from the provision of home care services, including fees for services and appropriations of public money for home care services. new text end

new text begin Subd. 27. new text end

new text begin Service plan. new text end

new text begin "Service plan" means the written plan between the client or client's representative and the temporary licensee or licensee about the services that will be provided to the client. new text end

new text begin Subd. 28. new text end

new text begin Social worker. new text end

new text begin "Social worker" means a person who is licensed under chapter 148D or 148E. new text end

new text begin Subd. 29. new text end

new text begin Speech-language pathologist. new text end

new text begin "Speech-language pathologist" has the meaning given in section 148.512. new text end

new text begin Subd. 30. new text end

new text begin Standby assistance. new text end

new text begin "Standby assistance" means the presence of another person within arm's reach to minimize the risk of injury while performing daily activities through physical intervention or cuing. new text end

new text begin Subd. 31. new text end

new text begin Substantial compliance. new text end

new text begin "Substantial compliance" means complying with the requirements in this chapter sufficiently to prevent unacceptable health or safety risks to the home care client. new text end

new text begin Subd. 32. new text end

new text begin Survey. new text end

new text begin "Survey" means an inspection of a licensee or applicant for licensure for compliance with this chapter. new text end

new text begin Subd. 33. new text end

new text begin Surveyor. new text end

new text begin "Surveyor" means a staff person of the department authorized to conduct surveys of home care providers and applicants. new text end

new text begin Subd. 34. new text end

new text begin Temporary license. new text end

new text begin "Temporary license" means the initial basic or comprehensive home care license the department issues after approval of a complete written application and before the department completes the temporary license survey and determines that the temporary licensee is in substantial compliance. new text end

new text begin Subd. 35. new text end

new text begin Treatment or therapy. new text end

new text begin "Treatment" or "therapy" means the provision of care, other than medications, ordered or prescribed by a licensed health professional provided to a client to cure, rehabilitate, or ease symptoms. new text end

new text begin Subd. 36. new text end

new text begin Unit of government. new text end

new text begin "Unit of government" means every city, county, town, school district, other political subdivisions of the state, or agency of the state or federal government, which includes any instrumentality of a unit of government. new text end

new text begin Subd. 37. new text end

new text begin Unlicensed personnel. new text end

new text begin "Unlicensed personnel" are individuals not otherwise licensed or certified by a governmental health board or agency who provide home care services in the client's home. new text end

new text begin Subd. 38. new text end

new text begin Verbal. new text end

new text begin "Verbal" means oral and not in writing. new text end

Sec. 8.

Minnesota Statutes 2012, section 144A.44, is amended to read:

144A.44 HOME CARE BILL OF RIGHTS.

Subdivision 1.

Statement of rights.

A person who receives home care services has these rights:

(1) the right to receive written information about rights deleted text begin in advance ofdeleted text end new text begin before new text end receiving deleted text begin care or during the initial evaluation visit before the initiation of treatmentdeleted text end new text begin servicesnew text end , including what to do if rights are violated;

(2) the right to receive care and services according to a suitable and up-to-date plan, and subject to accepted new text begin health care, new text end medical or nursing standards, to take an active part in deleted text begin creating and changing the plandeleted text end new text begin developing, modifying,new text end and evaluating deleted text begin caredeleted text end new text begin the plannew text end and services;

(3) the right to be told deleted text begin in advance ofdeleted text end new text begin beforenew text end receiving deleted text begin care about thedeleted text end services deleted text begin that will be provided, the disciplines that will furnish caredeleted text end new text begin the type and disciplines of staff who will be providing the servicesnew text end , the frequency of visits proposed to be furnished, other choices that are availablenew text begin for addressing home care needsnew text end , and deleted text begin the consequences of these choices includingdeleted text end the new text begin potential new text end consequences of refusing these services;

(4) the right to be told in advance of any deleted text begin changedeleted text end new text begin recommended changes by the providernew text end in the new text begin service new text end plan deleted text begin of caredeleted text end and to take an active part in any deleted text begin changedeleted text end new text begin decisions about changes to the service plannew text end ;

(5) the right to refuse services or treatment;

(6) the right to know, deleted text begin in advancedeleted text end new text begin before receiving services or during the initial visitnew text end , any limits to the services available from a new text begin home care new text end providerdeleted text begin , and the provider's grounds for a termination of servicesdeleted text end ;

deleted text begin (7) the right to know in advance of receiving care whether the services are covered by health insurance, medical assistance, or other health programs, the charges for services that will not be covered by Medicare, and the charges that the individual may have to pay; deleted text end

deleted text begin (8)deleted text end new text begin (7)new text end the right to deleted text begin knowdeleted text end new text begin be told before services are initiatednew text end what the new text begin provider new text end charges are for new text begin the new text end servicesdeleted text begin , no matter who will be paying the billdeleted text end new text begin ; to what extent payment may be expected from health insurance, public programs, or other sources, if known; and what charges the client may be responsible for payingnew text end ;

deleted text begin (9)deleted text end new text begin (8) new text end the right to know that there may be other services available in the community, including other home care services and providers, and to know where to deleted text begin go fordeleted text end new text begin findnew text end information about these services;

deleted text begin (10)deleted text end new text begin (9)new text end the right to choose freely among available providers and to change providers after services have begun, within the limits of health insurance, new text begin long-term care insurance, new text end medical assistance, or other health programs;

deleted text begin (11)deleted text end new text begin (10)new text end the right to have personal, financial, and medical information kept private, and to be advised of the provider's policies and procedures regarding disclosure of such information;

deleted text begin (12)deleted text end new text begin (11)new text end the right to deleted text begin be alloweddeleted text end access deleted text begin todeleted text end new text begin the client's own new text end records and written information from new text begin those new text end records in accordance with sections 144.291 to 144.298;

deleted text begin (13)deleted text end new text begin (12)new text end the right to be served by people who are properly trained and competent to perform their duties;

deleted text begin (14)deleted text end new text begin (13)new text end the right to be treated with courtesy and respect, and to have the deleted text begin patient'sdeleted text end new text begin client'snew text end property treated with respect;

deleted text begin (15)deleted text end new text begin (14)new text end the right to be free from physical and verbal abusenew text begin , neglect, financial exploitation, and all forms of maltreatment covered under the Vulnerable Adults Act and the Maltreatment of Minors Actnew text end ;

deleted text begin (16)deleted text end new text begin (15)new text end the right to reasonable, advance notice of changes in services or chargesdeleted text begin , includingdeleted text end new text begin ;new text end

new text begin (16) the right to know the provider's reason for termination of services; new text end

new text begin (17) the right tonew text end at least ten days' advance notice of the termination of a service by a provider, except in cases where:

(i) the deleted text begin recipient of servicesdeleted text end new text begin clientnew text end engages in conduct that new text begin significantly new text end alters the deleted text begin conditions of employment as specified in the employment contract betweendeleted text end new text begin terms of the service plan withnew text end the home care provider deleted text begin and the individual providing home care services, or createsdeleted text end new text begin ;new text end

new text begin (ii) the client, person who lives with the client, or others createnew text end an abusive or unsafe work environment for the deleted text begin individualdeleted text end new text begin personnew text end providing home care services; or

deleted text begin (ii)deleted text end new text begin (iii)new text end an emergency deleted text begin for the informal caregiverdeleted text end or a significant change in the deleted text begin recipient'sdeleted text end new text begin client'snew text end condition has resulted in service needs that exceed the current service deleted text begin provider agreementdeleted text end new text begin plannew text end and that cannot be safely met by the home care provider;

deleted text begin (17)deleted text end new text begin (18)new text end the right to a coordinated transfer when there will be a change in the provider of services;

deleted text begin (18)deleted text end new text begin (19)new text end the right to deleted text begin voice grievances regarding treatment or care that isdeleted text end new text begin complain about services that are providednew text end , or deleted text begin fails to be, furnished, or regardingdeleted text end new text begin fail to be provided, and new text end the lack of courtesy or respect to the deleted text begin patientdeleted text end new text begin client new text end or the deleted text begin patient'sdeleted text end new text begin client's new text end property;

deleted text begin (19)deleted text end new text begin (20)new text end the right to know how to contact an individual associated with the new text begin home care new text end provider who is responsible for handling problems and to have the new text begin home care new text end provider investigate and attempt to resolve the grievance or complaint;

deleted text begin (20)deleted text end new text begin (21)new text end the right to know the name and address of the state or county agency to contact for additional information or assistance; and

deleted text begin (21)deleted text end new text begin (22)new text end the right to assert these rights personally, or have them asserted by the deleted text begin patient's family or guardian when the patient has been judged incompetent,deleted text end new text begin client's representative or by anyone on behalf of the client,new text end without retaliation.

Subd. 2.

Interpretation and enforcement of rights.

These rights are established for the benefit of deleted text begin personsdeleted text end new text begin clientsnew text end who receive home care services. deleted text begin "Home care services" means home care services as defined in section 144A.43, subdivision 3, and unlicensed personal care assistance services, including services covered by medical assistance under section 256B.0625, subdivision 19a.deleted text end new text begin All home care providers, including those exempted under section 144A.471, must comply with this section. The commissioner shall enforce this section and the home care bill of rights requirement against home care providers exempt from licensure in the same manner as for licensees. new text end A home care provider may not new text begin request or new text end require a deleted text begin persondeleted text end new text begin clientnew text end to surrender new text begin any of new text end these rights as a condition of receiving services. deleted text begin A guardian or conservator or, when there is no guardian or conservator, a designated person, may seek to enforce these rights.deleted text end This statement of rights does not replace or diminish other rights and liberties that may exist relative to deleted text begin personsdeleted text end new text begin clientsnew text end receiving home care services, persons providing home care services, or providers licensed under deleted text begin Laws 1987, chapter 378. A copy of these rights must be provided to an individual at the time home care services, including personal care assistance services, are initiated. The copy shall also contain the address and phone number of the Office of Health Facility Complaints and the Office of Ombudsman for Long-Term Care and a brief statement describing how to file a complaint with these offices. Information about how to contact the Office of Ombudsman for Long-Term Care shall be included in notices of change in client fees and in notices where home care providers initiate transfer or discontinuation of servicesdeleted text end new text begin sections 144A.43 to 144A.482new text end .

Sec. 9.

Minnesota Statutes 2012, section 144A.45, is amended to read:

144A.45 REGULATION OF HOME CARE SERVICES.

Subdivision 1.

deleted text begin Rulesdeleted text end new text begin Regulationsnew text end .

The commissioner shall deleted text begin adopt rules for the regulation ofdeleted text end new text begin regulatenew text end home care providers pursuant to sections 144A.43 to deleted text begin 144A.47deleted text end new text begin 144A.482new text end . The deleted text begin rulesdeleted text end new text begin regulationsnew text end shall include the following:

(1) provisions to assure, to the extent possible, the health, safety deleted text begin anddeleted text end new text begin ,new text end well-being, and appropriate treatment of persons who receive home care servicesnew text begin while respecting a client's autonomy and choicenew text end ;

(2) requirements that home care providers furnish the commissioner with specified information necessary to implement sections 144A.43 to deleted text begin 144A.47deleted text end new text begin 144A.482new text end ;

(3) standards of training of home care provider personneldeleted text begin , which may vary according to the nature of the services provided or the health status of the consumerdeleted text end ;

new text begin (4) standards for provision of home care services; new text end

deleted text begin (4)deleted text end new text begin (5)new text end standards for medication management deleted text begin which may vary according to the nature of the services provided, the setting in which the services are provided, or the status of the consumer. Medication management includes the central storage, handling, distribution, and administration of medicationsdeleted text end ;

deleted text begin (5)deleted text end new text begin (6)new text end standards for supervision of home care services deleted text begin requiring supervision by a registered nurse or other appropriate health care professional which must occur on site at least every 62 days, or more frequently if indicated by a clinical assessment, and in accordance with sections 148.171 to 148.285 and rules adopted thereunder, except that a person performing home care aide tasks for a class B licensee providing paraprofessional services does not require nursing supervisiondeleted text end ;

deleted text begin (6)deleted text end new text begin (7)new text end standards for client evaluation or assessment deleted text begin which may vary according to the nature of the services provided or the status of the consumerdeleted text end ;

deleted text begin (7)deleted text end new text begin (8)new text end requirements for the involvement of a deleted text begin consumer's physiciandeleted text end new text begin client's health care providernew text end , the documentation of deleted text begin physicians'deleted text end new text begin health care providers'new text end orders, if required, and the deleted text begin consumer's treatmentdeleted text end new text begin client's servicenew text end plandeleted text begin , anddeleted text end new text begin ;new text end

new text begin (9)new text end the maintenance of accurate, current deleted text begin clinicaldeleted text end new text begin clientnew text end records;

deleted text begin (8)deleted text end new text begin (10)new text end the establishment of deleted text begin different classesdeleted text end new text begin basic and comprehensive levelsnew text end of licenses deleted text begin for different types of providers and different standards and requirements for different kinds of home caredeleted text end new text begin based on new text end servicesnew text begin providednew text end ; and

deleted text begin (9) operating procedures required to implementdeleted text end new text begin (11) provisions to enforce these regulations andnew text end the home care bill of rights.

deleted text begin Subd. 1a. deleted text end

deleted text begin Home care aide tasks. deleted text end

deleted text begin Notwithstanding the provisions of Minnesota Rules, part 4668.0110, subpart 1, item E, home care aide tasks also include assisting toileting, transfers, and ambulation if the client is ambulatory and if the client has no serious acute illness or infectious disease. deleted text end

deleted text begin Subd. 1b. deleted text end

deleted text begin Home health aide qualifications. deleted text end

deleted text begin Notwithstanding the provisions of Minnesota Rules, part 4668.0100, subpart 5, a person may perform home health aide tasks if the person maintains current registration as a nursing assistant on the Minnesota nursing assistant registry. Maintaining current registration on the Minnesota nursing assistant registry satisfies the documentation requirements of Minnesota Rules, part 4668.0110, subpart 3. deleted text end

Subd. 2.

Regulatory functions.

deleted text begin (a)deleted text end The commissioner shall:

(1) deleted text begin evaluate, monitor, anddeleted text end licensenew text begin , survey, and monitor without advance notice, new text end home care providers in accordance with sections deleted text begin 144A.45 to 144A.47deleted text end new text begin 144A.43 to 144A.482new text end ;

deleted text begin (2) inspect the office and records of a provider during regular business hours without advance notice to the home care provider; deleted text end

new text begin (2) survey every temporary licensee within one year of the temporary license issuance date subject to the temporary licensee providing home care services to a client or clients; new text end

new text begin (3) survey all licensed home care providers on an interval that will promote the health and safety of clients; new text end

deleted text begin (3)deleted text end new text begin (4)new text end with the consent of the deleted text begin consumerdeleted text end new text begin clientnew text end , visit the home where services are being provided;

deleted text begin (4)deleted text end new text begin (5)new text end issue correction orders and assess civil penalties in accordance with section 144.653, subdivisions 5 to 8, for violations of sections 144A.43 to deleted text begin 144A.47 or the rules adopted under those sectionsdeleted text end new text begin 144A.482new text end ;

deleted text begin (5)deleted text end new text begin (6)new text end take action as authorized in section deleted text begin 144A.46, subdivision 3deleted text end new text begin 144A.475new text end ; and

deleted text begin (6)deleted text end new text begin (7)new text end take other action reasonably required to accomplish the purposes of sections 144A.43 to deleted text begin 144A.47deleted text end new text begin 144A.482new text end .

deleted text begin (b) In the exercise of the authority granted in sections 144A.43 to 144A.47, the commissioner shall comply with the applicable requirements of section 144.122, the Government Data Practices Act, and the Administrative Procedure Act. deleted text end

deleted text begin Subd. 4. deleted text end

deleted text begin Medicaid reimbursement. deleted text end

deleted text begin Notwithstanding the provisions of section 256B.37 or state plan requirements to the contrary, certification by the federal Medicare program must not be a requirement of Medicaid payment for services delivered under section 144A.4605. deleted text end

deleted text begin Subd. 5. deleted text end

deleted text begin Home care providers; services for Alzheimer's disease or related disorder. deleted text end

deleted text begin (a) If a home care provider licensed under section 144A.46 or 144A.4605 markets or otherwise promotes services for persons with Alzheimer's disease or related disorders, the facility's direct care staff and their supervisors must be trained in dementia care. deleted text end

deleted text begin (b) Areas of required training include: deleted text end

deleted text begin (1) an explanation of Alzheimer's disease and related disorders; deleted text end

deleted text begin (2) assistance with activities of daily living; deleted text end

deleted text begin (3) problem solving with challenging behaviors; and deleted text end

deleted text begin (4) communication skills. deleted text end

deleted text begin (c) The licensee shall provide to consumers in written or electronic form a description of the training program, the categories of employees trained, the frequency of training, and the basic topics covered. deleted text end

Sec. 10.

new text begin [144A.471] HOME CARE PROVIDER AND HOME CARE SERVICES. new text end

new text begin Subdivision 1. new text end

new text begin License required. new text end

new text begin A home care provider may not open, operate, manage, conduct, maintain, or advertise itself as a home care provider or provide home care services in Minnesota without a temporary or current home care provider license issued by the commissioner of health. new text end

new text begin Subd. 2. new text end

new text begin Determination of direct home care service. new text end

new text begin (a) "Direct home care service" means a home care service provided to a client by the home care provider or its employees, and not by contract. Factors that must be considered in determining whether an individual or a business entity provides at least one home care service directly include, but are not limited to, whether the individual or business entity: new text end

new text begin (1) has the right to control, and does control, the types of services provided; new text end

new text begin (2) has the right to control, and does control, when and how the services are provided; new text end

new text begin (3) establishes the charges; new text end

new text begin (4) collects fees from the clients or receives payment from third-party payers on the clients' behalf; new text end

new text begin (5) pays individuals providing services compensation on an hourly, weekly, or similar basis; new text end

new text begin (6) treats the individuals providing services as employees for the purposes of payroll taxes and workers' compensation insurance; and new text end

new text begin (7) holds itself out as a provider of home care services or acts in a manner that leads clients or potential clients to believe that it is a home care provider providing home care services. new text end

new text begin (b) None of the factors listed in this subdivision is solely determinative. new text end

new text begin Subd. 3. new text end

new text begin Determination of regularly engaged. new text end

new text begin (a) "Regularly engaged" means providing, or offering to provide, home care services as a regular part of a business. The following factors must be considered by the commissioner in determining whether an individual or a business entity is regularly engaged in providing home care services: new text end

new text begin (1) whether the individual or business entity states or otherwise promotes that the individual or business entity provides home care services; new text end

new text begin (2) whether persons receiving home care services constitute a substantial part of the individual's or the business entity's clientele; and new text end

new text begin (3) whether the home care services provided are other than occasional or incidental to the provision of services other than home care services. new text end

new text begin (b) None of the factors listed in this subdivision is solely determinative. new text end

new text begin Subd. 4. new text end

new text begin Penalties for operating without license. new text end

new text begin A person involved in the management, operation, or control of a home care provider that operates without an appropriate license is guilty of a misdemeanor. This section does not apply to a person who has no legal authority to affect or change decisions related to the management, operation, or control of a home care provider. new text end

new text begin Subd. 5. new text end

new text begin Basic and comprehensive levels of licensure. new text end

new text begin An applicant seeking to become a home care provider must apply for either a basic or comprehensive home care license. new text end

new text begin Subd. 6. new text end

new text begin Basic home care license provider. new text end

new text begin Home care services that can be provided with a basic home care license are assistive tasks provided by licensed or unlicensed personnel that include: new text end

new text begin (1) assisting with dressing, self-feeding, oral hygiene, hair care, grooming, toileting, and bathing; new text end

new text begin (2) providing standby assistance; new text end

new text begin (3) providing verbal or visual reminders to the client to take regularly scheduled medication, which includes bringing the client previously set-up medication, medication in original containers, or liquid or food to accompany the medication; new text end

new text begin (4) providing verbal or visual reminders to the client to perform regularly scheduled treatments and exercises; new text end

new text begin (5) preparing modified diets ordered by a licensed health professional; and new text end

new text begin (6) assisting with laundry, housekeeping, meal preparation, shopping, or other household chores and services if the provider is also providing at least one of the activities in clauses (1) to (5). new text end

new text begin Subd. 7. new text end

new text begin Comprehensive home care license provider. new text end

new text begin Home care services that may be provided with a comprehensive home care license include any of the basic home care services listed in subdivision 6, and one or more of the following: new text end

new text begin (1) services of an advanced practice nurse, registered nurse, licensed practical nurse, physical therapist, respiratory therapist, occupational therapist, speech-language pathologist, dietitian or nutritionist, or social worker; new text end

new text begin (2) tasks delegated to unlicensed personnel by a registered nurse or assigned by a licensed health professional within the person's scope of practice; new text end

new text begin (3) medication management services; new text end

new text begin (4) hands-on assistance with transfers and mobility; new text end

new text begin (5) assisting clients with eating when the clients have complicating eating problems as identified in the client record or through an assessment such as difficulty swallowing, recurrent lung aspirations, or requiring the use of a tube or parenteral or intravenous instruments to be fed; or new text end

new text begin (6) providing other complex or specialty health care services. new text end

new text begin Subd. 8. new text end

new text begin Exemptions from home care services licensure. new text end

new text begin (a) Except as otherwise provided in this chapter, home care services that are provided by the state, counties, or other units of government must be licensed under this chapter. new text end

new text begin (b) An exemption under this subdivision does not excuse the exempted individual or organization from complying with applicable provisions of the home care bill of rights in section 144A.44. The following individuals or organizations are exempt from the requirement to obtain a home care provider license: new text end

new text begin (1) an individual or organization that offers, provides, or arranges for personal care assistance services under the medical assistance program as authorized under sections 256B.04, subdivision 16; 256B.0625, subdivision 19a; and 256B.0659; new text end

new text begin (2) a provider that is licensed by the commissioner of human services to provide semi-independent living services for persons with developmental disabilities under section 252.275 and Minnesota Rules, parts 9525.0900 to 9525.1020; new text end

new text begin (3) a provider that is licensed by the commissioner of human services to provide home and community-based services for persons with developmental disabilities under section 256B.092 and Minnesota Rules, parts 9525.1800 to 9525.1930; new text end

new text begin (4) an individual or organization that provides only home management services, if the individual or organization is registered under section 144A.482; or new text end

new text begin (5) an individual who is licensed in this state as a nurse, dietitian, social worker, occupational therapist, physical therapist, or speech-language pathologist who provides health care services in the home independently and not through any contractual or employment relationship with a home care provider or other organization. new text end

new text begin Subd. 9. new text end

new text begin Exclusions from home care licensure. new text end

new text begin The following are excluded from home care licensure and are not required to provide the home care bill of rights: new text end

new text begin (1) an individual or business entity providing only coordination of home care that includes one or more of the following: new text end

new text begin (i) determination of whether a client needs home care services, or assisting a client in determining what services are needed; new text end

new text begin (ii) referral of clients to a home care provider; new text end

new text begin (iii) administration of payments for home care services; or new text end

new text begin (iv) administration of a health care home established under section 256B.0751; new text end

new text begin (2) an individual who is not an employee of a licensed home care provider if the individual: new text end

new text begin (i) only provides services as an independent contractor to one or more licensed home care providers; new text end

new text begin (ii) provides no services under direct agreements or contracts with clients; and new text end

new text begin (iii) is contractually bound to perform services in compliance with the contracting home care provider's policies and service plans; new text end

new text begin (3) a business that provides staff to home care providers, such as a temporary employment agency, if the business: new text end

new text begin (i) only provides staff under contract to licensed or exempt providers; new text end

new text begin (ii) provides no services under direct agreements with clients; and new text end

new text begin (iii) is contractually bound to perform services under the contracting home care provider's direction and supervision; new text end

new text begin (4) any home care services conducted by and for the adherents of any recognized church or religious denomination for its members through spiritual means, or by prayer for healing; new text end

new text begin (5) an individual who only provides home care services to a relative; new text end

new text begin (6) an individual not connected with a home care provider that provides assistance with basic home care needs if the assistance is provided primarily as a contribution and not as a business; new text end

new text begin (7) an individual not connected with a home care provider that shares housing with and provides primarily housekeeping or homemaking services to an elderly or disabled person in return for free or reduced-cost housing; new text end

new text begin (8) an individual or provider providing home-delivered meal services; new text end

new text begin (9) an individual providing senior companion services and other older American volunteer programs (OAVP) established under the Domestic Volunteer Service Act of 1973, United States Code, title 42, chapter 66; new text end

new text begin (10) an employee of a nursing home licensed under this chapter or an employee of a boarding care home licensed under sections 144.50 to 144.56 who responds to occasional emergency calls from individuals residing in a residential setting that is attached to or located on property contiguous to the nursing home or boarding care home; new text end

new text begin (11) a member of a professional corporation organized under chapter 319B that does not regularly offer or provide home care services as defined in section 144A.43, subdivision 3; new text end

new text begin (12) the following organizations established to provide medical or surgical services that do not regularly offer or provide home care services as defined in section 144A.43, subdivision 3: a business trust organized under sections 318.01 to 318.04, a nonprofit corporation organized under chapter 317A, a partnership organized under chapter 323, or any other entity determined by the commissioner; new text end

new text begin (13) an individual or agency that provides medical supplies or durable medical equipment, except when the provision of supplies or equipment is accompanied by a home care service; new text end

new text begin (14) a physician licensed under chapter 147; new text end

new text begin (15) an individual who provides home care services to a person with a developmental disability who lives in a place of residence with a family, foster family, or primary caregiver; new text end

new text begin (16) a business that only provides services that are primarily instructional and not medical services or health-related support services; new text end

new text begin (17) an individual who performs basic home care services for no more than 14 hours each calendar week to no more than one client; new text end

new text begin (18) an individual or business licensed as hospice as defined in sections 144A.75 to 144A.755 who is not providing home care services independent of hospice service; new text end

new text begin (19) activities conducted by the commissioner of health or a board of health as defined in section 145A.02, subdivision 2, including communicable disease investigations or testing; or new text end

new text begin (20) administering or monitoring a prescribed therapy necessary to control or prevent a communicable disease, or the monitoring of an individual's compliance with a health directive as defined in section 144.4172, subdivision 6. new text end

Sec. 11.

new text begin [144A.472] HOME CARE PROVIDER LICENSE; APPLICATION AND RENEWAL. new text end

new text begin Subdivision 1. new text end

new text begin License applications. new text end

new text begin Each application for a home care provider license must include information sufficient to show that the applicant meets the requirements of licensure, including: new text end

new text begin (1) the applicant's name, e-mail address, physical address, and mailing address, including the name of the county in which the applicant resides and has a principal place of business; new text end

new text begin (2) the initial license fee in the amount specified in subdivision 7; new text end

new text begin (3) the e-mail address, physical address, mailing address, and telephone number of the principal administrative office; new text end

new text begin (4) the e-mail address, physical address, mailing address, and telephone number of each branch office, if any; new text end

new text begin (5) the names, e-mail and mailing addresses, and telephone numbers of all owners and managerial officials; new text end

new text begin (6) documentation of compliance with the background study requirements of section 144A.476 for all persons involved in the management, operation, or control of the home care provider; new text end

new text begin (7) documentation of a background study as required by section 144.057 for any individual seeking employment, paid or volunteer, with the home care provider; new text end

new text begin (8) evidence of workers' compensation coverage as required by sections 176.181 and 176.182; new text end

new text begin (9) documentation of liability coverage, if the provider has it; new text end

new text begin (10) identification of the license level the provider is seeking; new text end

new text begin (11) documentation that identifies the managerial official who is in charge of day-to-day operations and attestation that the person has reviewed and understands the home care provider regulations; new text end

new text begin (12) documentation that the applicant has designated one or more owners, managerial officials, or employees as an agent or agents, which shall not affect the legal responsibility of any other owner or managerial official under this chapter; new text end

new text begin (13) the signature of the officer or managing agent on behalf of an entity, corporation, association, or unit of government; new text end

new text begin (14) verification that the applicant has the following policies and procedures in place so that if a license is issued, the applicant will implement the policies and procedures and keep them current: new text end

new text begin (i) requirements in sections 626.556, reporting of maltreatment of minors, and 626.557, reporting of maltreatment of vulnerable adults; new text end

new text begin (ii) conducting and handling background studies on employees; new text end

new text begin (iii) orientation, training, and competency evaluations of home care staff, and a process for evaluating staff performance; new text end

new text begin (iv) handling complaints from clients, family members, or client representatives regarding staff or services provided by staff; new text end

new text begin (v) conducting initial evaluation of clients' needs and the providers' ability to provide those services; new text end

new text begin (vi) conducting initial and ongoing client evaluations and assessments and how changes in a client's condition are identified, managed, and communicated to staff and other health care providers as appropriate; new text end

new text begin (vii) orientation to and implementation of the home care client bill of rights; new text end

new text begin (viii) infection control practices; new text end

new text begin (ix) reminders for medications, treatments, or exercises, if provided; and new text end

new text begin (x) conducting appropriate screenings, or documentation of prior screenings, to show that staff are free of tuberculosis, consistent with current United States Centers for Disease Control and Prevention standards; and new text end

new text begin (15) other information required by the department. new text end

new text begin Subd. 2. new text end

new text begin Comprehensive home care license applications. new text end

new text begin In addition to the information and fee required in subdivision 1, applicants applying for a comprehensive home care license must also provide verification that the applicant has the following policies and procedures in place so that if a license is issued, the applicant will implement the policies and procedures in this subdivision and keep them current: new text end

new text begin (1) conducting initial and ongoing assessments of the client's needs by a registered nurse or appropriate licensed health professional, including how changes in the client's conditions are identified, managed, and communicated to staff and other health care providers, as appropriate; new text end

new text begin (2) ensuring that nurses and licensed health professionals have current and valid licenses to practice; new text end

new text begin (3) medication and treatment management; new text end

new text begin (4) delegation of home care tasks by registered nurses or licensed health professionals; new text end

new text begin (5) supervision of registered nurses and licensed health professionals; and new text end

new text begin (6) supervision of unlicensed personnel performing delegated home care tasks. new text end

new text begin Subd. 3. new text end

new text begin License renewal. new text end

new text begin (a) Except as provided in section 144A.475, a license may be renewed for a period of one year if the licensee satisfies the following: new text end

new text begin (1) submits an application for renewal in the format provided by the commissioner at least 30 days before expiration of the license; new text end

new text begin (2) submits the renewal fee in the amount specified in subdivision 7; new text end

new text begin (3) has provided home care services within the past 12 months; new text end

new text begin (4) complies with sections 144A.43 to 144A.4798; new text end

new text begin (5) provides information sufficient to show that the applicant meets the requirements of licensure, including items required under subdivision 1; new text end

new text begin (6) provides verification that all policies under subdivision 1 are current; and new text end

new text begin (7) provides any other information deemed necessary by the commissioner. new text end

new text begin (b) A renewal applicant who holds a comprehensive home care license must also provide verification that policies listed under subdivision 2 are current. new text end

new text begin Subd. 4. new text end

new text begin Multiple units. new text end

new text begin Multiple units or branches of a licensee must be separately licensed if the commissioner determines that the units cannot adequately share supervision and administration of services from the main office. new text end

new text begin Subd. 5. new text end

new text begin Transfers prohibited; changes in ownership. new text end

new text begin Any home care license issued by the commissioner may not be transferred to another party. Before acquiring ownership of a home care provider business, a prospective applicant must apply for a new temporary license. A change of ownership is a transfer of operational control to a different business entity and includes: new text end

new text begin (1) transfer of the business to a different or new corporation; new text end

new text begin (2) in the case of a partnership, the dissolution or termination of the partnership under chapter 323A, with the business continuing by a successor partnership or other entity; new text end

new text begin (3) relinquishment of control of the provider to another party, including to a contract management firm that is not under the control of the owner of the business' assets; new text end

new text begin (4) transfer of the business by a sole proprietor to another party or entity; or new text end

new text begin (5) in the case of a privately held corporation, the change in ownership or control of 50 percent or more of the outstanding voting stock. new text end

new text begin Subd. 6. new text end

new text begin Notification of changes of information. new text end

new text begin The temporary licensee or licensee shall notify the commissioner in writing within ten working days after any change in the information required in subdivision 1, except the information required in subdivision 1, clause (5), is required at the time of license renewal. new text end

new text begin Subd. 7. new text end

new text begin Fees; application, change of ownership, and renewal. new text end

new text begin (a) An initial applicant seeking a temporary home care licensure must submit the following application fee to the commissioner along with a completed application: new text end

new text begin (1) for a basic home care provider, $2,100; or new text end

new text begin (2) for a comprehensive home care provider, $4,200. new text end

new text begin (b) A home care provider who is filing a change of ownership as required under subdivision 5 must submit the following application fee to the commissioner, along with the documentation required for the change of ownership: new text end

new text begin (1) for a basic home care provider, $2,100; or new text end

new text begin (2) for a comprehensive home care provider, $4,200. new text end

new text begin (c) A home care provider who is seeking to renew the provider's license shall pay a fee to the commissioner based on revenues derived from the provision of home care services during the calendar year prior to the year in which the application is submitted, according to the following schedule: new text end

new text begin License Renewal Fee new text end

new text begin Provider Annual Revenue new text end new text begin Fee new text end
new text begin greater than $1,500,000 new text end new text begin $6,625 new text end
new text begin greater than $1,275,000 and no more than $1,500,000 new text end new text begin $5,797 new text end
new text begin greater than $1,100,000 and no more than $1,275,000 new text end new text begin $4,969 new text end
new text begin greater than $950,000 and no more than $1,100,000 new text end new text begin $4,141 new text end
new text begin greater than $850,000 and no more than $950,000 new text end new text begin $3,727 new text end
new text begin greater than $750,000 and no more than $850,000 new text end new text begin $3,313 new text end
new text begin greater than $650,000 and no more than $750,000 new text end new text begin $2,898 new text end
new text begin greater than $550,000 and no more than $650,000 new text end new text begin $2,485 new text end
new text begin greater than $450,000 and no more than $550,000 new text end new text begin $2,070 new text end
new text begin greater than $350,000 and no more than $450,000 new text end new text begin $1,656 new text end
new text begin greater than $250,000 and no more than $350,000 new text end new text begin $1,242 new text end
new text begin greater than $100,000 and no more than $250,000 new text end new text begin $828 new text end
new text begin greater than $50,000 and no more than $100,000 new text end new text begin $500 new text end
new text begin greater than $25,000 and no more than $50,000 new text end new text begin $400 new text end
new text begin no more than $25,000 new text end new text begin $200 new text end

new text begin (d) If requested, the home care provider shall provide the commissioner information to verify the provider's annual revenues or other information as needed, including copies of documents submitted to the Department of Revenue. new text end

new text begin (e) At each annual renewal, a home care provider may elect to pay the highest renewal fee for its license category, and not provide annual revenue information to the commissioner. new text end

new text begin (f) A temporary license or license applicant, or temporary licensee or licensee that knowingly provides the commissioner incorrect revenue amounts for the purpose of paying a lower license fee shall be subject to a civil penalty in the amount of double the fee the provider should have paid. new text end

new text begin (g) Fees and penalties collected under this section shall be deposited in the state treasury and credited to the special state government revenue fund. new text end

new text begin (h) The license renewal fee schedule in this subdivision is effective July 1, 2016. new text end

Sec. 12.

new text begin [144A.473] ISSUANCE OF TEMPORARY LICENSE AND LICENSE RENEWAL. new text end

new text begin Subdivision 1. new text end

new text begin Temporary license and renewal of license. new text end

new text begin (a) The department shall review each application to determine the applicant's knowledge of and compliance with Minnesota home care regulations. Before granting a temporary license or renewing a license, the commissioner may further evaluate the applicant or licensee by requesting additional information or documentation or by conducting an on-site survey of the applicant to determine compliance with sections 144A.43 to 144A.482. new text end

new text begin (b) Within 14 calendar days after receiving an application for a license, the commissioner shall acknowledge receipt of the application in writing. The acknowledgment must indicate whether the application appears to be complete or whether additional information is required before the application will be considered complete. new text end

new text begin (c) Within 90 days after receiving a complete application, the commissioner shall issue a temporary license, renew the license, or deny the license. new text end

new text begin (d) The commissioner shall issue a license that contains the home care provider's name, address, license level, expiration date of the license, and unique license number. All licenses are valid for one year from the date of issuance. new text end

new text begin Subd. 2. new text end

new text begin Temporary license. new text end

new text begin (a) For new license applicants, the commissioner shall issue a temporary license for either the basic or comprehensive home care level. A temporary license is effective for one year from the date of issuance. Temporary licensees must comply with sections 144A.43 to 144A.482. new text end

new text begin (b) During the temporary license year, the commissioner shall survey the temporary licensee after the commissioner is notified or has evidence that the temporary licensee is providing home care services. new text end

new text begin (c) Within five days of beginning the provision of services, the temporary licensee must notify the commissioner that it is serving clients. The notification to the commissioner may be mailed or e-mailed to the commissioner at the address provided by the commissioner. If the temporary licensee does not provide home care services during the temporary license year, then the temporary license expires at the end of the year and the applicant must reapply for a temporary home care license. new text end

new text begin (d) A temporary licensee may request a change in the level of licensure prior to being surveyed and granted a license by notifying the commissioner in writing and providing additional documentation or materials required to update or complete the changed temporary license application. The applicant must pay the difference between the application fees when changing from the basic level to the comprehensive level of licensure. No refund will be made if the provider chooses to change the license application to the basic level. new text end

new text begin (e) If the temporary licensee notifies the commissioner that the licensee has clients within 45 days prior to the temporary license expiration, the commissioner may extend the temporary license for up to 60 days in order to allow the commissioner to complete the on-site survey required under this section and follow-up survey visits. new text end

new text begin Subd. 3. new text end

new text begin Temporary licensee survey. new text end

new text begin (a) If the temporary licensee is in substantial compliance with the survey, the commissioner shall issue either a basic or comprehensive home care license. If the temporary licensee is not in substantial compliance with the survey, the commissioner shall not issue a basic or comprehensive license and there will be no contested hearing right under chapter 14. new text end

new text begin (b) If the temporary licensee whose basic or comprehensive license has been denied disagrees with the conclusions of the commissioner, then the licensee may request a reconsideration by the commissioner or commissioner's designee. The reconsideration request process must be conducted internally by the commissioner or commissioner's designee, and chapter 14 does not apply. new text end

new text begin (c) The temporary licensee requesting reconsideration must make the request in writing and must list and describe the reasons why the licensee disagrees with the decision to deny the basic or comprehensive home care license. new text end

new text begin (d) A temporary licensee whose license is denied must comply with the requirements for notification and transfer of clients in section 144A.475, subdivision 5. new text end

Sec. 13.

new text begin [144A.474] SURVEYS AND INVESTIGATIONS. new text end

new text begin Subdivision 1. new text end

new text begin Surveys. new text end

new text begin The commissioner shall conduct surveys of each home care provider. By June 30, 2016, the commissioner shall conduct a survey of home care providers on a frequency of at least once every three years. Survey frequency may be based on the license level, the provider's compliance history, number of clients served, or other factors as determined by the department deemed necessary to ensure the health, safety, and welfare of clients and compliance with the law. new text end

new text begin Subd. 2. new text end

new text begin Types of home care surveys. new text end

new text begin (a) "Initial full survey" means the survey of a new temporary licensee conducted after the department is notified or has evidence that the temporary licensee is providing home care services to determine if the provider is in compliance with home care requirements. Initial full surveys must be completed within 14 months after the department's issuance of a temporary basic or comprehensive license. new text end

new text begin (b) "Core survey" means periodic inspection of home care providers to determine ongoing compliance with the home care requirements, focusing on the essential health and safety requirements. Core surveys are available to licensed home care providers who have been licensed for three years and surveyed at least once in the past three years with the latest survey having no widespread violations beyond Level 1 as provided in subdivision 11. Providers must also not have had any substantiated licensing complaints, substantiated complaints against the agency under the Vulnerable Adults Act or Maltreatment of Minors Act, or an enforcement action as authorized in section 144A.475 in the past three years. new text end

new text begin (1) The core survey for basic home care providers must review compliance in the following areas: new text end

new text begin (i) reporting of maltreatment; new text end

new text begin (ii) orientation to and implementation of Home Care Client Bill of Rights; new text end

new text begin (iii) statement of home care services; new text end

new text begin (iv) initial evaluation of clients and initiation of services; new text end

new text begin (v) client review and monitoring; new text end

new text begin (vi) service plan implementation and changes to the service plan; new text end

new text begin (vii) client complaint and investigative process; new text end

new text begin (viii) competency of unlicensed personnel; and new text end

new text begin (ix) infection control. new text end

new text begin (2) For comprehensive home care providers, the core survey must include everything in the basic core survey plus these areas: new text end

new text begin (i) delegation to unlicensed personnel; new text end

new text begin (ii) assessment, monitoring, and reassessment of clients; and new text end

new text begin (iii) medication, treatment, and therapy management. new text end

new text begin (c) "Full survey" means the periodic inspection of home care providers to determine ongoing compliance with the home care requirements that cover the core survey areas and all the legal requirements for home care providers. A full survey is conducted for all temporary licensees and for providers who do not meet the requirements needed for a core survey, and when a surveyor identifies unacceptable client health or safety risks during a core survey. A full survey must include all the tasks identified as part of the core survey and any additional review deemed necessary by the department, including additional observation, interviewing, or records review of additional clients and staff. new text end

new text begin (d) "Follow-up surveys" means surveys conducted to determine if a home care provider has corrected deficient issues and systems identified during a core survey, full survey, or complaint investigation. Follow-up surveys may be conducted via phone, e-mail, fax, mail, or on-site reviews. Follow-up surveys, other than complaint surveys, shall be concluded with an exit conference and written information provided on the process for requesting a reconsideration of the survey results. new text end

new text begin (e) Upon receiving information alleging that a home care provider has violated or is currently violating a requirement of sections 144A.43 to 144A.482, the commissioner shall investigate the complaint according to sections 144A.51 to 144A.54. new text end

new text begin Subd. 3. new text end

new text begin Survey process. new text end

new text begin (a) The survey process for core surveys shall include the following as applicable to the particular licensee and setting surveyed: new text end

new text begin (1) presurvey review of pertinent documents and notification to the ombudsman for long-term care; new text end

new text begin (2) an entrance conference with available staff; new text end

new text begin (3) communication with managerial officials or the registered nurse in charge, if available, and ongoing communication with key staff throughout the survey regarding information needed by the surveyor, clarifications regarding home care requirements, and applicable standards of practice; new text end

new text begin (4) presentation of written contact information to the provider about the survey staff conducting the survey, the supervisor, and the process for requesting a reconsideration of the survey results; new text end

new text begin (5) a brief tour of a sample of the housing with services establishments in which the provider is providing home care services; new text end

new text begin (6) a sample selection of home care clients; new text end

new text begin (7) information-gathering through client and staff observations, client and staff interviews, and reviews of records, policies, procedures, practices, and other agency information; new text end

new text begin (8) interviews of clients' family members, if available, with clients' consent when the client can legally give consent; new text end

new text begin (9) except for complaint surveys conducted by the Office of Health Facilities Complaints, an on-site exit conference, with preliminary findings shared and discussed with the provider, documentation that an exit conference occurred, and written information provided on the process for requesting a reconsideration of the survey results; and new text end

new text begin (10) postsurvey analysis of findings and formulation of survey results, including correction orders when applicable. new text end

new text begin Subd. 4. new text end

new text begin Scheduling surveys. new text end

new text begin Surveys and investigations shall be conducted without advance notice to home care providers. Surveyors may contact the home care provider on the day of a survey to arrange for someone to be available at the survey site. The contact does not constitute advance notice. new text end

new text begin Subd. 5. new text end

new text begin Information provided by home care provider. new text end

new text begin The home care provider shall provide accurate and truthful information to the department during a survey, investigation, or other licensing activities. new text end

new text begin Subd. 6. new text end

new text begin Providing client records. new text end

new text begin Upon request of a surveyor, home care providers shall provide a list of current and past clients or client representatives that includes addresses and telephone numbers and any other information requested about the services to clients within a reasonable period of time. new text end

new text begin Subd. 7. new text end

new text begin Contacting and visiting clients. new text end

new text begin Surveyors may contact or visit a home care provider's clients to gather information without notice to the home care provider. Before visiting a client, a surveyor shall obtain the client's or client's representative's permission by telephone, mail, or in person. Surveyors shall inform all clients or client's representatives of their right to decline permission for a visit. new text end

new text begin Subd. 8. new text end

new text begin Correction orders. new text end

new text begin (a) A correction order may be issued whenever the commissioner finds upon survey or during a complaint investigation that a home care provider, a managerial official, or an employee of the provider is not in compliance with sections 144A.43 to 144A.482. The correction order shall cite the specific statute and document areas of noncompliance and the time allowed for correction. new text end

new text begin (b) The commissioner shall mail copies of any correction order within 30 calendar days after an exit survey to the last known address of the home care provider. A copy of each correction order and copies of any documentation supplied to the commissioner shall be kept on file by the home care provider, and public documents shall be made available for viewing by any person upon request. Copies may be kept electronically. new text end

new text begin (c) By the correction order date, the home care provider must document in the provider's records any action taken to comply with the correction order. The commissioner may request a copy of this documentation and the home care provider's action to respond to the correction order in future surveys, upon a complaint investigation, and as otherwise needed. new text end

new text begin Subd. 9. new text end

new text begin Follow-up surveys. new text end

new text begin For providers that have Level 3 or Level 4 violations, under subdivision 11, or any violations determined to be widespread, the department shall conduct a follow-up survey within 90 calendar days of the survey. When conducting a follow-up survey, the surveyor will focus on whether the previous violations have been corrected and may also address any new violations that are observed while evaluating the corrections that have been made. If a new violation is identified on a follow-up survey, no fine will be imposed unless it is not corrected on the next follow-up survey. new text end

new text begin Subd. 10. new text end

new text begin Performance incentive. new text end

new text begin A licensee is eligible for a performance incentive if there are no violations identified in a core or full survey. The performance incentive is a ten percent discount on the licensee's next home care renewal license fee. new text end

new text begin Subd. 11. new text end

new text begin Fines. new text end

new text begin (a) Fines and enforcement actions under this subdivision may be assessed based on the level and scope of the violations described in paragraph (c) as follows: new text end

new text begin (1) Level 1, no fines or enforcement; new text end

new text begin (2) Level 2, fines ranging from $0 to $500, in addition to any of the enforcement mechanisms authorized in section 144A.475 for widespread violations; new text end

new text begin (3) Level 3, fines ranging from $500 to $1,000, in addition to any of the enforcement mechanisms authorized in section 144A.475; and new text end

new text begin (4) Level 4, fines ranging from $1,000 to $5,000, in addition to any of the enforcement mechanisms authorized in section 144A.475. new text end

new text begin (b) Correction orders for violations are categorized by both level and scope and fines shall be assessed as follows: new text end

new text begin (1) Level of violation: new text end

new text begin (i) Level 1 is a violation that has no potential to cause more than a minimal impact on the client and does not affect health or safety; new text end

new text begin (ii) Level 2 is a violation that did not harm a client's health or safety but had the potential to have harmed a client's health or safety, but was not likely to cause serious injury, impairment, or death; new text end

new text begin (iii) Level 3 is a violation that harmed a client's health or safety, not including serious injury, impairment, or death, or a violation that has the potential to lead to serious injury, impairment, or death; and new text end

new text begin (iv) Level 4 is a violation that results in serious injury, impairment, or death. new text end

new text begin (2) Scope of violation: new text end

new text begin (i) isolated, when one or a limited number of clients are affected or one or a limited number of staff are involved or the situation has occurred only occasionally; new text end

new text begin (ii) pattern, when more than a limited number of clients are affected, more than a limited number of staff are involved, or the situation has occurred repeatedly but is not found to be pervasive; and new text end

new text begin (iii) widespread, when problems are pervasive or represent a systemic failure that has affected or has the potential to affect a large portion or all of the clients. new text end

new text begin (c) If the commissioner finds that the applicant or a home care provider required to be licensed under sections 144A.43 to 144A.482 has not corrected violations by the date specified in the correction order or conditional license resulting from a survey or complaint investigation, the commissioner may impose a fine. A notice of noncompliance with a correction order must be mailed to the applicant's or provider's last known address. The noncompliance notice must list the violations not corrected. new text end

new text begin (d) The license holder must pay the fines assessed on or before the payment date specified. If the license holder fails to fully comply with the order, the commissioner may issue a second fine or suspend the license until the license holder complies by paying the fine. A timely appeal shall stay payment of the fine until the commissioner issues a final order. new text end

new text begin (e) A license holder shall promptly notify the commissioner in writing when a violation specified in the order is corrected. If upon reinspection the commissioner determines that a violation has not been corrected as indicated by the order, the commissioner may issue a second fine. The commissioner shall notify the license holder by mail to the last known address in the licensing record that a second fine has been assessed. The license holder may appeal the second fine as provided under this subdivision. new text end

new text begin (f) A home care provider that has been assessed a fine under this subdivision has a right to a reconsideration or a hearing under this section and chapter 14. new text end

new text begin (g) When a fine has been assessed, the license holder may not avoid payment by closing, selling, or otherwise transferring the licensed program to a third party. In such an event, the license holder shall be liable for payment of the fine. new text end

new text begin (h) In addition to any fine imposed under this section, the commissioner may assess costs related to an investigation that results in a final order assessing a fine or other enforcement action authorized by this chapter. new text end

new text begin (i) Fines collected under this subdivision shall be deposited in the state government special revenue fund and credited to an account separate from the revenue collected under section 144A.472. Subject to an appropriation by the legislature, the revenue from the fines collected may be used by the commissioner for special projects to improve home care in Minnesota as recommended by the advisory council established in section 144A.4799. new text end

new text begin Subd. 12. new text end

new text begin Reconsideration. new text end

new text begin (a) The commissioner shall make available to home care providers a correction order reconsideration process. This process may be used to challenge the correction order issued, including the level and scope described in subdivision 11, and any fine assessed. During the correction order reconsideration request, the issuance for the correction orders under reconsideration are not stayed, but the department shall post information on the Web site with the correction order that the licensee has requested a reconsideration and that the review is pending. new text end

new text begin (b) A licensed home care provider may request from the commissioner, in writing, a correction order reconsideration regarding any correction order issued to the provider. The correction order reconsideration shall not be reviewed by any surveyor, investigator, or supervisor that participated in the writing or reviewing of the correction order being disputed. The correction order reconsiderations may be conducted in person, by telephone, by another electronic form, or in writing, as determined by the commissioner. The commissioner shall respond in writing to the request from a home care provider for a correction order reconsideration within 60 days of the date the provider requests a reconsideration. The commissioner's response shall identify the commissioner's decision regarding each citation challenged by the home care provider. new text end

new text begin (c) The findings of a correction order reconsideration process shall be one or more of the following: new text end

new text begin (1) supported in full, the correction order is supported in full, with no deletion of findings to the citation; new text end

new text begin (2) supported in substance, the correction order is supported, but one or more findings are deleted or modified without any change in the citation; new text end

new text begin (3) correction order cited an incorrect home care licensing requirement, the correction order is amended by changing the correction order to the appropriate statutory reference; new text end

new text begin (4) correction order was issued under an incorrect citation, the correction order is amended to be issued under the more appropriate correction order citation; new text end

new text begin (5) the correction order is rescinded; new text end

new text begin (6) fine is amended, it is determined that the fine assigned to the correction order was applied incorrectly; or new text end

new text begin (7) the level or scope of the citation is modified based on the reconsideration. new text end

new text begin (d) If the correction order findings are changed by the commissioner, the commissioner shall update the correction order Web site. new text end

new text begin Subd. 13. new text end

new text begin Home care surveyor training. new text end

new text begin (a) Before conducting a home care survey, each home care surveyor must receive training on the following topics: new text end

new text begin (1) Minnesota home care licensure requirements; new text end

new text begin (2) Minnesota Home Care Client Bill of Rights; new text end

new text begin (3) Minnesota Vulnerable Adults Act and reporting of maltreatment of minors; new text end

new text begin (4) principles of documentation; new text end

new text begin (5) survey protocol and processes; new text end

new text begin (6) Offices of the Ombudsman roles; new text end

new text begin (7) Office of Health Facility Complaints; new text end

new text begin (8) Minnesota landlord-tenant and housing with services laws; new text end

new text begin (9) types of payors for home care services; and new text end

new text begin (10) Minnesota Nurse Practice Act for nurse surveyors. new text end

new text begin (b) Materials used for the training in paragraph (a) shall be posted on the department Web site. Requisite understanding of these topics will be reviewed as part of the quality improvement plan in section 144A.483. new text end

Sec. 14.

new text begin [144A.475] ENFORCEMENT. new text end

new text begin Subdivision 1. new text end

new text begin Conditions. new text end

new text begin (a) The commissioner may refuse to grant a temporary license, renew a license, suspend or revoke a license, or impose a conditional license if the home care provider or owner or managerial official of the home care provider: new text end

new text begin (1) is in violation of, or during the term of the license has violated, any of the requirements in sections 144A.471 to 144A.482; new text end

new text begin (2) permits, aids, or abets the commission of any illegal act in the provision of home care; new text end

new text begin (3) performs any act detrimental to the health, safety, and welfare of a client; new text end

new text begin (4) obtains the license by fraud or misrepresentation; new text end

new text begin (5) knowingly made or makes a false statement of a material fact in the application for a license or in any other record or report required by this chapter; new text end

new text begin (6) denies representatives of the department access to any part of the home care provider's books, records, files, or employees; new text end

new text begin (7) interferes with or impedes a representative of the department in contacting the home care provider's clients; new text end

new text begin (8) interferes with or impedes a representative of the department in the enforcement of this chapter or has failed to fully cooperate with an inspection, survey, or investigation by the department; new text end

new text begin (9) destroys or makes unavailable any records or other evidence relating to the home care provider's compliance with this chapter; new text end

new text begin (10) refuses to initiate a background study under section 144.057 or 245A.04; new text end

new text begin (11) fails to timely pay any fines assessed by the department; new text end

new text begin (12) violates any local, city, or township ordinance relating to home care services; new text end

new text begin (13) has repeated incidents of personnel performing services beyond their competency level; or new text end

new text begin (14) has operated beyond the scope of the home care provider's license level. new text end

new text begin (b) A violation by a contractor providing the home care services of the home care provider is a violation by the home care provider. new text end

new text begin Subd. 2. new text end

new text begin Terms to suspension or conditional license. new text end

new text begin A suspension or conditional license designation may include terms that must be completed or met before a suspension or conditional license designation is lifted. A conditional license designation may include restrictions or conditions that are imposed on the provider. Terms for a suspension or conditional license may include one or more of the following and the scope of each will be determined by the commissioner: new text end

new text begin (1) requiring a consultant to review, evaluate, and make recommended changes to the home care provider's practices and submit reports to the commissioner at the cost of the home care provider; new text end

new text begin (2) requiring supervision of the home care provider or staff practices at the cost of the home care provider by an unrelated person who has sufficient knowledge and qualifications to oversee the practices and who will submit reports to the commissioner; new text end

new text begin (3) requiring the home care provider or employees to obtain training at the cost of the home care provider; new text end

new text begin (4) requiring the home care provider to submit reports to the commissioner; new text end

new text begin (5) prohibiting the home care provider from taking any new clients for a period of time; or new text end

new text begin (6) any other action reasonably required to accomplish the purpose of this subdivision and section 144A.45, subdivision 2. new text end

new text begin Subd. 3. new text end

new text begin Notice. new text end

new text begin Prior to any suspension, revocation, or refusal to renew a license, the home care provider shall be entitled to notice and a hearing as provided by sections 14.57 to 14.69. In addition to any other remedy provided by law, the commissioner may, without a prior contested case hearing, temporarily suspend a license or prohibit delivery of services by a provider for not more than 90 days if the commissioner determines that the health or safety of a consumer is in imminent danger, provided: new text end

new text begin (1) advance notice is given to the home care provider; new text end

new text begin (2) after notice, the home care provider fails to correct the problem; new text end

new text begin (3) the commissioner has reason to believe that other administrative remedies are not likely to be effective; and new text end

new text begin (4) there is an opportunity for a contested case hearing within the 90 days. new text end

new text begin Subd. 4. new text end

new text begin Time limits for appeals. new text end

new text begin To appeal the assessment of civil penalties under section 144A.45, subdivision 2, clause (5), and an action against a license under this section, a provider must request a hearing no later than 15 days after the provider receives notice of the action. new text end

new text begin Subd. 5. new text end

new text begin Plan required. new text end

new text begin (a) The process of suspending or revoking a license must include a plan for transferring affected clients to other providers by the home care provider, which will be monitored by the commissioner. Within three business days of being notified of the final revocation or suspension action, the home care provider shall provide the commissioner, the lead agencies as defined in section 256B.0911, and the ombudsman for long-term care with the following information: new text end

new text begin (1) a list of all clients, including full names and all contact information on file; new text end

new text begin (2) a list of each client's representative or emergency contact person, including full names and all contact information on file; new text end

new text begin (3) the location or current residence of each client; new text end

new text begin (4) the payor sources for each client, including payor source identification numbers; and new text end

new text begin (5) for each client, a copy of the client's service plan, and a list of the types of services being provided. new text end

new text begin (b) The revocation or suspension notification requirement is satisfied by mailing the notice to the address in the license record. The home care provider shall cooperate with the commissioner and the lead agencies during the process of transferring care of clients to qualified providers. Within three business days of being notified of the final revocation or suspension action, the home care provider must notify and disclose to each of the home care provider's clients, or the client's representative or emergency contact persons, that the commissioner is taking action against the home care provider's license by providing a copy of the revocation or suspension notice issued by the commissioner. new text end

new text begin Subd. 6. new text end

new text begin Owners and managerial officials; refusal to grant license. new text end

new text begin (a) The owner and managerial officials of a home care provider whose Minnesota license has not been renewed or that has been revoked because of noncompliance with applicable laws or rules shall not be eligible to apply for nor will be granted a home care license, including other licenses under this chapter, or be given status as an enrolled personal care assistance provider agency or personal care assistant by the Department of Human Services under section 256B.0659 for five years following the effective date of the nonrenewal or revocation. If the owner and managerial officials already have enrollment status, their enrollment will be terminated by the Department of Human Services. new text end

new text begin (b) The commissioner shall not issue a license to a home care provider for five years following the effective date of license nonrenewal or revocation if the owner or managerial official, including any individual who was an owner or managerial official of another home care provider, had a Minnesota license that was not renewed or was revoked as described in paragraph (a). new text end

new text begin (c) Notwithstanding subdivision 1, the commissioner shall not renew, or shall suspend or revoke, the license of any home care provider that includes any individual as an owner or managerial official who was an owner or managerial official of a home care provider whose Minnesota license was not renewed or was revoked as described in paragraph (a) for five years following the effective date of the nonrenewal or revocation. new text end

new text begin (d) The commissioner shall notify the home care provider 30 days in advance of the date of nonrenewal, suspension, or revocation of the license. Within ten days after the receipt of the notification, the home care provider may request, in writing, that the commissioner stay the nonrenewal, revocation, or suspension of the license. The home care provider shall specify the reasons for requesting the stay; the steps that will be taken to attain or maintain compliance with the licensure laws and regulations; any limits on the authority or responsibility of the owners or managerial officials whose actions resulted in the notice of nonrenewal, revocation, or suspension; and any other information to establish that the continuing affiliation with these individuals will not jeopardize client health, safety, or well-being. The commissioner shall determine whether the stay will be granted within 30 days of receiving the provider's request. The commissioner may propose additional restrictions or limitations on the provider's license and require that the granting of the stay be contingent upon compliance with those provisions. The commissioner shall take into consideration the following factors when determining whether the stay should be granted: new text end

new text begin (1) the threat that continued involvement of the owners and managerial officials with the home care provider poses to client health, safety, and well-being; new text end

new text begin (2) the compliance history of the home care provider; and new text end

new text begin (3) the appropriateness of any limits suggested by the home care provider. new text end

new text begin If the commissioner grants the stay, the order shall include any restrictions or limitation on the provider's license. The failure of the provider to comply with any restrictions or limitations shall result in the immediate removal of the stay and the commissioner shall take immediate action to suspend, revoke, or not renew the license. new text end

new text begin Subd. 7. new text end

new text begin Request for hearing. new text end

new text begin A request for a hearing must be in writing and must: new text end

new text begin (1) be mailed or delivered to the department or the commissioner's designee; new text end

new text begin (2) contain a brief and plain statement describing every matter or issue contested; and new text end

new text begin (3) contain a brief and plain statement of any new matter that the applicant or home care provider believes constitutes a defense or mitigating factor. new text end

new text begin Subd. 8. new text end

new text begin Informal conference. new text end

new text begin At any time, the applicant or home care provider and the commissioner may hold an informal conference to exchange information, clarify issues, or resolve issues. new text end

new text begin Subd. 9. new text end

new text begin Injunctive relief. new text end

new text begin In addition to any other remedy provided by law, the commissioner may bring an action in district court to enjoin a person who is involved in the management, operation, or control of a home care provider or an employee of the home care provider from illegally engaging in activities regulated by sections 144A.43 to 144A.482. The commissioner may bring an action under this subdivision in the district court in Ramsey County or in the district in which a home care provider is providing services. The court may grant a temporary restraining order in the proceeding if continued activity by the person who is involved in the management, operation, or control of a home care provider, or by an employee of the home care provider, would create an imminent risk of harm to a recipient of home care services. new text end

new text begin Subd. 10. new text end

new text begin Subpoena. new text end

new text begin In matters pending before the commissioner under sections 144A.43 to 144A.482, the commissioner may issue subpoenas and compel the attendance of witnesses and the production of all necessary papers, books, records, documents, and other evidentiary material. If a person fails or refuses to comply with a subpoena or order of the commissioner to appear or testify regarding any matter about which the person may be lawfully questioned or to produce any papers, books, records, documents, or evidentiary materials in the matter to be heard, the commissioner may apply to the district court in any district, and the court shall order the person to comply with the commissioner's order or subpoena. The commissioner of health may administer oaths to witnesses or take their affirmation. Depositions may be taken in or outside the state in the manner provided by law for the taking of depositions in civil actions. A subpoena or other process or paper may be served on a named person anywhere in the state by an officer authorized to serve subpoenas in civil actions, with the same fees and mileage and in the same manner as prescribed by law for a process issued out of a district court. A person subpoenaed under this subdivision shall receive the same fees, mileage, and other costs that are paid in proceedings in district court. new text end

Sec. 15.

new text begin [144A.476] BACKGROUND STUDIES. new text end

new text begin Subdivision 1. new text end

new text begin Prior criminal convictions; owner and managerial officials. new text end

new text begin (a) Before the commissioner issues a temporary license or renews a license, an owner or managerial official is required to complete a background study under section 144.057. No person may be involved in the management, operation, or control of a home care provider if the person has been disqualified under chapter 245C. If an individual is disqualified under section 144.057 or chapter 245C, the individual may request reconsideration of the disqualification. If the individual requests reconsideration and the commissioner sets aside or rescinds the disqualification, the individual is eligible to be involved in the management, operation, or control of the provider. If an individual has a disqualification under section 245C.15, subdivision 1, and the disqualification is affirmed, the individual's disqualification is barred from a set aside, and the individual must not be involved in the management, operation, or control of the provider. new text end

new text begin (b) For purposes of this section, owners of a home care provider subject to the background check requirement are those individuals whose ownership interest provides sufficient authority or control to affect or change decisions related to the operation of the home care provider. An owner includes a sole proprietor, a general partner, or any other individual whose individual ownership interest can affect the management and direction of the policies of the home care provider. new text end

new text begin (c) For the purposes of this section, managerial officials subject to the background check requirement are individuals who provide direct contact as defined in section 245C.02, subdivision 11, or individuals who have the responsibility for the ongoing management or direction of the policies, services, or employees of the home care provider. Data collected under this subdivision shall be classified as private data on individuals under section 13.02, subdivision 12. new text end

new text begin (d) The department shall not issue any license if the applicant or owner or managerial official has been unsuccessful in having a background study disqualification set aside under section 144.057 and chapter 245C; if the owner or managerial official, as an owner or managerial official of another home care provider, was substantially responsible for the other home care provider's failure to substantially comply with sections 144A.43 to 144A.482; or if an owner that has ceased doing business, either individually or as an owner of a home care provider, was issued a correction order for failing to assist clients in violation of this chapter. new text end

new text begin Subd. 2. new text end

new text begin Employees, contractors, and volunteers. new text end

new text begin (a) Employees, contractors, and volunteers of a home care provider are subject to the background study required by section 144.057, and may be disqualified under chapter 245C. Nothing in this section shall be construed to prohibit a home care provider from requiring self-disclosure of criminal conviction information. new text end

new text begin (b) Termination of an employee in good faith reliance on information or records obtained under paragraph (a) or subdivision 1, regarding a confirmed conviction does not subject the home care provider to civil liability or liability for unemployment benefits. new text end

Sec. 16.

new text begin [144A.477] COMPLIANCE. new text end

new text begin Subdivision 1. new text end

new text begin Medicare-certified providers; coordination of surveys. new text end

new text begin If feasible, the commissioner shall survey licensees to determine compliance with this chapter at the same time as surveys for certification for Medicare if Medicare certification is based on compliance with the federal conditions of participation and on survey and enforcement by the Department of Health as agent for the United States Department of Health and Human Services. new text end

new text begin Subd. 2. new text end

new text begin Medicare-certified providers; equivalent requirements. new text end

new text begin For home care providers licensed to provide comprehensive home care services that are also certified for participation in Medicare as a home health agency under Code of Federal Regulations, title 42, part 484, the following state licensure regulations are considered equivalent to the federal requirements: new text end

new text begin (1) quality management, section 144A.479, subdivision 3; new text end

new text begin (2) personnel records, section 144A.479, subdivision 7; new text end

new text begin (3) acceptance of clients, section 144A.4791, subdivision 4; new text end

new text begin (4) referrals, section 144A.4791, subdivision 5; new text end

new text begin (5) client assessment, sections 144A.4791, subdivision 8, and 144A.4792, subdivisions 2 and 3; new text end

new text begin (6) individualized monitoring and reassessment, sections 144A.4791, subdivision 8, and 144A.4792, subdivisions 2 and 3; new text end

new text begin (7) individualized service plan, sections 144A.4791, subdivision 9, 144A.4792, subdivision 5, and 144A.4793, subdivision 3; new text end

new text begin (8) client complaint and investigation process, section 144A.4791, subdivision 11; new text end

new text begin (9) prescription orders, section 144A.4792, subdivisions 13 to 16; new text end

new text begin (10) client records, section 144A.4794, subdivisions 1 to 3; new text end

new text begin (11) qualifications for unlicensed personnel performing delegated tasks, section 144A.4795; new text end

new text begin (12) training and competency staff, section 144A.4795; new text end

new text begin (13) training and competency for unlicensed personnel, section 144A.4795, subdivision 7; new text end

new text begin (14) delegation of home care services, section 144A.4795, subdivision 4; new text end

new text begin (15) availability of contact person, section 144A.4797, subdivision 1; and new text end

new text begin (16) supervision of staff, section 144A.4797, subdivisions 2 and 3. new text end

new text begin Violations of requirements in clauses (1) to (16) may lead to enforcement actions under section 144A.474. new text end

Sec. 17.

new text begin [144A.478] INNOVATION VARIANCE. new text end

new text begin Subdivision 1. new text end

new text begin Definition. new text end

new text begin For purposes of this section, "innovation variance" means a specified alternative to a requirement of this chapter. An innovation variance may be granted to allow a home care provider to offer home care services of a type or in a manner that is innovative, will not impair the services provided, will not adversely affect the health, safety, or welfare of the clients, and is likely to improve the services provided. The innovative variance cannot change any of the client's rights under section 144A.44, home care bill of rights. new text end

new text begin Subd. 2. new text end

new text begin Conditions. new text end

new text begin The commissioner may impose conditions on the granting of an innovation variance that the commissioner considers necessary. new text end

new text begin Subd. 3. new text end

new text begin Duration and renewal. new text end

new text begin The commissioner may limit the duration of any innovation variance and may renew a limited innovation variance. new text end

new text begin Subd. 4. new text end

new text begin Applications; innovation variance. new text end

new text begin An application for innovation variance from the requirements of this chapter may be made at any time, must be made in writing to the commissioner, and must specify the following: new text end

new text begin (1) the statute or law from which the innovation variance is requested; new text end

new text begin (2) the time period for which the innovation variance is requested; new text end

new text begin (3) the specific alternative action that the licensee proposes; new text end

new text begin (4) the reasons for the request; and new text end

new text begin (5) justification that an innovation variance will not impair the services provided, will not adversely affect the health, safety, or welfare of clients, and is likely to improve the services provided. new text end

new text begin The commissioner may require additional information from the home care provider before acting on the request. new text end

new text begin Subd. 5. new text end

new text begin Grants and denials. new text end

new text begin The commissioner shall grant or deny each request for an innovation variance in writing within 45 days of receipt of a complete request. Notice of a denial shall contain the reasons for the denial. The terms of a requested innovation variance may be modified upon agreement between the commissioner and the home care provider. new text end

new text begin Subd. 6. new text end

new text begin Violation of innovation variances. new text end

new text begin A failure to comply with the terms of an innovation variance shall be deemed to be a violation of this chapter. new text end

new text begin Subd. 7. new text end

new text begin Revocation or denial of renewal. new text end

new text begin The commissioner shall revoke or deny renewal of an innovation variance if: new text end

new text begin (1) it is determined that the innovation variance is adversely affecting the health, safety, or welfare of the licensee's clients; new text end

new text begin (2) the home care provider has failed to comply with the terms of the innovation variance; new text end

new text begin (3) the home care provider notifies the commissioner in writing that it wishes to relinquish the innovation variance and be subject to the statute previously varied; or new text end

new text begin (4) the revocation or denial is required by a change in law. new text end

Sec. 18.

new text begin [144A.479] HOME CARE PROVIDER RESPONSIBILITIES; BUSINESS OPERATION. new text end

new text begin Subdivision 1. new text end

new text begin Display of license. new text end

new text begin The original current license must be displayed in the home care providers' principal business office and copies must be displayed in any branch office. The home care provider must provide a copy of the license to any person who requests it. new text end

new text begin Subd. 2. new text end

new text begin Advertising. new text end

new text begin Home care providers shall not use false, fraudulent, or misleading advertising in the marketing of services. For purposes of this section, advertising includes any verbal, written, or electronic means of communicating to potential clients about the availability, nature, or terms of home care services. new text end

new text begin Subd. 3. new text end

new text begin Quality management. new text end

new text begin The home care provider shall engage in quality management appropriate to the size of the home care provider and relevant to the type of services the home care provider provides. The quality management activity means evaluating the quality of care by periodically reviewing client services, complaints made, and other issues that have occurred and determining whether changes in services, staffing, or other procedures need to be made in order to ensure safe and competent services to clients. Documentation about quality management activity must be available for two years. Information about quality management must be available to the commissioner at the time of the survey, investigation, or renewal. new text end

new text begin Subd. 4. new text end

new text begin Provider restrictions. new text end

new text begin (a) This subdivision does not apply to licensees that are Minnesota counties or other units of government. new text end

new text begin (b) A home care provider or staff cannot accept powers-of-attorney from clients for any purpose, and may not accept appointments as guardians or conservators of clients. new text end

new text begin (c) A home care provider cannot serve as a client's representative. new text end

new text begin Subd. 5. new text end

new text begin Handling of client's finances and property. new text end

new text begin (a) A home care provider may assist clients with household budgeting, including paying bills and purchasing household goods, but may not otherwise manage a client's property. A home care provider must provide a client with receipts for all transactions and purchases paid with the client's funds. When receipts are not available, the transaction or purchase must be documented. A home care provider must maintain records of all such transactions. new text end

new text begin (b) A home care provider or staff may not borrow a client's funds or personal or real property, nor in any way convert a client's property to the home care provider's or staff's possession. new text end

new text begin (c) Nothing in this section precludes a home care provider or staff from accepting gifts of minimal value, or precludes the acceptance of donations or bequests made to a home care provider that are exempt from income tax under section 501(c) of the Internal Revenue Code of 1986. new text end

new text begin Subd. 6. new text end

new text begin Reporting maltreatment of vulnerable adults and minors. new text end

new text begin (a) All home care providers must comply with requirements for the reporting of maltreatment of minors in section 626.556 and the requirements for the reporting of maltreatment of vulnerable adults in section 626.557. Each home care provider must establish and implement a written procedure to ensure that all cases of suspected maltreatment are reported. new text end

new text begin (b) Each home care provider must develop and implement an individual abuse prevention plan for each vulnerable minor or adult for whom home care services are provided by a home care provider. The plan shall contain an individualized review or assessment of the person's susceptibility to abuse by another individual, including other vulnerable adults or minors; the person's risk of abusing other vulnerable adults or minors; and statements of the specific measures to be taken to minimize the risk of abuse to that person and other vulnerable adults or minors. For purposes of the abuse prevention plan, the term abuse includes self-abuse. new text end

new text begin Subd. 7. new text end

new text begin Employee records. new text end

new text begin The home care provider must maintain current records of each paid employee, regularly scheduled volunteers providing home care services, and of each individual contractor providing home care services. The records must include the following information: new text end

new text begin (1) evidence of current professional licensure, registration, or certification, if licensure, registration, or certification is required by this statute, or other rules; new text end

new text begin (2) records of orientation, required annual training and infection control training, and competency evaluations; new text end

new text begin (3) current job description, including qualifications, responsibilities, and identification of staff providing supervision; new text end

new text begin (4) documentation of annual performance reviews which identify areas of improvement needed and training needs; new text end

new text begin (5) for individuals providing home care services, verification that required health screenings under section 144A.4798 have taken place and the dates of those screenings; and new text end

new text begin (6) documentation of the background study as required under section 144.057. new text end

new text begin Each employee record must be retained for at least three years after a paid employee, home care volunteer, or contractor ceases to be employed by or under contract with the home care provider. If a home care provider ceases operation, employee records must be maintained for three years. new text end

Sec. 19.

new text begin [144A.4791] HOME CARE PROVIDER RESPONSIBILITIES WITH RESPECT TO CLIENTS. new text end

new text begin Subdivision 1. new text end

new text begin Home care bill of rights; notification to client. new text end

new text begin (a) The home care provider shall provide the client or the client's representative a written notice of the rights under section 144A.44 before the initiation of services to that client. The provider shall make all reasonable efforts to provide notice of the rights to the client or the client's representative in a language the client or client's representative can understand. new text end

new text begin (b) In addition to the text of the home care bill of rights in section 144A.44, subdivision 1, the notice shall also contain the following statement describing how to file a complaint with these offices. new text end

new text begin "If you have a complaint about the provider or the person providing your home care services, you may call, write, or visit the Office of Health Facility Complaints, Minnesota Department of Health. You may also contact the Office of Ombudsman for Long-Term Care or the Office of Ombudsman for Mental Health and Developmental Disabilities." new text end

new text begin The statement should include the telephone number, Web site address, e-mail address, mailing address, and street address of the Office of Health Facility Complaints at the Minnesota Department of Health, the Office of the Ombudsman for Long-Term Care, and the Office of the Ombudsman for Mental Health and Developmental Disabilities. The statement should also include the home care provider's name, address, e-mail, telephone number, and name or title of the person at the provider to whom problems or complaints may be directed. It must also include a statement that the home care provider will not retaliate because of a complaint. new text end

new text begin (c) The home care provider shall obtain written acknowledgment of the client's receipt of the home care bill of rights or shall document why an acknowledgment cannot be obtained. The acknowledgment may be obtained from the client or the client's representative. Acknowledgment of receipt shall be retained in the client's record. new text end

new text begin Subd. 2. new text end

new text begin Notice of services for dementia, Alzheimer's disease, or related disorders. new text end

new text begin The home care provider that provides services to clients with dementia shall provide in written or electronic form, to clients and families or other persons who request it, a description of the training program and related training it provides, including the categories of employees trained, the frequency of training, and the basic topics covered. This information satisfies the disclosure requirements in section 325F.72, subdivision 2, clause (4). new text end

new text begin Subd. 3. new text end

new text begin Statement of home care services. new text end

new text begin Prior to the initiation of services, a home care provider must provide to the client or the client's representative a written statement which identifies if the provider has a basic or comprehensive home care license, the services the provider is authorized to provide, and which services the provider cannot provide under the scope of the provider's license. The home care provider shall obtain written acknowledgment from the clients that the provider has provided the statement or must document why the provider could not obtain the acknowledgment. new text end

new text begin Subd. 4. new text end

new text begin Acceptance of clients. new text end

new text begin No home care provider may accept a person as a client unless the home care provider has staff, sufficient in qualifications, competency, and numbers, to adequately provide the services agreed to in the service plan and that are within the provider's scope of practice. new text end

new text begin Subd. 5. new text end

new text begin Referrals. new text end

new text begin If a home care provider reasonably believes that a client is in need of another medical or health service, including a licensed health professional, or social service provider, the home care provider shall: new text end

new text begin (1) determine the client's preferences with respect to obtaining the service; and new text end

new text begin (2) inform the client of resources available, if known, to assist the client in obtaining services. new text end

new text begin Subd. 6. new text end

new text begin Initiation of services. new text end

new text begin When a provider initiates services and the individualized review or assessment required in subdivisions 7 and 8 has not been completed, the provider must complete a temporary plan and agreement with the client for services. new text end

new text begin Subd. 7. new text end

new text begin Basic individualized client review and monitoring. new text end

new text begin (a) When services being provided are basic home care services, an individualized initial review of the client's needs and preferences must be conducted at the client's residence with the client or client's representative. This initial review must be completed within 30 days after the initiation of the home care services. new text end

new text begin (b) Client monitoring and review must be conducted as needed based on changes in the needs of the client and cannot exceed 90 days from the date of the last review. The monitoring and review may be conducted at the client's residence or through the utilization of telecommunication methods based on practice standards that meet the individual client's needs. new text end

new text begin Subd. 8. new text end

new text begin Comprehensive assessment, monitoring, and reassessment. new text end

new text begin (a) When the services being provided are comprehensive home care services, an individualized initial assessment must be conducted in-person by a registered nurse. When the services are provided by other licensed health professionals, the assessment must be conducted by the appropriate health professional. This initial assessment must be completed within five days after initiation of home care services. new text end

new text begin (b) Client monitoring and reassessment must be conducted in the client's home no more than 14 days after initiation of services. new text end

new text begin (c) Ongoing client monitoring and reassessment must be conducted as needed based on changes in the needs of the client and cannot exceed 90 days from the last date of the assessment. The monitoring and reassessment may be conducted at the client's residence or through the utilization of telecommunication methods based on practice standards that meet the individual client's needs. new text end

new text begin Subd. 9. new text end

new text begin Service plan, implementation, and revisions to service plan. new text end

new text begin (a) No later than 14 days after the initiation of services, a home care provider shall finalize a current written service plan. new text end

new text begin (b) The service plan and any revisions must include a signature or other authentication by the home care provider and by the client or the client's representative documenting agreement on the services to be provided. The service plan must be revised, if needed, based on client review or reassessment under subdivisions 7 and 8. The provider must provide information to the client about changes to the provider's fee for services and how to contact the Office of the Ombudsman for Long-Term Care. new text end

new text begin (c) The home care provider must implement and provide all services required by the current service plan. new text end

new text begin (d) The service plan and revised service plan must be entered into the client's record, including notice of a change in a client's fees when applicable. new text end

new text begin (e) Staff providing home care services must be informed of the current written service plan. new text end

new text begin (f) The service plan must include: new text end

new text begin (1) a description of the home care services to be provided, the fees for services, and the frequency of each service, according to the client's current review or assessment and client preferences; new text end

new text begin (2) the identification of the staff or categories of staff who will provide the services; new text end

new text begin (3) the schedule and methods of monitoring reviews or assessments of the client; new text end

new text begin (4) the frequency of sessions of supervision of staff and type of personnel who will supervise staff; and new text end

new text begin (5) a contingency plan that includes: new text end

new text begin (i) the action to be taken by the home care provider and by the client or client's representative if the scheduled service cannot be provided; new text end

new text begin (ii) information and method for a client or client's representative to contact the home care provider; new text end

new text begin (iii) names and contact information of persons the client wishes to have notified in an emergency or if there is a significant adverse change in the client's condition, including identification of and information as to who has authority to sign for the client in an emergency; and new text end

new text begin (iv) the circumstances in which emergency medical services are not to be summoned consistent with chapters 145B and 145C, and declarations made by the client under those chapters. new text end

new text begin Subd. 10. new text end

new text begin Termination of service plan. new text end

new text begin (a) If a home care provider terminates a service plan with a client, and the client continues to need home care services, the home care provider shall provide the client and the client's representative, if any, with a written notice of termination which includes the following information: new text end

new text begin (1) the effective date of termination; new text end

new text begin (2) the reason for termination; new text end

new text begin (3) a list of known licensed home care providers in the client's immediate geographic area; new text end

new text begin (4) a statement that the home care provider will participate in a coordinated transfer of care of the client to another home care provider, health care provider, or caregiver, as required by the home care bill of rights, section 144A.44, subdivision 1, clause (17); new text end

new text begin (5) the name and contact information of a person employed by the home care provider with whom the client may discuss the notice of termination; and new text end

new text begin (6) if applicable, a statement that the notice of termination of home care services does not constitute notice of termination of the housing with services contract with a housing with services establishment. new text end

new text begin (b) When the home care provider voluntarily discontinues services to all clients, the home care provider must notify the commissioner, lead agencies, and the ombudsman for long-term care about its clients and comply with the requirements in this subdivision. new text end

new text begin Subd. 11. new text end

new text begin Client complaint and investigative process. new text end

new text begin (a) The home care provider must have a written policy and system for receiving, investigating, reporting, and attempting to resolve complaints from its clients or clients' representatives. The policy should clearly identify the process by which clients may file a complaint or concern about home care services and an explicit statement that the home care provider will not discriminate or retaliate against a client for expressing concerns or complaints. A home care provider must have a process in place to conduct investigations of complaints made by the client or the client's representative about the services in the client's plan that are or are not being provided or other items covered in the client's home care bill of rights. This complaint system must provide reasonable accommodations for any special needs of the client or client's representative if requested. new text end

new text begin (b) The home care provider must document the complaint, name of the client, investigation, and resolution of each complaint filed. The home care provider must maintain a record of all activities regarding complaints received, including the date the complaint was received, and the home care provider's investigation and resolution of the complaint. This complaint record must be kept for each event for at least two years after the date of entry and must be available to the commissioner for review. new text end

new text begin (c) The required complaint system must provide for written notice to each client or client's representative that includes: new text end

new text begin (1) the client's right to complain to the home care provider about the services received; new text end

new text begin (2) the name or title of the person or persons with the home care provider to contact with complaints; new text end

new text begin (3) the method of submitting a complaint to the home care provider; and new text end

new text begin (4) a statement that the provider is prohibited against retaliation according to paragraph (d). new text end

new text begin (d) A home care provider must not take any action that negatively affects a client in retaliation for a complaint made or a concern expressed by the client or the client's representative. new text end

new text begin Subd. 12. new text end

new text begin Disaster planning and emergency preparedness plan. new text end

new text begin The home care provider must have a written plan of action to facilitate the management of the client's care and services in response to a natural disaster, such as flood and storms, or other emergencies that may disrupt the home care provider's ability to provide care or services. The licensee must provide adequate orientation and training of staff on emergency preparedness. new text end

new text begin Subd. 13. new text end

new text begin Request for discontinuation of life-sustaining treatment. new text end

new text begin (a) If a client, family member, or other caregiver of the client requests that an employee or other agent of the home care provider discontinue a life-sustaining treatment, the employee or agent receiving the request: new text end

new text begin (1) shall take no action to discontinue the treatment; and new text end

new text begin (2) shall promptly inform the supervisor or other agent of the home care provider of the client's request. new text end

new text begin (b) Upon being informed of a request for termination of treatment, the home care provider shall promptly: new text end

new text begin (1) inform the client that the request will be made known to the physician who ordered the client's treatment; new text end

new text begin (2) inform the physician of the client's request; and new text end

new text begin (3) work with the client and the client's physician to comply with the provisions of the Health Care Directive Act in chapter 145C. new text end

new text begin (c) This section does not require the home care provider to discontinue treatment, except as may be required by law or court order. new text end

new text begin (d) This section does not diminish the rights of clients to control their treatments, refuse services, or terminate their relationships with the home care provider. new text end

new text begin (e) This section shall be construed in a manner consistent with chapter 145B or 145C, whichever applies, and declarations made by clients under those chapters. new text end

Sec. 20.

new text begin [144A.4792] MEDICATION MANAGEMENT. new text end

new text begin Subdivision 1. new text end

new text begin Medication management services; comprehensive home care license. new text end

new text begin (a) This subdivision applies only to home care providers with a comprehensive home care license that provide medication management services to clients. Medication management services may not be provided by a home care provider who has a basic home care license. new text end

new text begin (b) A comprehensive home care provider who provides medication management services must develop, implement, and maintain current written medication management policies and procedures. The policies and procedures must be developed under the supervision and direction of a registered nurse, licensed health professional, or pharmacist consistent with current practice standards and guidelines. new text end

new text begin (c) The written policies and procedures must address requesting and receiving prescriptions for medications; preparing and giving medications; verifying that prescription drugs are administered as prescribed; documenting medication management activities; controlling and storing medications; monitoring and evaluating medication use; resolving medication errors; communicating with the prescriber, pharmacist, and client and client representative, if any; disposing of unused medications; and educating clients and client representatives about medications. When controlled substances are being managed, the policies and procedures must also identify how the provider will ensure security and accountability for the overall management, control, and disposition of those substances in compliance with state and federal regulations and with subdivision 22. new text end

new text begin Subd. 2. new text end

new text begin Provision of medication management services. new text end

new text begin (a) For each client who requests medication management services, the comprehensive home care provider shall, prior to providing medication management services, have a registered nurse, licensed health professional, or authorized prescriber under section 151.37 conduct an assessment to determine what medication management services will be provided and how the services will be provided. This assessment must be conducted face-to-face with the client. The assessment must include an identification and review of all medications the client is known to be taking. The review and identification must include indications for medications, side effects, contraindications, allergic or adverse reactions, and actions to address these issues. new text end

new text begin (b) The assessment must identify interventions needed in management of medications to prevent diversion of medication by the client or others who may have access to the medications. "Diversion of medications" means the misuse, theft, or illegal or improper disposition of medications. new text end

new text begin Subd. 3. new text end

new text begin Individualized medication monitoring and reassessment. new text end

new text begin The comprehensive home care provider must monitor and reassess the client's medication management services as needed under subdivision 14 when the client presents with symptoms or other issues that may be medication-related and, at a minimum, annually. new text end

new text begin Subd. 4. new text end

new text begin Client refusal. new text end

new text begin The home care provider must document in the client's record any refusal for an assessment for medication management by the client. The provider must discuss with the client the possible consequences of the client's refusal and document the discussion in the client's record. new text end

new text begin Subd. 5. new text end

new text begin Individualized medication management plan. new text end

new text begin (a) For each client receiving medication management services, the comprehensive home care provider must prepare and include in the service plan a written statement of the medication management services that will be provided to the client. The provider must develop and maintain a current individualized medication management record for each client based on the client's assessment that must contain the following: new text end

new text begin (1) a statement describing the medication management services that will be provided; new text end

new text begin (2) a description of storage of medications based on the client's needs and preferences, risk of diversion, and consistent with the manufacturer's directions; new text end

new text begin (3) documentation of specific client instructions relating to the administration of medications; new text end

new text begin (4) identification of persons responsible for monitoring medication supplies and ensuring that medication refills are ordered on a timely basis; new text end

new text begin (5) identification of medication management tasks that may be delegated to unlicensed personnel; new text end

new text begin (6) procedures for staff notifying a registered nurse or appropriate licensed health professional when a problem arises with medication management services; and new text end

new text begin (7) any client-specific requirements relating to documenting medication administration, verifications that all medications are administered as prescribed, and monitoring of medication use to prevent possible complications or adverse reactions. new text end

new text begin (b) The medication management record must be current and updated when there are any changes. new text end

new text begin Subd. 6. new text end

new text begin Administration of medication. new text end

new text begin Medications may be administered by a nurse, physician, or other licensed health practitioner authorized to administer medications or by unlicensed personnel who have been delegated medication administration tasks by a registered nurse. new text end

new text begin Subd. 7. new text end

new text begin Delegation of medication administration. new text end

new text begin When administration of medications is delegated to unlicensed personnel, the comprehensive home care provider must ensure that the registered nurse has: new text end

new text begin (1) instructed the unlicensed personnel in the proper methods to administer the medications, and the unlicensed personnel has demonstrated ability to competently follow the procedures; new text end

new text begin (2) specified, in writing, specific instructions for each client and documented those instructions in the client's records; and new text end

new text begin (3) communicated with the unlicensed personnel about the individual needs of the client. new text end

new text begin Subd. 8. new text end

new text begin Documentation of administration of medications. new text end

new text begin Each medication administered by comprehensive home care provider staff must be documented in the client's record. The documentation must include the signature and title of the person who administered the medication. The documentation must include the medication name, dosage, date and time administered, and method and route of administration. The staff must document the reason why medication administration was not completed as prescribed and document any follow-up procedures that were provided to meet the client's needs when medication was not administered as prescribed and in compliance with the client's medication management plan. new text end

new text begin Subd. 9. new text end

new text begin Documentation of medication setup. new text end

new text begin Documentation of dates of medication setup, name of medication, quantity of dose, times to be administered, route of administration, and name of person completing medication setup must be done at time of setup. new text end

new text begin Subd. 10. new text end

new text begin Medication management for clients who will be away from home. new text end

new text begin (a) A home care provider who is providing medication management services to the client and controls the client's access to the medications must develop and implement policies and procedures for giving accurate and current medications to clients for planned or unplanned times away from home according to the client's individualized medication management plan. The policy and procedures must state that: new text end

new text begin (1) for planned time away, the medications must be obtained from the pharmacy or set up by the registered nurse according to appropriate state and federal laws and nursing standards of practice; new text end

new text begin (2) for unplanned time away, when the pharmacy is not able to provide the medications, a licensed nurse or unlicensed personnel shall give the client or client's representative medications in amounts and dosages needed for the length of the anticipated absence, not to exceed 120 hours; new text end

new text begin (3) the client, or the client's representative, must be provided written information on medications, including any special instructions for administering or handling the medications, including controlled substances; new text end

new text begin (4) the medications must be placed in a medication container or containers appropriate to the provider's medication system and must be labeled with the client's name and the dates and times that the medications are scheduled; and new text end

new text begin (5) the client or client's representative must be provided in writing the home care provider's name and information on how to contact the home care provider. new text end

new text begin (b) For unplanned time away when the licensed nurse is not available, the registered nurse may delegate this task to unlicensed personnel if: new text end

new text begin (1) the registered nurse has trained the unlicensed staff and determined the unlicensed staff is competent to follow the procedures for giving medications to clients; new text end

new text begin (2) the registered nurse has developed written procedures for the unlicensed personnel, including any special instructions or procedures regarding controlled substances that are prescribed for the client. The procedures must address: new text end

new text begin (i) the type of container or containers to be used for the medications appropriate to the provider's medication system; new text end

new text begin (ii) how the container or containers must be labeled; new text end

new text begin (iii) the written information about the medications to be given to the client or client's representative; new text end

new text begin (iv) how the unlicensed staff must document in the client's record that medications have been given to the client or the client's representative, including documenting the date the medications were given to the client or the client's representative and who received the medications, the person who gave the medications to the client, the number of medications that were given to the client, and other required information; new text end

new text begin (v) how the registered nurse shall be notified that medications have been given to the client or client's representative and whether the registered nurse needs to be contacted before the medications are given to the client or the client's representative; and new text end

new text begin (vi) a review by the registered nurse of the completion of this task to verify that this task was completed accurately by the unlicensed personnel. new text end

new text begin Subd. 11. new text end

new text begin Prescribed and nonprescribed medication. new text end

new text begin The comprehensive home care provider must determine whether the comprehensive home care provider shall require a prescription for all medications the provider manages. The comprehensive home care provider must inform the client or the client's representative whether the comprehensive home care provider requires a prescription for all over-the-counter and dietary supplements before the comprehensive home care provider agrees to manage those medications. new text end

new text begin Subd. 12. new text end

new text begin Medications; over-the-counter; dietary supplements not prescribed. new text end

new text begin A comprehensive home care provider providing medication management services for over-the-counter drugs or dietary supplements must retain those items in the original labeled container with directions for use prior to setting up for immediate or later administration. The provider must verify that the medications are up-to-date and stored as appropriate. new text end

new text begin Subd. 13. new text end

new text begin Prescriptions. new text end

new text begin There must be a current written or electronically recorded prescription as defined in Minnesota Rules, part 6800.0100, subpart 11a, for all prescribed medications that the comprehensive home care provider is managing for the client. new text end

new text begin Subd. 14. new text end

new text begin Renewal of prescriptions. new text end

new text begin Prescriptions must be renewed at least every 12 months or more frequently as indicated by the assessment in subdivision 2. Prescriptions for controlled substances must comply with chapter 152. new text end

new text begin Subd. 15. new text end

new text begin Verbal prescription orders. new text end

new text begin Verbal prescription orders from an authorized prescriber must be received by a nurse or pharmacist. The order must be handled according to Minnesota Rules, part 6800.6200. new text end

new text begin Subd. 16. new text end

new text begin Written or electronic prescription. new text end

new text begin When a written or electronic prescription is received, it must be communicated to the registered nurse in charge and recorded or placed in the client's record. new text end

new text begin Subd. 17. new text end

new text begin Records confidential. new text end

new text begin A prescription or order received verbally, in writing, or electronically must be kept confidential according to sections 144.291 to 144.298 and 144A.44. new text end

new text begin Subd. 18. new text end

new text begin Medications provided by client or family members. new text end

new text begin When the comprehensive home care provider is aware of any medications or dietary supplements that are being used by the client and are not included in the assessment for medication management services, the staff must advise the registered nurse and document that in the client's record. new text end

new text begin Subd. 19. new text end

new text begin Storage of medications. new text end

new text begin A comprehensive home care provider providing storage of medications outside of the client's private living space must store all prescription medications in securely locked and substantially constructed compartments according to the manufacturer's directions and permit only authorized personnel to have access. new text end

new text begin Subd. 20. new text end

new text begin Prescription drugs. new text end

new text begin A prescription drug, prior to being set up for immediate or later administration, must be kept in the original container in which it was dispensed by the pharmacy bearing the original prescription label with legible information including the expiration or beyond-use date of a time-dated drug. new text end

new text begin Subd. 21. new text end

new text begin Prohibitions. new text end

new text begin No prescription drug supply for one client may be used or saved for use by anyone other than the client. new text end

new text begin Subd. 22. new text end

new text begin Disposition of medications. new text end

new text begin (a) Any current medications being managed by the comprehensive home care provider must be given to the client or the client's representative when the client's service plan ends or medication management services are no longer part of the service plan. Medications that have been stored in the client's private living space for a client who is deceased or that have been discontinued or that have expired may be given to the client or the client's representative for disposal. new text end

new text begin (b) The comprehensive home care provider will dispose of any medications remaining with the comprehensive home care provider that are discontinued or expired or upon the termination of the service contract or the client's death according to state and federal regulations for disposition of medications and controlled substances. new text end

new text begin (c) Upon disposition, the comprehensive home care provider must document in the client's record the disposition of the medication including the medication's name, strength, prescription number as applicable, quantity, to whom the medications were given, date of disposition, and names of staff and other individuals involved in the disposition. new text end

new text begin Subd. 23. new text end

new text begin Loss or spillage. new text end

new text begin (a) Comprehensive home care providers providing medication management must develop and implement procedures for loss or spillage of all controlled substances defined in Minnesota Rules, part 6800.4220. These procedures must require that when a spillage of a controlled substance occurs, a notation must be made in the client's record explaining the spillage and the actions taken. The notation must be signed by the person responsible for the spillage and include verification that any contaminated substance was disposed of according to state or federal regulations. new text end

new text begin (b) The procedures must require the comprehensive home care provider of medication management to investigate any known loss or unaccounted for prescription drugs and take appropriate action required under state or federal regulations and document the investigation in required records. new text end

Sec. 21.

new text begin [144A.4793] TREATMENT AND THERAPY MANAGEMENT SERVICES. new text end

new text begin Subdivision 1. new text end

new text begin Providers with a comprehensive home care license. new text end

new text begin This section applies only to home care providers with a comprehensive home care license that provide treatment or therapy management services to clients. Treatment or therapy management services cannot be provided by a home care provider that has a basic home care license. new text end

new text begin Subd. 2. new text end

new text begin Policies and procedures. new text end

new text begin (a) A comprehensive home care provider who provides treatment and therapy management services must develop, implement, and maintain up-to-date written treatment or therapy management policies and procedures. The policies and procedures must be developed under the supervision and direction of a registered nurse or appropriate licensed health professional consistent with current practice standards and guidelines. new text end

new text begin (b) The written policies and procedures must address requesting and receiving orders or prescriptions for treatments or therapies, providing the treatment or therapy, documenting of treatment or therapy activities, educating and communicating with clients about treatments or therapy they are receiving, monitoring and evaluating the treatment and therapy, and communicating with the prescriber. new text end

new text begin Subd. 3. new text end

new text begin Individualized treatment or therapy management plan. new text end

new text begin For each client receiving management of ordered or prescribed treatments or therapy services, the comprehensive home care provider must prepare and include in the service plan a written statement of the treatment or therapy services that will be provided to the client. The provider must also develop and maintain a current individualized treatment and therapy management record for each client which must contain at least the following: new text end

new text begin (1) a statement of the type of services that will be provided; new text end

new text begin (2) documentation of specific client instructions relating to the treatments or therapy administration; new text end

new text begin (3) identification of treatment or therapy tasks that will be delegated to unlicensed personnel; new text end

new text begin (4) procedures for notifying a registered nurse or appropriate licensed health professional when a problem arises with treatments or therapy services; and new text end

new text begin (5) any client-specific requirements relating to documentation of treatment and therapy received, verification that all treatment and therapy was administered as prescribed, and monitoring of treatment or therapy to prevent possible complications or adverse reactions. The treatment or therapy management record must be current and updated when there are any changes. new text end

new text begin Subd. 4. new text end

new text begin Administration of treatments and therapy. new text end

new text begin Ordered or prescribed treatments or therapies must be administered by a nurse, physician, or other licensed health professional authorized to perform the treatment or therapy, or may be delegated or assigned to unlicensed personnel by the licensed health professional according to the appropriate practice standards for delegation or assignment. When administration of a treatment or therapy is delegated or assigned to unlicensed personnel, the home care provider must ensure that the registered nurse or authorized licensed health professional has: new text end

new text begin (1) instructed the unlicensed personnel in the proper methods with respect to each client and the unlicensed personnel has demonstrated the ability to competently follow the procedures; new text end

new text begin (2) specified, in writing, specific instructions for each client and documented those instructions in the client's record; and new text end

new text begin (3) communicated with the unlicensed personnel about the individual needs of the client. new text end

new text begin Subd. 5. new text end

new text begin Documentation of administration of treatments and therapies. new text end

new text begin Each treatment or therapy administered by a comprehensive home care provider must be documented in the client's record. The documentation must include the signature and title of the person who administered the treatment or therapy and must include the date and time of administration. When treatment or therapies are not administered as ordered or prescribed, the provider must document the reason why it was not administered and any follow-up procedures that were provided to meet the client's needs. new text end

new text begin Subd. 6. new text end

new text begin Orders or prescriptions. new text end

new text begin There must be an up-to-date written or electronically recorded order or prescription for all treatments and therapies. The order must contain the name of the client, description of the treatment or therapy to be provided, and the frequency and other information needed to administer the treatment or therapy. new text end

Sec. 22.

new text begin [144A.4794] CLIENT RECORD REQUIREMENTS. new text end

new text begin Subdivision 1. new text end

new text begin Client record. new text end

new text begin (a) The home care provider must maintain records for each client for whom it is providing services. Entries in the client records must be current, legible, permanently recorded, dated, and authenticated with the name and title of the person making the entry. new text end

new text begin (b) Client records, whether written or electronic, must be protected against loss, tampering, or unauthorized disclosure in compliance with chapter 13 and other applicable relevant federal and state laws. The home care provider shall establish and implement written procedures to control use, storage, and security of client's records and establish criteria for release of client information. new text end

new text begin (c) The home care provider may not disclose to any other person any personal, financial, medical, or other information about the client, except: new text end

new text begin (1) as may be required by law; new text end

new text begin (2) to employees or contractors of the home care provider, another home care provider, other health care practitioner or provider, or inpatient facility needing information in order to provide services to the client, but only such information that is necessary for the provision of services; new text end

new text begin (3) to persons authorized in writing by the client or the client's representative to receive the information, including third-party payers; and new text end

new text begin (4) to representatives of the commissioner authorized to survey or investigate home care providers under this chapter or federal laws. new text end

new text begin Subd. 2. new text end

new text begin Access to records. new text end

new text begin The home care provider must ensure that the appropriate records are readily available to employees or contractors authorized to access the records. Client records must be maintained in a manner that allows for timely access, printing, or transmission of the records. new text end

new text begin Subd. 3. new text end

new text begin Contents of client record. new text end

new text begin Contents of a client record include the following for each client: new text end

new text begin (1) identifying information, including the client's name, date of birth, address, and telephone number; new text end

new text begin (2) the name, address, and telephone number of an emergency contact, family members, client's representative, if any, or others as identified; new text end

new text begin (3) names, addresses, and telephone numbers of the client's health and medical service providers and other home care providers, if known; new text end

new text begin (4) health information, including medical history, allergies, and when the provider is managing medications, treatments or therapies that require documentation, and other relevant health records; new text end

new text begin (5) client's advance directives, if any; new text end

new text begin (6) the home care provider's current and previous assessments and service plans; new text end

new text begin (7) all records of communications pertinent to the client's home care services; new text end

new text begin (8) documentation of significant changes in the client's status and actions taken in response to the needs of the client including reporting to the appropriate supervisor or health care professional; new text end

new text begin (9) documentation of incidents involving the client and actions taken in response to the needs of the client including reporting to the appropriate supervisor or health care professional; new text end

new text begin (10) documentation that services have been provided as identified in the service plan; new text end

new text begin (11) documentation that the client has received and reviewed the home care bill of rights; new text end

new text begin (12) documentation that the client has been provided the statement of disclosure on limitations of services under section 144A.4791, subdivision 3; new text end

new text begin (13) documentation of complaints received and resolution; new text end

new text begin (14) discharge summary, including service termination notice and related documentation, when applicable; and new text end

new text begin (15) other documentation required under this chapter and relevant to the client's services or status. new text end

new text begin Subd. 4. new text end

new text begin Transfer of client records. new text end

new text begin If a client transfers to another home care provider or other health care practitioner or provider, or is admitted to an inpatient facility, the home care provider, upon request of the client or the client's representative, shall take steps to ensure a coordinated transfer including sending a copy or summary of the client's record to the new home care provider, facility, or the client, as appropriate. new text end

new text begin Subd. 5. new text end

new text begin Record retention. new text end

new text begin Following the client's discharge or termination of services, a home care provider must retain a client's record for at least five years, or as otherwise required by state or federal regulations. Arrangements must be made for secure storage and retrieval of client records if the home care provider ceases business. new text end

Sec. 23.

new text begin [144A.4795] HOME CARE PROVIDER RESPONSIBILITIES; STAFF. new text end

new text begin Subdivision 1. new text end

new text begin Qualifications, training, and competency. new text end

new text begin All staff providing home care services must: (1) be trained and competent in the provision of home care services consistent with current practice standards appropriate to the client's needs; and (2) be informed of the home care bill of rights under section 144A.44. new text end

new text begin Subd. 2. new text end

new text begin Licensed health professionals and nurses. new text end

new text begin (a) Licensed health professionals and nurses providing home care services as an employee of a licensed home care provider must possess current Minnesota license or registration to practice. new text end

new text begin (b) Licensed health professionals and registered nurses must be competent in assessing client needs, planning appropriate home care services to meet client needs, implementing services, and supervising staff if assigned. new text end

new text begin (c) Nothing in this section limits or expands the rights of nurses or licensed health professionals to provide services within the scope of their licenses or registrations, as provided by law. new text end

new text begin Subd. 3. new text end

new text begin Unlicensed personnel. new text end

new text begin (a) Unlicensed personnel providing basic home care services must have: new text end

new text begin (1) successfully completed a training and competency evaluation appropriate to the services provided by the home care provider and the topics listed in subdivision 7, paragraph (b); or new text end

new text begin (2) demonstrated competency by satisfactorily completing a written or oral test on the tasks the unlicensed personnel will perform and in the topics listed in subdivision 7, paragraph (b); and successfully demonstrate competency of topics in subdivision 7, paragraph (b), clauses (5), (7), and (8), by a practical skills test. new text end

new text begin Unlicensed personnel providing home care services for a basic home care provider may not perform delegated nursing or therapy tasks. new text end

new text begin (b) Unlicensed personnel performing delegated nursing tasks for a comprehensive home care provider must: new text end

new text begin (1) have successfully completed training and demonstrated competency by successfully completing a written or oral test of the topics in subdivision 7, paragraphs (b) and (c), and a practical skills test on tasks listed in subdivision 7, paragraphs (b), clauses (5) and (7), and (c), clauses (3), (5), (6), and (7), and all the delegated tasks they will perform; new text end

new text begin (2) satisfy the current requirements of Medicare for training or competency of home health aides or nursing assistants, as provided by Code of Federal Regulations, title 42, section 483 or section 484.36; or new text end

new text begin (3) have, before April 19, 1993, completed a training course for nursing assistants that was approved by the commissioner. new text end

new text begin (c) Unlicensed personnel performing therapy or treatment tasks delegated or assigned by a licensed health professional must meet the requirements for delegated tasks in subdivision 4 and any other training or competency requirements within the licensed health professional scope of practice relating to delegation or assignment of tasks to unlicensed personnel. new text end

new text begin Subd. 4. new text end

new text begin Delegation of home care tasks. new text end

new text begin A registered nurse or licensed health professional may delegate tasks only to staff that are competent and possess the knowledge and skills consistent with the complexity of the tasks and according to the appropriate Minnesota Practice Act. The comprehensive home care provider must establish and implement a system to communicate up-to-date information to the registered nurse or licensed health professional regarding the current available staff and their competency so the registered nurse or licensed health professional has sufficient information to determine the appropriateness of delegating tasks to meet individual client needs and preferences. new text end

new text begin Subd. 5. new text end

new text begin Individual contractors. new text end

new text begin When a home care provider contracts with an individual contractor excluded from licensure under section 144A.471 to provide home care services, the contractor must meet the same requirements required by this section for personnel employed by the home care provider. new text end

new text begin Subd. 6. new text end

new text begin Temporary staff. new text end

new text begin When a home care provider contracts with a temporary staffing agency excluded from licensure under section 144A.471, those individuals must meet the same requirements required by this section for personnel employed by the home care provider and shall be treated as if they are staff of the home care provider. new text end

new text begin Subd. 7. new text end

new text begin Requirements for instructors, training content, and competency evaluations for unlicensed personnel. new text end

new text begin (a) Instructors and competency evaluators must meet the following requirements: new text end

new text begin (1) training and competency evaluations of unlicensed personnel providing basic home care services must be conducted by individuals with work experience and training in providing home care services listed in section 144A.471, subdivisions 6 and 7; and new text end

new text begin (2) training and competency evaluations of unlicensed personnel providing comprehensive home care services must be conducted by a registered nurse, or another instructor may provide training in conjunction with the registered nurse. If the home care provider is providing services by licensed health professionals only, then that specific training and competency evaluation may be conducted by the licensed health professionals as appropriate. new text end

new text begin (b) Training and competency evaluations for all unlicensed personnel must include the following: new text end

new text begin (1) documentation requirements for all services provided; new text end

new text begin (2) reports of changes in the client's condition to the supervisor designated by the home care provider; new text end

new text begin (3) basic infection control, including blood-borne pathogens; new text end

new text begin (4) maintenance of a clean and safe environment; new text end

new text begin (5) appropriate and safe techniques in personal hygiene and grooming, including: new text end

new text begin (i) hair care and bathing; new text end

new text begin (ii) care of teeth, gums, and oral prosthetic devices; new text end

new text begin (iii) care and use of hearing aids; and new text end

new text begin (iv) dressing and assisting with toileting; new text end

new text begin (6) training on the prevention of falls for providers working with the elderly or individuals at risk of falls; new text end

new text begin (7) standby assistance techniques and how to perform them; new text end

new text begin (8) medication, exercise, and treatment reminders; new text end

new text begin (9) basic nutrition, meal preparation, food safety, and assistance with eating; new text end

new text begin (10) preparation of modified diets as ordered by a licensed health professional; new text end

new text begin (11) communication skills that include preserving the dignity of the client and showing respect for the client and the client's preferences, cultural background, and family; new text end

new text begin (12) awareness of confidentiality and privacy; new text end

new text begin (13) understanding appropriate boundaries between staff and clients and the client's family; new text end

new text begin (14) procedures to utilize in handling various emergency situations; and new text end

new text begin (15) awareness of commonly used health technology equipment and assistive devices. new text end

new text begin (c) In addition to paragraph (b), training and competency evaluation for unlicensed personnel providing comprehensive home care services must include: new text end

new text begin (1) observation, reporting, and documenting of client status; new text end

new text begin (2) basic knowledge of body functioning and changes in body functioning, injuries, or other observed changes that must be reported to appropriate personnel; new text end

new text begin (3) reading and recording temperature, pulse, and respirations of the client; new text end

new text begin (4) recognizing physical, emotional, cognitive, and developmental needs of the client; new text end

new text begin (5) safe transfer techniques and ambulation; new text end

new text begin (6) range of motioning and positioning; and new text end

new text begin (7) administering medications or treatments as required. new text end

new text begin (d) When the registered nurse or licensed health professional delegates tasks, they must ensure that prior to the delegation the unlicensed personnel is trained in the proper methods to perform the tasks or procedures for each client and are able to demonstrate the ability to competently follow the procedures and perform the tasks. If an unlicensed personnel has not regularly performed the delegated home care task for a period of 24 consecutive months, the unlicensed personnel must demonstrate competency in the task to the registered nurse or appropriate licensed health professional. The registered nurse or licensed health professional must document instructions for the delegated tasks in the client's record. new text end

Sec. 24.

new text begin [144A.4796] ORIENTATION AND ANNUAL TRAINING REQUIREMENTS. new text end

new text begin Subdivision 1. new text end

new text begin Orientation of staff and supervisors to home care. new text end

new text begin All staff providing and supervising direct home care services must complete an orientation to home care licensing requirements and regulations before providing home care services to clients. The orientation may be incorporated into the training required under subdivision 6. The orientation need only be completed once for each staff person and is not transferable to another home care provider. new text end

new text begin Subd. 2. new text end

new text begin Content. new text end

new text begin The orientation must contain the following topics: new text end

new text begin (1) an overview of sections 144A.43 to 144A.4798; new text end

new text begin (2) introduction and review of all the provider's policies and procedures related to the provision of home care services; new text end

new text begin (3) handling of emergencies and use of emergency services; new text end

new text begin (4) compliance with and reporting of the maltreatment of minors or vulnerable adults under sections 626.556 and 626.557; new text end

new text begin (5) home care bill of rights, under section 144A.44; new text end

new text begin (6) handling of clients' complaints; reporting of complaints and where to report complaints including information on the Office of Health Facility Complaints and the Common Entry Point; new text end

new text begin (7) consumer advocacy services of the Office of Ombudsman for Long-Term Care, Office of Ombudsman for Mental Health and Developmental Disabilities, Managed Care Ombudsman at the Department of Human Services, county managed care advocates, or other relevant advocacy services; and new text end

new text begin (8) review of the types of home care services the employee will be providing and the provider's scope of licensure. new text end

new text begin Subd. 3. new text end

new text begin Verification and documentation of orientation. new text end

new text begin Each home care provider shall retain evidence in the employee record of each staff person having completed the orientation required by this section. new text end

new text begin Subd. 4. new text end

new text begin Orientation to client. new text end

new text begin Staff providing home care services must be oriented specifically to each individual client and the services to be provided. This orientation may be provided in person, orally, in writing, or electronically. new text end

new text begin Subd. 5. new text end

new text begin Training required relating to Alzheimer's disease and related disorders. new text end

new text begin For home care providers that provide services for persons with Alzheimer's or related disorders, all direct care staff and supervisors working with those clients must receive training that includes a current explanation of Alzheimer's disease and related disorders, effective approaches to use to problem solve when working with a client's challenging behaviors, and how to communicate with clients who have Alzheimer's or related disorders. new text end

new text begin Subd. 6. new text end

new text begin Required annual training. new text end

new text begin All staff that perform direct home care services must complete at least eight hours of annual training for each 12 months of employment. The training may be obtained from the home care provider or another source and must include topics relevant to the provision of home care services. The annual training must include: new text end

new text begin (1) training on reporting of maltreatment of minors under section 626.556 and maltreatment of vulnerable adults under section 626.557, whichever is applicable to the services provided; new text end

new text begin (2) review of the home care bill of rights in section 144A.44; new text end

new text begin (3) review of infection control techniques used in the home and implementation of infection control standards including a review of hand washing techniques; the need for and use of protective gloves, gowns, and masks; appropriate disposal of contaminated materials and equipment, such as dressings, needles, syringes, and razor blades; disinfecting reusable equipment; disinfecting environmental surfaces; and reporting of communicable diseases; and new text end

new text begin (4) review of the provider's policies and procedures relating to the provision of home care services and how to implement those policies and procedures. new text end

new text begin Subd. 7. new text end

new text begin Documentation. new text end

new text begin A home care provider must retain documentation in the employee records of the staff that have satisfied the orientation and training requirements of this section. new text end

Sec. 25.

new text begin [144A.4797] PROVISION OF SERVICES. new text end

new text begin Subdivision 1. new text end

new text begin Availability of contact person to staff. new text end

new text begin (a) A home care provider with a basic home care license must have a person available to staff for consultation on items relating to the provision of services or about the client. new text end

new text begin (b) A home care provider with a comprehensive home care license must have a registered nurse available for consultation to staff performing delegated nursing tasks and must have an appropriate licensed health professional available if performing other delegated services such as therapies. new text end

new text begin (c) The appropriate contact person must be readily available either in person, by telephone, or by other means to the staff at times when the staff is providing services. new text end

new text begin Subd. 2. new text end

new text begin Supervision of staff; basic home care services. new text end

new text begin (a) Staff who perform basic home care services must be supervised periodically where the services are being provided to verify that the work is being performed competently and to identify problems and solutions to address issues relating to the staff's ability to provide the services. The supervision of the unlicensed personnel must be done by staff of the home care provider having the authority, skills, and ability to provide the supervision of unlicensed personnel and who can implement changes as needed, and train staff. new text end

new text begin (b) Supervision includes direct observation of unlicensed personnel while the unlicensed personnel are providing the services and may also include indirect methods of gaining input such as gathering feedback from the client. Supervisory review of staff must be provided at a frequency based on the staff person's competency and performance. new text end

new text begin (c) For an individual who is licensed as a home care provider, this section does not apply. new text end

new text begin Subd. 3. new text end

new text begin Supervision of staff providing delegated nursing or therapy home care tasks. new text end

new text begin (a) Staff who perform delegated nursing or therapy home care tasks must be supervised by an appropriate licensed health professional or a registered nurse periodically where the services are being provided to verify that the work is being performed competently and to identify problems and solutions related to the staff person's ability to perform the tasks. Supervision of staff performing medication or treatment administration shall be provided by a registered nurse or appropriate licensed health professional and must include observation of the staff administering the medication or treatment and the interaction with the client. new text end

new text begin (b) The direct supervision of staff performing delegated tasks must be provided within 30 days after the individual begins working for the home care provider and thereafter as needed based on performance. This requirement also applies to staff who have not performed delegated tasks for one year or longer. new text end

new text begin Subd. 4. new text end

new text begin Documentation. new text end

new text begin A home care provider must retain documentation of supervision activities in the personnel records. new text end

new text begin Subd. 5. new text end

new text begin Exemption. new text end

new text begin This section does not apply to an individual licensed under sections 144A.43 to 144A.4798. new text end

Sec. 26.

new text begin [144A.4798] EMPLOYEE HEALTH STATUS. new text end

new text begin Subdivision 1. new text end

new text begin Tuberculosis (TB) prevention and control. new text end

new text begin A home care provider must establish and maintain a TB prevention and control program based on the most current guidelines issued by the Centers for Disease Control and Prevention (CDC). Components of a TB prevention and control program include screening all staff providing home care services, both paid and unpaid, at the time of hire for active TB disease and latent TB infection, and developing and implementing a written TB infection control plan. The commissioner shall make the most recent CDC standards available to home care providers on the department's Web site. new text end

new text begin Subd. 2. new text end

new text begin Communicable diseases. new text end

new text begin A home care provider must follow current federal or state guidelines for prevention, control, and reporting of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus, or other communicable diseases as defined in Minnesota Rules, part 4605.7040. new text end

Sec. 27.

new text begin [144A.4799] DEPARTMENT OF HEALTH LICENSED HOME CARE PROVIDER ADVISORY COUNCIL. new text end

new text begin Subdivision 1. new text end

new text begin Membership. new text end

new text begin The commissioner of health shall appoint eight persons to a home care provider advisory council consisting of the following: new text end

new text begin (1) three public members as defined in section 214.02 who shall be either persons who are currently receiving home care services or have family members receiving home care services, or persons who have family members who have received home care services within five years of the application date; new text end

new text begin (2) three Minnesota home care licensees representing basic and comprehensive levels of licensure who may be a managerial official, an administrator, a supervising registered nurse, or an unlicensed personnel performing home care tasks; new text end

new text begin (3) one member representing the Minnesota Board of Nursing; and new text end

new text begin (4) one member representing the ombudsman for long-term care. new text end

new text begin Subd. 2. new text end

new text begin Organizations and meetings. new text end

new text begin The advisory council shall be organized and administered under section 15.059 with per diems and costs paid within the limits of available appropriations. Meetings will be held quarterly and hosted by the department. Subcommittees may be developed as necessary by the commissioner. Advisory council meetings are subject to the Open Meeting Law under chapter 13D. new text end

new text begin Subd. 3. new text end

new text begin Duties. new text end

new text begin At the commissioner's request, the advisory council shall provide advice regarding regulations of Department of Health licensed home care providers in this chapter such as: new text end

new text begin (1) advice to the commissioner regarding community standards for home care practices; new text end

new text begin (2) advice to the commissioner on enforcement of licensing standards and whether certain disciplinary actions are appropriate; new text end

new text begin (3) advice to the commissioner about ways of distributing information to licensees and consumers of home care; new text end

new text begin (4) advice to the commissioner about training standards; new text end

new text begin (5) identify emerging issues and opportunities in the home care field, including the use of technology in home and telehealth capabilities; and new text end

new text begin (6) perform other duties as directed by the commissioner. new text end

Sec. 28.

new text begin [144A.481] HOME CARE LICENSING IMPLEMENTATION FOR NEW LICENSEES AND TRANSITION PERIOD FOR CURRENT LICENSEES. new text end

new text begin Subdivision 1. new text end

new text begin Temporary home care licenses and changes of ownership. new text end

new text begin (a) Beginning January 1, 2014, all temporary license applicants must apply for either a temporary basic or comprehensive home care license. new text end

new text begin (b) Temporary home care licenses issued beginning January 1, 2014, shall be issued according to sections 144A.43 to 144A.4798, and the fees in section 144A.472. Temporary licensees must comply with the requirements of this chapter. new text end

new text begin (c) No temporary license applications will be accepted nor temporary licenses issued between December 1, 2013, and December 31, 2013. new text end

new text begin (d) Beginning October 1, 2013, changes in ownership applications will require payment of the new fees listed in section 144A.472. Providers who are providing nursing, delegated nursing, or professional health care services, must submit the fee for comprehensive home care providers, and all other providers must submit the fee for basic home care providers as provided in section 144A.472. Change of ownership applicants will be issued a new home care license based on the licensure law in effect on June 30, 2013. new text end

new text begin Subd. 2. new text end

new text begin Current home care licensees with licenses prior to July 1, 2013. new text end

new text begin (a) Beginning July 1, 2014, department licensed home care providers must apply for either the basic or comprehensive home care license on their regularly scheduled renewal date. new text end

new text begin (b) By June 30, 2015, all home care providers must either have a basic or comprehensive home care license or temporary license. new text end

new text begin Subd. 3. new text end

new text begin Renewal application of home care licensure during transition period. new text end

new text begin (a) Renewal and change of ownership applications of home care licenses issued beginning July 1, 2014, will be issued according to sections 144A.43 to 144A.4798 and, upon license renewal or issuance of a new license for a change of ownership, providers must comply with sections 144A.43 to 144A.4798. Prior to renewal, providers must comply with the home care licensure law in effect on June 30, 2013. new text end

new text begin (b) The fees charged for licenses renewed between July 1, 2014, and June 30, 2016, shall be the lesser of 200 percent or $1,000, except where the 200 percent or $1,000 increase exceeds the actual renewal fee charged, with a maximum renewal fee of $6,625. new text end

new text begin (c) For fiscal year 2014 only, the fees for providers with revenues greater than $25,000 and no more than $100,000 will be $313 and for providers with revenues no more than $25,000 the fee will be $125. new text end

Sec. 29.

new text begin [144A.482] REGISTRATION OF HOME MANAGEMENT PROVIDERS. new text end

new text begin (a) For purposes of this section, a home management provider is a person or organization that provides at least two of the following services: housekeeping, meal preparation, and shopping to a person who is unable to perform these activities due to illness, disability, or physical condition. new text end

new text begin (b) A person or organization that provides only home management services may not operate in the state without a current certificate of registration issued by the commissioner of health. To obtain a certificate of registration, the person or organization must annually submit to the commissioner the name, mailing and physical addresses, e-mail address, and telephone number of the person or organization and a signed statement declaring that the person or organization is aware that the home care bill of rights applies to their clients and that the person or organization will comply with the home care bill of rights provisions contained in section 144A.44. A person or organization applying for a certificate must also provide the name, business address, and telephone number of each of the persons responsible for the management or direction of the organization. new text end

new text begin (c) The commissioner shall charge an annual registration fee of $20 for persons and $50 for organizations. The registration fee shall be deposited in the state treasury and credited to the state government special revenue fund. new text end

new text begin (d) A home care provider that provides home management services and other home care services must be licensed, but licensure requirements other than the home care bill of rights do not apply to those employees or volunteers who provide only home management services to clients who do not receive any other home care services from the provider. A licensed home care provider need not be registered as a home management service provider but must provide an orientation on the home care bill of rights to its employees or volunteers who provide home management services. new text end

new text begin (e) An individual who provides home management services under this section must, within 120 days after beginning to provide services, attend an orientation session approved by the commissioner that provides training on the home care bill of rights and an orientation on the aging process and the needs and concerns of elderly and disabled persons. new text end

new text begin (f) The commissioner may suspend or revoke a provider's certificate of registration or assess fines for violation of the home care bill of rights. Any fine assessed for a violation of the home care bill of rights by a provider registered under this section shall be in the amount established in the licensure rules for home care providers. As a condition of registration, a provider must cooperate fully with any investigation conducted by the commissioner, including providing specific information requested by the commissioner on clients served and the employees and volunteers who provide services. Fines collected under this paragraph shall be deposited in the state treasury and credited to the fund specified in the statute or rule in which the penalty was established. new text end

new text begin (g) The commissioner may use any of the powers granted in sections 144A.43 to 144A.4798 to administer the registration system and enforce the home care bill of rights under this section. new text end

Sec. 30.

new text begin [144A.483] AGENCY QUALITY IMPROVEMENT PROGRAM. new text end

new text begin Subdivision 1. new text end

new text begin Annual legislative report on home care licensing. new text end

new text begin The commissioner shall establish a quality improvement program for the home care survey and home care complaint investigation processes. The commissioner shall submit to the legislature an annual report, beginning October 1, 2015, and each October 1 thereafter. Each report will review the previous state fiscal year of home care licensing and regulatory activities. The report must include, but is not limited to, an analysis of: new text end

new text begin (1) the number of FTE's in the Division of Compliance Monitoring, including the Office of Health Facility Complaints units assigned to home care licensing, survey, investigation and enforcement process; new text end

new text begin (2) numbers of and descriptive information about licenses issued, complaints received and investigated, including allegations made and correction orders issued, surveys completed and timelines, and correction order reconsiderations and results; new text end

new text begin (3) descriptions of emerging trends in home care provision and areas of concern identified by the department in its regulation of home care providers; new text end

new text begin (4) information and data regarding performance improvement projects underway and planned by the commissioner in the area of home care surveys; and new text end

new text begin (5) work of the Department of Health Home Care Advisory Council. new text end

new text begin Subd. 2. new text end

new text begin Study of correction order appeal process. new text end

new text begin Starting July 1, 2015, the commissioner shall study whether to add a correction order appeal process conducted by an independent reviewer such as an administrative law judge or other office and submit a report to the legislature by February 1, 2016. The commissioner shall review home care regulatory systems in other states as part of that study. The commissioner shall consult with the home care providers and representatives. new text end

Sec. 31.

new text begin INTEGRATED LICENSING SYSTEM FOR HOME CARE AND HOME AND COMMUNITY-BASED SERVICES. new text end

new text begin (a) The Department of Health Compliance Monitoring Division and the Department of Human Services Licensing Division shall jointly develop an integrated licensing system for providers of both home care services subject to licensure under Minnesota Statutes, chapter 144A, and for home and community-based services subject to licensure under Minnesota Statutes, chapter 245D. The integrated licensing system shall: new text end

new text begin (1) require only one license of any provider of services under Minnesota Statutes, sections 144A.43 to 144A.482, and 245D.03, subdivision 1; new text end

new text begin (2) promote quality services that recognize a person's individual needs and protect the person's health, safety, rights, and well-being; new text end

new text begin (3) promote provider accountability through application requirements, compliance inspections, investigations, and enforcement actions; new text end

new text begin (4) reference other applicable requirements in existing state and federal laws, including the federal Affordable Care Act; new text end

new text begin (5) establish internal procedures to facilitate ongoing communications between the agencies, and with providers and services recipients about the regulatory activities; new text end

new text begin (6) create a link between the agency Web sites so that providers and the public can access the same information regardless of which Web site is accessed initially; and new text end

new text begin (7) collect data on identified outcome measures as necessary for the agencies to report to the Centers for Medicare and Medicaid Services. new text end

new text begin (b) The joint recommendations for legislative changes to implement the integrated licensing system are due to the legislature by February 15, 2014. new text end

new text begin (c) Before implementation of the integrated licensing system, providers licensed as home care providers under Minnesota Statutes, chapter 144A, may also provide home and community-based services subject to licensure under Minnesota Statutes, chapter 245D, without obtaining a home and community-based services license under Minnesota Statutes, chapter 245D. During this time, the conditions under clauses (1) to (3) shall apply to these providers: new text end

new text begin (1) the provider must comply with all requirements under Minnesota Statutes, chapter 245D, for services otherwise subject to licensure under Minnesota Statutes, chapter 245D; new text end

new text begin (2) a violation of requirements under Minnesota Statutes, chapter 245D, may be enforced by the Department of Health under the enforcement authority set forth in Minnesota Statutes, section 144A.475; and new text end

new text begin (3) the Department of Health will provide information to the Department of Human Services about each provider licensed under this section, including the provider's license application, licensing documents, inspections, information about complaints received, and investigations conducted for possible violations of Minnesota Statutes, chapter 245D. new text end

Sec. 32.

new text begin STUDY OF CORRECTION ORDER APPEAL PROCESS. new text end

new text begin Beginning July 1, 2015, the commissioner of health shall study whether to use a correction order appeal process conducted by an independent reviewer, such as an administrative law judge or other office. The commissioner shall review home care regulatory systems in other states and consult with the home care providers and representatives. By February 1, 2016, the commissioner shall submit a report to the chairs and ranking minority members of the committees of the legislature with jurisdiction over health and human services and judiciary issues with any recommendations regarding an independent appeal process. new text end

Sec. 33.

new text begin REPEALER. new text end

new text begin (a) new text end new text begin Minnesota Statutes 2012, sections 144A.46; and 144A.461, new text end new text begin are repealed. new text end

new text begin (b) new text end new text begin Minnesota Rules, parts 4668.0002; 4668.0003; 4668.0005; 4668.0008; 4668.0012; 4668.0016; 4668.0017; 4668.0019; 4668.0030; 4668.0035; 4668.0040; 4668.0050; 4668.0060; 4668.0065; 4668.0070; 4668.0075; 4668.0080; 4668.0100; 4668.0110; 4668.0120; 4668.0130; 4668.0140; 4668.0150; 4668.0160; 4668.0170; 4668.0180; 4668.0190; 4668.0200; 4668.0218; 4668.0220; 4668.0230; 4668.0240; 4668.0800; 4668.0805; 4668.0810; 4668.0815; 4668.0820; 4668.0825; 4668.0830; 4668.0835; 4668.0840; 4668.0845; 4668.0855; 4668.0860; 4668.0865; 4668.0870; 4669.0001; 4669.0010; 4669.0020; 4669.0030; 4669.0040; and 4669.0050, new text end new text begin are repealed. new text end

Sec. 34.

new text begin EFFECTIVE DATE. new text end

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

ARTICLE 12

HEALTH DEPARTMENT

Section 1.

Minnesota Statutes 2012, section 16A.724, subdivision 2, is amended to read:

Subd. 2.

Transfers.

(a) Notwithstanding section 295.581, to the extent available resources in the health care access fund exceed expenditures in that fund, effective for the biennium beginning July 1, 2007, the commissioner of management and budget shall transfer the excess funds from the health care access fund to the general fund on June 30 of each year, provided that the amount transferred in any fiscal biennium shall not exceed $96,000,000. The purpose of this transfer is to meet the rate increase required under Laws 2003, First Special Session chapter 14, article 13C, section 2, subdivision 6.

(b) For fiscal years 2006 to 2011, MinnesotaCare shall be a forecasted program, and, if necessary, the commissioner shall reduce these transfers from the health care access fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary, transfer sufficient funds from the general fund to the health care access fund to meet annual MinnesotaCare expenditures.

new text begin (c) Notwithstanding section 295.581, to the extent available resources in the health care access fund exceed expenditures in that fund after the transfer required in paragraph (a), effective for the biennium beginning July 1, 2013, the commissioner of management and budget shall transfer $1,000,000 each fiscal year from the health access fund to the medical education and research costs fund established under section 62J.692, for distribution under section 62J.692, subdivision 4, paragraph (c). new text end

Sec. 2.

Minnesota Statutes 2012, section 43A.23, is amended by adding a subdivision to read:

new text begin Subd. 4. new text end

new text begin Coverage for autism spectrum disorders. new text end

new text begin For participants in the state employee group insurance program, the commissioner of management and budget must administer the identical benefit as is required under section 62A.3094. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2016, or the date a collective bargaining agreement or compensation plan that includes changes to this section is approved under Minnesota Statutes, section 3.855, whichever is earlier. new text end

Sec. 3.

new text begin [62A.3094] COVERAGE FOR AUTISM SPECTRUM DISORDERS. new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the terms defined in paragraphs (b) to (d) have the meanings given. new text end

new text begin (b) "Autism spectrum disorders" means the conditions as determined by criteria set forth in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association. new text end

new text begin (c) "Medically necessary care" means health care services appropriate, in terms of type, frequency, level, setting, and duration, to the enrollee's condition, and diagnostic testing and preventative services. Medically necessary care must be consistent with generally accepted practice parameters as determined by physicians and licensed psychologists who typically manage patients who have autism spectrum disorders. new text end

new text begin (d) "Mental health professional" means a mental health professional as defined in section 245.4871, subdivision 27, clause (1), (2), (3), (4), or (6), who has training and expertise in autism spectrum disorder and child development. new text end

new text begin Subd. 2. new text end

new text begin Coverage required. new text end

new text begin (a) A health plan issued to a large employer, as defined in section 62Q.18, subdivision 1, must provide coverage for the diagnosis, evaluation, multidisciplinary assessment, and medically necessary care of children under 18 with autism spectrum disorders, including but not limited to the following: new text end

new text begin (1) early intensive behavioral and developmental therapy based in behavioral and developmental science, including, but not limited to, all types of applied behavior analysis, intensive early intervention behavior therapy, and intensive behavior intervention; new text end

new text begin (2) neurodevelopmental and behavioral health treatments and management; new text end

new text begin (3) speech therapy; new text end

new text begin (4) occupational therapy; new text end

new text begin (5) physical therapy; and new text end

new text begin (6) medications. new text end

new text begin (b) The diagnosis, evaluation, and assessment must include an assessment of the child's developmental skills, functional behavior, needs, and capacities. new text end

new text begin (c) The coverage required under this subdivision must include treatment that is in accordance with an individualized treatment plan prescribed by the enrollee's treating physician or mental health professional. new text end

new text begin (d) A health carrier may not refuse to renew or reissue, or otherwise terminate or restrict, coverage of an individual solely because the individual is diagnosed with an autism spectrum disorder. new text end

new text begin (e) A health carrier may request an updated treatment plan only once every six months, unless the health carrier and the treating physician or mental health professional agree that a more frequent review is necessary due to emerging circumstances. new text end

new text begin (g) An independent progress evaluation conducted by a mental health professional with expertise and training in autism spectrum disorder and child development must be completed to determine if progress toward function and generalizable gains, as determined in the treatment plan, is being made. new text end

new text begin Subd. 3. new text end

new text begin No effect on other law. new text end

new text begin Nothing in this section limits the coverage required under section 62Q.47. new text end

new text begin Subd. 4. new text end

new text begin State health care programs. new text end

new text begin This section does not affect benefits available under the medical assistance and MinnesotaCare programs and does not limit, restrict, or otherwise reduce coverage under these programs. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for health plans offered, sold, issued, or renewed on or after January 1, 2014. new text end

Sec. 4.

Minnesota Statutes 2012, section 62J.692, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

For purposes of this section, the following definitions apply:

(a) "Accredited clinical training" means the clinical training provided by a medical education program that is accredited through an organization recognized by the Department of Education, the Centers for Medicare and Medicaid Services, or another national body who reviews the accrediting organizations for multiple disciplines and whose standards for recognizing accrediting organizations are reviewed and approved by the commissioner of health deleted text begin in consultation with the Medical Education and Research Advisory Committeedeleted text end .

(b) "Commissioner" means the commissioner of health.

(c) "Clinical medical education program" means the accredited clinical training of physicians (medical students and residents), doctor of pharmacy practitioners, doctors of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified registered nurse anesthetists, nurse practitioners, and certified nurse midwives), deleted text begin anddeleted text end physician assistantsnew text begin , dental therapists and advanced dental therapists, psychologists, clinical social workers, community paramedics, and community health workersnew text end .

(d) "Sponsoring institution" means a hospital, school, or consortium located in Minnesota that sponsors and maintains primary organizational and financial responsibility for a clinical medical education program in Minnesota and which is accountable to the accrediting body.

(e) "Teaching institution" means a hospital, medical center, clinic, or other organization that conducts a clinical medical education program in Minnesota.

(f) "Trainee" means a student or resident involved in a clinical medical education program.

(g) "Eligible trainee FTE's" means the number of trainees, as measured by full-time equivalent counts, that are at training sites located in Minnesota with currently active medical assistance enrollment status and a National Provider Identification (NPI) number where training occurs in either an inpatient or ambulatory patient care setting and where the training is funded, in part, by patient care revenues. Training that occurs in nursing facility settings is not eligible for funding under this section.

Sec. 5.

Minnesota Statutes 2012, section 62J.692, subdivision 3, is amended to read:

Subd. 3.

Application process.

(a) A clinical medical education program conducted in Minnesota by a teaching institution to train physicians, doctor of pharmacy practitioners, dentists, chiropractors, deleted text begin ordeleted text end physician assistants deleted text begin isdeleted text end new text begin , dental therapists and advanced dental therapists, psychologists, clinical social workers, community paramedics, or community health workers arenew text end eligible for funds under subdivision 4 if the program:

(1) is funded, in part, by patient care revenues;

(2) occurs in patient care settings that face increased financial pressure as a result of competition with nonteaching patient care entities; and

(3) emphasizes primary care or specialties that are in undersupply in Minnesota.

(b) A clinical medical education program for advanced practice nursing is eligible for funds under subdivision 4 if the program meets the eligibility requirements in paragraph (a), clauses (1) to (3), and is sponsored by the University of Minnesota Academic Health Center, the Mayo Foundation, or institutions that are part of the Minnesota State Colleges and Universities system or members of the Minnesota Private College Council.

(c) Applications must be submitted to the commissioner by a sponsoring institution on behalf of an eligible clinical medical education program and must be received by October 31 of each year for distribution in the following year. An application for funds must contain the following information:

(1) the official name and address of the sponsoring institution and the official name and site address of the clinical medical education programs on whose behalf the sponsoring institution is applying;

(2) the name, title, and business address of those persons responsible for administering the funds;

(3) for each clinical medical education program for which funds are being sought; the type and specialty orientation of trainees in the program; the name, site address, and medical assistance provider number and national provider identification number of each training site used in the program; the federal tax identification number of each training site used in the program, where available; the total number of trainees at each training site; and the total number of eligible trainee FTEs at each site; and

(4) other supporting information the commissioner deems necessary to determine program eligibility based on the criteria in paragraphs (a) and (b) and to ensure the equitable distribution of funds.

(d) An application must include the information specified in clauses (1) to (3) for each clinical medical education program on an annual basis for three consecutive years. After that time, an application must include the information specified in clauses (1) to (3) when requested, at the discretion of the commissioner:

(1) audited clinical training costs per trainee for each clinical medical education program when available or estimates of clinical training costs based on audited financial data;

(2) a description of current sources of funding for clinical medical education costs, including a description and dollar amount of all state and federal financial support, including Medicare direct and indirect payments; and

(3) other revenue received for the purposes of clinical training.

(e) An applicant that does not provide information requested by the commissioner shall not be eligible for funds for the current funding cycle.

Sec. 6.

Minnesota Statutes 2012, section 62J.692, subdivision 4, is amended to read:

Subd. 4.

Distribution of funds.

(a) The commissioner shall annually distribute the available medical education funds to all qualifying applicants based on deleted text begin a distribution formula that reflects a summation of two factors:deleted text end

deleted text begin (1)deleted text end a public program volume factor, which is determined by the total volume of public program revenue received by each training site as a percentage of all public program revenue received by all training sites in the fund pooldeleted text begin ; anddeleted text end

deleted text begin (2) a supplemental public program volume factor, which is determined by providing a supplemental payment of 20 percent of each training site's grant to training sites whose public program revenue accounted for at least 0.98 percent of the total public program revenue received by all eligible training sites. Grants to training sites whose public program revenue accounted for less than 0.98 percent of the total public program revenue received by all eligible training sites shall be reduced by an amount equal to the total value of the supplemental paymentdeleted text end .

Public program revenue for the distribution formula includes revenue from medical assistance, prepaid medical assistance, general assistance medical care, and prepaid general assistance medical care. Training sites that receive no public program revenue are ineligible for funds available under this subdivision. For purposes of determining training-site level grants to be distributed under deleted text begin paragraph (a)deleted text end new text begin this paragraphnew text end , total statewide average costs per trainee for medical residents is based on audited clinical training costs per trainee in primary care clinical medical education programs for medical residents. Total statewide average costs per trainee for dental residents is based on audited clinical training costs per trainee in clinical medical education programs for dental students. Total statewide average costs per trainee for pharmacy residents is based on audited clinical training costs per trainee in clinical medical education programs for pharmacy students. Training sites whose training site level grant is less than deleted text begin $1,000deleted text end new text begin $5,000new text end , based on the formula described in this paragraph, new text begin or that train fewer than 0.1 FTE eligible trainees, new text end are ineligible for funds available under this subdivisionnew text begin . No training sites shall receive a grant per FTE trainee that is in excess of the 95th percentile grant per FTE across all eligible training sites; grants in excess of this amount will be redistributed to other eligible sites based on the formula described in this paragraphnew text end .

new text begin (b) For funds distributed in fiscal years 2014 and 2015, the distribution formula shall include a supplemental public program volume factor, which is determined by providing a supplemental payment to training sites whose public program revenue accounted for at least 0.98 percent of the total public program revenue received by all eligible training sites. The supplemental public program volume factor shall be equal to ten percent of each training sites grant for funds distributed in fiscal year 2014 and for funds distributed in fiscal year 2015. Grants to training sites whose public program revenue accounted for less than 0.98 percent of the total public program revenue received by all eligible training sites shall be reduced by an amount equal to the total value of the supplemental payment. For fiscal year 2016 and beyond, the distribution of funds shall be based solely on the public program volume factor as described in paragraph (a). new text end

new text begin (c) Of available medical education funds, $1,000,000 shall be distributed each year for grants to family medicine residency programs located outside of the seven-county metropolitan area, as defined in section 473.121, subdivision 4, focused on eduction and training of family medicine physicians to serve communities outside the metropolitan area. To be eligible for a grant under this paragraph, a family medicine residency program must demonstrate that over the most recent three calendar years, at least 25 percent of its residents practice in Minnesota communities outside of the metropolitan area. Grant funds must be allocated proportionally based on the number of residents per eligible residency program. new text end

deleted text begin (b)deleted text end new text begin (d)new text end Funds distributed shall not be used to displace current funding appropriations from federal or state sources.

deleted text begin (c)deleted text end new text begin (e)new text end Funds shall be distributed to the sponsoring institutions indicating the amount to be distributed to each of the sponsor's clinical medical education programs based on the criteria in this subdivision and in accordance with the commissioner's approval letter. Each clinical medical education program must distribute funds allocated under deleted text begin paragraphdeleted text end new text begin paragraphsnew text end (a)new text begin and (b)new text end to the training sites as specified in the commissioner's approval letter. Sponsoring institutions, which are accredited through an organization recognized by the Department of Education or the Centers for Medicare and Medicaid Services, may contract directly with training sites to provide clinical training. To ensure the quality of clinical training, those accredited sponsoring institutions must:

(1) develop contracts specifying the terms, expectations, and outcomes of the clinical training conducted at sites; and

(2) take necessary action if the contract requirements are not met. Action may include the withholding of payments under this section or the removal of students from the site.

deleted text begin (d) deleted text end new text begin (f) Use of funds is limited to expenses related to clinical training program costs for eligible programs. new text end

new text begin (g)new text end Any funds not distributed in accordance with the commissioner's approval letter must be returned to the medical education and research fund within 30 days of receiving notice from the commissioner. The commissioner shall distribute returned funds to the appropriate training sites in accordance with the commissioner's approval letter.

deleted text begin (e)deleted text end new text begin (h)new text end A maximum of $150,000 of the funds dedicated to the commissioner under section 297F.10, subdivision 1, clause (2), may be used by the commissioner for administrative expenses associated with implementing this section.

Sec. 7.

Minnesota Statutes 2012, section 62J.692, subdivision 5, is amended to read:

Subd. 5.

Report.

(a) Sponsoring institutions receiving funds under this section must sign and submit a medical education grant verification report (GVR) to verify that the correct grant amount was forwarded to each eligible training site. If the sponsoring institution fails to submit the GVR by the stated deadline, or to request and meet the deadline for an extension, the sponsoring institution is required to return the full amount of funds received to the commissioner within 30 days of receiving notice from the commissioner. The commissioner shall distribute returned funds to the appropriate training sites in accordance with the commissioner's approval letter.

(b) The reports must provide verification of the distribution of the funds and must include:

(1) the total number of eligible trainee FTEs in each clinical medical education program;

(2) the name of each funded program and, for each program, the dollar amount distributed to each training sitenew text begin and a training site expenditure reportnew text end ;

(3) documentation of any discrepancies between the initial grant distribution notice included in the commissioner's approval letter and the actual distribution;

(4) a statement by the sponsoring institution stating that the completed grant verification report is valid and accurate; and

(5) other information the commissionerdeleted text begin , with advice from the advisory committee,deleted text end deems appropriate to evaluate the effectiveness of the use of funds for medical education.

(c) deleted text begin By February 15 ofdeleted text end Each year, the commissionerdeleted text begin , with advice from the advisory committee,deleted text end shall provide an annual summary report to the legislature on the implementation of this section.

Sec. 8.

Minnesota Statutes 2012, section 62J.692, subdivision 9, is amended to read:

Subd. 9.

Review of eligible providers.

The commissioner deleted text begin and the Medical Education and Research Costs Advisory Committeedeleted text end may review provider groups included in the definition of a clinical medical education program to assure that the distribution of the funds continue to be consistent with the purpose of this section. The results of any such reviews must be reported to the chairs and ranking minority members of the legislative committees with jurisdiction over health care policy and finance.

Sec. 9.

Minnesota Statutes 2012, section 62J.692, is amended by adding a subdivision to read:

new text begin Subd. 4a. new text end

new text begin Distribution of funds. new text end

new text begin If federal approval is not received for the formula described in subdivision 4, paragraphs (a) and (b), 100 percent of available medical education and research funds shall be distributed based on a distribution formula that reflects as summation of two factors: new text end

new text begin (1) a public program volume factor, that is determined by the total volume of public program revenue received by each training site as a percentage of all public program revenue received by all training sites in the fund pool; and new text end

new text begin (2) a supplemental public program volume factor, that is determined by providing a supplemental payment of 20 percent of each training site's grant to training sites whose public program revenue accounted for a least 0.98 percent of the total public program revenue received by all eligible training sites. Grants to training sites whose public program revenue accounted for less than 0.98 percent of the total public program revenue received by all eligible training sites shall be reduced by an amount equal to the total value of the supplemental payment. new text end

Sec. 10.

Minnesota Statutes 2012, section 62Q.19, subdivision 1, is amended to read:

Subdivision 1.

Designation.

(a) The commissioner shall designate essential community providers. The criteria for essential community provider designation shall be the following:

(1) a demonstrated ability to integrate applicable supportive and stabilizing services with medical care for uninsured persons and high-risk and special needs populations, underserved, and other special needs populations; and

(2) a commitment to serve low-income and underserved populations by meeting the following requirements:

(i) has nonprofit status in accordance with chapter 317A;

(ii) has tax-exempt status in accordance with the Internal Revenue Service Code, section 501(c)(3);

(iii) charges for services on a sliding fee schedule based on current poverty income guidelines; and

(iv) does not restrict access or services because of a client's financial limitation;

(3) status as a local government unit as defined in section 62D.02, subdivision 11, a hospital district created or reorganized under sections 447.31 to 447.37, an Indian tribal government, an Indian health service unit, or a community health board as defined in chapter 145A;

(4) a former state hospital that specializes in the treatment of cerebral palsy, spina bifida, epilepsy, closed head injuries, specialized orthopedic problems, and other disabling conditions;

(5) a sole community hospital. For these rural hospitals, the essential community provider designation applies to all health services provided, including both inpatient and outpatient services. For purposes of this section, "sole community hospital" means a rural hospital that:

(i) is eligible to be classified as a sole community hospital according to Code of Federal Regulations, title 42, section 412.92, or is located in a community with a population of less than 5,000 and located more than 25 miles from a like hospital currently providing acute short-term services;

(ii) has experienced net operating income losses in two of the previous three most recent consecutive hospital fiscal years for which audited financial information is available; and

(iii) consists of 40 or fewer licensed beds; deleted text begin ordeleted text end

(6) a birth center licensed under section 144.615new text begin ; ornew text end

new text begin (7) a hospital and affiliated specialty clinics that predominantly serve patients who are under 21 years of age and meet the following criteria: new text end

new text begin (i) provide intensive specialty pediatric services that are routinely provided in fewer than five hospitals in the state; and new text end

new text begin (ii) serve children from at least half of the counties in the statenew text end .

(b) Prior to designation, the commissioner shall publish the names of all applicants in the State Register. The public shall have 30 days from the date of publication to submit written comments to the commissioner on the application. No designation shall be made by the commissioner until the 30-day period has expired.

(c) The commissioner may designate an eligible provider as an essential community provider for all the services offered by that provider or for specific services designated by the commissioner.

(d) For the purpose of this subdivision, supportive and stabilizing services include at a minimum, transportation, child care, cultural, and linguistic services where 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. 11.

Minnesota Statutes 2012, section 103I.005, is amended by adding a subdivision to read:

new text begin Subd. 1a. new text end

new text begin Bored geothermal heat exchanger. new text end

new text begin "Bored geothermal heat exchanger" means an earth-coupled heating or cooling device consisting of a sealed closed-loop piping system installed in a boring in the ground to transfer heat to or from the surrounding earth with no discharge. new text end

Sec. 12.

Minnesota Statutes 2012, section 103I.521, is amended to read:

103I.521 FEES deleted text begin DEPOSITED WITH COMMISSIONER OF MANAGEMENT AND BUDGETdeleted text end .

new text begin Unless otherwise specified, new text end fees collected deleted text begin for licenses or registrationdeleted text end new text begin by the commissionernew text end under this chapter shall be deposited in the state treasurynew text begin and credited to the state government special revenue fundnew text end .

Sec. 13.

Minnesota Statutes 2012, section 144.123, subdivision 1, is amended to read:

Subdivision 1.

Who must pay.

Except for the limitation contained in this section, the commissioner of health deleted text begin shall charge a handling feedeleted text end new text begin may enter into a contractual agreement to recover costs incurred for analysis for diagnostic purposesnew text end for each specimen submitted to the Department of Health deleted text begin for analysis for diagnostic purposesdeleted text end by any hospital, deleted text begin privatedeleted text end laboratory, deleted text begin privatedeleted text end clinic, or physician. deleted text begin No fee shall be charged to any entity which receives direct or indirect financial assistance from state or federal funds administered by the Department of Health, including any public health department, nonprofit community clinic, sexually transmitted disease clinic, or similar entity. No fee will be chargeddeleted text end new text begin The commissioner shall not chargenew text end for any biological materials submitted to the Department of Health as a requirement of Minnesota Rules, part 4605.7040, or for those biological materials requested by the department to gather information for disease prevention or control purposes. The commissioner of health may establish other exceptions to the handling fee as may be necessary to protect the public's health. deleted text begin All fees collected pursuant to this section shall be deposited in the state treasury and credited to the state government special revenue fund.deleted text end new text begin Funds generated in a contractual agreement made pursuant to this section shall be deposited in a special account and are appropriated to the commissioner for purposes of providing the services specified in the contracts. All such contractual agreements shall be processed in accordance with the provisions of chapter 16C.new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2014. new text end

Sec. 14.

Minnesota Statutes 2012, section 144.125, subdivision 1, is amended to read:

Subdivision 1.

Duty to perform testing.

new text begin (a) new text end It is the duty of (1) the administrative officer or other person in charge of each institution caring for infants 28 days or less of age, (2) the person required in pursuance of the provisions of section 144.215, to register the birth of a child, or (3) the nurse midwife or midwife in attendance at the birth, to arrange to have administered to every infant or child in its care tests for heritable and congenital disorders according to subdivision 2 and rules prescribed by the state commissioner of health.

new text begin (b)new text end Testing deleted text begin and thedeleted text end new text begin ,new text end recording deleted text begin anddeleted text end new text begin of test results,new text end reporting of test resultsnew text begin , and follow-up of infants with heritable congenital disorders, including hearing loss detected through the early hearing detection and intervention program in section 144.966,new text end shall be performed at the times and in the manner prescribed by the commissioner of health. deleted text begin The commissioner shall charge a fee so that the total of fees collected will approximate the costs of conducting the tests and implementing and maintaining a system to follow-up infants with heritable or congenital disorders, including hearing loss detected through the early hearing detection and intervention program under section 144.966.deleted text end

new text begin (c)new text end The fee deleted text begin is $101 per specimen. Effective July 1, 2010, the fee shall be increased to $106deleted text end new text begin to support the newborn screening program, including tests administered under this section and section 144.966, shall be $135new text end per specimen. deleted text begin The increased fee amount shall be deposited in the general fund. Costs associated with capital expenditures and the development of new procedures may be prorated over a three-year period when calculating the amount of the fees.deleted text end new text begin This fee amount shall be deposited in the state treasury and credited to the state government special revenue fund.new text end

new text begin (d) The fee to offset the cost of the support services provided under section 144.966, subdivision 3a, shall be $15 per specimen. This fee shall be deposited in the state treasury and credited to the general fund. new text end

Sec. 15.

new text begin [144.1251] NEWBORN SCREENING FOR CRITICAL CONGENITAL HEART DISEASE (CCHD). new text end

new text begin Subdivision 1. new text end

new text begin Required testing and reporting. new text end

new text begin (a) Each licensed hospital or state-licensed birthing center or facility that provides maternity and newborn care services shall provide screening for congenital heart disease to all newborns prior to discharge using pulse oximetry screening. The screening must occur after the infant is 24 hours old, before discharge from the nursery. If discharge occurs before the infant is 24 hours old, the screening must occur as close as possible to the time of discharge. new text end

new text begin (b) For premature infants (less than 36 weeks of gestation) and infants admitted to a higher-level nursery (special care or intensive care), pulse oximetry must be performed when medically appropriate prior to discharge. new text end

new text begin (c) Results of the screening must be reported to the Department of Health. new text end

new text begin Subd. 2. new text end

new text begin Implementation. new text end

new text begin The Department of Health shall: new text end

new text begin (1) communicate the screening protocol requirements; new text end

new text begin (2) make information and forms available to the hospitals, birthing centers, and other facilities that are required to provide the screening, health care providers who provide prenatal care and care to newborns, and expectant parents and parents of newborns. The information and forms must include screening protocol and reporting requirements and parental options; new text end

new text begin (3) provide training to ensure compliance with and appropriate implementation of the screening; new text end

new text begin (4) establish the mechanism for the required data collection and reporting of screening and follow-up diagnostic results to the Department of Health according to the Department of Health's recommendations; new text end

new text begin (5) coordinate the implementation of universal standardized screening; new text end

new text begin (6) act as a resource for providers as the screening program is implemented, and in consultation with the Advisory Committee on Heritable and Congenital Disorders, develop and implement policies for early medical and developmental intervention services and long-term follow-up services for children and their families identified with a CCHD; and new text end

new text begin (7) comply with sections 144.125 to 144.128. new text end

Sec. 16.

Minnesota Statutes 2012, section 144.212, is amended to read:

144.212 DEFINITIONS.

Subdivision 1.

Scope.

As used in sections 144.211 to 144.227, the following terms have the meanings given.

Subd. 1a.

Amendment.

"Amendment" means completion or correction deleted text begin ofdeleted text end new text begin made to certification items on new text end a vital recorddeleted text begin .deleted text end new text begin after a certification has been issued or more than one year after the event, whichever occurs first, that does not result in a sealed or replaced record.new text end

new text begin Subd. 1b. new text end

new text begin Authorized representative. new text end

new text begin "Authorized representative" means an agent designated in a written and witnessed statement signed by the subject of the record or other qualified applicant. new text end

new text begin Subd. 1c. new text end

new text begin Certification item. new text end

new text begin "Certification item" means all individual items appearing on a certificate of birth and the demographic and legal items on a certificate of death. new text end

Subd. 2.

Commissioner.

"Commissioner" means the commissioner of health.

new text begin Subd. 2a. new text end

new text begin Correction. new text end

new text begin "Correction" means a change made to a noncertification item, including information collected for medical and statistical purposes. A correction also means a change to a certification item within one year of the event provided that no certification, whether paper or electronic, has been issued. new text end

new text begin Subd. 2b. new text end

new text begin Court of competent jurisdiction. new text end

new text begin "Court of competent jurisdiction" means a court within the United States with jurisdiction over the individual and such other individuals that the court deems necessary. new text end

Subd. deleted text begin 2adeleted text end new text begin 2cnew text end .

Delayed registration.

"Delayed registration" means registration of a record of birth or death filed one or more years after the date of birth or death.

new text begin Subd. 2d. new text end

new text begin Disclosure. new text end

new text begin "Disclosure" means to make available or make known personally identifiable information contained in a vital record, by any means of communication. new text end

Subd. 3.

File.

"File" means to present a vital record or report for registration to the Office of deleted text begin the State Registrardeleted text end new text begin Vital Recordsnew text end and to have the vital record or report accepted for registration by the Office of deleted text begin the State Registrardeleted text end new text begin Vital Recordsnew text end .

Subd. 4.

Final disposition.

"Final disposition" means the burial, interment, cremation, removal from the state, or other authorized disposition of a dead body or dead fetus.

Subd. 4a.

Institution.

"Institution" means a public or private establishment that:

(1) provides inpatient or outpatient medical, surgical, or diagnostic care or treatment; or

(2) provides nursing, custodial, or domiciliary care, or to which persons are committed by law.

new text begin Subd. 4b. new text end

new text begin Legal representative. new text end

new text begin "Legal representative" means a licensed attorney representing an individual. new text end

new text begin Subd. 4c. new text end

new text begin Local issuance office. new text end

new text begin "Local issuance office" means a county governmental office authorized by the state registrar to issue certified birth and death records. new text end

new text begin Subd. 4d. new text end

new text begin Record. new text end

new text begin "Record" means a report of a vital event that has been registered by the state registrar. new text end

Subd. 5.

Registration.

"Registration" means the process by which vital records are completed, filed, and incorporated into the official records of the Office of deleted text begin the Statedeleted text end new text begin Vital Recordsnew text end deleted text begin Registrardeleted text end .

Subd. 6.

State registrar.

"State registrar" means the commissioner of health or a designee.

Subd. 7.

System of vital statistics.

"System of vital statistics" includes the registration, collection, preservation, amendment, new text begin verification, maintenance of the security and integrity of, new text end and certification of vital records, the collection of other reports required by sections 144.211 to 144.227, and related activities including the tabulation, analysis, publication, and dissemination of vital statistics.

new text begin Subd. 7a. new text end

new text begin Verification. new text end

new text begin "Verification" means a confirmation of the information on a vital record based on the facts contained in a certification. new text end

Subd. 8.

Vital record.

"Vital record" means a record or report of birth, stillbirth, death, marriage, dissolution and annulment, and data related thereto. The birth record is not a medical record of the mother or the child.

Subd. 9.

Vital statistics.

"Vital statistics" means the data derived from records and reports of birth, death, fetal death, induced abortion, marriage, dissolution and annulment, and related reports.

deleted text begin Subd. 10. deleted text end

deleted text begin Local registrar. deleted text end

deleted text begin "Local registrar" means an individual designated under section 144.214, subdivision 1, to perform the duties of a local registrar. deleted text end

Subd. 11.

Consent to disclosure.

"Consent to disclosure" means an affidavit filed with the state registrar which sets forth the following information:

(1) the current name and address of the affiant;

(2) any previous name by which the affiant was known;

(3) the original and adopted names, if known, of the adopted child whose original birth record is to be disclosed;

(4) the place and date of birth of the adopted child;

(5) the biological relationship of the affiant to the adopted child; and

(6) the affiant's consent to disclosure of information from the original birth record of the adopted child.

Sec. 17.

Minnesota Statutes 2012, section 144.213, is amended to read:

144.213 OFFICE OF deleted text begin THE STATE REGISTRARdeleted text end new text begin VITAL RECORDSnew text end .

Subdivision 1.

Creation; state registrarnew text begin ; Office of Vital Recordsnew text end .

The commissioner shall establish an Office of deleted text begin the State Registrardeleted text end new text begin Vital Records new text end under the supervision of the state registrar. deleted text begin The commissioner shall furnish to local registrars the forms necessary for correct reporting of vital statistics, and shall instruct the local registrars in the collection and compilation of the data.deleted text end The commissioner shall promulgate rules for the collection, filing, and registering of vital statistics information by new text begin the new text end state deleted text begin and local registrarsdeleted text end new text begin registrarnew text end , physicians, morticians, and others. Except as otherwise provided in sections 144.211 to 144.227, rules previously promulgated by the commissioner relating to the collection, filing and registering of vital statistics shall remain in effect until repealed, modified or superseded by a rule promulgated by the commissioner.

Subd. 2.

General duties.

new text begin (a) new text end The state registrar shall deleted text begin coordinate the work of local registrars todeleted text end maintain a statewide system of vital statistics. The state registrar is responsible for the administration and enforcement of sections 144.211 to 144.227deleted text begin ,deleted text end and shall supervise deleted text begin local registrars indeleted text end the enforcement of sections 144.211 to 144.227 and the rules promulgated thereunder.new text begin Local issuance offices that fail to comply with the statutes or rules or to properly train employees may have their issuance privileges and access to the vital records system revoked.new text end

new text begin (b) To preserve vital records the state registrar is authorized to prepare typewritten, photographic, electronic or other reproductions of original records and files in the Office of Vital Records. The reproductions when certified by the state registrar shall be accepted as the original records. new text end

new text begin (c) The state registrar shall also: new text end

new text begin (1) establish, designate, and eliminate offices in the state to aid in the efficient issuance of vital records; new text end

new text begin (2) direct the activities of all persons engaged in activities pertaining to the operation of the system of vital statistics; new text end

new text begin (3) develop and conduct training programs to promote uniformity of policy and procedures throughout the state in matters pertaining to the system of vital statistics; and new text end

new text begin (4) prescribe, furnish, and distribute all forms required by sections 144.211 to 144.227 and any rules adopted under these sections, and prescribe other means for the transmission of data, including electronic submission, that will accomplish the purpose of complete, accurate, and timely reporting and registration. new text end

deleted text begin Subd. 3. deleted text end

deleted text begin Record keeping. deleted text end

deleted text begin To preserve vital records the state registrar is authorized to prepare typewritten, photographic, electronic or other reproductions of original records and files in the Office of the State Registrar. The reproductions when certified by the state or local registrar shall be accepted as the original records. deleted text end

Sec. 18.

new text begin [144.2131] SECURITY OF VITAL RECORDS SYSTEM. new text end

new text begin The state registrar shall: new text end

new text begin (1) authenticate all users of the system of vital statistics and document that all users require access based on their official duties; new text end

new text begin (2) authorize authenticated users of the system of vital statistics to access specific components of the vital statistics systems necessary for their official roles and duties; new text end

new text begin (3) establish separation of duties between staff roles that may be susceptible to fraud or misuse and routinely perform audits of staff work for the purposes of identifying fraud or misuse within the vital statistics system; new text end

new text begin (4) require that authenticated and authorized users of the system of vital statistics maintain a specified level of training related to security and provide written acknowledgment of security procedures and penalties; new text end

new text begin (5) validate data submitted for registration through site visits or with independent sources outside the registration system at a frequency specified by the state registrar to maximize the integrity of the data collected; new text end

new text begin (6) protect personally identifiable information and maintain systems pursuant to applicable state and federal laws; new text end

new text begin (7) accept a report of death if the decedent was born in Minnesota or if the decedent was a resident of Minnesota from the United States Department of Defense or the United States Department of State when the death of a United States citizen occurs outside the United States; new text end

new text begin (8) match death records registered in Minnesota and death records provided from other jurisdictions to live birth records in Minnesota; new text end

new text begin (9) match death records received from the United States Department of Defense or the United States Department of State for deaths of United States citizens occurring outside the United States to live birth records in Minnesota; new text end

new text begin (10) work with law enforcement to initiate and provide evidence for active fraud investigations; new text end

new text begin (11) provide secure workplace, storage, and technology environments that have limited role-based access; new text end

new text begin (12) maintain overt, covert, and forensic security measures for certifications, verifications, and automated systems that are part of the vital statistics system; and new text end

new text begin (13) comply with applicable state and federal laws and rules associated with information technology systems and related information security requirements. new text end

Sec. 19.

Minnesota Statutes 2012, section 144.215, subdivision 3, is amended to read:

Subd. 3.

Father's name; child's name.

In any case in which paternity of a child is determined by a court of competent jurisdiction, deleted text begin a declaration of parentage is executed under section 257.34,deleted text end or a recognition of parentage is executed under section 257.75, the name of the father shall be entered on the birth record. If the order of the court declares the name of the child, it shall also be entered on the birth record. If the order of the court does not declare the name of the child, or there is no court order, then upon the request of both parents in writing, the surname of the child shall be defined by both parents.

Sec. 20.

Minnesota Statutes 2012, section 144.215, subdivision 4, is amended to read:

Subd. 4.

Social Security number registration.

(a) Parents of a child born within this state shall give the parents' Social Security numbers to the Office of deleted text begin the State Registrardeleted text end new text begin Vital Recordsnew text end at the time of filing the birth record, but the numbers shall not appear on the new text begin certified new text end record.

(b) The Social Security numbers are classified as private datadeleted text begin , as defined in section 13.02, subdivision 12, on individualsdeleted text end , but the Office of deleted text begin the State Registrardeleted text end new text begin Vital Recordsnew text end shall provide a Social Security number to the public authority responsible for child support services upon request by the public authority for use in the establishment of parentage and the enforcement of child support obligations.

Sec. 21.

Minnesota Statutes 2012, section 144.216, subdivision 1, is amended to read:

Subdivision 1.

Reporting a foundling.

Whoever finds a live born infant of unknown parentage shall report within five days to the Office of deleted text begin the State Registrardeleted text end new text begin Vital Recordsnew text end such information as the commissioner may by rule require to identify the foundling.

Sec. 22.

Minnesota Statutes 2012, section 144.217, subdivision 2, is amended to read:

Subd. 2.

Court petition.

If a delayed record of birth is rejected under subdivision 1, a person may petition the appropriate court new text begin in the county in which the birth allegedly occurred new text end for an order establishing a record of the date and place of the birth and the parentage of the person whose birth is to be registered. The petition shall state:

(1) that the person for whom a delayed record of birth is sought was born in this state;

(2) that no record of birth can be found in the Office of deleted text begin the State Registrardeleted text end new text begin Vital Recordsnew text end ;

(3) that diligent efforts by the petitioner have failed to obtain the evidence required in subdivision 1;

(4) that the state registrar has refused to register a delayed record of birth; and

(5) other information as may be required by the court.

Sec. 23.

Minnesota Statutes 2012, section 144.218, subdivision 5, is amended to read:

Subd. 5.

Replacement of vital records.

Upon the order of a court of this state, upon the request of a court of another state, deleted text begin upon the filing of a declaration of parentage under section 257.34,deleted text end or upon the filing of a recognition of parentage with deleted text begin adeleted text end new text begin the statenew text end registrar, a replacement birth record must be registered consistent with the findings of the courtdeleted text begin , the declaration of parentage,deleted text end or the recognition of parentage.

Sec. 24.

new text begin [144.2181] AMENDMENT AND CORRECTION OF VITAL RECORDS. new text end

new text begin (a) A vital record registered under sections 144.212 to 144.227 may be amended or corrected only according to sections 144.212 to 144.227 and rules adopted by the commissioner of health to protect the integrity and accuracy of vital records. new text end

new text begin (b)(1) A vital record that is amended under this section shall indicate that it has been amended, except as otherwise provided in this section or by rule. new text end

new text begin (2) Electronic documentation shall be maintained by the state registrar that identifies the evidence upon which the amendment or correction was based, the date of the amendment or correction, and the identity of the authorized person making the amendment or correction. new text end

new text begin (c) Upon receipt of a certified copy of an order of a court of competent jurisdiction changing the name of a person whose birth is registered in Minnesota and upon request of such person if 18 years of age or older or having the status of emancipated minor, the state registrar shall amend the birth record to show the new name. If the person is a minor or an incapacitated person then a parent, guardian, or legal representative of the minor or incapacitated person may make the request. new text end

new text begin (d) When an applicant does not submit the minimum documentation required for amending a vital record or when the state registrar has cause to question the validity or completeness of the applicant's statements or the documentary evidence, and the deficiencies are not corrected, the state registrar shall not amend the vital record. The state registrar shall advise the applicant of the reason for this action and shall further advise the applicant of the right of appeal to a court with competent jurisdiction over the Department of Health. new text end

Sec. 25.

Minnesota Statutes 2012, section 144.225, subdivision 1, is amended to read:

Subdivision 1.

Public information; access to vital records.

Except as otherwise provided for in this section and section 144.2252, information contained in vital records shall be public information. Physical access to vital records shall be subject to the supervision and regulation of new text begin the new text end state deleted text begin and local registrarsdeleted text end new text begin registrar new text end and deleted text begin theirdeleted text end employees pursuant to rules promulgated by the commissioner in order to protect vital records from loss, mutilation or destruction and to prevent improper disclosure of vital records which are confidential or private data on individuals, as defined in section 13.02, subdivisions 3 and 12.

Sec. 26.

Minnesota Statutes 2012, section 144.225, subdivision 4, is amended to read:

Subd. 4.

Access to records for research purposes.

The state registrar may permit persons performing medical research access to the information restricted in subdivision 2 new text begin or 2a new text end if those persons agree in writing not to disclose private or confidential data on individuals.

Sec. 27.

Minnesota Statutes 2012, section 144.225, subdivision 7, is amended to read:

Subd. 7.

Certified birth or death record.

(a) The state deleted text begin or localdeleted text end registrar new text begin or local issuance office new text end shall issue a certified birth or death record or a statement of no vital record found to an individual upon the individual's proper completion of an attestation provided by the commissionernew text begin and payment of the required feenew text end :

(1) to a person who has a tangible interest in the requested vital record. A person who has a tangible interest is:

(i) the subject of the vital record;

(ii) a child of the subject;

(iii) the spouse of the subject;

(iv) a parent of the subject;

(v) the grandparent or grandchild of the subject;

(vi) if the requested record is a death record, a sibling of the subject;

(vii) the party responsible for filing the vital record;

(viii) the legal custodian, guardian or conservator, or health care agent of the subject;

(ix) a personal representative, by sworn affidavit of the fact that the certified copy is required for administration of the estate;

(x) a successor of the subject, as defined in section 524.1-201, if the subject is deceased, by sworn affidavit of the fact that the certified copy is required for administration of the estate;

(xi) if the requested record is a death record, a trustee of a trust by sworn affidavit of the fact that the certified copy is needed for the proper administration of the trust;

(xii) a person or entity who demonstrates that a certified vital record is necessary for the determination or protection of a personal or property right, pursuant to rules adopted by the commissioner; or

(xiii) adoption agencies in order to complete confidential postadoption searches as required by section 259.83;

(2) to any local, state, or federal governmental agency upon request if the certified vital record is necessary for the governmental agency to perform its authorized dutiesdeleted text begin . An authorized governmental agency includes the Department of Human Services, the Department of Revenue, and the United States Citizenship and Immigration Servicesdeleted text end ;

(3) to an attorney upon evidence of the attorney's license;

(4) pursuant to a court order issued by a court of competent jurisdiction. For purposes of this section, a subpoena does not constitute a court order; or

(5) to a representative authorized by a person under clauses (1) to (4).

(b) The state deleted text begin or localdeleted text end registrar new text begin or local issuance office new text end shall also issue a certified death record to an individual described in paragraph (a), clause (1), items (ii) to (viii), if, on behalf of the individual, a licensed mortician furnishes the registrar with a properly completed attestation in the form provided by the commissioner within 180 days of the time of death of the subject of the death record. This paragraph is not subject to the requirements specified in Minnesota Rules, part 4601.2600, subpart 5, item B.

Sec. 28.

Minnesota Statutes 2012, section 144.225, subdivision 8, is amended to read:

Subd. 8.

Standardized format for certified birth and death records.

deleted text begin No later than July 1, 2000,deleted text end The commissioner shall deleted text begin developdeleted text end new text begin maintainnew text end a standardized format for certified birth records and death records issued by new text begin the new text end state deleted text begin and local registrarsdeleted text end new text begin registrar and local issuance officesnew text end . The format shall incorporate security features in accordance with this section. deleted text begin The standardized format must be implemented on a statewide basis by July 1, 2001.deleted text end

Sec. 29.

Minnesota Statutes 2012, section 144.226, is amended to read:

144.226 FEES.

Subdivision 1.

Which services are for fee.

The fees for the following services shall be the following or an amount prescribed by rule of the commissioner:

(a) The fee for the deleted text begin issuance ofdeleted text end new text begin administrative review and processing of a request fornew text end a certified vital record or a certification that the vital record cannot be found is $9. deleted text begin No fee shall be charged for a certified birth, stillbirth, or death record that is reissued within one year of the original issue, if an amendment is made to the vital record and if the previously issued vital record is surrendered.deleted text end The fee is new text begin payable at the time of application and is new text end nonrefundable.

(b) The fee for processing a request for the replacement of a birth record for all events, except when filing a recognition of parentage pursuant to section 257.73, subdivision 1, is $40. The fee is payable at the time of application and is nonrefundable.

(c) The fee for new text begin administrative review and new text end processing new text begin ofnew text end a request for the filing of a delayed registration of birth, stillbirth, or death is $40. The fee is payable at the time of application and is nonrefundable. deleted text begin This fee includes one subsequent review of the request if the request is not acceptable upon the initial receipt.deleted text end

(d) The fee for new text begin administrative review and new text end processing new text begin ofnew text end a request for the amendment of any vital record deleted text begin when requested more than 45 days after the filing of the vital recorddeleted text end is $40. deleted text begin No fee shall be charged for an amendment requested within 45 days after the filing of the vital record.deleted text end The fee is payable at the time of application and is nonrefundable. deleted text begin This fee includes one subsequent review of the request if the request is not acceptable upon the initial receipt.deleted text end

(e) The fee for new text begin administrative review and new text end processing new text begin ofnew text end a request for the verification of information from vital records is $9 when the applicant furnishes the specific information to locate the vital record. When the applicant does not furnish specific information, the fee is $20 per hour for staff time expended. Specific information includes the correct date of the event and the correct name of the deleted text begin registrantdeleted text end new text begin subject of the recordnew text end . Fees charged shall approximate the costs incurred in searching and copying the vital records. The fee is payable at the time of application and is nonrefundable.

(f) The fee for new text begin administrative review and new text end processing new text begin ofnew text end a request for the issuance of a copy of any document on file pertaining to a vital record or statement that a related document cannot be found is $9. The fee is payable at the time of application and is nonrefundable.

Subd. 2.

Fees to state government special revenue fund.

Fees collected under this section by the state registrar shall be deposited new text begin in the state treasury and credited new text end to the state government special revenue fund.

Subd. 3.

Birth record surcharge.

(a) In addition to any fee prescribed under subdivision 1, there shall be a nonrefundable surcharge of $3 for each certified birth or stillbirth record and for a certification that the vital record cannot be found. The deleted text begin local ordeleted text end state registrar new text begin or local issuance office new text end shall forward this amount to the commissioner of management and budget for deposit into the account for the children's trust fund for the prevention of child abuse established under section 256E.22. This surcharge shall not be charged under those circumstances in which no fee for a certified birth or stillbirth record is permitted under subdivision 1, paragraph (a). Upon certification by the commissioner of management and budget that the assets in that fund exceed $20,000,000, this surcharge shall be discontinued.

(b) In addition to any fee prescribed under subdivision 1, there shall be a nonrefundable surcharge of $10 for each certified birth record. The deleted text begin local ordeleted text end state registrar new text begin or local issuance office new text end shall forward this amount to the commissioner of management and budget for deposit in the general fund. deleted text begin This surcharge shall not be charged under those circumstances in which no fee for a certified birth record is permitted under subdivision 1, paragraph (a).deleted text end

Subd. 4.

Vital records surcharge.

deleted text begin (a)deleted text end In addition to any fee prescribed under subdivision 1, there is a nonrefundable surcharge of deleted text begin $2deleted text end new text begin $4new text end for each certified and noncertified birth, stillbirth, or death record, and for a certification that the record cannot be found. The local new text begin issuance office new text end or state registrar shall forward this amount to the commissioner of management and budget to be deposited into the state government special revenue fund. deleted text begin This surcharge shall not be charged under those circumstances in which no fee for a birth, stillbirth, or death record is permitted under subdivision 1, paragraph (a).deleted text end

deleted text begin (b) Effective August 1, 2005, the surcharge in paragraph (a) is $4. deleted text end

Subd. 5.

Electronic verification.

A fee for the electronic verification new text begin or electronic certification new text end of a vital event, when the information being verified new text begin or certified new text end is obtained from a certified birth or death record, shall be established through contractual or interagency agreements deleted text begin with interested local, state, or federal government agenciesdeleted text end .

Subd. 6.

Alternative payment methods.

Notwithstanding subdivision 1, alternative payment methods may be approved and implemented by the state registrar or a local deleted text begin registrardeleted text end new text begin issuance officenew text end .

Sec. 30.

new text begin [144.492] DEFINITIONS. new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin For the purposes of sections 144.492 to 144.494, the terms defined in this section have the meanings given them. new text end

new text begin Subd. 2. new text end

new text begin Commissioner. new text end

new text begin "Commissioner" means the commissioner of health. new text end

new text begin Subd. 3. new text end

new text begin Joint commission. new text end

new text begin "Joint commission" means the independent, not-for-profit organization that accredits and certifies health care organizations and programs in the United States. new text end

new text begin Subd. 4. new text end

new text begin Stroke. new text end

new text begin "Stroke" means the sudden death of brain cells in a localized area due to inadequate blood flow. new text end

Sec. 31.

new text begin [144.493] CRITERIA. new text end

new text begin Subdivision 1. new text end

new text begin Comprehensive stroke center. new text end

new text begin A hospital meets the criteria for a comprehensive stroke center if the hospital has been certified as a comprehensive stroke center by the joint commission or another nationally recognized accreditation entity. new text end

new text begin Subd. 2. new text end

new text begin Primary stroke center. new text end

new text begin A hospital meets the criteria for a primary stroke center if the hospital has been certified as a primary stroke center by the joint commission or another nationally recognized accreditation entity. new text end

new text begin Subd. 3. new text end

new text begin Acute stroke ready hospital. new text end

new text begin A hospital meets the criteria for an acute stroke ready hospital if the hospital has the following elements of an acute stroke ready hospital: new text end

new text begin (1) an acute stroke team available or on-call 24 hours a days, seven days a week; new text end

new text begin (2) written stroke protocols, including triage, stabilization of vital functions, initial diagnostic tests, and use of medications; new text end

new text begin (3) a written plan and letter of cooperation with emergency medical services regarding triage and communication that are consistent with regional patient care procedures; new text end

new text begin (4) emergency department personnel who are trained in diagnosing and treating acute stroke; new text end

new text begin (5) the capacity to complete basic laboratory tests, electrocardiograms, and chest x-rays 24 hours a day, seven days a week; new text end

new text begin (6) the capacity to perform and interpret brain injury imaging studies 24 hours a day, seven days a week; new text end

new text begin (7) written protocols that detail available emergent therapies and reflect current treatment guidelines, which include performance measures and are revised at least annually; new text end

new text begin (8) a neurosurgery coverage plan, call schedule, and a triage and transportation plan; new text end

new text begin (9) transfer protocols and agreements for stroke patients; and new text end

new text begin (10) a designated medical director with experience and expertise in acute stroke care. new text end

Sec. 32.

new text begin [144.494] DESIGNATING STROKE CENTERS AND STROKE HOSPITALS. new text end

new text begin Subdivision 1. new text end

new text begin Naming privileges. new text end

new text begin Unless it has been designated as a stroke center or stroke hospital pursuant to section 144.493, no hospital shall use the term "stroke center" or "stroke hospital" in its name or its advertising or shall otherwise indicate it has stroke treatment capabilities. new text end

new text begin Subd. 2. new text end

new text begin Designation. new text end

new text begin A hospital that voluntarily meets the criteria for a comprehensive stroke center, primary stroke center, or acute stroke ready hospital may apply to the commissioner for designation, and upon the commissioner's review and approval of the application, shall be designated as a comprehensive stroke center, a primary stroke center, or an acute stroke ready hospital for a three-year period. If a hospital loses its certification as a comprehensive stroke center or primary stroke center from the joint commission or other nationally recognized accreditation entity, its Minnesota designation shall be immediately withdrawn. Prior to the expiration of the three-year designation, a hospital seeking to remain part of the voluntary acute stroke system may reapply to the commissioner for designation. new text end

Sec. 33.

new text begin [144.554] HEALTH FACILITIES CONSTRUCTION PLAN SUBMITTAL AND FEES. new text end

new text begin For hospitals, nursing homes, boarding care homes, residential hospices, supervised living facilities, freestanding outpatient surgical centers, and end-stage renal disease facilities, the commissioner shall collect a fee for the review and approval of architectural, mechanical, and electrical plans and specifications submitted before construction begins for each project relative to construction of new buildings, additions to existing buildings, or remodeling or alterations of existing buildings. All fees collected in this section shall be deposited in the state treasury and credited to the state government special revenue fund. Fees must be paid at the time of submission of final plans for review and are not refundable. The fee is calculated as follows: new text end

new text begin Construction project total estimated cost new text end new text begin Fee new text end
new text begin $0 - $10,000 new text end new text begin $30 new text end
new text begin $10,001 - $50,000 new text end new text begin $150 new text end
new text begin $50,001 - $100,000 new text end new text begin $300 new text end
new text begin $100,001 - $150,000 new text end new text begin $450 new text end
new text begin $150,001 - $200,000 new text end new text begin $600 new text end
new text begin $200,001 - $250,000 new text end new text begin $750 new text end
new text begin $250,001 - $300,000 new text end new text begin $900 new text end
new text begin $300,001 - $350,000 new text end new text begin $1,050 new text end
new text begin $350,001 - $400,000 new text end new text begin $1,200 new text end
new text begin $400,001 - $450,000 new text end new text begin $1,350 new text end
new text begin $450,001 - $500,000 new text end new text begin $1,500 new text end
new text begin $500,001 - $550,000 new text end new text begin $1,650 new text end
new text begin $550,001 - $600,000 new text end new text begin $1,800 new text end
new text begin $600,001 - $650,000 new text end new text begin $1,950 new text end
new text begin $650,001 - $700,000 new text end new text begin $2,100 new text end
new text begin $700,001 - $750,000 new text end new text begin $2,250 new text end
new text begin $750,001 - $800,000 new text end new text begin $2,400 new text end
new text begin $800,001 - $850,000 new text end new text begin $2,550 new text end
new text begin $850,001 - $900,000 new text end new text begin $2,700 new text end
new text begin $900,001 - $950,000 new text end new text begin $2,850 new text end
new text begin $950,001 - $1,000,000 new text end new text begin $3,000 new text end
new text begin $1,000,001 - $1,050,000 new text end new text begin $3,150 new text end
new text begin $1,050,001 - $1,100,000 new text end new text begin $3,300 new text end
new text begin $1,100,001 - $1,150,000 new text end new text begin $3,450 new text end
new text begin $1,150,001 - $1,200,000 new text end new text begin $3,600 new text end
new text begin $1,200,001 - $1,250,000 new text end new text begin $3,750 new text end
new text begin $1,250,001 - $1,300,000 new text end new text begin $3,900 new text end
new text begin $1,300,001 - $1,350,000 new text end new text begin $4,050 new text end
new text begin $1,350,001 - $1,400,000 new text end new text begin $4,200 new text end
new text begin $1,400,001 - $1,450,000 new text end new text begin $4,350 new text end
new text begin $1,450,001 - $1,500,000 new text end new text begin $4,500 new text end
new text begin $1,500,001 and over new text end new text begin $4,800 new text end

Sec. 34.

Minnesota Statutes 2012, section 144.966, subdivision 2, is amended to read:

Subd. 2.

Newborn Hearing Screening Advisory Committee.

(a) The commissioner of health shall establish a Newborn Hearing Screening Advisory Committee to advise and assist the Department of Health and the Department of Education in:

(1) developing protocols and timelines for screening, rescreening, and diagnostic audiological assessment and early medical, audiological, and educational intervention services for children who are deaf or hard-of-hearing;

(2) designing protocols for tracking children from birth through age three that may have passed newborn screening but are at risk for delayed or late onset of permanent hearing loss;

(3) designing a technical assistance program to support facilities implementing the screening program and facilities conducting rescreening and diagnostic audiological assessment;

(4) designing implementation and evaluation of a system of follow-up and tracking; and

(5) evaluating program outcomes to increase effectiveness and efficiency and ensure culturally appropriate services for children with a confirmed hearing loss and their families.

(b) The commissioner of health shall appoint at least one member from each of the following groups with no less than two of the members being deaf or hard-of-hearing:

(1) a representative from a consumer organization representing culturally deaf persons;

(2) a parent with a child with hearing loss representing a parent organization;

(3) a consumer from an organization representing oral communication options;

(4) a consumer from an organization representing cued speech communication options;

(5) an audiologist who has experience in evaluation and intervention of infants and young children;

(6) a speech-language pathologist who has experience in evaluation and intervention of infants and young children;

(7) two primary care providers who have experience in the care of infants and young children, one of which shall be a pediatrician;

(8) a representative from the early hearing detection intervention teams;

(9) a representative from the Department of Education resource center for the deaf and hard-of-hearing or the representative's designee;

(10) a representative of the Commission of Deaf, DeafBlind and Hard-of-Hearing Minnesotans;

(11) a representative from the Department of Human Services Deaf and Hard-of-Hearing Services Division;

(12) one or more of the Part C coordinators from the Department of Education, the Department of Health, or the Department of Human Services or the department's designees;

(13) the Department of Health early hearing detection and intervention coordinators;

(14) two birth hospital representatives from one rural and one urban hospital;

(15) a pediatric geneticist;

(16) an otolaryngologist;

(17) a representative from the Newborn Screening Advisory Committee under this subdivision; and

(18) a representative of the Department of Education regional low-incidence facilitators.

The commissioner must complete the appointments required under this subdivision by September 1, 2007.

(c) The Department of Health member shall chair the first meeting of the committee. At the first meeting, the committee shall elect a chair from its membership. The committee shall meet at the call of the chair, at least four times a year. The committee shall adopt written bylaws to govern its activities. The Department of Health shall provide technical and administrative support services as required by the committee. These services shall include technical support from individuals qualified to administer infant hearing screening, rescreening, and diagnostic audiological assessments.

Members of the committee shall receive no compensation for their service, but shall be reimbursed as provided in section 15.059 for expenses incurred as a result of their duties as members of the committee.

(d) This subdivision expires June 30, deleted text begin 2013deleted text end new text begin 2019new text end .

Sec. 35.

Minnesota Statutes 2012, section 144.966, subdivision 3a, is amended to read:

Subd. 3a.

Support services to families.

new text begin (a) new text end The commissioner shall contract with a nonprofit organization to provide support and assistance to families with children who are deaf or have a hearing loss. The family support provided must includenew text begin :new text end

new text begin (1)new text end direct new text begin hearing loss specific new text end parent-to-parent assistance and new text begin unbiased new text end information on communication, educational, and medical optionsnew text begin ; andnew text end

new text begin (2) individualized deaf or hard-of-hearing mentors who provide education, including instruction in American Sign Language as an available optionnew text end .

The commissioner shall give preference to a nonprofit organization that has the ability to provide these services throughout the state.

new text begin (b) Family participation in the support and assistance services is voluntary. new text end

Sec. 36.

Minnesota Statutes 2012, section 144.98, subdivision 3, is amended to read:

Subd. 3.

Annual fees.

(a) An application for accreditation under subdivision 6 must be accompanied by the annual fees specified in this subdivision. The annual fees include:

(1) base accreditation fee, deleted text begin $1,500deleted text end new text begin $600new text end ;

(2) sample preparation techniques fee, $200 per technique;

(3) an administrative fee for laboratories located outside this state, deleted text begin $3,750deleted text end new text begin $2,000new text end ; and

(4) test category fees.

(b) For the programs in subdivision 3a, the commissioner may accredit laboratories for fields of testing under the categories listed in clauses (1) to (10) upon completion of the application requirements provided by subdivision 6 and receipt of the fees for each category under each program that accreditation is requested. The categories offered and related fees include:

(1) microbiology, deleted text begin $450deleted text end new text begin $200new text end ;

(2) inorganics, deleted text begin $450deleted text end new text begin $200new text end ;

(3) metals, deleted text begin $1,000deleted text end new text begin $500new text end ;

(4) volatile organics, deleted text begin $1,300deleted text end new text begin $1,000new text end ;

(5) other organics, deleted text begin $1,300deleted text end new text begin $1,000new text end ;

(6) radiochemistry, deleted text begin $1,500deleted text end new text begin $750new text end ;

(7) emerging contaminants, deleted text begin $1,500deleted text end new text begin $1,000new text end ;

(8) agricultural contaminants, deleted text begin $1,250deleted text end new text begin $1,000new text end ;

(9) toxicity (bioassay), deleted text begin $1,000deleted text end new text begin $500new text end ; and

(10) physical characterization, $250.

(c) The total annual fee includes the base fee, the sample preparation techniques fees, the test category fees per program, and, when applicable, an administrative fee for out-of-state laboratories.

new text begin EFFECTIVE DATE. new text end

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

Sec. 37.

Minnesota Statutes 2012, section 144.98, subdivision 5, is amended to read:

Subd. 5.

State government special revenue fund.

Fees collected new text begin by the commissioner new text end under this section must be deposited in the state new text begin treasury and credited to the state new text end government special revenue fund.

new text begin EFFECTIVE DATE. new text end

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

Sec. 38.

Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision to read:

new text begin Subd. 10. new text end

new text begin Establishing a selection committee. new text end

new text begin (a) The commissioner shall establish a selection committee for the purpose of recommending approval of qualified laboratory assessors and assessment bodies. Committee members shall demonstrate competence in assessment practices. The committee shall initially consist of seven members appointed by the commissioner as follows: new text end

new text begin (1) one member from a municipal laboratory accredited by the commissioner; new text end

new text begin (2) one member from an industrial treatment laboratory accredited by the commissioner; new text end

new text begin (3) one member from a commercial laboratory located in this state and accredited by the commissioner; new text end

new text begin (4) one member from a commercial laboratory located outside the state and accredited by the commissioner; new text end

new text begin (5) one member from a nongovernmental client of environmental laboratories; new text end

new text begin (6) one member from a professional organization with a demonstrated interest in environmental laboratory data and accreditation; and new text end

new text begin (7) one employee of the laboratory accreditation program administered by the department. new text end

new text begin (b) Committee appointments begin on January 1 and end on December 31 of the same year. new text end

new text begin (c) The commissioner shall appoint persons to fill vacant committee positions, expand the total number of appointed positions, or change the designated positions upon the advice of the committee. new text end

new text begin (d) The commissioner shall rescind the appointment of a selection committee member for sufficient cause as the commissioner determines, such as: new text end

new text begin (1) neglect of duty; new text end

new text begin (2) failure to notify the commissioner of a real or perceived conflict of interest; new text end

new text begin (3) nonconformance with committee procedures; new text end

new text begin (4) failure to demonstrate competence in assessment practices; or new text end

new text begin (5) official misconduct. new text end

new text begin (e) Members of the selection committee shall be compensated according to the provisions in section 15.059, subdivision 3. new text end

Sec. 39.

Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision to read:

new text begin Subd. 11. new text end

new text begin Activities of the selection committee. new text end

new text begin (a) The selection committee shall determine assessor and assessment organization application requirements, the frequency of application submittal, and the application review schedule. The commissioner shall publish the application requirements and procedures on the accreditation program Web site. new text end

new text begin (b) In its selection process, the committee shall ensure its application requirements and review process: new text end

new text begin (1) meet the standards implemented in subdivision 2a; new text end

new text begin (2) ensure assessors have demonstrated competence in technical disciplines offered for accreditation by the commissioner; and new text end

new text begin (3) consider any history of repeated nonconformance or complaints regarding assessors or assessment bodies. new text end

new text begin (c) The selection committee shall consider an application received from qualified applicants and shall supply a list of recommended assessors and assessment bodies to the commissioner of health no later than 90 days after the commissioner notifies the committee of the need for review of applications. new text end

Sec. 40.

Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision to read:

new text begin Subd. 12. new text end

new text begin Commissioner approval of assessors and scheduling of assessments. new text end

new text begin (a) The commissioner shall approve assessors who: new text end

new text begin (1) are employed by the commissioner for the purpose of accrediting laboratories and demonstrate competence in assessment practices for environmental laboratories; or new text end

new text begin (2) are employed by a state or federal agency with established agreements for mutual assistance or recognition with the commissioner and demonstrate competence in assessment practices for environmental laboratories. new text end

new text begin (b) The commissioner may approve other assessors or assessment organizations who are recommended by the selection committee according to subdivision 11, paragraph (c). The commissioner shall publish the list of assessors and assessment organizations approved from the recommendations. new text end

new text begin (c) The commissioner shall rescind approval for an assessor or assessment organization for sufficient cause as the commissioner determines, such as: new text end

new text begin (1) failure to meet the minimum qualifications for performing assessments; new text end

new text begin (2) lack of availability; new text end

new text begin (3) nonconformance with the applicable laws, rules, standards, policies, and procedures; new text end

new text begin (4) misrepresentation of application information regarding qualifications and training; or new text end

new text begin (5) excessive cost to perform the assessment activities. new text end

Sec. 41.

Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision to read:

new text begin Subd. 13. new text end

new text begin Laboratory requirements for assessor selection and scheduling assessments. new text end

new text begin (a) A laboratory accredited or seeking accreditation that requires an assessment by the commissioner must select an assessor, group of assessors, or assessment organization from the published list specified in subdivision 12, paragraph (b). An accredited laboratory must complete an assessment and make all corrective actions at least once every 24 months. Unless the commissioner grants interim accreditation, a laboratory seeking accreditation must complete an assessment and make all corrective actions prior to, but no earlier than, 18 months prior to the date the application is submitted to the commissioner. new text end

new text begin (b) A laboratory shall not select the same assessor more than twice in succession for assessments of the same facility unless the laboratory receives written approval from the commissioner for the selection. The laboratory must supply a written request to the commissioner for approval and must justify the reason for the request and provide the alternate options considered. new text end

new text begin (c) A laboratory must select assessors appropriate to the size and scope of the laboratory's application or existing accreditation. new text end

new text begin (d) A laboratory must enter into its own contract for direct payment of the assessors or assessment organization. The contract must authorize the assessor, assessment organization, or subcontractors to release all records to the commissioner regarding the assessment activity, when the assessment is performed in compliance with this section. new text end

new text begin (e) A laboratory must agree to permit other assessors as selected by the commissioner to participate in the assessment activities. new text end

new text begin (f) If the laboratory determines no approved assessor is available to perform the assessment, the laboratory must notify the commissioner in writing and provide a justification for the determination. If the commissioner confirms no approved assessor is available, the commissioner may designate an alternate assessor from those approved in subdivision 12, paragraph (a), or the commissioner may delay the assessment until an assessor is available. If an approved alternate assessor performs the assessment, the commissioner may collect fees equivalent to the cost of performing the assessment activities. new text end

new text begin (g) Fees collected under this section are deposited in a special account and are annually appropriated to the commissioner for the purpose of performing assessment activities. 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. 42.

Minnesota Statutes 2012, section 144.99, subdivision 4, is amended to read:

Subd. 4.

Administrative penalty orders.

(a) The commissioner may issue an order requiring violations to be corrected and administratively assessing monetary penalties for violations of the statutes, rules, and other actions listed in subdivision 1. The procedures in section 144.991 must be followed when issuing administrative penalty orders. Except in the case of repeated or serious violations, the penalty assessed in the order must be forgiven if the person who is subject to the order demonstrates in writing to the commissioner before the 31st day after receiving the order that the person has corrected the violation or has developed a corrective plan acceptable to the commissioner. The maximum amount of an administrative penalty order is $10,000 for each violator for all violations by that violator identified in an inspection or review of compliance.

(b) Notwithstanding paragraph (a), the commissioner may issue to a large public water supply, serving a population of more than 10,000 persons, an administrative penalty order imposing a penalty of at least $1,000 per day per violation, not to exceed $10,000 for each violation of sections 144.381 to 144.385 and rules adopted thereunder.

new text begin (c) Notwithstanding paragraph (a), the commissioner may issue to a certified lead firm or person performing regulated lead work, an administrative penalty order imposing a penalty of at least $5,000 per violation per day, not to exceed $10,000 for each violation of sections 144.9501 to 144.9512 and rules adopted thereunder. All revenue collected from monetary penalties in this section shall be deposited in the state treasury and credited to the state government special revenue fund. new text end

Sec. 43.

new text begin [145.4716] SAFE HARBOR FOR SEXUALLY EXPLOITED YOUTH. new text end

new text begin Subdivision 1. new text end

new text begin Director. new text end

new text begin The commissioner of health shall establish a position for a director of child sex trafficking prevention. new text end

new text begin Subd. 2. new text end

new text begin Duties of director. new text end

new text begin The director of child sex trafficking prevention is responsible for the following: new text end

new text begin (1) developing and providing comprehensive training on sexual exploitation of youth for social service professionals, medical professionals, public health workers, and criminal justice professionals; new text end

new text begin (2) collecting, organizing, maintaining, and disseminating information on sexual exploitation and services across the state, including maintaining a list of resources on the Department of Health Web site; new text end

new text begin (3) monitoring and applying for federal funding for antitrafficking efforts that may benefit victims in the state; new text end

new text begin (4) managing grant programs established under this act; new text end

new text begin (5) identifying best practices in serving sexually exploited youth, as defined in section 260C.007, subdivision 31; new text end

new text begin (6) providing oversight of and technical support to regional navigators pursuant to section 145.4717; new text end

new text begin (7) conducting a comprehensive evaluation of the statewide program for safe harbor of sexually exploited youth; and new text end

new text begin (8) developing a policy, consistent with the requirements of chapter 13, for sharing data related to sexually exploited youth, as defined in section 260C.007, subdivision 31, among regional navigators and community-based advocates. new text end

Sec. 44.

new text begin [145.4717] REGIONAL NAVIGATOR GRANTS. new text end

new text begin The commissioner of health, through its director of child sex trafficking prevention, established in section 145.4716, shall provide grants to regional navigators serving six regions of the state to be determined by the commissioner. Each regional navigator must develop and annually submit a work plan to the director of child sex trafficking prevention. The work plans must include, but are not limited to, the following information: new text end

new text begin (1) a needs statement specific to the region, including an examination of the population at risk; new text end

new text begin (2) regional resources available to sexually exploited youth, as defined in section 260C.007, subdivision 31; new text end

new text begin (3) grant goals and measurable outcomes; and new text end

new text begin (4) grant activities including timelines. new text end

Sec. 45.

new text begin [145.4718] PROGRAM EVALUATION. new text end

new text begin (a) The director of child sex trafficking prevention, established under section 145.4716, must conduct, or contract for, comprehensive evaluation of the statewide program for safe harbor for sexually exploited youth. The first evaluation must be completed by June 30, 2015, and must be submitted to the commissioner of health by September 1, 2015, and every two years thereafter. The evaluation must consider whether the program is reaching intended victims and whether support services are available, accessible, and adequate for sexually exploited youth, as defined in section 260C.007, subdivision 31. new text end

new text begin (b) In conducting the evaluation, the director of child sex trafficking prevention must consider evaluation of outcomes, including whether the program increases identification of sexually exploited youth, coordination of investigations, access to services and housing available for sexually exploited youth, and improved effectiveness of services. The evaluation must also include examination of the ways in which penalties under section 609.3241 are assessed, collected, and distributed to ensure funding for investigation, prosecution, and victim services to combat sexual exploitation of youth. new text end

Sec. 46.

Minnesota Statutes 2012, section 145.906, is amended to read:

145.906 POSTPARTUM DEPRESSION EDUCATION AND INFORMATION.

(a) The commissioner of health shall work with health care facilities, licensed health and mental health care professionals, the women, infants, and children (WIC) program, mental health advocates, consumers, and families in the state to develop materials and information about postpartum depression, including treatment resources, and develop policies and procedures to comply with this section.

(b) Physicians, traditional midwives, and other licensed health care professionals providing prenatal care to women must have available to women and their families information about postpartum depression.

(c) Hospitals and other health care facilities in the state must provide departing new mothers and fathers and other family members, as appropriate, with written information about postpartum depression, including its symptoms, methods of coping with the illness, and treatment resources.

(d) Information about postpartum depression, including its symptoms, potential impact on families, and treatment resources, must be available at WIC sites.

new text begin (e) The commissioner of health, in collaboration with the commissioner of human services and to the extent authorized by the federal Centers for Disease Control and Prevention, shall review the materials and information related to postpartum depression to determine their effectiveness in transmitting the information in a way that reduces racial health disparities as reported in surveys of maternal attitudes and experiences before, during, and after pregnancy, including those conducted by the commissioner of health. The commissioner shall implement changes to reduce racial health disparities in the information reviewed, as needed, and ensure that women of color are receiving the information. new text end

Sec. 47.

new text begin [145.907] MATERNAL DEPRESSION; DEFINITION. new text end

new text begin "Maternal depression" means depression or other perinatal mood or anxiety disorder experienced by a woman during pregnancy or during the first year following the birth of her child. new text end

Sec. 48.

Minnesota Statutes 2012, section 145.986, is amended to read:

145.986 STATEWIDE HEALTH IMPROVEMENT PROGRAM.

Subdivision 1.

deleted text begin Grants to local communitiesdeleted text end new text begin Purposenew text end .

new text begin The purpose of the statewide health improvement program is to: new text end

new text begin (1) address the top three leading preventable causes of illness and death: tobacco use and exposure, poor diet, and lack of regular physical activity; new text end

new text begin (2) promote the development, availability, and use of evidence-based, community level, comprehensive strategies to create healthy communities; and new text end

new text begin (3) measure the impact of the evidence-based, community health improvement practices which over time work to contain health care costs and reduce chronic diseases. new text end

new text begin Subd. 1a. new text end

new text begin Grants to local communities. new text end

(a) Beginning July 1, 2009, the commissioner of health shall award competitive grants to community health boards established pursuant to section 145A.09 and tribal governments to convene, coordinate, and implement evidence-based strategies targeted at reducing the percentage of Minnesotans who are obese or overweight and to reduce the use of tobacco.new text begin Grants shall be awarded to all community health boards and tribal governments whose proposals demonstrate the ability to implement programs designed to achieve the purposes in subdivision 1 and other requirements of this section.new text end

(b) Grantee activities shall:

(1) be based on scientific evidence;

(2) be based on community input;

(3) address behavior change at the individual, community, and systems levels;

(4) occur in community, school, worksite, and health care settings; deleted text begin anddeleted text end

(5) be focused on policy, systems, and environmental changes that support healthy behaviorsdeleted text begin .deleted text end new text begin ; andnew text end

new text begin (6) address the health disparities and inequities that exist in the grantee's community. new text end

(c) To receive a grant under this section, community health boards and tribal governments must submit proposals to the commissioner. A local match of ten percent of the total funding allocation is required. This local match may include funds donated by community partners.

(d) In order to receive a grant, community health boards and tribal governments must submit a health improvement plan to the commissioner of health for approval. The commissioner may require the plan to identify a community leadership team, community partners, and a community action plan that includes an assessment of area strengths and needs, proposed action strategies, technical assistance needs, and a staffing plan.

(e) The grant recipient must implement the health improvement plan, evaluate the effectiveness of the deleted text begin interventionsdeleted text end new text begin strategiesnew text end , and modify or discontinue deleted text begin interventionsdeleted text end new text begin strategies new text end found to be ineffective.

deleted text begin (f) By January 15, 2011, the commissioner of health shall recommend whether any funding should be distributed to community health boards and tribal governments based on health disparities demonstrated in the populations served. deleted text end

deleted text begin (g)deleted text end new text begin (f)new text end Grant recipients shall report their activities and their progress toward the outcomes established under subdivision 2 to the commissioner in a format and at a time specified by the commissioner.

deleted text begin (h)deleted text end new text begin (g)new text end All grant recipients shall be held accountable for making progress toward the measurable outcomes established in subdivision 2. The commissioner shall require a corrective action plan and may reduce the funding level of grant recipients that do not make adequate progress toward the measurable outcomes.

Subd. 2.

Outcomes.

(a) The commissioner shall set measurable outcomes to meet the goals specified in subdivision 1, and annually review the progress of grant recipients in meeting the outcomes.

(b) The commissioner shall measure current public health status, using existing measures and data collection systems when available, to determine baseline data against which progress shall be monitored.

Subd. 3.

Technical assistance and oversight.

new text begin (a) new text end The commissioner shall provide content expertise, technical expertise, deleted text begin anddeleted text end training to grant recipients and advice on evidence-based strategies, including those based on populations and types of communities served. The commissioner shall ensure that the statewide health improvement program meets the outcomes established under subdivision 2 by conducting a comprehensive statewide evaluation and assisting grant recipients to modify or discontinue interventions found to be ineffective.

new text begin (b) For the purposes of carrying out the grant program under this section, including for administrative purposes, the commissioner shall award contracts to appropriate entities to assist in training and provide technical assistance to grantees. new text end

new text begin (c) Contracts awarded under paragraph (b) may be used to provide technical assistance and training in the areas of: new text end

new text begin (1) community engagement and capacity building; new text end

new text begin (2) tribal support; new text end

new text begin (3) community asset building and risk behavior reduction; new text end

new text begin (4) legal; new text end

new text begin (5) communications; new text end

new text begin (6) community, school, health care, work site, and other site-specific strategies; and new text end

new text begin (7) health equity. new text end

Subd. 4.

Evaluation.

new text begin (a) new text end Using the outcome measures established in subdivision 3, the commissioner shall conduct a biennial evaluation of the statewide health improvement program funded under this section. Grant recipients shall cooperate with the commissioner in the evaluation and provide the commissioner with the information necessary to conduct the evaluation.

new text begin (b) Grant recipients will collect, monitor, and submit to the Department of Health baseline and annual data and provide information to improve the quality and impact of community health improvement strategies. new text end

new text begin (c) For the purposes of carrying out the grant program under this section, including for administrative purposes, the commissioner shall award contracts to appropriate entities to assist in designing and implementing evaluation systems. new text end

new text begin (d) Contracts awarded under paragraph (c) may be used to: new text end

new text begin (1) develop grantee monitoring and reporting systems to track grantee progress, including aggregated and disaggregated data; new text end

new text begin (2) manage, analyze, and report program evaluation data results; and new text end

new text begin (3) utilize innovative support tools to analyze and predict the impact of prevention strategies on health outcomes and state health care costs over time. new text end

Subd. 5.

Report.

The commissioner shall submit a biennial report to the legislature on the statewide health improvement program funded under this section. deleted text begin These reports deleted text end new text begin The report new text end must include information on new text begin each new text end grant deleted text begin recipientsdeleted text end new text begin recipientnew text end , new text begin including the new text end activities that were conducted new text begin by the grantee new text end using grant funds, deleted text begin evaluation data, and outcome measures, if available.deleted text end new text begin the grantee's progress toward achieving the measurable outcomes established under subdivision 2, and the data provided to the commissioner by the grantee to measure these outcomes for grant activities. new text end new text begin The commissioner shall provide information on grants in which a corrective action plan was required under subdivision 1a, the types of plan action, and the progress that has been made toward meeting the measurable outcomes. new text end In addition, the commissioner shall provide recommendations on future areas of focus for health improvement. These reports are due by January 15 of every other year, beginning in 2010. deleted text begin In the report due on January 15, 2010, the commissioner shall include recommendations on a sustainable funding source for the statewide health improvement program other than the health care access funddeleted text end new text begin In the report due on January 15, 2014, the commissioner shall include a description of the contracts awarded under subdivision 4, paragraph (c), and the monitoring and evaluation systems that were designed and implemented under these contractsnew text end .

Subd. 6.

Supplantation of existing funds.

Community health boards and tribal governments must use funds received under this section to develop new programs, expand current programs that work to reduce the percentage of Minnesotans who are obese or overweight or who use tobacco, or replace discontinued state or federal funds previously used to reduce the percentage of Minnesotans who are obese or overweight or who use tobacco. Funds must not be used to supplant current state or local funding to community health boards or tribal governments used to reduce the percentage of Minnesotans who are obese or overweight or to reduce tobacco use.

Sec. 49.

Minnesota Statutes 2012, section 145A.17, subdivision 1, is amended to read:

Subdivision 1.

Establishment; goals.

The commissioner shall establish a program to fund family home visiting programs designed to foster healthy beginnings, improve pregnancy outcomes, promote school readiness, prevent child abuse and neglect, reduce juvenile delinquency, promote positive parenting and resiliency in children, and promote family health and economic self-sufficiency for children and families. The commissioner shall promote partnerships, collaboration, and multidisciplinary visiting done by teams of professionals and paraprofessionals from the fields of public health nursing, social work, and early childhood education. A program funded under this section must serve families at or below 200 percent of the federal poverty guidelines, and other families determined to be at risk, including but not limited to being at risk for child abuse, child neglect, or juvenile delinquency. Programs must begin prenatally whenever possible and must be targeted to families with:

(1) adolescent parents;

(2) a history of alcohol or other drug abuse;

(3) a history of child abuse, domestic abuse, or other types of violence;

(4) a history of domestic abuse, rape, or other forms of victimization;

(5) reduced cognitive functioning;

(6) a lack of knowledge of child growth and development stages;

(7) low resiliency to adversities and environmental stresses;

(8) insufficient financial resources to meet family needs;

(9) a history of homelessness;

(10) a risk of long-term welfare dependence or family instability due to employment barriers; deleted text begin ordeleted text end

new text begin (11) a serious mental health disorder, including maternal depression as defined in section 145.907; or new text end

deleted text begin (11)deleted text end new text begin (12)new text end other risk factors as determined by the commissioner.

Sec. 50.

Minnesota Statutes 2012, section 149A.02, subdivision 1a, is amended to read:

Subd. 1a.

Alkaline hydrolysis.

"Alkaline hydrolysis" means the reduction of a dead human body to essential elements through deleted text begin exposure to a combination of heat and alkaline hydrolysis and the repositioning or movement of the body during the process to facilitate reduction,deleted text end new text begin a water-based dissolution process using alkaline chemicals, heat, agitation, and pressure to accelerate natural decomposition;new text end the processing of the new text begin hydrolyzed new text end remains after removal from the alkaline hydrolysis deleted text begin chamber,deleted text end new text begin vessel;new text end placement of the processed remains in a new text begin hydrolyzed new text end remains containerdeleted text begin ,deleted text end new text begin ;new text end and release of the new text begin hydrolyzed new text end remains to an appropriate party. Alkaline hydrolysis is a form of final disposition.

Sec. 51.

Minnesota Statutes 2012, section 149A.02, is amended by adding a subdivision to read:

new text begin Subd. 1b. new text end

new text begin Alkaline hydrolysis container. new text end

new text begin "Alkaline hydrolysis container" means a hydrolyzable or biodegradable closed container or pouch resistant to leakage of bodily fluids that encases the body and into which a dead human body is placed prior to insertion into an alkaline hydrolysis vessel. Alkaline hydrolysis containers may be hydrolyzable or biodegradable alternative containers or caskets. new text end

Sec. 52.

Minnesota Statutes 2012, section 149A.02, is amended by adding a subdivision to read:

new text begin Subd. 1c. new text end

new text begin Alkaline hydrolysis facility. new text end

new text begin "Alkaline hydrolysis facility" means a building or structure containing one or more alkaline hydrolysis vessels for the alkaline hydrolysis of dead human bodies. new text end

Sec. 53.

Minnesota Statutes 2012, section 149A.02, is amended by adding a subdivision to read:

new text begin Subd. 1d. new text end

new text begin Alkaline hydrolysis vessel. new text end

new text begin "Alkaline hydrolysis vessel" means the container in which the alkaline hydrolysis of a dead human body is performed. new text end

Sec. 54.

Minnesota Statutes 2012, section 149A.02, subdivision 2, is amended to read:

Subd. 2.

Alternative container.

"Alternative container" means a nonmetal receptacle or enclosure, without ornamentation or a fixed interior lining, which is designed for the encasement of dead human bodies and is made of new text begin hydrolyzable or biodegradable materials, new text end corrugated cardboard, fiberboard, pressed-wood, or other like materials.

Sec. 55.

Minnesota Statutes 2012, section 149A.02, subdivision 3, is amended to read:

Subd. 3.

Arrangements for disposition.

"Arrangements for disposition" means any action normally taken by a funeral provider in anticipation of or preparation for the entombment, burial in a cemetery, new text begin alkaline hydrolysis, new text end or cremation of a dead human body.

Sec. 56.

Minnesota Statutes 2012, section 149A.02, subdivision 4, is amended to read:

Subd. 4.

Cash advance item.

"Cash advance item" means any item of service or merchandise described to a purchaser as a "cash advance," "accommodation," "cash disbursement," or similar term. A cash advance item is also any item obtained from a third party and paid for by the funeral provider on the purchaser's behalf. Cash advance items include, but are not limited to, cemeterynew text begin , alkaline hydrolysis, new text end or crematory services, pallbearers, public transportation, clergy honoraria, flowers, musicians or singers, obituary notices, gratuities, and death records.

Sec. 57.

Minnesota Statutes 2012, section 149A.02, subdivision 5, is amended to read:

Subd. 5.

Casket.

"Casket" means a rigid container which is designed for the encasement of a dead human body and is usually constructed of new text begin hydrolyzable or biodegradable materials, new text end wood, metal, fiberglass, plastic, or like material, and ornamented and lined with fabric.

Sec. 58.

Minnesota Statutes 2012, section 149A.02, is amended by adding a subdivision to read:

new text begin Subd. 12a. new text end

new text begin Crypt. new text end

new text begin "Crypt" means a space in a mausoleum of sufficient size, used or intended to be used, to entomb human remains, cremated remains, or hydrolyzed remains. new text end

Sec. 59.

Minnesota Statutes 2012, section 149A.02, is amended by adding a subdivision to read:

new text begin Subd. 12b. new text end

new text begin Direct alkaline hydrolysis. new text end

new text begin "Direct alkaline hydrolysis" means a final disposition of a dead human body by alkaline hydrolysis, without formal viewing, visitation, or ceremony with the body present. new text end

Sec. 60.

Minnesota Statutes 2012, section 149A.02, subdivision 16, is amended to read:

Subd. 16.

Final disposition.

"Final disposition" means the acts leading to and the entombment, burial in a cemetery, new text begin alkaline hydrolysis, new text end or cremation of a dead human body.

Sec. 61.

Minnesota Statutes 2012, section 149A.02, subdivision 23, is amended to read:

Subd. 23.

Funeral services.

"Funeral services" means any services which may be used to: (1) care for and prepare dead human bodies for burial, new text begin alkaline hydrolysis, new text end cremation, or other final disposition; and (2) arrange, supervise, or conduct the funeral ceremony or the final disposition of dead human bodies.

Sec. 62.

Minnesota Statutes 2012, section 149A.02, is amended by adding a subdivision to read:

new text begin Subd. 24a. new text end

new text begin Hydrolyzed remains. new text end

new text begin "Hydrolyzed remains" means the remains of a dead human body following the alkaline hydrolysis process. Hydrolyzed remains does not include pacemakers, prostheses, or similar foreign materials. new text end

Sec. 63.

Minnesota Statutes 2012, section 149A.02, is amended by adding a subdivision to read:

new text begin Subd. 24b. new text end

new text begin Hydrolyzed remains container. new text end

new text begin "Hydrolyzed remains container" means a receptacle in which hydrolyzed remains are placed. For purposes of this chapter, a hydrolyzed remains container is interchangeable with "urn" or similar keepsake storage jewelry. new text end

Sec. 64.

Minnesota Statutes 2012, section 149A.02, is amended by adding a subdivision to read:

new text begin Subd. 26a. new text end

new text begin Inurnment. new text end

new text begin "Inurnment" means placing hydrolyzed or cremated remains in a hydrolyzed or cremated remains container suitable for placement, burial, or shipment. new text end

Sec. 65.

Minnesota Statutes 2012, section 149A.02, subdivision 27, is amended to read:

Subd. 27.

Licensee.

"Licensee" means any person new text begin or entity new text end that has been issued a license to practice mortuary science, to operate a funeral establishment, new text begin to operate an alkaline hydrolysis facility, new text end or to operate a crematory by the Minnesota commissioner of health.

Sec. 66.

Minnesota Statutes 2012, section 149A.02, is amended by adding a subdivision to read:

new text begin Subd. 30a. new text end

new text begin Niche. new text end

new text begin "Niche" means a space in a columbarium used, or intended to be used, for the placement of hydrolyzed or cremated remains. new text end

Sec. 67.

Minnesota Statutes 2012, section 149A.02, is amended by adding a subdivision to read:

new text begin Subd. 32a. new text end

new text begin Placement. new text end

new text begin "Placement" means the placing of a container holding hydrolyzed or cremated remains in a crypt, vault, or niche. new text end

Sec. 68.

Minnesota Statutes 2012, section 149A.02, subdivision 34, is amended to read:

Subd. 34.

Preparation of the body.

"Preparation of the body" means new text begin placement of the body into an appropriate cremation or alkaline hydrolysis container, new text end embalming of the body or such items of care as washing, disinfecting, shaving, positioning of features, restorative procedures, application of cosmetics, dressing, and casketing.

Sec. 69.

Minnesota Statutes 2012, section 149A.02, subdivision 35, is amended to read:

Subd. 35.

Processing.

"Processing" means the removal of foreign objectsnew text begin , drying or cooling,new text end and the reduction of the new text begin hydrolyzed or new text end cremated remains by mechanical means including, but not limited to, grinding, crushing, or pulverizing, to a granulated appearance appropriate for final disposition.

Sec. 70.

Minnesota Statutes 2012, section 149A.02, subdivision 37, is amended to read:

Subd. 37.

Public transportation.

"Public transportation" means all manner of transportation via common carrier available to the general public including airlines, buses, railroads, and ships. For purposes of this chapter, a livery service providing transportation to private funeral establishmentsnew text begin , alkaline hydrolysis facilities, new text end or crematories is not public transportation.

Sec. 71.

Minnesota Statutes 2012, section 149A.02, is amended by adding a subdivision to read:

new text begin Subd. 37c. new text end

new text begin Scattering. new text end

new text begin "Scattering" means the authorized dispersal of hydrolyzed or cremated remains in a defined area of a dedicated cemetery or in areas where no local prohibition exists provided that the hydrolyzed or cremated remains are not distinguishable to the public, are not in a container, and that the person who has control over disposition of the hydrolyzed or cremated remains has obtained written permission of the property owner or governing agency to scatter on the property. new text end

Sec. 72.

Minnesota Statutes 2012, section 149A.02, is amended by adding a subdivision to read:

new text begin Subd. 41. new text end

new text begin Vault. new text end

new text begin "Vault" means a space in a mausoleum of sufficient size, used or intended to be used, to entomb human remains, cremated remains, or hydrolyzed remains. Vault may also mean a sealed and lined casket enclosure. new text end

Sec. 73.

Minnesota Statutes 2012, section 149A.03, is amended to read:

149A.03 DUTIES OF COMMISSIONER.

The commissioner shall:

(1) enforce all laws and adopt and enforce rules relating to the:

(i) removal, preparation, transportation, arrangements for disposition, and final disposition of dead human bodies;

(ii) licensure and professional conduct of funeral directors, morticians, interns, practicum students, and clinical students;

(iii) licensing and operation of a funeral establishment; deleted text begin anddeleted text end

new text begin (iv) licensing and operation of an alkaline hydrolysis facility; and new text end

deleted text begin (iv)deleted text end new text begin (v) new text end licensing and operation of a crematory;

(2) provide copies of the requirements for licensure and permits to all applicants;

(3) administer examinations and issue licenses and permits to qualified persons and other legal entities;

(4) maintain a record of the name and location of all current licensees and interns;

(5) perform periodic compliance reviews and premise inspections of licensees;

(6) accept and investigate complaints relating to conduct governed by this chapter;

(7) maintain a record of all current preneed arrangement trust accounts;

(8) maintain a schedule of application, examination, permit, and licensure fees, initial and renewal, sufficient to cover all necessary operating expenses;

(9) educate the public about the existence and content of the laws and rules for mortuary science licensing and the removal, preparation, transportation, arrangements for disposition, and final disposition of dead human bodies to enable consumers to file complaints against licensees and others who may have violated those laws or rules;

(10) evaluate the laws, rules, and procedures regulating the practice of mortuary science in order to refine the standards for licensing and to improve the regulatory and enforcement methods used; and

(11) initiate proceedings to address and remedy deficiencies and inconsistencies in the laws, rules, or procedures governing the practice of mortuary science and the removal, preparation, transportation, arrangements for disposition, and final disposition of dead human bodies.

Sec. 74.

new text begin [149A.54] LICENSE TO OPERATE AN ALKALINE HYDROLYSIS FACILITY. new text end

new text begin Subdivision 1. new text end

new text begin License requirement. new text end

new text begin Except as provided in section 149A.01, subdivision 3, a place or premise shall not be maintained, managed, or operated which is devoted to or used in the holding and alkaline hydrolysis of a dead human body without possessing a valid license to operate an alkaline hydrolysis facility issued by the commissioner of health. new text end

new text begin Subd. 2. new text end

new text begin Requirements for an alkaline hydrolysis facility. new text end

new text begin (a) An alkaline hydrolysis facility licensed under this section must consist of: new text end

new text begin (1) a building or structure that complies with applicable local and state building codes, zoning laws and ordinances, and wastewater management and environmental standards, containing one or more alkaline hydrolysis vessels for the alkaline hydrolysis of dead human bodies; new text end

new text begin (2) a method approved by the commissioner of health to dry the hydrolyzed remains and which is located within the licensed facility; new text end

new text begin (3) a means approved by the commissioner of health for refrigeration of dead human bodies awaiting alkaline hydrolysis; new text end

new text begin (4) an appropriate means of processing hydrolyzed remains to a granulated appearance appropriate for final disposition; and new text end

new text begin (5) an appropriate holding facility for dead human bodies awaiting alkaline hydrolysis. new text end

new text begin (b) An alkaline hydrolysis facility licensed under this section may also contain a display room for funeral goods. new text end

new text begin Subd. 3. new text end

new text begin Application procedure; documentation; initial inspection. new text end

new text begin An application to license and operate an alkaline hydrolysis facility shall be submitted to the commissioner of health. A completed application includes: new text end

new text begin (1) a completed application form, as provided by the commissioner; new text end

new text begin (2) proof of business form and ownership; new text end

new text begin (3) proof of liability insurance coverage or other financial documentation, as determined by the commissioner, that demonstrates the applicant's ability to respond in damages for liability arising from the ownership, maintenance management, or operation of an alkaline hydrolysis facility; and new text end

new text begin (4) copies of wastewater and other environmental regulatory permits and environmental regulatory licenses necessary to conduct operations. new text end

new text begin Upon receipt of the application and appropriate fee, the commissioner shall review and verify all information. Upon completion of the verification process and resolution of any deficiencies in the application information, the commissioner shall conduct an initial inspection of the premises to be licensed. After the inspection and resolution of any deficiencies found and any reinspections as may be necessary, the commissioner shall make a determination, based on all the information available, to grant or deny licensure. If the commissioner's determination is to grant the license, the applicant shall be notified and the license shall issue and remain valid for a period prescribed on the license, but not to exceed one calendar year from the date of issuance of the license. If the commissioner's determination is to deny the license, the commissioner must notify the applicant in writing of the denial and provide the specific reason for denial. new text end

new text begin Subd. 4. new text end

new text begin Nontransferability of license. new text end

new text begin A license to operate an alkaline hydrolysis facility is not assignable or transferable and shall not be valid for any entity other than the one named. Each license issued to operate an alkaline hydrolysis facility is valid only for the location identified on the license. A 50 percent or more change in ownership or location of the alkaline hydrolysis facility automatically terminates the license. Separate licenses shall be required of two or more persons or other legal entities operating from the same location. new text end

new text begin Subd. 5. new text end

new text begin Display of license. new text end

new text begin Each license to operate an alkaline hydrolysis facility must be conspicuously displayed in the alkaline hydrolysis facility at all times. Conspicuous display means in a location where a member of the general public within the alkaline hydrolysis facility is able to observe and read the license. new text end

new text begin Subd. 6. new text end

new text begin Period of licensure. new text end

new text begin All licenses to operate an alkaline hydrolysis facility issued by the commissioner are valid for a period of one calendar year beginning on July 1 and ending on June 30, regardless of the date of issuance. new text end

new text begin Subd. 7. new text end

new text begin Reporting changes in license information. new text end

new text begin Any change of license information must be reported to the commissioner, on forms provided by the commissioner, no later than 30 calendar days after the change occurs. Failure to report changes is grounds for disciplinary action. new text end

new text begin Subd. 8. new text end

new text begin Notification to the commissioner. new text end

new text begin If the licensee is operating under a wastewater or an environmental permit or license that is subsequently revoked, denied, or terminated, the licensee shall notify the commissioner. new text end

new text begin Subd. 9. new text end

new text begin Application information. new text end

new text begin All information submitted to the commissioner for a license to operate an alkaline hydrolysis facility is classified as licensing data under section 13.41, subdivision 5. new text end

Sec. 75.

new text begin [149A.55] RENEWAL OF LICENSE TO OPERATE AN ALKALINE HYDROLYSIS FACILITY. new text end

new text begin Subdivision 1. new text end

new text begin Renewal required. new text end

new text begin All licenses to operate an alkaline hydrolysis facility issued by the commissioner expire on June 30 following the date of issuance of the license and must be renewed to remain valid. new text end

new text begin Subd. 2. new text end

new text begin Renewal procedure and documentation. new text end

new text begin Licensees who wish to renew their licenses must submit to the commissioner a completed renewal application no later than June 30 following the date the license was issued. A completed renewal application includes: new text end

new text begin (1) a completed renewal application form, as provided by the commissioner; and new text end

new text begin (2) proof of liability insurance coverage or other financial documentation, as determined by the commissioner, that demonstrates the applicant's ability to respond in damages for liability arising from the ownership, maintenance, management, or operation of an alkaline hydrolysis facility. new text end

new text begin Upon receipt of the completed renewal application, the commissioner shall review and verify the information. Upon completion of the verification process and resolution of any deficiencies in the renewal application information, the commissioner shall make a determination, based on all the information available, to reissue or refuse to reissue the license. If the commissioner's determination is to reissue the license, the applicant shall be notified and the license shall issue and remain valid for a period prescribed on the license, but not to exceed one calendar year from the date of issuance of the license. If the commissioner's determination is to refuse to reissue the license, section 149A.09, subdivision 2, applies. new text end

new text begin Subd. 3. new text end

new text begin Penalty for late filing. new text end

new text begin Renewal applications received after the expiration date of a license will result in the assessment of a late filing penalty. The late filing penalty must be paid before the reissuance of the license and received by the commissioner no later than 31 calendar days after the expiration date of the license. new text end

new text begin Subd. 4. new text end

new text begin Lapse of license. new text end

new text begin Licenses to operate alkaline hydrolysis facilities shall automatically lapse when a completed renewal application is not received by the commissioner within 31 calendar days after the expiration date of a license, or a late filing penalty assessed under subdivision 3 is not received by the commissioner within 31 calendar days after the expiration of a license. new text end

new text begin Subd. 5. new text end

new text begin Effect of lapse of license. new text end

new text begin Upon the lapse of a license, the person to whom the license was issued is no longer licensed to operate an alkaline hydrolysis facility in Minnesota. The commissioner shall issue a cease and desist order to prevent the lapsed license holder from operating an alkaline hydrolysis facility in Minnesota and may pursue any additional lawful remedies as justified by the case. new text end

new text begin Subd. 6. new text end

new text begin Restoration of lapsed license. new text end

new text begin The commissioner may restore a lapsed license upon receipt and review of a completed renewal application, receipt of the late filing penalty, and reinspection of the premises, provided that the receipt is made within one calendar year from the expiration date of the lapsed license and the cease and desist order issued by the commissioner has not been violated. If a lapsed license is not restored within one calendar year from the expiration date of the lapsed license, the holder of the lapsed license cannot be relicensed until the requirements in section 149A.54 are met. new text end

new text begin Subd. 7. new text end

new text begin Reporting changes in license information. new text end

new text begin Any change of license information must be reported to the commissioner, on forms provided by the commissioner, no later than 30 calendar days after the change occurs. Failure to report changes is grounds for disciplinary action. new text end

new text begin Subd. 8. new text end

new text begin Application information. new text end

new text begin All information submitted to the commissioner by an applicant for renewal of licensure to operate an alkaline hydrolysis facility is classified as licensing data under section 13.41, subdivision 5. new text end

Sec. 76.

Minnesota Statutes 2012, section 149A.65, is amended by adding a subdivision to read:

new text begin Subd. 6. new text end

new text begin Alkaline hydrolysis facilities. new text end

new text begin The initial and renewal fee for an alkaline hydrolysis facility is $300. The late fee charge for a license renewal is $25. new text end

Sec. 77.

Minnesota Statutes 2012, section 149A.65, is amended by adding a subdivision to read:

new text begin Subd. 7. new text end

new text begin State government special revenue fund. new text end

new text begin Fees collected by the commissioner under this section must be deposited in the state treasury and credited to the state government special revenue fund. new text end

Sec. 78.

Minnesota Statutes 2012, section 149A.70, subdivision 1, is amended to read:

Subdivision 1.

Use of titles.

Only a person holding a valid license to practice mortuary science issued by the commissioner may use the title of mortician, funeral director, or any other title implying that the licensee is engaged in the business or practice of mortuary science. new text begin Only the holder of a valid license to operate an alkaline hydrolysis facility issued by the commissioner may use the title of alkaline hydrolysis facility, water cremation, water-reduction, biocremation, green-cremation, resomation, dissolution, or any other title, word, or term implying that the licensee operates an alkaline hydrolysis facility. new text end Only the holder of a valid license to operate a funeral establishment issued by the commissioner may use the title of funeral home, funeral chapel, funeral service, or any other title, word, or term implying that the licensee is engaged in the business or practice of mortuary science. Only the holder of a valid license to operate a crematory issued by the commissioner may use the title of crematory, crematorium, new text begin green-cremation, new text end or any other title, word, or term implying that the licensee operates a crematory or crematorium.

Sec. 79.

Minnesota Statutes 2012, section 149A.70, subdivision 2, is amended to read:

Subd. 2.

Business location.

A funeral establishmentnew text begin , alkaline hydrolysis facility, new text end or crematory shall not do business in a location that is not licensed as a funeral establishmentnew text begin , alkaline hydrolysis facility, new text end or crematory and shall not advertise a service that is available from an unlicensed location.

Sec. 80.

Minnesota Statutes 2012, section 149A.70, subdivision 3, is amended to read:

Subd. 3.

Advertising.

No licensee, clinical student, practicum student, or intern shall publish or disseminate false, misleading, or deceptive advertising. False, misleading, or deceptive advertising includes, but is not limited to:

(1) identifying, by using the names or pictures of, persons who are not licensed to practice mortuary science in a way that leads the public to believe that those persons will provide mortuary science services;

(2) using any name other than the names under which the funeral establishmentnew text begin , alkaline hydrolysis facility, new text end or crematory is known to or licensed by the commissioner;

(3) using a surname not directly, actively, or presently associated with a licensed funeral establishmentnew text begin , alkaline hydrolysis facility, new text end or crematory, unless the surname had been previously and continuously used by the licensed funeral establishmentnew text begin , alkaline hydrolysis facility, new text end or crematory; and

(4) using a founding or establishing date or total years of service not directly or continuously related to a name under which the funeral establishmentnew text begin , alkaline hydrolysis facility, new text end or crematory is currently or was previously licensed.

Any advertising or other printed material that contains the names or pictures of persons affiliated with a funeral establishmentnew text begin , alkaline hydrolysis facility, new text end or crematory shall state the position held by the persons and shall identify each person who is licensed or unlicensed under this chapter.

Sec. 81.

Minnesota Statutes 2012, section 149A.70, subdivision 5, is amended to read:

Subd. 5.

Reimbursement prohibited.

No licensee, clinical student, practicum student, or intern shall offer, solicit, or accept a commission, fee, bonus, rebate, or other reimbursement in consideration for recommending or causing a dead human body to be disposed of by a specific body donation program, funeral establishment, new text begin alkaline hydrolysis facility, new text end crematory, mausoleum, or cemetery.

Sec. 82.

Minnesota Statutes 2012, section 149A.71, subdivision 2, is amended to read:

Subd. 2.

Preventive requirements.

(a) To prevent unfair or deceptive acts or practices, the requirements of this subdivision must be met.

(b) Funeral providers must tell persons who ask by telephone about the funeral provider's offerings or prices any accurate information from the price lists described in paragraphs (c) to (e) and any other readily available information that reasonably answers the questions asked.

(c) Funeral providers must make available for viewing to people who inquire in person about the offerings or prices of funeral goods or burial site goods, separate printed or typewritten price lists using a ten-point font or larger. Each funeral provider must have a separate price list for each of the following types of goods that are sold or offered for sale:

(1) caskets;

(2) alternative containers;

(3) outer burial containers;

new text begin (4) alkaline hydrolysis containers; new text end

deleted text begin (4)deleted text end new text begin (5)new text end cremation containers;

new text begin (6) hydrolyzed remains containers; new text end

deleted text begin (5)deleted text end new text begin (7) new text end cremated remains containers;

deleted text begin (6)deleted text end new text begin (8) new text end markers; and

deleted text begin (7)deleted text end new text begin (9) new text end headstones.

(d) Each separate price list must contain the name of the funeral provider's place of business, address, and telephone number and a caption describing the list as a price list for one of the types of funeral goods or burial site goods described in paragraph (c), clauses (1) to deleted text begin (7)deleted text end new text begin (9)new text end . The funeral provider must offer the list upon beginning discussion of, but in any event before showing, the specific funeral goods or burial site goods and must provide a photocopy of the price list, for retention, if so asked by the consumer. The list must contain, at least, the retail prices of all the specific funeral goods and burial site goods offered which do not require special ordering, enough information to identify each, and the effective date for the price list. However, funeral providers are not required to make a specific price list available if the funeral providers place the information required by this paragraph on the general price list described in paragraph (e).

(e) Funeral providers must give a printed price list, for retention, to persons who inquire in person about the funeral goods, funeral services, burial site goods, or burial site services or prices offered by the funeral provider. The funeral provider must give the list upon beginning discussion of either the prices of or the overall type of funeral service or disposition or specific funeral goods, funeral services, burial site goods, or burial site services offered by the provider. This requirement applies whether the discussion takes place in the funeral establishment or elsewhere. However, when the deceased is removed for transportation to the funeral establishment, an in-person request for authorization to embalm does not, by itself, trigger the requirement to offer the general price list. If the provider, in making an in-person request for authorization to embalm, discloses that embalming is not required by law except in certain special cases, the provider is not required to offer the general price list. Any other discussion during that time about prices or the selection of funeral goods, funeral services, burial site goods, or burial site services triggers the requirement to give the consumer a general price list. The general price list must contain the following information:

(1) the name, address, and telephone number of the funeral provider's place of business;

(2) a caption describing the list as a "general price list";

(3) the effective date for the price list;

(4) the retail prices, in any order, expressed either as a flat fee or as the prices per hour, mile, or other unit of computation, and other information described as follows:

(i) forwarding of remains to another funeral establishment, together with a list of the services provided for any quoted price;

(ii) receiving remains from another funeral establishment, together with a list of the services provided for any quoted price;

(iii) separate prices for each new text begin alkaline hydrolysis or new text end cremation offered by the funeral provider, with the price including an alternative new text begin container new text end or new text begin alkaline hydrolysis or new text end cremation container, any new text begin alkaline hydrolysis or new text end crematory charges, and a description of the services and container included in the price, where applicable, and the price of new text begin alkaline hydrolysis or new text end cremation where the purchaser provides the container;

(iv) separate prices for each immediate burial offered by the funeral provider, including a casket or alternative container, and a description of the services and container included in that price, and the price of immediate burial where the purchaser provides the casket or alternative container;

(v) transfer of remains to the funeral establishment or other location;

(vi) embalming;

(vii) other preparation of the body;

(viii) use of facilities, equipment, or staff for viewing;

(ix) use of facilities, equipment, or staff for funeral ceremony;

(x) use of facilities, equipment, or staff for memorial service;

(xi) use of equipment or staff for graveside service;

(xii) hearse or funeral coach;

(xiii) limousine; and

(xiv) separate prices for all cemetery-specific goods and services, including all goods and services associated with interment and burial site goods and services and excluding markers and headstones;

(5) the price range for the caskets offered by the funeral provider, together with the statement "A complete price list will be provided at the funeral establishment or casket sale location." or the prices of individual caskets, as disclosed in the manner described in paragraphs (c) and (d);

(6) the price range for the alternative containers offered by the funeral provider, together with the statement "A complete price list will be provided at the funeral establishment or alternative container sale location." or the prices of individual alternative containers, as disclosed in the manner described in paragraphs (c) and (d);

(7) the price range for the outer burial containers offered by the funeral provider, together with the statement "A complete price list will be provided at the funeral establishment or outer burial container sale location." or the prices of individual outer burial containers, as disclosed in the manner described in paragraphs (c) and (d);

new text begin (8) the price range for the alkaline hydrolysis container offered by the funeral provider, together with the statement: "A complete price list will be provided at the funeral establishment or alkaline hydrolysis container sale location.", or the prices of individual alkaline hydrolysis containers, as disclosed in the manner described in paragraphs (c) and (d); new text end

new text begin (9) the price range for the hydrolyzed remains container offered by the funeral provider, together with the statement: "A complete price list will be provided at the funeral establishment or hydrolyzed remains container sale location.", or the prices of individual hydrolyzed remains container, as disclosed in the manner described in paragraphs (c) and (d); new text end

deleted text begin (8)deleted text end new text begin (10) new text end the price range for the cremation containers offered by the funeral provider, together with the statement "A complete price list will be provided at the funeral establishment or cremation container sale location." or the prices of individual cremation containersdeleted text begin and cremated remains containersdeleted text end , as disclosed in the manner described in paragraphs (c) and (d);

deleted text begin (9)deleted text end new text begin (11) new text end the price range for the cremated remains containers offered by the funeral provider, together with the statement, "A complete price list will be provided at the funeral establishment or deleted text begin cremationdeleted text end new text begin cremated remainsnew text end container sale location," or the prices of individual cremation containers as disclosed in the manner described in paragraphs (c) and (d);

deleted text begin (10)deleted text end new text begin (12) new text end the price for the basic services of funeral provider and staff, together with a list of the principal basic services provided for any quoted price and, if the charge cannot be declined by the purchaser, the statement "This fee for our basic services will be added to the total cost of the funeral arrangements you select. (This fee is already included in our charges for new text begin alkaline hydrolysis, new text end direct cremations, immediate burials, and forwarding or receiving remains.)" If the charge cannot be declined by the purchaser, the quoted price shall include all charges for the recovery of unallocated funeral provider overhead, and funeral providers may include in the required disclosure the phrase "and overhead" after the word "services." This services fee is the only funeral provider fee for services, facilities, or unallocated overhead permitted by this subdivision to be nondeclinable, unless otherwise required by law;

deleted text begin (11)deleted text end new text begin (13) new text end the price range for the markers and headstones offered by the funeral provider, together with the statement "A complete price list will be provided at the funeral establishment or marker or headstone sale location." or the prices of individual markers and headstones, as disclosed in the manner described in paragraphs (c) and (d); and

deleted text begin (12)deleted text end new text begin (14) new text end any package priced funerals offered must be listed in addition to and following the information required in paragraph (e) and must clearly state the funeral goods and services being offered, the price being charged for those goods and services, and the discounted savings.

(f) Funeral providers must give an itemized written statement, for retention, to each consumer who arranges an at-need funeral or other disposition of human remains at the conclusion of the discussion of the arrangements. The itemized written statement must be signed by the consumer selecting the goods and services as required in section 149A.80. If the statement is provided by a funeral establishment, the statement must be signed by the licensed funeral director or mortician planning the arrangements. If the statement is provided by any other funeral provider, the statement must be signed by an authorized agent of the funeral provider. The statement must list the funeral goods, funeral services, burial site goods, or burial site services selected by that consumer and the prices to be paid for each item, specifically itemized cash advance items (these prices must be given to the extent then known or reasonably ascertainable if the prices are not known or reasonably ascertainable, a good faith estimate shall be given and a written statement of the actual charges shall be provided before the final bill is paid), and the total cost of goods and services selected. At the conclusion of an at-need arrangement, the funeral provider is required to give the consumer a copy of the signed itemized written contract that must contain the information required in this paragraph.

(g) Upon receiving actual notice of the death of an individual with whom a funeral provider has entered a preneed funeral agreement, the funeral provider must provide a copy of all preneed funeral agreement documents to the person who controls final disposition of the human remains or to the designee of the person controlling disposition. The person controlling final disposition shall be provided with these documents at the time of the person's first in-person contact with the funeral provider, if the first contact occurs in person at a funeral establishment, new text begin alkaline hydrolysis facility, new text end crematory, or other place of business of the funeral provider. If the contact occurs by other means or at another location, the documents must be provided within 24 hours of the first contact.

Sec. 83.

Minnesota Statutes 2012, section 149A.71, subdivision 4, is amended to read:

Subd. 4.

Casket, alternate container, new text begin alkaline hydrolysis container, new text end and cremation container sales; records; required disclosures.

Any funeral provider who sells or offers to sell a casket, alternate container, deleted text begin ordeleted text end new text begin alkaline hydrolysis container, hydrolyzed remains container,new text end cremation container, or cremated remains container to the public must maintain a record of each sale that includes the name of the purchaser, the purchaser's mailing address, the name of the decedent, the date of the decedent's death, and the place of death. These records shall be open to inspection by the regulatory agency. Any funeral provider selling a casket, alternate container, or cremation container to the public, and not having charge of the final disposition of the dead human body, shall provide a copy of the statutes and rules controlling the removal, preparation, transportation, arrangements for disposition, and final disposition of a dead human body. This subdivision does not apply to morticians, funeral directors, funeral establishments, crematories, or wholesale distributors of caskets, alternate containers, new text begin alkaline hydrolysis containers, new text end or cremation containers.

Sec. 84.

Minnesota Statutes 2012, section 149A.72, subdivision 3, is amended to read:

Subd. 3.

Casket for new text begin alkaline hydrolysis or new text end cremation provisions; deceptive acts or practices.

In selling or offering to sell funeral goods or funeral services to the public, it is a deceptive act or practice for a funeral provider to represent that a casket is required for new text begin alkaline hydrolysis or new text end cremations by state or local law or otherwise.

Sec. 85.

Minnesota Statutes 2012, section 149A.72, is amended by adding a subdivision to read:

new text begin Subd. 3a. new text end

new text begin Casket for alkaline hydrolysis provision; preventive measures. new text end

new text begin To prevent deceptive acts or practices, funeral providers must place the following disclosure in immediate conjunction with the prices shown for alkaline hydrolysis: "Minnesota law does not require you to purchase a casket for alkaline hydrolysis. If you want to arrange for alkaline hydrolysis, you can use an alkaline hydrolysis container. An alkaline hydrolysis container is a hydrolyzable or biodegradable closed container or pouch resistant to leakage of bodily fluids that encases the body and into which a dead human body is placed prior to insertion into an alkaline hydrolysis vessel. The containers we provide are (specify containers provided)." This disclosure is required only if the funeral provider arranges alkaline hydrolysis. new text end

Sec. 86.

Minnesota Statutes 2012, section 149A.72, subdivision 9, is amended to read:

Subd. 9.

Deceptive acts or practices.

In selling or offering to sell funeral goods, funeral services, burial site goods, or burial site services to the public, it is a deceptive act or practice for a funeral provider to represent that federal, state, or local laws, or particular cemeteriesnew text begin , alkaline hydrolysis facilities,new text end or crematories, require the purchase of any funeral goods, funeral services, burial site goods, or burial site services when that is not the case.

Sec. 87.

Minnesota Statutes 2012, section 149A.73, subdivision 1, is amended to read:

Subdivision 1.

Casket for new text begin alkaline hydrolysis or new text end cremation provisions; deceptive acts or practices.

In selling or offering to sell funeral goods, funeral services, burial site goods, or burial site services to the public, it is a deceptive act or practice for a funeral provider to require that a casket be purchased for new text begin alkaline hydrolysis or new text end cremation.

Sec. 88.

Minnesota Statutes 2012, section 149A.73, subdivision 2, is amended to read:

Subd. 2.

Casket for new text begin alkaline hydrolysis or new text end cremation; preventive requirements.

To prevent unfair or deceptive acts or practices, if funeral providers arrange new text begin for alkaline hydrolysis or new text end cremations, they must make deleted text begin adeleted text end new text begin an alkaline hydrolysis container ornew text end cremation container available for new text begin alkaline hydrolysis or new text end cremations.

Sec. 89.

Minnesota Statutes 2012, section 149A.73, subdivision 4, is amended to read:

Subd. 4.

Required purchases of funeral goods or services; preventive requirements.

To prevent unfair or deceptive acts or practices, funeral providers must place the following disclosure in the general price list, immediately above the prices required by section 149A.71, subdivision 2, paragraph (e), clauses (4) to (10): "The goods and services shown below are those we can provide to our customers. You may choose only the items you desire. If legal or other requirements mean that you must buy any items you did not specifically ask for, we will explain the reason in writing on the statement we provide describing the funeral goods, funeral services, burial site goods, and burial site services you selected." However, if the charge for "services of funeral director and staff" cannot be declined by the purchaser, the statement shall include the sentence "However, any funeral arrangements you select will include a charge for our basic services." between the second and third sentences of the sentences specified in this subdivision. The statement may include the phrase "and overhead" after the word "services" if the fee includes a charge for the recovery of unallocated funeral overhead. If the funeral provider does not include this disclosure statement, then the following disclosure statement must be placed in the statement of funeral goods, funeral services, burial site goods, and burial site services selected, as described in section 149A.71, subdivision 2, paragraph (f): "Charges are only for those items that you selected or that are required. If we are required by law or by a cemeterynew text begin , alkaline hydrolysis facility,new text end or crematory to use any items, we will explain the reasons in writing below." A funeral provider is not in violation of this subdivision by failing to comply with a request for a combination of goods or services which would be impossible, impractical, or excessively burdensome to provide.

Sec. 90.

Minnesota Statutes 2012, section 149A.74, is amended to read:

149A.74 FUNERAL SERVICES PROVIDED WITHOUT PRIOR APPROVAL.

Subdivision 1.

Services provided without prior approval; deceptive acts or practices.

In selling or offering to sell funeral goods or funeral services to the public, it is a deceptive act or practice for any funeral provider to embalm a dead human body unless state or local law or regulation requires embalming in the particular circumstances regardless of any funeral choice which might be made, or prior approval for embalming has been obtained from an individual legally authorized to make such a decision. In seeking approval to embalm, the funeral provider must disclose that embalming is not required by law except in certain circumstances; that a fee will be charged if a funeral is selected which requires embalming, such as a funeral with viewing; and that no embalming fee will be charged if the family selects a service which does not require embalming, such as new text begin direct alkaline hydrolysis, new text end direct cremationnew text begin ,new text end or immediate burial.

Subd. 2.

Services provided without prior approval; preventive requirement.

To prevent unfair or deceptive acts or practices, funeral providers must include on the itemized statement of funeral goods or services, as described in section 149A.71, subdivision 2, paragraph (f), the statement "If you selected a funeral that may require embalming, such as a funeral with viewing, you may have to pay for embalming. You do not have to pay for embalming you did not approve if you selected arrangements such as new text begin direct alkaline hydrolysis, new text end direct cremationnew text begin ,new text end or immediate burial. If we charged for embalming, we will explain why below."

Sec. 91.

Minnesota Statutes 2012, section 149A.91, subdivision 9, is amended to read:

Subd. 9.

deleted text begin Embalmeddeleted text end Bodies awaiting new text begin final new text end disposition.

All deleted text begin embalmeddeleted text end bodies awaiting final disposition shall be kept in an appropriate holding facility or preparation and embalming room. The holding facility must be secure from access by anyone except the authorized personnel of the funeral establishment, preserve the dignity and integrity of the body, and protect the health and safety of the personnel of the funeral establishment.

Sec. 92.

Minnesota Statutes 2012, section 149A.93, subdivision 3, is amended to read:

Subd. 3.

Disposition permit.

A disposition permit is required before a body can be buried, entombed, new text begin alkaline hydrolyzed, new text end or cremated. No disposition permit shall be issued until a fact of death record has been completed and filed with the local or state registrar of vital statistics.

Sec. 93.

Minnesota Statutes 2012, section 149A.93, subdivision 6, is amended to read:

Subd. 6.

Conveyances permitted for transportation.

A dead human body may be transported by means of private vehicle or private aircraft, provided that the body must be encased in an appropriate container, that meets the following standards:

(1) promotes respect for and preserves the dignity of the dead human body;

(2) shields the body from being viewed from outside of the conveyance;

(3) has ample enclosed area to accommodate a cot, stretcher, rigid tray, casket, alternative container, new text begin alkaline hydrolysis container, new text end or cremation container in a horizontal position;

(4) is designed to permit loading and unloading of the body without excessive tilting of the cot, stretcher, rigid tray, casket, alternative container,new text begin alkaline hydrolysis container,new text end or cremation container; and

(5) if used for the transportation of more than one dead human body at one time, the vehicle must be designed so that a body or container does not rest directly on top of another body or container and that each body or container is secured to prevent the body or container from excessive movement within the conveyance.

A vehicle that is a dignified conveyance and was specified for use by the deceased or by the family of the deceased may be used to transport the body to the place of final disposition.

Sec. 94.

Minnesota Statutes 2012, section 149A.94, is amended to read:

149A.94 FINAL DISPOSITION.

Subdivision 1.

Generally.

Every dead human body lying within the state, except unclaimed bodies delivered for dissection by the medical examiner, those delivered for anatomical study pursuant to section 149A.81, subdivision 2, or lawfully carried through the state for the purpose of disposition elsewhere; and the remains of any dead human body after dissection or anatomical study, shall be decently burieddeleted text begin ,deleted text end new text begin ornew text end entombed in a public or private cemetery, new text begin alkaline hydrolyzed new text end or cremateddeleted text begin ,deleted text end within a reasonable time after death. Where final disposition of a body will not be accomplished within 72 hours following death or release of the body by a competent authority with jurisdiction over the body, the body must be properly embalmed, refrigerated, or packed with dry ice. A body may not be kept in refrigeration for a period exceeding six calendar days, or packed in dry ice for a period that exceeds four calendar days, from the time of death or release of the body from the coroner or medical examiner.

Subd. 3.

Permit required.

No dead human body shall be buried, entombed, or cremated without a disposition permit. The disposition permit must be filed with the person in charge of the place of final disposition. Where a dead human body will be transported out of this state for final disposition, the body must be accompanied by a certificate of removal.

Subd. 4.

new text begin Alkaline hydrolysis or new text end cremation.

Inurnment of new text begin alkaline hydrolyzed or new text end cremated remains and release to an appropriate party is considered final disposition and no further permits or authorizations are required for transportation, interment, entombment, or placement of the cremated remains, except as provided in section 149A.95, subdivision 16.

Sec. 95.

new text begin [149A.941] ALKALINE HYDROLYSIS FACILITIES AND ALKALINE HYDROLYSIS. new text end

new text begin Subdivision 1. new text end

new text begin License required. new text end

new text begin A dead human body may only be hydrolyzed in this state at an alkaline hydrolysis facility licensed by the commissioner of health. new text end

new text begin Subd. 2. new text end

new text begin General requirements. new text end

new text begin Any building to be used as an alkaline hydrolysis facility must comply with all applicable local and state building codes, zoning laws and ordinances, wastewater management regulations, and environmental statutes, rules, and standards. An alkaline hydrolysis facility must have, on site, a purpose built human alkaline hydrolysis system approved by the commissioner of health, a system approved by the commissioner of health for drying the hydrolyzed remains, a motorized mechanical device approved by the commissioner of health for processing hydrolyzed remains, and in the building a holding facility approved by the commissioner of health for the retention of dead human bodies awaiting alkaline hydrolysis. The holding facility must be secure from access by anyone except the authorized personnel of the alkaline hydrolysis facility, preserve the dignity of the remains, and protect the health and safety of the alkaline hydrolysis facility personnel. new text end

new text begin Subd. 3. new text end

new text begin Lighting and ventilation. new text end

new text begin The room where the alkaline hydrolysis vessel is located and the room where the chemical storage takes place shall be properly lit and ventilated with an exhaust fan that provides at least 12 air changes per hour. new text end

new text begin Subd. 4. new text end

new text begin Plumbing connections. new text end

new text begin All plumbing fixtures, water supply lines, plumbing vents, and waste drains shall be properly vented and connected pursuant to the Minnesota Plumbing Code. The alkaline hydrolysis facility shall be equipped with a functional sink with hot and cold running water. new text end

new text begin Subd. 5. new text end

new text begin Flooring, walls, ceiling, doors, and windows. new text end

new text begin The room where the alkaline hydrolysis vessel is located and the room where the chemical storage takes place shall have nonporous flooring, so that a sanitary condition is provided. The walls and ceiling of the room where the alkaline hydrolysis vessel is located and the room where the chemical storage takes place shall run from floor to ceiling and be covered with tile, or by plaster or sheetrock painted with washable paint or other appropriate material so that a sanitary condition is provided. The doors, walls, ceiling, and windows shall be constructed to prevent odors from entering any other part of the building. All windows or other openings to the outside must be screened, and all windows must be treated in a manner that prevents viewing into the room where the alkaline hydrolysis vessel is located and the room where the chemical storage takes place. A viewing window for authorized family members or their designees is not a violation of this subdivision. new text end

new text begin Subd. 6. new text end

new text begin Equipment and supplies. new text end

new text begin The alkaline hydrolysis facility must have a functional emergency eye wash and quick drench shower. new text end

new text begin Subd. 7. new text end

new text begin Access and privacy. new text end

new text begin (a) The room where the alkaline hydrolysis vessel is located and the room where the chemical storage takes place must be private and have no general passageway through it. The room shall, at all times, be secure from the entrance of unauthorized persons. Authorized persons are: new text end

new text begin (1) licensed morticians; new text end

new text begin (2) registered interns or students as described in section 149A.91, subdivision 6; new text end

new text begin (3) public officials or representatives in the discharge of their official duties; new text end

new text begin (4) trained alkaline hydrolysis facility operators; and new text end

new text begin (5) the person or persons with the right to control the dead human body as defined in section 149A.80, subdivision 2, and their designees. new text end

new text begin (b) Each door allowing ingress or egress shall carry a sign that indicates that the room is private and access is limited. All authorized persons who are present in or enter the room where the alkaline hydrolysis vessel is located while a body is being prepared for final disposition must be attired according to all applicable state and federal regulations regarding the control of infectious disease and occupational and workplace health and safety. new text end

new text begin Subd. 8. new text end

new text begin Sanitary conditions and permitted use. new text end

new text begin The room where the alkaline hydrolysis vessel is located and the room where the chemical storage takes place and all fixtures, equipment, instruments, receptacles, clothing, and other appliances or supplies stored or used in the room must be maintained in a clean and sanitary condition at all times. new text end

new text begin Subd. 9. new text end

new text begin Boiler use. new text end

new text begin When a boiler is required by the manufacturer of the alkaline hydrolysis vessel for its operation, all state and local regulations for that boiler must be followed. new text end

new text begin Subd. 10. new text end

new text begin Occupational and workplace safety. new text end

new text begin All applicable provisions of state and federal regulations regarding exposure to workplace hazards and accidents shall be followed in order to protect the health and safety of all authorized persons at the alkaline hydrolysis facility. new text end

new text begin Subd. 11. new text end

new text begin Licensed personnel. new text end

new text begin A licensed alkaline hydrolysis facility must employ a licensed mortician to carry out the process of alkaline hydrolysis of a dead human body. It is the duty of the licensed alkaline hydrolysis facility to provide proper procedures for all personnel, and the licensed alkaline hydrolysis facility shall be strictly accountable for compliance with this chapter and other applicable state and federal regulations regarding occupational and workplace health and safety. new text end

new text begin Subd. 12. new text end

new text begin Authorization to hydrolyze required. new text end

new text begin No alkaline hydrolysis facility shall hydrolyze or cause to be hydrolyzed any dead human body or identifiable body part without receiving written authorization to do so from the person or persons who have the legal right to control disposition as described in section 149A.80 or the person's legal designee. The written authorization must include: new text end

new text begin (1) the name of the deceased and the date of death of the deceased; new text end

new text begin (2) a statement authorizing the alkaline hydrolysis facility to hydrolyze the body; new text end

new text begin (3) the name, address, telephone number, relationship to the deceased, and signature of the person or persons with legal right to control final disposition or a legal designee; new text end

new text begin (4) directions for the disposition of any nonhydrolyzed materials or items recovered from the alkaline hydrolysis vessel; new text end

new text begin (5) acknowledgment that the hydrolyzed remains will be dried and mechanically reduced to a granulated appearance and placed in an appropriate container and authorization to place any hydrolyzed remains that a selected urn or container will not accommodate into a temporary container; new text end

new text begin (6) new text end new text begin acknowledgment that, even with the exercise of reasonable care, it is not possible to recover all particles of the hydrolyzed remains and that some particles may inadvertently become commingled with particles of other hydrolyzed remains that remain in the alkaline hydrolysis vessel or other mechanical devices used to process the hydrolyzed remains; new text end

new text begin (7) directions for the ultimate disposition of the hydrolyzed remains; and new text end

new text begin (8) a statement that includes, but is not limited to, the following information: "During the alkaline hydrolysis process, chemical dissolution using heat, water, and an alkaline solution is used to chemically break down the human tissue and the hydrolyzable alkaline hydrolysis container. After the process is complete, the liquid effluent solution contains the chemical by-products of the alkaline hydrolysis process except for the deceased's bone fragments. The solution is cooled and released according to local environmental regulations. A water rinse is applied to the hydrolyzed remains which are then dried and processed to facilitate inurnment or scattering." new text end

new text begin Subd. 13. new text end

new text begin Limitation of liability. new text end

new text begin A licensed alkaline hydrolysis facility acting in good faith, with reasonable reliance upon an authorization to hydrolyze, pursuant to an authorization to hydrolyze and in an otherwise lawful manner, shall be held harmless from civil liability and criminal prosecution for any actions taken by the alkaline hydrolysis facility. new text end

new text begin Subd. 14. new text end

new text begin Acceptance of delivery of body. new text end

new text begin (a) No dead human body shall be accepted for final disposition by alkaline hydrolysis unless: new text end

new text begin (1) encased in an appropriate alkaline hydrolysis container; new text end

new text begin (2) accompanied by a disposition permit issued pursuant to section 149A.93, subdivision 3, including a photocopy of the completed death record or a signed release authorizing alkaline hydrolysis of the body received from the coroner or medical examiner; and new text end

new text begin (3) accompanied by an alkaline hydrolysis authorization that complies with subdivision 12. new text end

new text begin (b) An alkaline hydrolysis facility shall refuse to accept delivery of an alkaline hydrolysis container where there is: new text end

new text begin (1) evidence of leakage of fluids from the alkaline hydrolysis container; new text end

new text begin (2) a known dispute concerning hydrolysis of the body delivered; new text end

new text begin (3) a reasonable basis for questioning any of the representations made on the written authorization to hydrolyze; or new text end

new text begin (4) any other lawful reason. new text end

new text begin Subd. 15. new text end

new text begin Bodies awaiting hydrolysis. new text end

new text begin A dead human body must be hydrolyzed within 24 hours of the alkaline hydrolysis facility accepting legal and physical custody of the body. new text end

new text begin Subd. 16. new text end

new text begin Handling of alkaline hydrolysis containers for dead human bodies. new text end

new text begin All alkaline hydrolysis facility employees handling alkaline hydrolysis containers for dead human bodies shall use universal precautions and otherwise exercise all reasonable precautions to minimize the risk of transmitting any communicable disease from the body. No dead human body shall be removed from the container in which it is delivered. new text end

new text begin Subd. 17. new text end

new text begin Identification of body. new text end

new text begin All licensed alkaline hydrolysis facilities shall develop, implement, and maintain an identification procedure whereby dead human bodies can be identified from the time the alkaline hydrolysis facility accepts delivery of the remains until the hydrolyzed remains are released to an authorized party. After hydrolyzation, an identifying disk, tab, or other permanent label shall be placed within the hydrolyzed remains container before the hydrolyzed remains are released from the alkaline hydrolysis facility. Each identification disk, tab, or label shall have a number that shall be recorded on all paperwork regarding the decedent. This procedure shall be designed to reasonably ensure that the proper body is hydrolyzed and that the hydrolyzed remains are returned to the appropriate party. Loss of all or part of the hydrolyzed remains or the inability to individually identify the hydrolyzed remains is a violation of this subdivision. new text end

new text begin Subd. 18. new text end

new text begin Alkaline hydrolysis vessel for human remains. new text end

new text begin A licensed alkaline hydrolysis facility shall knowingly hydrolyze only dead human bodies or human remains in an alkaline hydrolysis vessel, along with the alkaline hydrolysis container used for infectious disease control. new text end

new text begin Subd. 19. new text end

new text begin Alkaline hydrolysis procedures; privacy. new text end

new text begin The final disposition of dead human bodies by alkaline hydrolysis shall be done in privacy. Unless there is written authorization from the person with the legal right to control the disposition, only authorized alkaline hydrolysis facility personnel shall be permitted in the alkaline hydrolysis area while any dead human body is in the alkaline hydrolysis area awaiting alkaline hydrolysis, in the alkaline hydrolysis vessel, being removed from the alkaline hydrolysis vessel, or being processed and placed in a hydrolyzed remains container. new text end

new text begin Subd. 20. new text end

new text begin Alkaline hydrolysis procedures; commingling of hydrolyzed remains prohibited. new text end

new text begin Except with the express written permission of the person with the legal right to control the disposition, no alkaline hydrolysis facility shall hydrolyze more than one dead human body at the same time and in the same alkaline hydrolysis vessel, or introduce a second dead human body into an alkaline hydrolysis vessel until reasonable efforts have been employed to remove all fragments of the preceding hydrolyzed remains, or hydrolyze a dead human body and other human remains at the same time and in the same alkaline hydrolysis vessel. This section does not apply where commingling of human remains during alkaline hydrolysis is otherwise provided by law. The fact that there is incidental and unavoidable residue in the alkaline hydrolysis vessel used in a prior hydrolyzation is not a violation of this subdivision. new text end

new text begin Subd. 21. new text end

new text begin Alkaline hydrolysis procedures; removal from alkaline hydrolysis vessel. new text end

new text begin Upon completion of the alkaline hydrolysis process, reasonable efforts shall be made to remove from the alkaline hydrolysis vessel all of the recoverable hydrolyzed remains and nonhydrolyzed materials or items. Further, all reasonable efforts shall be made to separate and recover the nonhydrolyzed materials or items from the hydrolyzed human remains and dispose of these materials in a lawful manner, by the alkaline hydrolysis facility. The hydrolyzed human remains shall be placed in an appropriate container to be transported to the processing area. new text end

new text begin Subd. 22. new text end

new text begin Drying device or mechanical processor procedures; commingling of hydrolyzed remains prohibited. new text end

new text begin Except with the express written permission of the person with the legal right to control the final disposition or otherwise provided by law, no alkaline hydrolysis facility shall dry or mechanically process the hydrolyzed human remains of more than one body at a time in the same drying device or mechanical processor, or introduce the hydrolyzed human remains of a second body into a drying device or mechanical processor until processing of any preceding hydrolyzed human remains has been terminated and reasonable efforts have been employed to remove all fragments of the preceding hydrolyzed remains. The fact that there is incidental and unavoidable residue in the drying device, the mechanical processor, or any container used in a prior alkaline hydrolysis process, is not a violation of this provision. new text end

new text begin Subd. 23. new text end

new text begin Alkaline hydrolysis procedures; processing hydrolyzed remains. new text end

new text begin The hydrolyzed human remains shall be dried and then reduced by a motorized mechanical device to a granulated appearance appropriate for final disposition and placed in an alkaline hydrolysis remains container along with the appropriate identifying disk, tab, or permanent label. Processing must take place within the licensed alkaline hydrolysis facility. Dental gold, silver or amalgam, jewelry, or mementos, to the extent that they can be identified, may be removed prior to processing the hydrolyzed remains, only by staff licensed or registered by the commissioner of health; however, any dental gold and silver, jewelry, or mementos that are removed shall be returned to the hydrolyzed remains container unless otherwise directed by the person or persons having the right to control the final disposition. Every person who removes or possesses dental gold or silver, jewelry, or mementos from any hydrolyzed remains without specific written permission of the person or persons having the right to control those remains is guilty of a misdemeanor. The fact that residue and any unavoidable dental gold or dental silver, or other precious metals remain in the alkaline hydrolysis vessel or other equipment or any container used in a prior hydrolysis is not a violation of this section. new text end

new text begin Subd. 24. new text end

new text begin Alkaline hydrolysis procedures; container of insufficient capacity. new text end

new text begin If a hydrolyzed remains container is of insufficient capacity to accommodate all hydrolyzed remains of a given dead human body, subject to directives provided in the written authorization to hydrolyze, the alkaline hydrolysis facility shall place the excess hydrolyzed remains in a secondary alkaline hydrolysis remains container and attach the second container, in a manner so as not to be easily detached through incidental contact, to the primary alkaline hydrolysis remains container. The secondary container shall contain a duplicate of the identification disk, tab, or permanent label that was placed in the primary container and all paperwork regarding the given body shall include a notation that the hydrolyzed remains were placed in two containers. Keepsake jewelry or similar miniature hydrolyzed remains containers are not subject to the requirements of this subdivision. new text end

new text begin Subd. 25. new text end

new text begin Disposition procedures; commingling of hydrolyzed remains prohibited. new text end

new text begin No hydrolyzed remains shall be disposed of or scattered in a manner or in a location where the hydrolyzed remains are commingled with those of another person without the express written permission of the person with the legal right to control disposition or as otherwise provided by law. This subdivision does not apply to the scattering or burial of hydrolyzed remains at sea or in a body of water from individual containers, to the scattering or burial of hydrolyzed remains in a dedicated cemetery, to the disposal in a dedicated cemetery of accumulated residue removed from an alkaline hydrolysis vessel or other alkaline hydrolysis equipment, to the inurnment of members of the same family in a common container designed for the hydrolyzed remains of more than one body, or to the inurnment in a container or interment in a space that has been previously designated, at the time of sale or purchase, as being intended for the inurnment or interment of the hydrolyzed remains of more than one person. new text end

new text begin Subd. 26. new text end

new text begin Alkaline hydrolysis procedures; disposition of accumulated residue. new text end

new text begin Every alkaline hydrolysis facility shall provide for the removal and disposition in a dedicated cemetery of any accumulated residue from any alkaline hydrolysis vessel, drying device, mechanical processor, container, or other equipment used in alkaline hydrolysis. Disposition of accumulated residue shall be according to the regulations of the dedicated cemetery and any applicable local ordinances. new text end

new text begin Subd. 27. new text end

new text begin Alkaline hydrolysis procedures; release of hydrolyzed remains. new text end

new text begin Following completion of the hydrolyzation, the inurned hydrolyzed remains shall be released according to the instructions given on the written authorization to hydrolyze. If the hydrolyzed remains are to be shipped, they must be securely packaged and transported by a method which has an internal tracing system available and which provides for a receipt signed by the person accepting delivery. Where there is a dispute over release or disposition of the hydrolyzed remains, an alkaline hydrolysis facility may deposit the hydrolyzed remains with a court of competent jurisdiction pending resolution of the dispute or retain the hydrolyzed remains until the person with the legal right to control disposition presents satisfactory indication that the dispute is resolved. new text end

new text begin Subd. 28. new text end

new text begin Unclaimed hydrolyzed remains. new text end

new text begin If, after 30 calendar days following the inurnment, the hydrolyzed remains are not claimed or disposed of according to the written authorization to hydrolyze, the alkaline hydrolysis facility or funeral establishment may give written notice, by certified mail, to the person with the legal right to control the final disposition or a legal designee, that the hydrolyzed remains are unclaimed and requesting further release directions. Should the hydrolyzed remains be unclaimed 120 calendar days following the mailing of the written notification, the alkaline hydrolysis facility or funeral establishment may dispose of the hydrolyzed remains in any lawful manner deemed appropriate. new text end

new text begin Subd. 29. new text end

new text begin Required records. new text end

new text begin Every alkaline hydrolysis facility shall create and maintain on its premises or other business location in Minnesota an accurate record of every hydrolyzation provided. The record shall include all of the following information for each hydrolyzation: new text end

new text begin (1) the name of the person or funeral establishment delivering the body for alkaline hydrolysis; new text end

new text begin (2) the name of the deceased and the identification number assigned to the body; new text end

new text begin (3) the date of acceptance of delivery; new text end

new text begin (4) the names of the alkaline hydrolysis vessel, drying device, and mechanical processor operator; new text end

new text begin (5) the time and date that the body was placed in and removed from the alkaline hydrolysis vessel; new text end

new text begin (6) the time and date that processing and inurnment of the hydrolyzed remains was completed; new text end

new text begin (7) the time, date, and manner of release of the hydrolyzed remains; new text end

new text begin (8) the name and address of the person who signed the authorization to hydrolyze; new text end

new text begin (9) all supporting documentation, including any transit or disposition permits, a photocopy of the death record, and the authorization to hydrolyze; and new text end

new text begin (10) the type of alkaline hydrolysis container. new text end

new text begin Subd. 30. new text end

new text begin Retention of records. new text end

new text begin Records required under subdivision 29 shall be maintained for a period of three calendar years after the release of the hydrolyzed remains. Following this period and subject to any other laws requiring retention of records, the alkaline hydrolysis facility may then place the records in storage or reduce them to microfilm, microfiche, laser disc, or any other method that can produce an accurate reproduction of the original record, for retention for a period of ten calendar years from the date of release of the hydrolyzed remains. At the end of this period and subject to any other laws requiring retention of records, the alkaline hydrolysis facility may destroy the records by shredding, incineration, or any other manner that protects the privacy of the individuals identified. new text end

Sec. 96.

Minnesota Statutes 2012, section 149A.96, subdivision 9, is amended to read:

Subd. 9.

new text begin Hydrolyzed and new text end cremated remains.

Subject to section 149A.95, subdivision 16, inurnment of the new text begin hydrolyzed or new text end cremated remains and release to an appropriate party is considered final disposition and no further permits or authorizations are required for disinterment, transportation, or placement of the new text begin hydrolyzed or new text end cremated remains.

Sec. 97.

Minnesota Statutes 2012, section 257.75, subdivision 7, is amended to read:

Subd. 7.

Hospital and Department of Health; recognition form.

Hospitals that provide obstetric services and the state registrar of vital statistics shall distribute the educational materials and recognition of parentage forms prepared by the commissioner of human services to new parents, shall assist parents in understanding the recognition of parentage form, including following the provisions for notice under subdivision 5, shall provide notary services for parents who complete the recognition of parentage form, and shall timely file the completed recognition of parentage form with the Office of deleted text begin the State Registrar ofdeleted text end Vital deleted text begin Statisticsdeleted text end new text begin Recordsnew text end unless otherwise instructed by the Office of deleted text begin the State Registrar ofdeleted text end Vital deleted text begin Statisticsdeleted text end new text begin Recordsnew text end . deleted text begin On and after January 1, 1994, hospitals may not distribute the declaration of parentage forms.deleted text end

Sec. 98.

Minnesota Statutes 2012, section 260C.635, subdivision 1, is amended to read:

Subdivision 1.

Legal effect.

(a) Upon adoption, the adopted child becomes the legal child of the adopting parent and the adopting parent becomes the legal parent of the child with all the rights and duties between them of a birth parent and child.

(b) The child shall inherit from the adoptive parent and the adoptive parent's relatives the same as though the child were the birth child of the parent, and in case of the child's death intestate, the adoptive parent and the adoptive parent's relatives shall inherit the child's estate as if the child had been the adoptive parent's birth child.

(c) After a decree of adoption is entered, the birth parents or previous legal parents of the child shall be relieved of all parental responsibilities for the child except child support that has accrued to the date of the order for guardianship to the commissioner which continues to be due and owing. The child's birth or previous legal parent shall not exercise or have any rights over the adopted child or the adopted child's property, person, privacy, or reputation.

(d) The adopted child shall not owe the birth parents or the birth parent's relatives any legal duty nor shall the adopted child inherit from the birth parents or kindred unless otherwise provided for in a will of the birth parent or kindred.

(e) Upon adoption, the court shall complete a certificate of adoption form and mail the form to the Office of deleted text begin the State Registrardeleted text end new text begin Vital Recordsnew text end at the Minnesota Department of Health. Upon receiving the certificate of adoption, the state registrar shall register a replacement vital record in the new name of the adopted child as required under section 144.218.

Sec. 99.

Minnesota Statutes 2012, section 517.001, is amended to read:

517.001 DEFINITION.

As used in this chapter, "local registrar" deleted text begin has the meaning given in section 144.212, subdivision 10deleted text end new text begin means an individual designated by the county board of commissioners to register marriagesnew text end .

Sec. 100.

Laws 2011, First Special Session chapter 9, article 2, section 27, is amended to read:

Sec. 27.

MINNESOTA TASK FORCE ON PREMATURITY.

Subdivision 1.

Establishment.

The Minnesota Task Force on Prematurity is established to evaluate and make recommendations on methods for reducing prematurity and improving premature infant health care in the state.

Subd. 2.

Membership; meetings; staff.

(a) The task force shall be composed of at least the following members, who serve at the pleasure of their appointing authority:

(1) deleted text begin 15deleted text end new text begin 11new text end representatives of the Minnesota Prematurity Coalition including, but not limited to, health care providers who treat pregnant women or neonates, organizations focused on preterm births, early childhood education and development professionals, and families affected by prematurity;

(2) one representative appointed by the commissioner of human services;

(3) two representatives appointed by the commissioner of health;

(4) one representative appointed by the commissioner of education;

(5) two members of the house of representatives, one appointed by the speaker of the house and one appointed by the minority leader; and

(6) two members of the senate, appointed according to the rules of the senate.

(b) Members of the task force serve without compensation or payment of expenses.

(c) The commissioner of health must convene the first meeting of the Minnesota Task Force on Prematurity by July 31, 2011. The task force must continue to meet at least quarterly. Staffing and technical assistance shall be provided by the Minnesota Perinatal Coalition.

Subd. 3.

Duties.

The task force must report the current state of prematurity in Minnesota and develop recommendations on strategies for reducing prematurity and improving premature infant health care in the state by deleted text begin considering the followingdeleted text end :

(1) new text begin promoting adherence to new text end standards of care for premature infants born less than 37 weeks gestational age, including deleted text begin recommendations to improvedeleted text end new text begin utilization of appropriatenew text end hospital discharge and follow-up care procedures;

(2) coordination of information among appropriate professional and advocacy organizations on measures to improve health care for infants born prematurely;

(3) identification and centralization of available resources to improve access and awareness for caregivers of premature infants; new text begin andnew text end

deleted text begin (4) development and dissemination of evidence-based practices through networking and educational opportunities; deleted text end

deleted text begin (5) a review of relevant evidence-based research regarding the causes and effects of premature births in Minnesota; deleted text end

deleted text begin (6) a review of relevant evidence-based research regarding premature infant health care, including methods for improving quality of and access to care for premature infants; deleted text end

deleted text begin (7)deleted text end new text begin (4) new text end a review of the potential improvements in health status related to the use of health care homes to provide and coordinate pregnancy-related servicesdeleted text begin ; anddeleted text end new text begin .new text end

deleted text begin (8) identification of gaps in public reporting measures and possible effects of these measures on prematurity rates. deleted text end

Subd. 4.

Report; expiration.

(a) By deleted text begin November 30, 2011deleted text end new text begin January 15, 2015new text end , the task force must submit a new text begin final new text end report new text begin to the chairs and ranking minority members of the legislative policy committees on health and human services new text end on the deleted text begin currentdeleted text end state of prematurity in Minnesota deleted text begin to the chairs of the legislative policy committees on health and human servicesdeleted text end new text begin , including any recommendations to reduce premature births and improve premature infant health in the statenew text end .

deleted text begin (b) By January 15, 2013, the task force must report its final recommendations, including any draft legislation necessary for implementation, to the chairs of the legislative policy committees on health and human services. deleted text end

deleted text begin (c)deleted text end new text begin (b)new text end This task force expires on January 31, deleted text begin 2013deleted text end new text begin 2015new text end , or upon submission of the final report required in paragraph deleted text begin (b)deleted text end new text begin (a)new text end , whichever is earlier.

Sec. 101.

new text begin FUNERAL ESTABLISHMENTS; BRANCH LOCATIONS. new text end

new text begin The commissioner of health shall review the statutory requirements for preparation and embalming rooms and develop legislation with input from stakeholders that provides appropriate health and safety protection for funeral home locations where deceased bodies are present, but are branch locations associated through a majority ownership of a licensed funeral establishment that meets the requirements of Minnesota Statutes, sections 149A.50 and 149A.92, subdivisions 2 to 10. The review shall include consideration of distance between the main location and branch, and other health and safety issues. new text end

Sec. 102.

new text begin HEALTH EQUITY REPORT. new text end

new text begin By February 1, 2014, the commissioner of health, in consultation with local public health, health care, and community partners, must submit a report to the chairs and ranking minority members of the committees with jurisdiction over health policy and finance, on a plan for advancing health equity in Minnesota. The report must include the following: new text end

new text begin (1) assessment of health disparities that exist in the state and how these disparities relate to health equity; new text end

new text begin (2) identification of policies, processes, and systems that contribute to health inequity in the state; new text end

new text begin (3) recommendations for changes to policies, processes and systems within the Department of Health that would increase the department's leadership in addressing health inequities; new text end

new text begin (4) identification of best practices for local public health, health care, and community partners to provide culturally responsive services and advance health equity; and new text end

new text begin (5) recommendations for strategies for the use of data to document and monitor existing health inequities and to evaluate effectiveness of policies, processes, systems, and environmental changes that will advance health equity. new text end

Sec. 103.

new text begin GUARANTEED RENEWABILITY STUDY. new text end

new text begin The commissioner of commerce, in consultation with the commissioner of health, and representatives of health carriers and consumer advocates, shall study guaranteed renewability of health plans in the individual market and assess the need for statutory provisions related to permitting the discontinuance or modification of health plan coverage in the individual market by a health carrier. The commissioner shall submit recommendations and draft legislation, if needed, to the chairs and ranking minority members of the legislative committees with jurisdiction over health insurance policy issues by February 1, 2014. new text end

Sec. 104.

new text begin CAPITAL RESERVES LIMITS STUDY. new text end

new text begin By February 1, 2014, the commissioner of health, in consultation with the commissioners of human services and commerce, shall study methodologies for determining appropriate levels for capital reserves of health maintenance organizations and requirements for reducing capital reserves to any recommended maximum levels. In conducting the study, the commissioner shall consult with health maintenance organizations, stakeholders, consumers, and other states' insurance regulators. The commissioner shall make recommendations on the need for a level of capital reserves, and framework for implementing any recommended levels. The commissioner shall submit a report to the chairs and ranking minority members of the legislative committees with jurisdiction over health and human services. new text end

Sec. 105.

new text begin STUDY AND RECOMMENDATIONS REGARDING MINNESOTA COMPREHENSIVE HEALTH ASSOCIATION. new text end

new text begin By August 15, 2013, the Department of Commerce shall study and report to the legislature on reasonable and efficient options for coverage for high-quality, medically necessary, evidence-based treatment of autism spectrum disorders up to age 18, including whether the Minnesota Comprehensive Health Association could provide coverage options through January 1, 2016, under Minnesota Statutes, chapter 62E. new text end

Sec. 106.

new text begin ESSENTIAL HEALTH BENEFITS. new text end

new text begin By December 31, 2014, the Department of Commerce shall request that the United States Department of Human Services include autism services in Minnesota's Essential Health Benefits when the next benefit set is selected in 2016. These services should include but not be limited to the services listed in Minnesota Statutes, section 62A.3094, subdivision 2, paragraph (a). new text end

Sec. 107.

new text begin ATTORNEY GENERAL LEGAL OPINION REQUIRED. new text end

new text begin Pursuant to the requirements of Minnesota Statutes, section 8.05, and no later than October 1, 2013, the attorney general shall give a written legal opinion on whether a health plan, as defined by Minnesota Statutes, section 62Q.01, subdivision 3, is required to provide coverage of treatment for mental health and mental health-related illnesses, including autism spectrum disorders and any other mental health condition as determined by criteria set forth in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association. The attorney general shall provide copies of this legal opinion to the commissioners of commerce and human services, the board of directors of the Minnesota Insurance Marketplace, and the legislative chairs with jurisdiction over commerce and health policy. new text end

Sec. 108.

new text begin REVISOR'S INSTRUCTION. new text end

new text begin The revisor shall substitute the term "vertical heat exchangers" or "vertical heat exchanger" with "bored geothermal heat exchangers" or "bored geothermal heat exchanger" wherever it appears in Minnesota Statutes, sections 103I.005, subdivisions 2 and 12; 103I.101, subdivisions 2 and 5; 103I.105; 103I.205, subdivision 4; 103I.208, subdivision 2; 103I.501; 103I.531, subdivision 5; and 103I.641, subdivisions 1, 2, and 3. new text end

Sec. 109.

new text begin REPEALER. new text end

new text begin (a) Minnesota Statutes 2012, sections 62J.693; 103I.005, subdivision 20; 149A.025; 149A.20, subdivision 8; 149A.30, subdivision 2; 149A.40, subdivision 8; 149A.45, subdivision 6; 149A.50, subdivision 6; 149A.51, subdivision 7; 149A.52, subdivision 5a; 149A.53, subdivision 9; and 485.14, new text end new text begin are repealed. new text end

new text begin (b) new text end new text begin Minnesota Statutes 2012, section 144.123, subdivision 2, new text end new text begin is repealed effective July 1, 2014. new text end

ARTICLE 13

PAYMENT METHODOLOGIES FOR HOME AND COMMUNITY-BASED SERVICES

Section 1.

Minnesota Statutes 2012, section 252.41, subdivision 3, is amended to read:

Subd. 3.

Day training and habilitation services for adults with developmental disabilities.

"Day training and habilitation services for adults with developmental disabilities" means services that:

(1) include supervision, training, assistance, and supported employment, work-related activities, or other community-integrated activities designed and implemented in accordance with the individual service and individual habilitation plans required under Minnesota Rules, parts 9525.0015 to 9525.0165, to help an adult reach and maintain the highest possible level of independence, productivity, and integration into the community; and

(2) are provided deleted text begin under contract with the county where the services are delivereddeleted text end by a vendor licensed under sections 245A.01 to 245A.16 and 252.28, subdivision 2, to provide day training and habilitation services.

Day training and habilitation services reimbursable under this section do not include special education and related services as defined in the Education of the Individuals with Disabilities Act, United States Code, title 20, chapter 33, section 1401, clauses (6) and (17), or vocational services funded under section 110 of the Rehabilitation Act of 1973, United States Code, title 29, section 720, as amended.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 2.

Minnesota Statutes 2012, section 252.42, is amended to read:

252.42 SERVICE PRINCIPLES.

The design and delivery of services eligible for reimbursement deleted text begin under the rates established in section 252.46deleted text end should reflect the following principles:

(1) services must suit a person's chronological age and be provided in the least restrictive environment possible, consistent with the needs identified in the person's individual service and individual habilitation plans under Minnesota Rules, parts 9525.0015 to 9525.0165;

(2) a person with a developmental disability whose individual service and individual habilitation plans authorize employment or employment-related activities shall be given the opportunity to participate in employment and employment-related activities in which nondisabled persons participate;

(3) a person with a developmental disability participating in work shall be paid wages commensurate with the rate for comparable work and productivity except as regional centers are governed by section 246.151;

(4) a person with a developmental disability shall receive services which include services offered in settings used by the general public and designed to increase the person's active participation in ordinary community activities;

(5) a person with a developmental disability shall participate in the patterns, conditions, and rhythms of everyday living and working that are consistent with the norms of the mainstream of society.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 3.

Minnesota Statutes 2012, section 252.43, is amended to read:

252.43 COMMISSIONER'S DUTIES.

The commissioner shall supervise county boards' provision of day training and habilitation services to adults with developmental disabilities. The commissioner shall:

(1) determine the need for day training and habilitation services under section 252.28;

(2) deleted text begin approvedeleted text end new text begin establishnew text end payment rates deleted text begin established by a county under section 252.46, subdivision 1deleted text end new text begin as provided under section 256B.4914new text end ;

(3) adopt rules for the administration and provision of day training and habilitation services under sections deleted text begin 252.40deleted text end new text begin 252.41new text end to 252.46 and sections 245A.01 to 245A.16 and 252.28, subdivision 2;

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

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

(6) provide information and technical help to county boards and vendors in their administration and provision of day training and habilitation services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 4.

Minnesota Statutes 2012, section 252.44, is amended to read:

252.44 COUNTY BOARD RESPONSIBILITIES.

deleted text begin (a)deleted text end When the need for day training and habilitation services in a county has been determined under section 252.28, the board of commissioners for that county shall:

(1) authorize the delivery of services according to the individual service and habilitation plans required as part of the county's provision of case management services under Minnesota Rules, parts 9525.0015 to 9525.0165. For calendar years for which section 252.46, subdivisions 2 to 10, apply, the county board shall not authorize a change in service days from the number of days authorized for the previous calendar year unless there is documentation for the change in the individual service plan. An increase in service days must also be supported by documentation that the goals and objectives assigned to the vendor cannot be met more economically and effectively by other available community services and that without the additional days of service the individual service plan could not be implemented in a manner consistent with the service principles in section 252.42;

deleted text begin (2) contract with licensed vendors, as specified in paragraph (b), under sections 256E.12 and 256B.092 and rules adopted under those sections; deleted text end

deleted text begin (3)deleted text end new text begin (2)new text end ensure that transportation is provided or arranged by the vendor in the most efficient and reasonable way possible;new text begin andnew text end

deleted text begin (4) set payment rates under section 252.46; deleted text end

deleted text begin (5)deleted text end new text begin (3)new text end monitor and evaluate the cost and effectiveness of the servicesdeleted text begin ; anddeleted text end new text begin .new text end

deleted text begin (6) reimburse vendors for the provision of authorized services according to the rates, procedures, and regulations governing reimbursement. deleted text end

deleted text begin (b) With all vendors except regional centers, the contract must include the approved payment rates, the projected budget for the contract period, and any actual expenditures of previous and current contract periods. With all vendors, including regional centers, the contract must also include the amount, availability, and components of day training and habilitation services to be provided, the performance standards governing service provision and evaluation, and the time period in which the contract is effective. deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 5.

Minnesota Statutes 2012, section 252.45, is amended to read:

252.45 VENDOR'S DUTIES.

A deleted text begin vendor's responsibilitydeleted text end new text begin vendor enrolled with the commissioner is responsible for itemsnew text end under clauses (1), (2), and (3)new text begin , andnew text end extends only to the provision of services that are reimbursable under state and federal law. A vendor deleted text begin under contract with a county board to providedeleted text end new text begin providingnew text end day training and habilitation services shall:

(1) provide the amount and type of services authorized in the individual service plan under Minnesota Rules, parts 9525.0015 to 9525.0165;

(2) design the services to achieve the outcomes assigned to the vendor in the individual service plan;

(3) provide or arrange for transportation of persons receiving services to and from service sites;

(4) enter into agreements with community-based intermediate care facilities for persons with developmental disabilities to ensure compliance with applicable federal regulations; and

(5) comply with state and federal law.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 6.

Minnesota Statutes 2012, section 252.46, subdivision 1a, is amended to read:

Subd. 1a.

Day training and habilitation rates.

The commissioner shall establish a statewide rate-setting methodology for all day training and habilitation servicesnew text begin as provided under section 256B.4914new text end . The rate-setting methodology must abide by the principles of transparency and equitability across the state. The methodology must involve a uniform process of structuring rates for each service and must promote quality and participant choice.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2014. new text end

Sec. 7.

Minnesota Statutes 2012, section 256B.4912, subdivision 2, is amended to read:

Subd. 2.

Payment methodologies.

(a) The commissioner shall establishnew text begin , as defined under section 256B.4914,new text end statewide payment methodologies that meet federal waiver requirements for home and community-based waiver services for individuals with disabilities. The payment methodologies must abide by the principles of transparency and equitability across the state. The methodologies must involve a uniform process of structuring rates for each service and must promote quality and participant choice.

(b) As of January 1, 2012, counties shall not implement changes to established processes for rate-setting methodologies for individuals using components of or data from research rates.

Sec. 8.

Minnesota Statutes 2012, section 256B.4912, subdivision 3, is amended to read:

Subd. 3.

Payment requirements.

The payment methodologies established under this section shall accommodate:

(1) supervision costs;

(2) deleted text begin staffing patternsdeleted text end new text begin staff compensationnew text end ;

new text begin (3) staffing and supervisory patterns; new text end

deleted text begin (3)deleted text end new text begin (4)new text end program-related expenses;

deleted text begin (4)deleted text end new text begin (5)new text end general and administrative expenses; and

deleted text begin (5)deleted text end new text begin (6)new text end consideration of recipient intensity.

Sec. 9.

Minnesota Statutes 2012, section 256B.4913, is amended by adding a subdivision to read:

new text begin Subd. 4a. new text end

new text begin Rate stabilization adjustment. new text end

new text begin (a) For purposes of this subdivision, "implementation period" shall mean the period beginning January 1, 2014, and ending on the last day of the month in which the rate management system is populated with the data necessary to calculate rates for substantially all individuals receiving home and community-based services. new text end

new text begin (b) For purposes of this subdivision, the banding value for all service recipients shall mean the individual reimbursement rate for a recipient in effect on December 1, 2013, except that: new text end

new text begin (1)(i) for day training and habilitation pilot program service recipients, the banding value shall be the authorized rate for the provider in the county of service effective December 1, 2013, if the recipient: was not authorized to receive these waiver services prior to January 1, 2014; added a new service or services on or after January 1, 2014; or changed providers on or after January 1, 2014; and new text end

new text begin (ii) for all other unit or day service recipients, the banding value shall be the weighted average authorized rate for each provider number in the county of service effective December 1, 2013, if the recipient: was not authorized to receive these waiver services prior to January 1, 2014; added a new service or services on or after January 1, 2014; or changed providers on or after January 1, 2014; and new text end

new text begin (2) for residential service recipients who change providers on or after January 1, 2014, the banding value shall be set by each lead agency within their county aggregate budget using their respective methodology for residential services effective December 1, 2013, for determining the provider rate for a similarly situated recipient being served by that provider. new text end

new text begin (c) The commissioner shall adjust individual reimbursement rates determined under this section so that the unit rate is no higher or lower than: new text end

new text begin (1) 0.5 percent from the banding value for the implementation period; new text end

new text begin (2) 0.5 percent from the rate in effect in clause (1), for the 12-month period immediately following the time period of clause (1); new text end

new text begin (3) 1.0 percent from the rate in effect in clause (2), for the 12-month period immediately following the time period of clause (2); new text end

new text begin (4) 1.0 percent from the rate in effect in clause (3), for the 12-month period immediately following the time period of clause (3); and new text end

new text begin (5) 1.0 percent from the rate in effect in clause (4), for the 12-month period immediately following the time period of clause (4). new text end

new text begin (d) This subdivision shall not apply to rates for recipients served by providers new to a given county after January 1, 2014. new text end

Sec. 10.

Minnesota Statutes 2012, section 256B.4913, subdivision 5, is amended to read:

Subd. 5.

Stakeholder consultation.

The commissioner shall continue consultation on regular intervals with the existing stakeholder group established as part of the rate-setting methodology processnew text begin and others,new text end to gather input, concerns, and data, deleted text begin and exchange ideas for the legislative proposals fordeleted text end new text begin to assist in the full implementation ofnew text end the new rate payment system andnew text begin tonew text end make pertinent information available to the public through the department's Web site.

Sec. 11.

Minnesota Statutes 2012, section 256B.4913, subdivision 6, is amended to read:

Subd. 6.

Implementation.

new text begin (a) new text end The commissioner deleted text begin maydeleted text end new text begin shallnew text end implement changes deleted text begin no sooner thandeleted text end new text begin onnew text end January 1, 2014, to payment rates for individuals receiving home and community-based waivered services after the enactment of legislation that establishes specific payment methodology frameworks, processes for rate calculations, and specific values to populate the deleted text begin payment methodology frameworksdeleted text end new text begin disability waiver rates systemnew text end .

new text begin (b) On January 1, 2014, all new service authorizations must use the disability waiver rates system. Beginning January 1, 2014, all renewing individual service plans must use the disability waiver rates system as reassessment and reauthorization occurs. By December 31, 2014, data for all recipients must be entered into the disability waiver rates system. new text end

Sec. 12.

new text begin [256B.4914] HOME AND COMMUNITY-BASED SERVICES WAIVERS; RATE SETTING. new text end

new text begin Subdivision 1. new text end

new text begin Application. new text end

new text begin The payment methodologies in this section apply to home and community-based services waivers under sections 256B.092 and 256B.49. This section does not change existing waiver policies and procedures. new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms have the meanings given them, unless the context clearly indicates otherwise. new text end

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

new text begin (c) "Component value" means underlying factors that are part of the cost of providing services that are built into the waiver rates methodology to calculate service rates. new text end

new text begin (d) "Customized living tool" means a methodology for setting service rates that delineates and documents the amount of each component service included in a recipient's customized living service plan. new text end

new text begin (e) "Disability waiver rates system" means a statewide system that establishes rates that are based on uniform processes and captures the individualized nature of waiver services and recipient needs. new text end

new text begin (f) "Lead agency" means a county, partnership of counties, or tribal agency charged with administering waivered services under sections 256B.092 and 256B.49. new text end

new text begin (g) "Median" means the amount that divides distribution into two equal groups, one-half above the median and one-half below the median. new text end

new text begin (h) "Payment or rate" means reimbursement to an eligible provider for services provided to a qualified individual based on an approved service authorization. new text end

new text begin (i) "Rates management system" means a Web-based software application that uses a framework and component values, as determined by the commissioner, to establish service rates. new text end

new text begin (j) "Recipient" means a person receiving home and community-based services funded under any of the disability waivers. new text end

new text begin Subd. 3. new text end

new text begin Applicable services. new text end

new text begin 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: new text end

new text begin (1) 24 hour customized living; new text end

new text begin (2) adult day care; new text end

new text begin (3) adult day care bath; new text end

new text begin (4) behavioral programming; new text end

new text begin (5) companion services; new text end

new text begin (6) customized living; new text end

new text begin (7) day training and habilitation; new text end

new text begin (8) housing access coordination; new text end

new text begin (9) independent living skills; new text end

new text begin (10) in-home family support; new text end

new text begin (11) night supervision; new text end

new text begin (12) personal support; new text end

new text begin (13) prevocational services; new text end

new text begin (14) residential care services; new text end

new text begin (15) residential support services; new text end

new text begin (16) respite services; new text end

new text begin (17) structured day services; new text end

new text begin (18) supported employment services; new text end

new text begin (19) supported living services; new text end

new text begin (20) transportation services; and new text end

new text begin (21) other services as approved by the federal government in the state home and community-based services plan. new text end

new text begin Subd. 4. new text end

new text begin Data collection for rate determination. new text end

new text begin (a) Rates for applicable home and community-based waivered services, including rate exceptions under subdivision 12, are set by the rates management system. new text end

new text begin (b) Data for services under section 256B.4913, subdivision 4a, shall be collected in a manner prescribed by the commissioner. new text end

new text begin (c) Data and information in the rates management system may be used to calculate an individual's rate. new text end

new text begin (d) Service providers, with information from the community support plan and oversight by lead agencies, shall provide values and information needed to calculate an individual's rate into the rates management system. These values and information include: new text end

new text begin (1) shared staffing hours; new text end

new text begin (2) individual staffing hours; new text end

new text begin (3) direct RN hours; new text end

new text begin (4) direct LPN hours; new text end

new text begin (5) staffing ratios; new text end

new text begin (6) information to document variable levels of service qualification for variable levels of reimbursement in each framework; new text end

new text begin (7) shared or individualized arrangements for unit-based services, including the staffing ratio; new text end

new text begin (8) number of trips and miles for transportation services; and new text end

new text begin (9) service hours provided through monitoring technology. new text end

new text begin (e) Updates to individual data shall include: new text end

new text begin (1) data for each individual that is updated annually when renewing service plans; and new text end

new text begin (2) requests by individuals or lead agencies to update a rate whenever there is a change in an individual's service needs, with accompanying documentation. new text end

new text begin (f) Lead agencies shall review and approve values to calculate the final payment rate for each individual. Lead agencies must notify the individual and the service provider of the final agreed-upon values and rate. If a value used was mistakenly or erroneously entered and used to calculate a rate, a provider may petition lead agencies to correct it. Lead agencies must respond to these requests. new text end

new text begin Subd. 5. new text end

new text begin Base wage index and standard component values. new text end

new text begin (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 shall be used. The base wage index shall be calculated as follows: new text end

new text begin (1) for residential direct care staff, the sum of: new text end

new text begin (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 new text end

new text begin (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); new text end

new text begin (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); new text end

new text begin (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; new text end

new text begin (4) for behavior program analyst staff, 100 percent of the median wage for mental health counselors (SOC code 21-1014); new text end

new text begin (5) for behavior program professional staff, 100 percent of the median wage for clinical counseling and school psychologist (SOC code 19-3031); new text end

new text begin (6) for behavior program specialist staff, 100 percent of the median wage for psychiatric technicians (SOC code 29-2053); new text end

new text begin (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); new text end

new text begin (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); new text end

new text begin (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); new text end

new text begin (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 end

new text begin (11) 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); new text end

new text begin (12) 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); new text end

new text begin (13) 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); new text end

new text begin (14) 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); new text end

new text begin (15) 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); new text end

new text begin (16) for supervisory staff, the basic wage is $17.43 per hour with exception of the supervisor of behavior analyst and behavior specialists, which shall be $30.75 per hour; new text end

new text begin (17) for RN, the basic wage is $30.82 per hour; and new text end

new text begin (18) for LPN, the basic wage is $18.64 per hour. new text end

new text begin (b) Component values for residential support services are: new text end

new text begin (1) supervisory span of control ratio: 11 percent; new text end

new text begin (2) employee vacation, sick, and training allowance ratio: 8.71 percent; new text end

new text begin (3) employee-related cost ratio: 23.6 percent; new text end

new text begin (4) general administrative support ratio: 13.25 percent; new text end

new text begin (5) program-related expense ratio: 1.3 percent; and new text end

new text begin (6) absence and utilization factor ratio: 3.9 percent. new text end

new text begin (c) Component values for family foster care are: new text end

new text begin (1) supervisory span of control ratio: 11 percent; new text end

new text begin (2) employee vacation, sick, and training allowance ratio: 8.71 percent; new text end

new text begin (3) employee-related cost ratio: 23.6 percent; new text end

new text begin (4) general administrative support ratio: 3.3 percent; new text end

new text begin (5) program-related expense ratio: 1.3 percent; and new text end

new text begin (6) absence factor: 1.7 percent. new text end

new text begin (d) Component values for day services for all services are: new text end

new text begin (1) supervisory span of control ratio: 11 percent; new text end

new text begin (2) employee vacation, sick, and training allowance ratio: 8.71 percent; new text end

new text begin (3) employee-related cost ratio: 23.6 percent; new text end

new text begin (4) program plan support ratio: 5.6 percent; new text end

new text begin (5) client programming and support ratio: ten percent; new text end

new text begin (6) general administrative support ratio: 13.25 percent; new text end

new text begin (7) program-related expense ratio: 1.8 percent; and new text end

new text begin (8) absence and utilization factor ratio: 3.9 percent. new text end

new text begin (e) Component values for unit-based services with programming are: new text end

new text begin (1) supervisory span of control ratio: 11 percent; new text end

new text begin (2) employee vacation, sick, and training allowance ratio: 8.71 percent; new text end

new text begin (3) employee-related cost ratio: 23.6 percent; new text end

new text begin (4) program plan supports ratio: 3.1 percent; new text end

new text begin (5) client programming and supports ratio: 8.6 percent; new text end

new text begin (6) general administrative support ratio: 13.25 percent; new text end

new text begin (7) program-related expense ratio: 6.1 percent; and new text end

new text begin (8) absence and utilization factor ratio: 3.9 percent. new text end

new text begin (f) Component values for unit-based services without programming except respite are: new text end

new text begin (1) supervisory span of control ratio: 11 percent; new text end

new text begin (2) employee vacation, sick, and training allowance ratio: 8.71 percent; new text end

new text begin (3) employee-related cost ratio: 23.6 percent; new text end

new text begin (4) program plan support ratio: 3.1 percent; new text end

new text begin (5) client programming and support ratio: 8.6 percent; new text end

new text begin (6) general administrative support ratio: 13.25 percent; new text end

new text begin (7) program-related expense ratio: 6.1 percent; and new text end

new text begin (8) absence and utilization factor ratio: 3.9 percent. new text end

new text begin (g) Component values for unit-based services without programming for respite are: new text end

new text begin (1) supervisory span of control ratio: 11 percent; new text end

new text begin (2) employee vacation, sick, and training allowance ratio: 8.71 percent; new text end

new text begin (3) employee-related cost ratio: 23.6 percent; new text end

new text begin (4) general administrative support ratio: 13.25 percent; new text end

new text begin (5) program-related expense ratio: 6.1 percent; and new text end

new text begin (6) absence and utilization factor ratio: 3.9 percent. new text end

new text begin (h) On July 1, 2017, the commissioner shall update the base wage index in paragraph (b) 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. new text end

new text begin (i) On July 1, 2017, the commissioner shall update the framework components in paragraph (c) 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 end

new text begin Subd. 6. new text end

new text begin Payments for residential support services. new text end

new text begin (a) Payments for residential support services, as defined in sections 256B.092, subdivision 11, and 256B.49, subdivision 22, must be calculated as follows: new text end

new text begin (1) determine the number of shared and individual direct staff hours to meet a recipient's needs provided on-site or through monitoring technology; new text end

new text begin (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. This is defined as the direct-care rate; new text end

new text begin (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; new text end

new text begin (4) multiply the number of shared and individual direct staff hours provided on-site or through monitoring technology and direct nursing hours by the appropriate staff wages in subdivision 5, paragraph (a), or the customized direct-care rate; new text end

new text begin (5) multiply the number of shared and individual direct staff hours provided on-site or through monitoring technology and direct nursing hours by the product of the supervision span of control ratio in subdivision 5, paragraph (b), clause (1), and the appropriate supervision wage in subdivision 5, paragraph (a), clause (16); new text end

new text begin (6) combine the results of clauses (4) and (5), excluding any shared and individual direct staff hours provided through monitoring technology, and multiply the result by one plus the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (b), clause (2). This is defined as the direct staffing cost; new text end

new text begin (7) for employee-related expenses, multiply the direct staffing cost, excluding any shared and individual direct staff hours provided through monitoring technology, by one plus the employee-related cost ratio in subdivision 5, paragraph (b), clause (3); new text end

new text begin (8) for client programming and supports, the commissioner shall add $2,179; and new text end

new text begin (9) for transportation, if provided, the commissioner shall add $1,680, or $3,000 if customized for adapted transport, per year. new text end

new text begin (b) The total rate shall be calculated using the following steps: new text end

new text begin (1) subtotal paragraph (a), clauses (7) to (9), and the direct staffing cost of any shared and individual direct staff hours provided through monitoring technology that was excluded in clause (7); new text end

new text begin (2) sum the standard general and administrative rate, the program-related expense ratio, and the absence and utilization ratio; new text end

new text begin (3) divide the result of clause (1) by one minus the result of clause (2). This is the total payment amount; and new text end

new text begin (4) adjust the result of clause (3) by a factor to be determined by the commissioner to adjust for regional differences in the cost of providing services. new text end

new text begin (c) The payment methodology for customized living, 24-hour customized living, and residential care services shall be the customized living tool. Revisions to the customized living tool shall be made to reflect the services and activities unique to disability-related recipient needs. new text end

new text begin (d) The commissioner shall establish a Monitoring Technology Review Panel to annually review and approve the plans, safeguards, and rates that include residential direct care provided remotely through monitoring technology. Lead agencies shall submit individual service plans that include supervision using monitoring technology to the Monitoring Technology Review Panel for approval. Individual service plans that include supervision using monitoring technology as of December 31, 2013, shall be submitted to the Monitoring Technology Review Panel, but the plans are not subject to approval. new text end

new text begin Subd. 7. new text end

new text begin Payments for day programs. new text end

new text begin Payments for services with day programs including adult day care, day treatment and habilitation, prevocational services, and structured day services must be calculated as follows: new text end

new text begin (1) determine the number of units of service to meet a recipient's needs; new text end

new text begin (2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 5; new text end

new text begin (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; new text end

new text begin (4) multiply the number of day program direct staff hours and direct nursing hours by the appropriate staff wage in subdivision 5, paragraph (a), or the customized direct-care rate; new text end

new text begin (5) multiply the number of day direct staff hours by the product of the supervision span of control ratio in subdivision 5, paragraph (d), clause (1), and the appropriate supervision wage in subdivision 5, paragraph (a), clause (16); new text end

new text begin (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 (d), clause (2). This is defined as the direct staffing rate; new text end

new text begin (7) for program plan support, multiply the result of clause (6) by one plus the program plan support ratio in subdivision 5, paragraph (d), clause (4); new text end

new text begin (8) for employee-related expenses, multiply the result of clause (7) by one plus the employee-related cost ratio in subdivision 5, paragraph (d), clause (3); new text end

new text begin (9) for client programming and supports, multiply the result of clause (8) by one plus the client programming and support ratio in subdivision 5, paragraph (d), clause (5); new text end

new text begin (10) for program facility costs, add $19.30 per week with consideration of staffing ratios to meet individual needs; new text end

new text begin (11) for adult day bath services, add $7.01 per 15 minute unit; new text end

new text begin (12) this is the subtotal rate; new text end

new text begin (13) sum the standard general and administrative rate, the program-related expense ratio, and the absence and utilization factor ratio; new text end

new text begin (14) divide the result of clause (12) by one minus the result of clause (13). This is the total payment amount; new text end

new text begin (15) adjust the result of clause (14) by a factor to be determined by the commissioner to adjust for regional differences in the cost of providing services; new text end

new text begin (16) for transportation provided as part of day training and habilitation for an individual who does not require a lift, add: new text end

new text begin (i) $10.50 for a trip between zero and ten miles for a nonshared ride in a vehicle without a lift, $8.83 for a shared ride in a vehicle without a lift, and $9.25 for a shared ride in a vehicle with a lift; new text end

new text begin (ii) $15.75 for a trip between 11 and 20 miles for a nonshared ride in a vehicle without a lift, $10.58 for a shared ride in a vehicle without a lift, and $11.88 for a shared ride in a vehicle with a lift; new text end

new text begin (iii) $25.75 for a trip between 21 and 50 miles for a nonshared ride in a vehicle without a lift, $13.92 for a shared ride in a vehicle without a lift, and $16.88 for a shared ride in a vehicle with a lift; or new text end

new text begin (iv) $33.50 for a trip of 51 miles or more for a nonshared ride in a vehicle without a lift, $16.50 for a shared ride in a vehicle without a lift, and $20.75 for a shared ride in a vehicle with a lift; new text end

new text begin (17) for transportation provide as part of day training and habilitation for an individual who does require a lift, add: new text end

new text begin (i) $19.05 for a trip between zero and ten miles for a nonshared ride in a vehicle with a lift, and $15.05 for a shared ride in a vehicle with a lift; new text end

new text begin (ii) $32.16 for a trip between 11 and 20 miles for a nonshared ride in a vehicle with a lift, and $28.16 for a shared ride in a vehicle with a lift; new text end

new text begin (iii) $58.76 for a trip between 21 and 50 miles for a nonshared ride in a vehicle with a lift, and $58.76 for a shared ride in a vehicle with a lift; or new text end

new text begin (iv) $80.93 for a trip of 51 miles or more for a nonshared ride in a vehicle with a lift, and $80.93 for a shared ride in a vehicle with a lift. new text end

new text begin Subd. 8. new text end

new text begin Payments for unit-based services with programming. new text end

new text begin Payments for unit-based with program services, including behavior programming, housing access coordination, in-home family support, independent living skills training, 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: new text end

new text begin (1) determine the number of units of service to meet a recipient's needs; new text end

new text begin (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; new text end

new text begin (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; new text end

new text begin (4) multiply the number of direct staff hours by the appropriate staff wage in subdivision 5, paragraph (a), or the customized direct care rate; new text end

new text begin (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); new text end

new text begin (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; new text end

new text begin (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); new text end

new text begin (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); new text end

new text begin (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); new text end

new text begin (10) this is the subtotal rate; new text end

new text begin (11) sum the standard general and administrative rate, the program-related expense ratio, and the absence and utilization factor ratio; new text end

new text begin (12) divide the result of clause (10) by one minus the result of clause (11). This is the total payment amount; new text end

new text begin (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 training provided in a shared manner, divide the total payment amount in clause (12) by the number of service recipients, not to exceed two; and new text end

new text begin (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 end

new text begin Subd. 9. new text end

new text begin Payments for unit-based services without programming. new text end

new text begin Payments for unit-based without program services, including night supervision, personal support, respite, and companion care 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: new text end

new text begin (1) for all services except respite, determine the number of units of service to meet a recipient's needs; new text end

new text begin (2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5; new text end

new text begin (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; new text end

new text begin (4) multiply the number of direct staff hours by the appropriate staff wage in subdivision 5 or the customized direct care rate; new text end

new text begin (5) multiply the number of direct staff hours by the product of the supervision span of control ratio in subdivision 5, paragraph (f), clause (1), and the appropriate supervision wage in subdivision 5, paragraph (a), clause (16); new text end

new text begin (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 (f), clause (2). This is defined as the direct staffing rate; new text end

new text begin (7) for program plan support, multiply the result of clause (6) by one plus the program plan support ratio in subdivision 5, paragraph (f), clause (4); new text end

new text begin (8) for employee-related expenses, multiply the result of clause (7) by one plus the employee-related cost ratio in subdivision 5, paragraph (f), clause (3); new text end

new text begin (9) for client programming and supports, multiply the result of clause (8) by one plus the client programming and support ratio in subdivision 5, paragraph (f), clause (5); new text end

new text begin (10) this is the subtotal rate; new text end

new text begin (11) sum the standard general and administrative rate, the program-related expense ratio, and the absence and utilization factor ratio; new text end

new text begin (12) divide the result of clause (10) by one minus the result of clause (11). This is the total payment amount; new text end

new text begin (13) for respite services, determine the number of daily units of service to meet an individual's needs; new text end

new text begin (14) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5; new text end

new text begin (15) for a recipient requiring deaf and hard-of-hearing customization under subdivision 12, add the customization rate provided in subdivision 12 to the result of clause (14). This is defined as the customized direct care rate; new text end

new text begin (16) multiply the number of direct staff hours by the appropriate staff wage in subdivision 5, paragraph (a); new text end

new text begin (17) multiply the number of direct staff hours by the product of the supervisory span of control ratio in subdivision 5, paragraph (g), clause (1), and the appropriate supervision wage in subdivision 5, paragraph (a), clause (16); new text end

new text begin (18) combine the results of clauses (16) and (17), and multiply the result by one plus the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (g), clause (2). This is defined as the direct staffing rate; new text end

new text begin (19) for employee-related expenses, multiply the result of clause (18) by one plus the employee-related cost ratio in subdivision 5, paragraph (g), clause (3); new text end

new text begin (20) this is the subtotal rate; new text end

new text begin (21) sum the standard general and administrative rate, the program-related expense ratio, and the absence and utilization factor ratio; new text end

new text begin (22) divide the result of clause (20) by one minus the result of clause (21). This is the total payment amount; and new text end

new text begin (23) adjust the result of clauses (12) and (22) by a factor to be determined by the commissioner to adjust for regional differences in the cost of providing services. new text end

new text begin Subd. 10. new text end

new text begin Updating payment values and additional information. new text end

new text begin (a) From January 1, 2014, through December 31, 2017, the commissioner shall develop and implement uniform procedures to refine terms and adjust values used to calculate payment rates in this section. new text end

new text begin (b) The commissioner shall, within available resources, conduct research and gather data and information from existing state systems or other outside sources on the following items: new text end

new text begin (1) differences in the underlying cost to provide services and care across the state; and new text end

new text begin (2) mileage and utilization of transportation for all day and unit-based services. new text end

new text begin (c) Using a statistically valid set of rates management system data, the commissioner, in consultation with stakeholders, shall analyze for each service the average difference in the rate on December 31, 2013, and the framework rate at the individual, provider, lead agency, and state levels. new text end

new text begin (d) The commissioner, in consultation with stakeholders, shall review and evaluate the following values already in subdivisions 6 to 9, or issues that impact all services, including, but not limited to: new text end

new text begin (1) values for transportation rates for day services; new text end

new text begin (2) values for transportation rates in residential services; new text end

new text begin (3) values for services where monitoring technology replaces staff time; new text end

new text begin (4) values for indirect services; new text end

new text begin (5) values for nursing; new text end

new text begin (6) component values for independent living skills; new text end

new text begin (7) component values for family foster care that reflect licensing requirements; new text end

new text begin (8) adjustments to other components to replace the budget neutrality factor; new text end

new text begin (9) remote monitoring technology for nonresidential services; new text end

new text begin (10) values for basic and intensive services in residential services; new text end

new text begin (11) values for the facility use rate in day services; new text end

new text begin (12) values for workers compensation as part of employee-related expenses; new text end

new text begin (13) values for unemployment insurance as part of employee-related expenses; new text end

new text begin (14) a component value to reflect costs for individuals with rates previously adjusted for the inclusion of group residential housing rate 3 costs, only for any individual enrolled as of December 31, 2013; and new text end

new text begin (15) any changes in state or federal law with an impact on the underlying cost of providing home and community-based services. new text end

new text begin (e) The commissioner shall report to the chairs and the ranking minority members of the legislative committees and divisions with jurisdiction over health and human services policy and finance with the information and data gathered under paragraphs (b) to (d) on the following dates: new text end

new text begin (1) January 15, 2015, with preliminary results and data; new text end

new text begin (2) January 15, 2016, with a status implementation update, and additional data and summary information; new text end

new text begin (3) January 15, 2017, with the full report; and new text end

new text begin (4) January 15, 2019, with another full report, and a full report once every four years thereafter. new text end

new text begin (f) Based on the commissioner's evaluation of the information and data collected in paragraphs (b) to (d), the commissioner may make recommendations to the legislature to address any potential issues. new text end

new text begin (g) The commissioner shall implement a regional adjustment factor to all rate calculations in subdivisions 6 to 9, effective no later than January 1, 2015. Prior to implementation, the commissioner shall consult with stakeholders on the methodology to calculate the adjustment. new text end

new text begin (h) The commissioner shall provide a public notice via LISTSERV in October of each year beginning October 1, 2014, containing information detailing legislatively approved changes in: new text end

new text begin (1) calculation values including derived wage rates and related employee and administrative factors; new text end

new text begin (2) service utilization; new text end

new text begin (3) county and tribal allocation changes; and new text end

new text begin (4) information on adjustments made to calculation values and the timing of those adjustments. new text end

new text begin The information in this notice shall be effective January 1 of the following year. new text end

new text begin Subd. 11. new text end

new text begin Payment implementation. new text end

new text begin Upon implementation of the payment methodologies under this section, those payment rates supersede rates established in county contracts for recipients receiving waiver services under section 256B.092 or 256B.49. new text end

new text begin Subd. 12. new text end

new text begin Customization of rates for individuals. new text end

new text begin (a) For persons determined to have higher needs based on being deaf or hard-of-hearing, the direct-care costs must be increased by an adjustment factor prior to calculating the rate under subdivisions 6, 7, 8, and 9. The customization rate with respect to deaf or hard-of-hearing persons shall be $2.50 per hour for waiver recipients who meet the respective criteria as determined by the commissioner. new text end

new text begin (b) For the purposes of this section, "deaf and hard-of-hearing" means: new text end

new text begin (1) the person has a developmental disability and an assessment score which indicates a hearing impairment that is severe or that the person has no useful hearing; new text end

new text begin (2) the person has a developmental disability and an expressive communications score that indicates the person uses single signs or gestures, uses an augmentative communication aid, or does not have functional communication, or the person's expressive communications is unknown; and new text end

new text begin (3) the person has a developmental disability and a communication score which indicates the person comprehends signs, gestures and modeling prompts or does not comprehend verbal, visual or gestural communication or that the person's receptive communication score is unknown; or new text end

new text begin (4) the person receives long-term care services and has an assessment score that indicates they hear only very loud sounds, have no useful hearing, or a determination cannot be made; and the person receives long-term care services and has an assessment that indicates the person communicates needs with sign language, symbol board, written messages, gestures or an interpreter; communicates with inappropriate content, makes garbled sounds or displays echolalia, or does not communicate needs. new text end

new text begin Subd. 13. new text end

new text begin Transportation. new text end

new text begin The commissioner shall require that the purchase of transportation services be cost-effective and be limited to market rates where the transportation mode is generally available and accessible. new text end

new text begin Subd. 14. new text end

new text begin Exceptions. new text end

new text begin (a) In a format prescribed by the commissioner, lead agencies must identify individuals with exceptional needs that cannot be met under the disability waiver rate system. The commissioner shall use that information to evaluate and, if necessary, approve an alternative payment rate for those individuals. new text end

new text begin (b) Lead agencies must submit exception requests to the state. new text end

new text begin (c) An application for a rate exception may be submitted for the following criteria: new text end

new text begin (1) an individual has service needs that cannot be met through additional units of service; or new text end

new text begin (2) an individual's rate determined under subdivisions 6, 7, 8, and 9 results in an individual being discharged. new text end

new text begin (d) Exception requests must include the following information: new text end

new text begin (1) the service needs required by each individual that are not accounted for in subdivisions 6, 7, 8, and 9; new text end

new text begin (2) the service rate requested and the difference from the rate determined in subdivisions 6, 7, 8, and 9; new text end

new text begin (3) a basis for the underlying costs used for the rate exception and any accompanying documentation; new text end

new text begin (4) the duration of the rate exception; and new text end

new text begin (5) any contingencies for approval. new text end

new text begin (e) Approved rate exceptions shall be managed within lead agency allocations under sections 256B.092 and 256B.49. new text end

new text begin (f) Individual disability waiver recipients may request that a lead agency submit an exception request. A lead agency that denies such a request shall notify the individual waiver recipient of its decision and the reasons for denying the request in writing no later than 30 days after the individual's request has been made. new text end

new text begin (g) The commissioner shall determine whether to approve or deny an exception request no more than 30 days after receiving the request. If the commissioner denies the request, the commissioner shall notify the lead agency and the individual disability waiver recipient in writing of the reasons for the denial. new text end

new text begin (h) The individual disability waiver recipient may appeal any denial of an exception request by either the lead agency or the commissioner, pursuant to sections 256.045 and 256.0451. When the denial of an exception request results in the proposed demission of a waiver recipient from a residential or day habilitation program, the commissioner shall issue a temporary stay of demission, when requested by the disability waiver recipient, consistent with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c). The temporary stay shall remain in effect until the lead agency can provide an informed choice of appropriate, alternative services to the disability waiver. new text end

new text begin (i) Providers may petition lead agencies to update values that were entered incorrectly or erroneously into the rate management system, based on past service level discussions and determination in subdivision 4, without applying for a rate exception. new text end

new text begin Subd. 15. new text end

new text begin County or tribal allocations. new text end

new text begin (a) Upon implementation of the disability waiver rates management system on January 1, 2014, the commissioner shall establish a method of tracking and reporting the fiscal impact of the disability waiver rates management system on individual lead agencies. new text end

new text begin (b) Beginning January 1, 2014, the commissioner shall make annual adjustments to lead agencies' home and community-based waivered service budget allocations to adjust for rate differences and the resulting impact on county allocations upon implementation of the disability waiver rates system. new text end

new text begin Subd. 16. new text end

new text begin Budget neutrality adjustments. new text end

new text begin (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: new text end

new text begin (1) for residential services: 1.003; new text end

new text begin (2) for day services: 1.000; new text end

new text begin (3) for unit-based services with programming: 0.941; and new text end

new text begin (4) for unit-based services without programming: 0.796. new text end

new text begin (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 end

Sec. 13.

new text begin FEDERAL APPROVAL. new text end

new text begin During the transition to a new disability waivers payment methodology system, the commissioner of human services has the authority to manage the disability home and community-based service waiver programs within federally required parameters. The commissioner may negotiate an agreement with the Centers for Medicare and Medicaid Services for the implementation of the disability waivers payment methodology system in order to prevent federal action that would withhold or disallow federal funding for current waiver recipients, or new waiver recipients as authorized by the legislature. The commissioner must provide for public notice and comment, as required by state and federal law, to changes related to federal approval of the disability waivers payment methodology system. If the Centers for Medicare and Medicaid Services requires changes to the disability waivers payment rate methodology implementation plan, the commissioner shall implement the changes in accordance with Minnesota Statutes, section 256B.4914, subdivision 16, and upon: new text end

new text begin (1) public notice; new text end

new text begin (2) federal approval; new text end

new text begin (3) Legislative Advisory Commission review and recommendation, in a manner described under Minnesota Statutes, section 3.3005, subdivision 4; and new text end

new text begin (4) recommendation of necessary legislation to the chairs and ranking minority members of the legislative committees with jurisdiction over health and human services policy and finance by January 15, 2014. The changed implementation plan must provide for a transition from the historical to the new rate setting methodology. new text end

Sec. 14.

new text begin REPEALER. new text end

new text begin (a) Minnesota Statutes 2012, sections 252.40; 252.46, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 16, 17, 18, 19, 20, and 21; 256B.4913, subdivisions 1, 2, 3, and 4; and 256B.501, subdivision 8, new text end new text begin are repealed effective January 1, 2014. new text end

new text begin (b) Minnesota Rules, part 9525.1860, subparts 3, items B and C and 4, item D, new text end new text begin are repealed effective January 1, 2014. new text end

ARTICLE 14

HEALTH AND HUMAN SERVICES APPROPRIATIONS

Section 1.

new text begin HEALTH AND HUMAN SERVICES APPROPRIATIONS.new text end

new text begin The sums shown in the columns marked "Appropriations" are appropriated to the agencies and for the purposes specified in this article. The appropriations are from the general fund, or another named fund, and are available for the fiscal years indicated for each purpose. The figures "2014" and "2015" used in this article mean that the appropriations listed under them are available for the fiscal year ending June 30, 2014, or June 30, 2015, respectively. "The first year" is fiscal year 2014. "The second year" is fiscal year 2015. "The biennium" is fiscal years 2014 and 2015. new text end

new text begin APPROPRIATIONS new text end
new text begin Available for the Year new text end
new text begin Ending June 30 new text end
new text begin 2014 new text end new text begin 2015 new text end

Sec. 2.

new text begin COMMISSIONER OF HUMAN SERVICES new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation new text end

new text begin $ new text end new text begin 6,438,485,000 new text end new text begin $ new text end new text begin 6,457,117,000 new text end
new text begin Appropriations by Fund new text end
new text begin 2014 new text end new text begin 2015 new text end
new text begin General new text end new text begin 5,654,765,000 new text end new text begin 5,677,458,000 new text end
new text begin State Government Special Revenue new text end new text begin 4,099,000 new text end new text begin 4,510,000 new text end
new text begin Health Care Access new text end new text begin 519,816,000 new text end new text begin 518,446,000 new text end
new text begin Federal TANF new text end new text begin 257,915,000 new text end new text begin 254,813,000 new text end
new text begin Lottery Prize Fund new text end new text begin 1,890,000 new text end new text begin 1,890,000 new text end

new text begin Receipts for Systems Projects. Appropriations and federal receipts for information systems projects for MAXIS, PRISM, MMIS, and SSIS must be deposited in the state system account authorized in Minnesota Statutes, section 256.014. Money appropriated for computer projects approved by the commissioner of Minnesota information technology services, funded by the legislature, and approved by the commissioner of management and budget, may be transferred from one project to another and from development to operations as the commissioner of human services considers necessary. Any unexpended balance in the appropriation for these projects does not cancel but is available for ongoing development and operations. new text end

new text begin Nonfederal Share Transfers. The nonfederal share of activities for which federal administrative reimbursement is appropriated to the commissioner may be transferred to the special revenue fund. new text end

new text begin ARRA Supplemental Nutrition Assistance Benefit Increases. The funds provided for food support benefit increases under the Supplemental Nutrition Assistance Program provisions of the American Recovery and Reinvestment Act (ARRA) of 2009 must be used for benefit increases beginning July 1, 2009. new text end

new text begin Supplemental Nutrition Assistance Program Employment and Training. (1) Notwithstanding Minnesota Statutes, sections 256D.051, subdivisions 1a, 6b, and 6c, and 256J.626, federal Supplemental Nutrition Assistance employment and training funds received as reimbursement of MFIP consolidated fund grant expenditures for diversionary work program participants and child care assistance program expenditures must be deposited in the general fund. The amount of funds must be limited to $4,900,000 per year in fiscal years 2014 and 2015, and to $4,400,000 per year in fiscal years 2016 and 2017, contingent on approval by the federal Food and Nutrition Service. new text end

new text begin (2) Consistent with the receipt of the federal funds, the commissioner may adjust the level of working family credit expenditures claimed as TANF maintenance of effort. Notwithstanding any contrary provision in this article, this rider expires June 30, 2017. new text end

new text begin TANF Maintenance of Effort. (a) In order to meet the basic maintenance of effort (MOE) requirements of the TANF block grant specified under Code of Federal Regulations, title 45, section 263.1, the commissioner may only report nonfederal money expended for allowable activities listed in the following clauses as TANF/MOE expenditures: new text end

new text begin (1) MFIP cash, diversionary work program, and food assistance benefits under Minnesota Statutes, chapter 256J; new text end

new text begin (2) the child care assistance programs under Minnesota Statutes, sections 119B.03 and 119B.05, and county child care administrative costs under Minnesota Statutes, section 119B.15; new text end

new text begin (3) state and county MFIP administrative costs under Minnesota Statutes, chapters 256J and 256K; new text end

new text begin (4) state, county, and tribal MFIP employment services under Minnesota Statutes, chapters 256J and 256K; new text end

new text begin (5) expenditures made on behalf of legal noncitizen MFIP recipients who qualify for the MinnesotaCare program under Minnesota Statutes, chapter 256L; new text end

new text begin (6) qualifying working family credit expenditures under Minnesota Statutes, section 290.0671; new text end

new text begin (7) qualifying Minnesota education credit expenditures under Minnesota Statutes, section 290.0674; and new text end

new text begin (8) qualifying Head Start expenditures under Minnesota Statutes, section 119A.50. new text end

new text begin (b) The commissioner shall ensure that sufficient qualified nonfederal expenditures are made each year to meet the state's TANF/MOE requirements. For the activities listed in paragraph (a), clauses (2) to (8), the commissioner may only report expenditures that are excluded from the definition of assistance under Code of Federal Regulations, title 45, section 260.31. new text end

new text begin (c) For fiscal years beginning with state fiscal year 2003, the commissioner shall ensure that the maintenance of effort used by the commissioner of management and budget for the February and November forecasts required under Minnesota Statutes, section 16A.103, contains expenditures under paragraph (a), clause (1), equal to at least 16 percent of the total required under Code of Federal Regulations, title 45, section 263.1. new text end

new text begin (d) The requirement in Minnesota Statutes, section 256.011, subdivision 3, that federal grants or aids secured or obtained under that subdivision be used to reduce any direct appropriations provided by law, do not apply if the grants or aids are federal TANF funds. new text end

new text begin (e) For the federal fiscal years beginning on or after October 1, 2007, the commissioner may not claim an amount of TANF/MOE in excess of the 75 percent standard in Code of Federal Regulations, title 45, section 263.1(a)(2), except: new text end

new text begin (1) to the extent necessary to meet the 80 percent standard under Code of Federal Regulations, title 45, section 263.1(a)(1), if it is determined by the commissioner that the state will not meet the TANF work participation target rate for the current year; new text end

new text begin (2) to provide any additional amounts under Code of Federal Regulations, title 45, section 264.5, that relate to replacement of TANF funds due to the operation of TANF penalties; and new text end

new text begin (3) to provide any additional amounts that may contribute to avoiding or reducing TANF work participation penalties through the operation of the excess MOE provisions of Code of Federal Regulations, title 45, section 261.43(a)(2). new text end

new text begin For the purposes of clauses (1) to (3), the commissioner may supplement the MOE claim with working family credit expenditures or other qualified expenditures to the extent such expenditures are otherwise available after considering the expenditures allowed in this subdivision and subdivisions 2 and 3. new text end

new text begin (f) Notwithstanding any contrary provision in this article, paragraphs (a) to (e) expire June 30, 2017. new text end

new text begin Working Family Credit Expenditures as TANF/MOE. The commissioner may claim as TANF maintenance of effort up to $6,707,000 per year of working family credit expenditures in each fiscal year. new text end

new text begin Subd. 2. new text end

new text begin Working Family Credit to be Claimed for TANF/MOE new text end

new text begin The commissioner may count the following amounts of working family credit expenditures as TANF/MOE: new text end

new text begin (1) fiscal year 2014, $50,272,000; new text end

new text begin (2) fiscal year 2015, $34,894,000; new text end

new text begin (3) fiscal year 2016, $0; and new text end

new text begin (4) fiscal year 2017, $1,283,000. new text end

new text begin Subd. 3. new text end

new text begin TANF Transfer to Federal Child Care and Development Fund new text end

new text begin (a) The following TANF fund amounts are appropriated to the commissioner for purposes of MFIP/transition year child care assistance under Minnesota Statutes, section 119B.05: new text end

new text begin (1) fiscal year 2014; $14,020,000; and new text end

new text begin (2) fiscal year 2015, $14,020,000. new text end

new text begin (b) The commissioner shall authorize the transfer of sufficient TANF funds to the federal child care and development fund to meet this appropriation and shall ensure that all transferred funds are expended according to federal child care and development fund regulations. new text end

new text begin Subd. 4. new text end

new text begin Central Office new text end

new text begin The amounts that may be spent from this appropriation for each purpose are as follows: new text end

new text begin (a) Operations new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 101,979,000 new text end new text begin 96,858,000 new text end
new text begin State Government Special Revenue new text end new text begin 3,974,000 new text end new text begin 4,385,000 new text end
new text begin Health Care Access new text end new text begin 13,177,000 new text end new text begin 13,004,000 new text end
new text begin Federal TANF new text end new text begin 100,000 new text end new text begin 100,000 new text end

new text begin DHS Receipt Center Accounting. The commissioner is authorized to transfer appropriations to, and account for DHS receipt center operations in, the special revenue fund. new text end

new text begin Administrative Recovery; Set-Aside. The commissioner may invoice local entities through the SWIFT accounting system as an alternative means to recover the actual cost of administering the following provisions: new text end

new text begin (1) Minnesota Statutes, section 125A.744, subdivision 3; new text end

new text begin (2) Minnesota Statutes, section 245.495, paragraph (b); new text end

new text begin (3) Minnesota Statutes, section 256B.0625, subdivision 20, paragraph (k); new text end

new text begin (4) Minnesota Statutes, section 256B.0924, subdivision 6, paragraph (g); new text end

new text begin (5) Minnesota Statutes, section 256B.0945, subdivision 4, paragraph (d); and new text end

new text begin (6) Minnesota Statutes, section 256F.10, subdivision 6, paragraph (b). new text end

new text begin Systems Modernization. The following amounts are appropriated for transfer to the state systems account authorized in Minnesota Statutes, section 256.014: new text end

new text begin (1) $1,825,000 in fiscal year 2014 and $2,502,000 in fiscal year 2015 is for the state share of Medicaid-allocated costs of the health insurance exchange information technology and operational structure. The funding base is $3,222,000 in fiscal year 2016 and $3,037,000 in fiscal year 2017 but shall not be included in the base thereafter; and new text end

new text begin (2) $9,344,000 in fiscal year 2014 and $3,660,000 in fiscal year 2015 are for the modernization and streamlining of agency eligibility and child support systems. The funding base is $5,921,000 in fiscal year 2016 and $1,792,000 in fiscal year 2017 but shall not be included in the base thereafter. new text end

new text begin The unexpended balance of the $9,344,000 appropriation in fiscal year 2014 and the $3,660,000 appropriation in fiscal year 2015 must be transferred from the Department of Human Services state systems account to the Office of Enterprise Technology when the Office of Enterprise Technology has negotiated a federally approved internal service fund rates and billing process with sufficient internal accounting controls to properly maximize federal reimbursement to Minnesota for human services system modernization projects, but not later than June 30, 2015. new text end

new text begin If contingent funding is fully or partially disbursed under article 15, section 3, and transferred to the state systems account, the unexpended balance of that appropriation must be transferred to the Office of Enterprise Technology in accordance with this clause. Contingent funding must not exceed $11,598,000 for the biennium. new text end

new text begin Base Adjustment. The general fund base is increased by $2,868,000 in fiscal year 2016 and decreased by $1,206,000 in fiscal year 2017. The health access fund base is decreased by $551,000 in fiscal years 2016 and 2017. The state government special revenue fund base is increased by $4,000 in fiscal year 2016 and decreased by $236,000 in fiscal year 2017. new text end

new text begin (b) Children and Families new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 8,023,000 new text end new text begin 8,015,000 new text end
new text begin Federal TANF new text end new text begin 2,282,000 new text end new text begin 2,282,000 new text end

new text begin Financial Institution Data Match and Payment of Fees. The commissioner is authorized to allocate up to $310,000 each year in fiscal years 2014 and 2015 from the PRISM special revenue account to make payments to financial institutions in exchange for performing data matches between account information held by financial institutions and the public authority's database of child support obligors as authorized by Minnesota Statutes, section 13B.06, subdivision 7. new text end

new text begin new text begin Base Adjustment. new text end The general fund base is decreased by $300,000 in fiscal years 2016 and 2017. The TANF fund base is increased by $300,000 in fiscal years 2016 and 2017. new text end

new text begin (c) Health Care new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 14,028,000 new text end new text begin 13,826,000 new text end
new text begin Health Care Access new text end new text begin 28,442,000 new text end new text begin 31,137,000 new text end

new text begin Base Adjustment. The general fund base is decreased by $86,000 in fiscal year 2016 and by $86,000 in fiscal year 2017. The health care access fund base is increased by $6,954,000 in fiscal year 2016 and by $5,489,000 in fiscal year 2017. new text end

new text begin (d) Continuing Care new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 20,993,000 new text end new text begin 22,359,000 new text end
new text begin State Government Special Revenue new text end new text begin 125,000 new text end new text begin 125,000 new text end

new text begin Base Adjustment. The general fund base is increased by $1,690,000 in fiscal year 2016 and by $798,000 in fiscal year 2017. new text end

new text begin (e) Chemical and Mental Health new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 4,639,000 new text end new text begin 4,490,000 new text end
new text begin Lottery Prize Fund new text end new text begin 157,000 new text end new text begin 157,000 new text end

new text begin Subd. 5. new text end

new text begin Forecasted Programs new text end

new text begin The amounts that may be spent from this appropriation for each purpose are as follows: new text end

new text begin (a) MFIP/DWP new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 72,583,000 new text end new text begin 76,927,000 new text end
new text begin Federal TANF new text end new text begin 80,342,000 new text end new text begin 76,851,000 new text end
new text begin (b) MFIP Child Care Assistance new text end new text begin 61,701,000 new text end new text begin 69,294,000 new text end
new text begin (c) General Assistance new text end new text begin 54,787,000 new text end new text begin 56,068,000 new text end

new text begin General Assistance Standard. The commissioner shall set the monthly standard of assistance for general assistance units consisting of an adult recipient who is childless and unmarried or living apart from parents or a legal guardian at $203. The commissioner may reduce this amount according to Laws 1997, chapter 85, article 3, section 54. new text end

new text begin Emergency General Assistance. The amount appropriated for emergency general assistance funds is limited to no more than $6,729,812 in fiscal year 2014 and $6,729,812 in fiscal year 2015. Funds to counties shall be allocated by the commissioner using the allocation method in Minnesota Statutes, section 256D.06. new text end

new text begin (d) MN Supplemental Assistance new text end new text begin 38,646,000 new text end new text begin 39,821,000 new text end
new text begin (e) Group Residential Housing new text end new text begin 141,138,000 new text end new text begin 150,988,000 new text end
new text begin (f) MinnesotaCare new text end new text begin 297,707,000 new text end new text begin 247,284,000 new text end

new text begin This appropriation is from the health care access fund. new text end

new text begin (g) Medical Assistance new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 4,443,768,000 new text end new text begin 4,431,612,000 new text end
new text begin Health Care Access new text end new text begin 179,550,000 new text end new text begin 226,081,000 new text end

new text begin new text begin Spending to be apportioned.new text end The commissioner shall apportion expenditures under this paragraph consistent with the requirements of section 12. new text end

new text begin Support Services for Deaf and Hard-of-Hearing. $121,000 in fiscal year 2014 and $141,000 in fiscal year 2015; and $10,000 in fiscal year 2014 and $13,000 in fiscal year 2015 are from the health care access fund for the hospital reimbursement increase in Minnesota Statutes, section 256.969, subdivision 29, paragraph (b). new text end

new text begin new text begin Disproportionate Share Payments.new text end Effective for services provided on or after July 1, 2011, through June 30, 2015, the commissioner of human services shall deposit, in the health care access fund, additional federal matching funds received under Minnesota Statutes, section 256B.199, paragraph (e), as disproportionate share hospital payments for inpatient hospital services provided under MinnesotaCare to lawfully present noncitizens who are not eligible for MinnesotaCare with federal financial participation due to immigration status. The amount deposited shall not exceed $2,200,000 for the time period specified. new text end

new text begin new text begin Funding for Services Provided to EMA Recipients.new text end $2,200,000 in fiscal year 2014 is from the health care access fund to provide services to emergency medical assistance recipients under Minnesota Statutes, section 256B.06, subdivision 4, paragraph (l). This is a onetime appropriation and is available in either year of the biennium. new text end

new text begin (h) Alternative Care new text end new text begin 50,776,000 new text end new text begin 54,922,000 new text end

new text begin Alternative Care Transfer. Any money allocated to the alternative care program that is not spent for the purposes indicated does not cancel but shall be transferred to the medical assistance account. new text end

new text begin (i) CD Treatment Fund new text end new text begin 81,440,000 new text end new text begin 74,875,000 new text end

new text begin Balance Transfer. The commissioner must transfer $18,188,000 from the consolidated chemical dependency treatment fund to the general fund by September 30, 2013. new text end

new text begin Subd. 6. new text end

new text begin Grant Programs new text end

new text begin The amounts that may be spent from this appropriation for each purpose are as follows: new text end

new text begin (a) Support Services Grants new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 8,915,000 new text end new text begin 13,333,000 new text end
new text begin Federal TANF new text end new text begin 94,611,000 new text end new text begin 94,611,000 new text end

new text begin new text begin Paid Work Experience.new text end $2,168,000 each year in fiscal years 2015 and 2016 is from the general fund for paid work experience for long-term MFIP recipients. Paid work includes full and partial wage subsidies and other related services such as job development, marketing, preworksite training, job coaching, and postplacement services. These are onetime appropriations. Unexpended funds for fiscal year 2015 do not cancel, but are available to the commissioner for this purpose in fiscal year 2016. new text end

new text begin new text begin Work Study Funding for MFIP Participants.new text end $250,000 each year in fiscal years 2015 and 2016 is from the general fund to pilot work study jobs for MFIP recipients in approved postsecondary education programs. This is a onetime appropriation. Unexpended funds for fiscal year 2015 do not cancel, but are available for this purpose in fiscal year 2016. new text end

new text begin new text begin Local Strategies to Reduce Disparities.new text end $2,000,000 each year in fiscal years 2015 and 2016 is from the general fund for local projects that focus on services for subgroups within the MFIP caseload who are experiencing poor employment outcomes. These are onetime appropriations. Unexpended funds for fiscal year 2015 do not cancel, but are available to the commissioner for this purpose in fiscal year 2016. new text end

new text begin new text begin Home Visiting Collaborations for MFIP Teen Parents.new text end $200,000 per year in fiscal years 2014 and 2015 is from the general fund and $200,000 in fiscal year 2016 is from the federal TANF fund for technical assistance and training to support local collaborations that provide home visiting services for MFIP teen parents. The general fund appropriation is onetime. The federal TANF fund appropriation is added to the base. new text end

new text begin new text begin Performance Bonus Funds for Counties.new text end The TANF fund base is increased by $1,500,000 each year in fiscal years 2016 and 2017. The commissioner must allocate this amount each year to counties that exceed their expected range of performance on the annualized three-year self-support index as defined in Minnesota Statutes, section 256J.751, subdivision 2, clause (6). This is a permanent base adjustment. Notwithstanding any contrary provisions in this article, this provision expires June 30, 2016. new text end

new text begin new text begin Base Adjustment. new text end The general fund base is decreased by $200,000 in fiscal year 2016 and $4,618,000 in fiscal year 2017. The TANF fund base is increased by $1,700,000 in fiscal years 2016 and 2017. new text end

new text begin (b) Basic Sliding Fee Child Care Assistance Grants new text end new text begin 36,836,000 new text end new text begin 42,318,000 new text end

new text begin new text begin Base Adjustment. new text end The general fund base is increased by $3,778,000 in fiscal year 2016 and by $3,849,000 in fiscal year 2017. new text end

new text begin (c) Child Care Development Grants new text end new text begin 1,612,000 new text end new text begin 1,737,000 new text end
new text begin (d) Child Support Enforcement Grants new text end new text begin 50,000 new text end new text begin 50,000 new text end

new text begin Federal Child Support Demonstration Grants. Federal administrative reimbursement resulting from the federal child support grant expenditures authorized under United States Code, title 42, section 1315, is appropriated to the commissioner for this activity. new text end

new text begin (e) Children's Services Grants new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 49,760,000 new text end new text begin 52,961,000 new text end
new text begin Federal TANF new text end new text begin 140,000 new text end new text begin 140,000 new text end

new text begin Adoption Assistance and Relative Custody Assistance. $37,453,000 in fiscal year 2014 and $37,453,000 in fiscal year 2015 is for the adoption assistance and relative custody assistance programs. The commissioner shall determine with the commissioner of Minnesota Management and Budget the appropriation for Northstar Care for Children effective January 1, 2015. The commissioner may transfer appropriations for adoption assistance, relative custody assistance, and Northstar Care for Children between fiscal years and among programs to adjust for transfers across the programs. new text end

new text begin Title IV-E Adoption Assistance. Additional federal reimbursements to the state as a result of the Fostering Connections to Success and Increasing Adoptions Act's expanded eligibility for Title IV-E adoption assistance are appropriated for postadoption services, including a parent-to-parent support network. new text end

new text begin Privatized Adoption Grants. Federal reimbursement for privatized adoption grant and foster care recruitment grant expenditures is appropriated to the commissioner for adoption grants and foster care and adoption administrative purposes. new text end

new text begin new text begin Adoption Assistance Incentive Grants.new text end Federal funds available during fiscal years 2014 and 2015 for adoption incentive grants are appropriated for postadoption services, including a parent-to-parent support network. new text end

new text begin Base Adjustment. The general fund base is increased by $5,913,000 in fiscal year 2016 and by $10,297,000 in fiscal year 2017. new text end

new text begin (f) Child and Community Service Grants new text end new text begin 53,301,000 new text end new text begin 53,301,000 new text end
new text begin (g) Child and Economic Support Grants new text end new text begin 21,047,000 new text end new text begin 20,848,000 new text end

new text begin new text begin Minnesota Food Assistance Program. new text end Unexpended funds for the Minnesota food assistance program for fiscal year 2014 do not cancel but are available for this purpose in fiscal year 2015. new text end

new text begin Transitional Housing. $250,000 each year is for the transitional housing programs under Minnesota Statutes, section 256E.33. new text end

new text begin Emergency Services. $250,000 each year is for emergency services grants under Minnesota Statutes, section 256E.36. new text end

new text begin Family Assets for Independence. $250,000 each year is for the Family Assets for Independence Minnesota program. This appropriation is available in either year of the biennium and may be transferred between fiscal years. new text end

new text begin Food Shelf Programs. $375,000 in fiscal year 2014 and $375,000 in fiscal year 2015 are for food shelf programs under Minnesota Statutes, section 256E.34. If the appropriation for either year is insufficient, the appropriation for the other year is available for it. Notwithstanding Minnesota Statutes, section 256E.34, subdivision 4, no portion of this appropriation may be used by Hunger Solutions for its administrative expenses, including but not limited to rent and salaries. new text end

new text begin Homeless Youth Act. $2,000,000 in fiscal year 2014 and $2,000,000 in fiscal year 2015 is for purposes of Minnesota Statutes, section 256K.45. new text end

new text begin Safe Harbor Shelter and Housing. $500,000 in fiscal year 2014 and $500,000 in fiscal year 2015 is for a safe harbor shelter and housing fund for housing and supportive services for youth who are sexually exploited. new text end

new text begin (h) Health Care Grants new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 190,000 new text end new text begin 190,000 new text end
new text begin Health Care Access new text end new text begin 190,000 new text end new text begin 190,000 new text end

new text begin Emergency Medical Assistance Referral and Assistance Grants. (a) The commissioner of human services shall award grants to nonprofit programs that provide immigration legal services based on indigency to provide legal services for immigration assistance to individuals with emergency medical conditions or complex and chronic health conditions who are not currently eligible for medical assistance or other public health care programs, but who may meet eligibility requirements with immigration assistance. new text end

new text begin (b) The grantees, in collaboration with hospitals and safety net providers, shall provide referral assistance to connect individuals identified in paragraph (a) with alternative resources and services to assist in meeting their health care needs. $100,000 is appropriated in fiscal year 2014 and $100,000 in fiscal year 2015. This is a onetime appropriation. new text end

new text begin Base Adjustment. The general fund is decreased by $100,000 in fiscal year 2016 and $100,000 in fiscal year 2017. new text end

new text begin (i) Aging and Adult Services Grants new text end new text begin 14,827,000 new text end new text begin 15,010,000 new text end

new text begin Base Adjustment. The general fund is increased by $1,150,000 in fiscal year 2016 and $1,151,000 in fiscal year 2017. new text end

new text begin new text begin Community Service Development Grants and Community Services Grants.new text end Community service development grants and community services grants are reduced by $1,150,000 each year. This is a onetime reduction. new text end

new text begin (j) Deaf and Hard-of-Hearing Grants new text end new text begin 1,771,000 new text end new text begin 1,785,000 new text end
new text begin (k) Disabilities Grants new text end new text begin 18,605,000 new text end new text begin 18,823,000 new text end

new text begin Advocating Change Together. $310,000 in fiscal year 2014 is for a grant to Advocating Change Together (ACT) to maintain and promote services for persons with intellectual and developmental disabilities throughout the state. This appropriation is onetime. Of this appropriation: new text end

new text begin (1) $120,000 is for direct costs associated with the delivery and evaluation of peer-to-peer training programs administered throughout the state, focusing on education, employment, housing, transportation, and voting; new text end

new text begin (2) $100,000 is for delivery of statewide conferences focusing on leadership and skill development within the disability community; and new text end

new text begin (3) $90,000 is for administrative and general operating costs associated with managing or maintaining facilities, program delivery, staff, and technology. new text end

new text begin Base Adjustment. The general fund base is increased by $535,000 in fiscal year 2016 and by $709,000 in fiscal year 2017. new text end

new text begin (l) Adult Mental Health Grants new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 71,199,000 new text end new text begin 69,530,000 new text end
new text begin Health Care Access new text end new text begin 750,000 new text end new text begin 750,000 new text end
new text begin Lottery Prize new text end new text begin 1,733,000 new text end new text begin 1,733,000 new text end

new text begin Problem Gambling. $225,000 in fiscal year 2014 and $225,000 in fiscal year 2015 is appropriated from the lottery prize fund for a grant to the state affiliate recognized by the National Council on Problem Gambling. The affiliate must provide services to increase public awareness of problem gambling, education and training for individuals and organizations providing effective treatment services to problem gamblers and their families, and research relating to problem gambling. new text end

new text begin Funding Usage. Up to 75 percent of a fiscal year's appropriations for adult mental health grants may be used to fund allocations in that portion of the fiscal year ending December 31. new text end

new text begin Base Adjustment. The general fund base is decreased by $4,427,000 in fiscal years 2016 and 2017. new text end

new text begin new text begin Mental Health Pilot Project. new text end $230,000 each year is for a grant to the Zumbro Valley Mental Health Center. The grant shall be used to implement a pilot project to test an integrated behavioral health care coordination model. The grant recipient must report measurable outcomes and savings to the commissioner of human services by January 15, 2016. This is a onetime appropriation. new text end

new text begin new text begin High-risk adults.new text end $200,000 in fiscal year 2014 is for a grant to the nonprofit organization selected to administer the demonstration project for high-risk adults under Laws 2007, chapter 54, article 1, section 19, in order to complete the project. This is a onetime appropriation. new text end

new text begin (m) Child Mental Health Grants new text end new text begin 18,246,000 new text end new text begin 20,636,000 new text end

new text begin new text begin Text Message Suicide Prevention Program.new text end $625,000 in fiscal year 2014 and $625,000 in fiscal year 2015 is for a grant to a nonprofit organization to establish and implement a statewide text message suicide prevention program. The program shall implement a suicide prevention counseling text line designed to use text messaging to connect with crisis counselors and to obtain emergency information and referrals to local resources in the local community. The program shall include training within schools and communities to encourage the use of the program. new text end

new text begin Mental Health First Aid Training. $22,000 in fiscal year 2014 and $23,000 in fiscal year 2015 is to train teachers, social service personnel, law enforcement, and others who come into contact with children with mental illnesses, in children and adolescents mental health first aid training. new text end

new text begin Funding Usage. Up to 75 percent of a fiscal year's appropriation for child mental health grants may be used to fund allocations in that portion of the fiscal year ending December 31. new text end

new text begin (n) CD Treatment Support Grants new text end new text begin 1,816,000 new text end new text begin 1,816,000 new text end

new text begin SBIRT Training. (1) $300,000 each year is for grants to train primary care clinicians to provide substance abuse brief intervention and referral to treatment (SBIRT). This is a onetime appropriation. The commissioner of human services shall apply to SAMHSA for an SBIRT professional training grant. new text end

new text begin (2) If the commissioner of human services receives a grant under clause (1) funds appropriated under this clause, equal to the grant amount, up to the available appropriation, shall be transferred to the Minnesota Organization on Fetal Alcohol Syndrome (MOFAS). MOFAS must use the funds for grants. Grant recipients must be selected from communities that are not currently served by federal Substance Abuse Prevention and Treatment Block Grant funds. Grant money must be used to reduce the rates of fetal alcohol syndrome and fetal alcohol effects, and the number of drug-exposed infants. Grant money may be used for prevention and intervention services and programs, including, but not limited to, community grants, professional eduction, public awareness, and diagnosis. new text end

new text begin Fetal Alcohol Syndrome Grant. $180,000 each year from the general fund is for a grant to the Minnesota Organization on Fetal Alcohol Syndrome (MOFAS) to support nonprofit Fetal Alcohol Spectrum Disorders (FASD) outreach prevention programs in Olmsted County. This is a onetime appropriation. new text end

new text begin Base Adjustment. The general fund base is decreased by $480,000 in fiscal year 2016 and $480,000 in fiscal year 2017. new text end

new text begin Subd. 7. new text end

new text begin State-Operated Services new text end

new text begin Transfer Authority Related to State-Operated Services. Money appropriated for state-operated services may be transferred between fiscal years of the biennium with the approval of the commissioner of management and budget. new text end

new text begin The amounts that may be spent from the appropriation for each purpose are as follows: new text end

new text begin (a) SOS Mental Health new text end new text begin 115,738,000 new text end new text begin 115,738,000 new text end

new text begin Dedicated Receipts Available. Of the revenue received under Minnesota Statutes, section 246.18, subdivision 8, paragraph (a), $1,000,000 each year is available for the purposes of paragraph (b), clause (1), of that subdivision, $1,000,000 each year is available to transfer to the adult mental health budget activity for the purposes of paragraph (b), clause (2), of that subdivision, and up to $2,713,000 each year is available for the purposes of paragraph (b), clause (3), of that subdivision. new text end

new text begin (b) SOS MN Security Hospital new text end new text begin 69,582,000 new text end new text begin 69,582,000 new text end

new text begin Subd. 8. new text end

new text begin Sex Offender Program new text end

new text begin 76,769,000 new text end new text begin 79,745,000 new text end

new text begin Transfer Authority Related to Minnesota Sex Offender Program. Money appropriated for the Minnesota sex offender program may be transferred between fiscal years of the biennium with the approval of the commissioner of management and budget. new text end

new text begin Subd. 9. new text end

new text begin Technical Activities new text end

new text begin 80,440,000 new text end new text begin 80,829,000 new text end

new text begin This appropriation is from the federal TANF fund. new text end

new text begin Base Adjustment. The federal TANF fund base is increased by $278,000 in fiscal year 2016 and increased by $651,000 in fiscal year 2017. new text end

new text begin Subd. 10. new text end

new text begin C.A.R.E. new text end

new text begin (a) Notwithstanding Minnesota Statutes, section 254B.06, subdivision 1, $2,200,000 is transferred from the consolidated chemical dependency treatment fund administrative account in the special revenue fund and deposited into the enterprise fund for the Community Addiction Recovery Enterprise in fiscal year 2013. new text end

new text begin (b) Notwithstanding Minnesota Statutes, section 245.037, $1,000,000 must be transferred from the dedicated services - Lease Income Brainerd account in the special revenue fund and deposited into the enterprise fund for the Community Addiction Recovery Enterprise in fiscal year 2013. new text end

new text begin (c) Paragraphs (a) and (b) are effective the day following final enactment. new text end

Sec. 3.

new text begin COMMISSIONER OF HEALTH new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation new text end

new text begin $ new text end new text begin 169,326,000 new text end new text begin $ new text end new text begin 165,531,000 new text end
new text begin Appropriations by Fund new text end
new text begin 2014 new text end new text begin 2015 new text end
new text begin General new text end new text begin 79,476,000 new text end new text begin 74,256,000 new text end
new text begin State Government Special Revenue new text end new text begin 48,094,000 new text end new text begin 50,119,000 new text end
new text begin Health Care Access new text end new text begin 29,743,000 new text end new text begin 29,143,000 new text end
new text begin Federal TANF new text end new text begin 11,713,000 new text end new text begin 11,713,000 new text end
new text begin Special Revenue new text end new text begin 300,000 new text end new text begin 300,000 new text end

new text begin The amounts that may be spent for each purpose are specified in the following subdivisions. new text end

new text begin Subd. 2. new text end

new text begin Health Improvement new text end

new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 52,864,000 new text end new text begin 47,644,000 new text end
new text begin State Government Special Revenue new text end new text begin 1,033,000 new text end new text begin 1,033,000 new text end
new text begin Health Care Access new text end new text begin 17,500,000 new text end new text begin 17,500,000 new text end
new text begin Federal TANF new text end new text begin 11,713,000 new text end new text begin 11,713,000 new text end

new text begin Notwithstanding the cancellation requirement in Minnesota Statutes, section 256J.02, subdivision 6, TANF funds awarded under Minnesota Statutes, section 145.928, during fiscal year 2013 to grantees determined during the application process to have limited financial capacity, are available until June 30, 2014. new text end

new text begin Statewide Health Improvement Program. $17,500,000 in fiscal year 2014 and $17,500,000 in fiscal year 2015 is from the health care access fund for the statewide health improvement program under Minnesota Statutes, section 145.986. Funds appropriated under this paragraph are available until expended. No more than 16 percent of the SHIP budget may be used for administration, technical assistance, and state-level evaluation costs. The commissioner shall incorporate strategies for improving health outcomes and reducing health care costs in populations over age 60 to the menu of statewide health improvement program strategies. new text end

new text begin Statewide Cancer Surveillance System. new text end new text begin Of the general fund appropriation, $350,000 in fiscal year 2014 and $350,000 in fiscal year 2015 is to develop and implement a new cancer reporting system under Minnesota Statutes, sections 144.671 to 144.69. Any information technology development or support costs necessary for the cancer surveillance system must be incorporated into the agency's service level agreement and paid to the Office of Enterprise Technology. new text end

new text begin Minnesota Poison Information Center. $500,000 in fiscal year 2014 and $500,000 in fiscal year 2015 from the general fund is for regional poison information centers according to Minnesota Statutes, section 145.93. new text end

new text begin Support Services for Deaf and Hard-of-Hearing. (a) $365,000 in fiscal year 2014 and $349,000 in fiscal year 2015 are for providing support services to families as required under Minnesota Statutes, section 144.966, subdivision 3a. new text end

new text begin (b) $164,000 in fiscal year 2014 and $156,000 in fiscal year 2015 are for home-based education in American Sign Language for families with children who are deaf or have hearing loss, as required under Minnesota Statutes, section 144.966, subdivision 3a. new text end

new text begin Reproductive Health Strategic Plan to Reduce Health Disparities for Somali Women. To the extent funds are available for fiscal years 2014 and 2015 for grants provided pursuant to Minnesota Statutes, section 145.928, the commissioner shall provide a grant to a Somali-based organization located in the metropolitan area to develop a reproductive health strategic plan to eliminate reproductive health disparities for Somali women. The plan shall develop initiatives to provide educational and information resources to health care providers, community organizations, and Somali women to ensure effective interaction with Somali culture and western medicine and the delivery of appropriate health care services, and the achievement of better health outcomes for Somali women. The plan must engage health care providers, the Somali community, and Somali health-centered organizations. The commissioner shall submit a report to the chairs and ranking minority members of the senate and house committees with jurisdiction over health policy on the strategic plan developed under this grant for eliminating reproductive health disparities for Somali women. The report must be submitted by February 15, 2014. new text end

new text begin new text begin Sexual Violence Prevention.new text end Within available appropriations, by January 15, 2015, the commissioner must report to the legislature on its activities to prevent sexual violence, including activities to promote coordination of existing state programs and services to achieve maximum impact on addressing the root causes of sexual violence. new text end

new text begin new text begin Safe Harbor for Sexually Exploited Youth.new text end (a) $375,000 in fiscal year 2014 and $375,000 in fiscal year 2015 are for grants to six regional navigators under Minnesota Statutes, section 145.4717. new text end

new text begin (b) $100,000 in fiscal year 2014 and $100,000 in fiscal year 2015 are for the director of child sex trafficking prevention position. new text end

new text begin (c) $50,000 in fiscal year 2015 is for program evaluation required under Minnesota Statutes, section 145.4718. new text end

new text begin TANF Appropriations. new text end new text begin (1) $1,156,000 of the TANF funds is appropriated each year of the biennium to the commissioner for family planning grants under Minnesota Statutes, section 145.925. new text end

new text begin (2) $3,579,000 of the TANF funds is appropriated each year of the biennium to the commissioner for home visiting and nutritional services listed under Minnesota Statutes, section 145.882, subdivision 7, clauses (6) and (7). Funds must be distributed to community health boards according to Minnesota Statutes, section 145A.131, subdivision 1. new text end

new text begin (3) $2,000,000 of the TANF funds is appropriated each year of the biennium to the commissioner for decreasing racial and ethnic disparities in infant mortality rates under Minnesota Statutes, section 145.928, subdivision 7. new text end

new text begin (4) $4,978,000 of the TANF funds is appropriated each year of the biennium to the commissioner for the family home visiting grant program according to Minnesota Statutes, section 145A.17. $4,000,000 of the funding must be distributed to community health boards according to Minnesota Statutes, section 145A.131, subdivision 1. $978,000 of the funding must be distributed to tribal governments based on Minnesota Statutes, section 145A.14, subdivision 2a. new text end

new text begin (5) The commissioner may use up to 6.23 percent of the funds appropriated each fiscal year to conduct the ongoing evaluations required under Minnesota Statutes, section 145A.17, subdivision 7, and training and technical assistance as required under Minnesota Statutes, section 145A.17, subdivisions 4 and 5. new text end

new text begin TANF Carryforward. new text end new text begin Any unexpended balance of the TANF appropriation in the first year of the biennium does not cancel but is available for the second year. new text end

new text begin Subd. 3. new text end

new text begin Policy Quality and Compliance new text end

new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 9,391,000 new text end new text begin 9,391,000 new text end
new text begin State Government Special Revenue new text end new text begin 14,428,000 new text end new text begin 16,450,000 new text end
new text begin Health Care Access new text end new text begin 12,243,000 new text end new text begin 11,643,000 new text end

new text begin The health care access fund appropriation includes the base appropriation for health care homes activities. new text end

new text begin Base Level Adjustment. new text end new text begin The health care access base shall be increased by $600,000 in fiscal year 2016. new text end

new text begin new text begin Criminal Background Checks. new text end The state government special revenue fund base for fiscal year 2017 includes $111,000 for the implementation of criminal background checks for occupational therapy practitioners, speech-language pathologists, audiologists, and hearing aid dispensers, if the Sunset Advisory Commission under Minnesota Statutes, section 3D.03, is repealed before June 30, 2014. new text end

new text begin Subd. 4. new text end

new text begin Health Protection new text end

new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 9,201,000 new text end new text begin 9,201,000 new text end
new text begin State Government Special Revenue new text end new text begin 32,633,000 new text end new text begin 32,636,000 new text end
new text begin Special Revenue new text end new text begin 300,000 new text end new text begin 300,000 new text end

new text begin Infectious Disease Laboratory. new text end new text begin Of the general fund appropriation, $200,000 in fiscal year 2014 and $200,000 in fiscal year 2015 are to monitor infectious disease trends and investigate infectious disease outbreaks. new text end

new text begin Surveillance for Elevated Blood Lead Levels. Of the general fund appropriation, $100,000 in fiscal year 2014 and $100,000 in fiscal year 2015 are for the blood lead surveillance system under Minnesota Statutes, section 144.9502. new text end

new text begin Base Level Adjustment. The state government special revenue base is increased by $6,000 in fiscal year 2016 and by $13,000 in fiscal year 2017. new text end

new text begin Subd. 5. new text end

new text begin Administrative Support Services new text end

new text begin 8,020,000 new text end new text begin 8,020,000 new text end

new text begin The general fund appropriation includes the base appropriation for the Office of the State Epidemiologist. new text end

new text begin Regional Support for Local Public Health Departments. new text end new text begin $350,000 in fiscal year 2014 and $350,000 in fiscal year 2015 is for regional staff who provide specialized expertise to local public health departments. new text end

Sec. 4.

new text begin HEALTH-RELATED BOARDS new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation new text end

new text begin $ new text end new text begin 20,040,000 new text end new text begin $ new text end new text begin 18,446,000 new text end

new text begin This appropriation is from the state government special revenue fund. new text end

new text begin The amounts that may be spent for each purpose are specified in the following subdivisions. new text end

new text begin Subd. 2. new text end

new text begin Board of Chiropractic Examiners new text end

new text begin 508,000 new text end new text begin 490,000 new text end

new text begin This appropriation includes $10,000 for information technology hardware to streamline board operations. This is a onetime appropriation. $15,000 is for a LEAN evaluation. This is a onetime appropriation. $2,000 in fiscal years 2014 and 2015 is for rental of additional storage space. new text end

new text begin Subd. 3. new text end

new text begin Board of Dentistry new text end

new text begin 2,059,000 new text end new text begin 2,056,000 new text end

new text begin This appropriation includes $843,000 in fiscal year 2014 and $837,000 in fiscal year 2015 for the health professional services program. new text end

new text begin $15,000 in fiscal year 2014 is for repairs, maintenance, furnishings, and ergonomic upgrades. This is a onetime appropriation. $35,000 in fiscal years 2014 and 2015 is for additional staff to implement new regulatory activity. $20,000 in fiscal years 2014 and 2015 is for database upgrades for regulatory and licensing activities. $10,000 in fiscal years 2014 and 2015 is for professional and technical contracts for expert consultants to review complex complaints, advise on specialty dentistry areas, and to serve as expert witnesses in contested case matters. new text end

new text begin Subd. 4. new text end

new text begin Board of Dietetic and Nutrition Practice new text end

new text begin 111,000 new text end new text begin 111,000 new text end

new text begin Subd. 5. new text end

new text begin Board of Marriage and Family Therapy new text end

new text begin 254,000 new text end new text begin 226,000 new text end

new text begin This appropriation includes $25,000 in fiscal year 2014 for rulemaking. This is a onetime appropriation. $31,000 in fiscal year 2014 and $27,000 in fiscal year 2015 are for additional staff to improve licensing and licensing renewal activities. $30,000 in fiscal year 2014 and $31,000 in fiscal year 2015 are to increase the executive director to a full-time position. new text end

new text begin The remaining balance of the state government special revenue fund appropriation in Laws 2011, First Special Session chapter 9, article 10, section 8, subdivision 5, for Board of Marriage and Family Therapy rulemaking, estimated to be $25,000, is canceled. This paragraph is effective the day following final enactment. new text end

new text begin Subd. 6. new text end

new text begin Board of Medical Practice new text end

new text begin 3,867,000 new text end new text begin 3,867,000 new text end

new text begin Subd. 7. new text end

new text begin Board of Nursing new text end

new text begin 3,637,000 new text end new text begin 3,637,000 new text end

new text begin Subd. 8. new text end

new text begin Board of Nursing Home Administrators new text end

new text begin 3,742,000 new text end new text begin 2,252,000 new text end

new text begin Administrative Services Unit - Operating Costs. Of this appropriation, $676,000 in fiscal year 2014 and $626,000 in fiscal year 2015 are for operating costs of the administrative services unit. The administrative services unit may receive and expend reimbursements for services performed by other agencies. new text end

new text begin Administrative Services Unit - Volunteer Health Care Provider Program. Of this appropriation, $150,000 in fiscal year 2014 and $150,000 in fiscal year 2015 are to pay for medical professional liability coverage required under Minnesota Statutes, section 214.40. new text end

new text begin Administrative Services Unit - Contested Cases and Other Legal Proceedings. Of this appropriation, $200,000 in fiscal year 2014 and $200,000 in fiscal year 2015 are for costs of contested case hearings and other unanticipated costs of legal proceedings involving health-related boards funded under this section. Upon certification of a health-related board to the administrative services unit that the costs will be incurred and that there is insufficient money available to pay for the costs out of money currently available to that board, the administrative services unit is authorized to transfer money from this appropriation to the board for payment of those costs with the approval of the commissioner of management and budget. new text end

new text begin This appropriation includes $44,000 in fiscal year 2014 for rulemaking. This is a onetime appropriation. $1,441,000 in fiscal year 2014 and $420,000 in fiscal year 2015 are for the development of a shared disciplinary, regulatory, licensing, and information management system. $391,000 in fiscal year 2014 is a onetime appropriation for retirement costs in the health-related boards. This funding may be transferred to the health boards incurring retirement costs. These funds are available either year of the biennium. new text end

new text begin This appropriation includes $16,000 in fiscal years 2014 and 2015 for evening security, $2,000 in fiscal years 2014 and 2015 for a state vehicle lease, and $18,000 in fiscal years 2014 and 2015 for shared office space and administrative support. $205,000 in fiscal year 2014 and $221,000 in fiscal year 2015 are for shared information technology services, equipment, and maintenance. new text end

new text begin The remaining balance of the state government special revenue fund appropriation in Laws 2011, First Special Session chapter 9, article 10, section 8, subdivision 8, for Board of Nursing Home Administrators rulemaking, estimated to be $44,000, is canceled, and the remaining balance of the state government special revenue fund appropriation in Laws 2011, First Special Session chapter 9, article 10, section 8, subdivision 8, for electronic licensing system adaptors, estimated to be $761,000, and for the development and implementation of a disciplinary, regulatory, licensing, and information management system, estimated to be $1,100,000, are canceled. This paragraph is effective the day following final enactment. new text end

new text begin Base Adjustment. The base is decreased by $370,000 in fiscal years 2016 and 2017. new text end

new text begin Subd. 9. new text end

new text begin Board of Optometry new text end

new text begin 107,000 new text end new text begin 107,000 new text end

new text begin Subd. 10. new text end

new text begin Board of Pharmacy new text end

new text begin 2,555,000 new text end new text begin 2,555,000 new text end

new text begin Prescription Electronic Reporting. Of this appropriation, $356,000 in fiscal year 2014 and $356,000 in fiscal year 2015 from the state government special revenue fund are to the board to operate the prescription monitoring program in Minnesota Statutes, section 152.126. new text end

new text begin Subd. 11. new text end

new text begin Board of Physical Therapy new text end

new text begin 390,000 new text end new text begin 346,000 new text end

new text begin This appropriation includes $44,000 in fiscal year 2014 for rulemaking. This is a onetime appropriation. new text end

new text begin The remaining balance of the state government special revenue fund appropriation in Laws 2011, First Special Session chapter 9, article 10, section 8, subdivision 11, for Board of Physical Therapy rulemaking, estimated to be $44,000, is canceled. This paragraph is effective the day following final enactment. new text end

new text begin Subd. 12. new text end

new text begin Board of Podiatry new text end

new text begin 76,000 new text end new text begin 76,000 new text end

new text begin Subd. 13. new text end

new text begin Board of Psychology new text end

new text begin 892,000 new text end new text begin 892,000 new text end

new text begin This appropriation includes $15,000 in fiscal years 2014 and 2015 for continuing educational programming. $5,000 in fiscal years 2014 and 2015 are for a public education program. $25,000 in fiscal years 2014 and 2015 are for development of educational materials. This is a onetime appropriation. new text end

new text begin Base Adjustment. The base is decreased by $45,000 in fiscal years 2016 and 2017. new text end

new text begin Subd. 14. new text end

new text begin Board of Social Work new text end

new text begin 1,109,000 new text end new text begin 1,110,000 new text end

new text begin This appropriation includes $55,000 in fiscal year 2014 and $56,000 in fiscal year 2015 for additional staff to enhance the board's complaint resolution process. new text end

new text begin Subd. 15. new text end

new text begin Board of Veterinary Medicine new text end

new text begin 262,000 new text end new text begin 256,000 new text end

new text begin This appropriation includes $32,000 in fiscal year 2014 and $26,000 in fiscal year 2015 for additional staff to improve the board's complaint resolution process. new text end

new text begin Subd. 16. new text end

new text begin Board of Behavioral Health and Therapy new text end

new text begin 471,000 new text end new text begin 465,000 new text end

new text begin This appropriation includes $56,000 in fiscal year 2014 and $50,000 in fiscal year 2015 for additional staff to enhance the licensing and complaint resolution processes of the board. new text end

Sec. 5.

new text begin EMERGENCY MEDICAL SERVICES REGULATORY BOARD new text end

new text begin $ new text end new text begin 2,741,000 new text end new text begin $ new text end new text begin 2,741,000 new text end

new text begin Regional Grants. $585,000 in fiscal year 2014 and $585,000 in fiscal year 2015 are for regional emergency medical services programs, to be distributed equally to the eight emergency medical service regions. new text end

new text begin Cooper/Sams Volunteer Ambulance Program. new text end new text begin $700,000 in fiscal year 2014 and $700,000 in fiscal year 2015 are for the Cooper/Sams volunteer ambulance program under Minnesota Statutes, section 144E.40. new text end

new text begin (a) Of this amount, $611,000 in fiscal year 2014 and $611,000 in fiscal year 2015 are for the ambulance service personnel longevity award and incentive program under Minnesota Statutes, section 144E.40. new text end

new text begin (b) Of this amount, $89,000 in fiscal year 2014 and $89,000 in fiscal year 2015 are for the operations of the ambulance service personnel longevity award and incentive program under Minnesota Statutes, section 144E.40. new text end

new text begin Ambulance Training Grant. $361,000 in fiscal year 2014 and $361,000 in fiscal year 2015 are for training grants. new text end

new text begin EMSRB Board Operations. $1,095,000 in fiscal year 2014 and $1,095,000 in fiscal year 2015 are for operations. new text end

Sec. 6.

new text begin COUNCIL ON DISABILITY new text end

new text begin $ new text end new text begin 614,000 new text end new text begin $ new text end new text begin 614,000 new text end

Sec. 7.

new text begin OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES new text end

new text begin $ new text end new text begin 1,654,000 new text end new text begin $ new text end new text begin 1,654,000 new text end

Sec. 8.

new text begin OMBUDSPERSON FOR FAMILIES new text end

new text begin $ new text end new text begin 333,000 new text end new text begin $ new text end new text begin 334,000 new text end

Sec. 9.

Minnesota Statutes 2012, section 256.01, subdivision 34, is amended to read:

Subd. 34.

Federal administrative reimbursement dedicated.

Federal administrative reimbursement resulting from the following activities is appropriated to the commissioner for the designated purposes:

(1) reimbursement for the Minnesota senior health options project; deleted text begin anddeleted text end

(2) reimbursement related to prior authorization and inpatient admission certification by a professional review organization. A portion of these funds must be used for activities to decrease unnecessary pharmaceutical costs in medical assistancedeleted text begin .deleted text end new text begin ; andnew text end

new text begin (3) reimbursement resulting from the federal child support grant expenditures authorized under United States Code, title 42, section 1315. new text end

Sec. 10.

Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision to read:

new text begin Subd. 36. new text end

new text begin Federal reimbursement for privatized adoption grants. new text end

new text begin Federal reimbursement for privatized adoption grant and foster care recruitment grant expenditures is appropriated to the commissioner for adoption grants and foster care and adoption administrative purposes. new text end

Sec. 11.

Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision to read:

new text begin Subd. 37. new text end

new text begin DHS receipt center accounting. new text end

new text begin The commissioner may transfer appropriations to, and account for DHS receipt center operations in, the special revenue fund. new text end

Sec. 12.

new text begin APPROPRIATION ADJUSTMENTS. new text end

new text begin (a) The general fund appropriation in section 2, subdivision 5, paragraph (g), includes up to $53,391,000 in fiscal year 2014; $216,637,000 in fiscal year 2015; $261,660,000 in fiscal year 2016; and $279,984,000 in fiscal year 2017, for medical assistance eligibility and administration changes related to: new text end

new text begin (1) eligibility for children age two to 18 with income up to 275 percent of the federal poverty guidelines; new text end

new text begin (2) eligibility for pregnant women with income up to 275 percent of the federal poverty guidelines; new text end

new text begin (3) Affordable Care Act enrollment and renewal processes, including elimination of six-month renewals, ex parte eligibility reviews, preprinted renewal forms, changes in verification requirements, and other changes in the eligibility determination and enrollment and renewal process; new text end

new text begin (4) automatic eligibility for children who turn 18 in foster care until they reach age 26; new text end

new text begin (5) eligibility related to spousal impoverishment provisions for waiver recipients; and new text end

new text begin (6) presumptive eligibility determinations by hospitals. new text end

new text begin (b) The commissioner of human services shall determine the difference between the actual or forecasted costs to the medical assistance program attributable to the program changes in paragraph (a), clauses (1) to (6), and the costs of paragraph (a), clauses (1) to (6), that were estimated during the 2013 legislative session based on data from the 2013 February forecast. The costs in this paragraph must be calculated between January 1, 2014, and June 30, 2017. new text end

new text begin (c) For each fiscal year from 2014 to 2017, the commissioner of human services shall certify the actual or forecasted cost differences to the medical assistance program determined under paragraph (b), and report the difference in costs to the commissioner of management and budget at least four weeks prior to a forecast under Minnesota Statutes, section 16A.103. No later than three weeks before the release of the forecast under Minnesota Statutes, section 16A.103, the commissioner of management and budget shall reduce the health care access fund appropriation in section 2, subdivision 5, paragraph (g), by the cumulative difference in costs determined in paragraph (b). If for any fiscal year, the amount of the cumulative cost differences determined under paragraph (b) is positive, no adjustment shall be made to the health care access fund appropriation. If for any fiscal year, the amount of the cumulative cost differences determined under paragraph (b) is less than the original appropriation, the appropriation for that fiscal year is zero. new text end

new text begin (d) This section expires on January 1, 2018. new text end

Sec. 13.

new text begin TRANSFERS. new text end

new text begin Subdivision 1. new text end

new text begin Grants. new text end

new text begin The commissioner of human services, with the approval of the commissioner of management and budget, may transfer unencumbered appropriation balances for the biennium ending June 30, 2015, within fiscal years among the MFIP, general assistance, general assistance medical care under Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, medical assistance, MinnesotaCare, MFIP child care assistance under Minnesota Statutes, section 119B.05, Minnesota supplemental aid, group residential housing programs, the entitlement portion of the chemical dependency consolidated treatment fund, and between fiscal years of the biennium. The commissioner shall inform the chairs and ranking minority members of the senate Health and Human Services Finance Division and the house of representatives Health and Human Services Finance Committee quarterly about transfers made under this provision. new text end

new text begin Subd. 2. new text end

new text begin Administration. new text end

new text begin Positions, salary money, and nonsalary administrative money may be transferred within the Departments of Human Services and Health as the commissioners consider necessary, with the advance approval of the commissioner of management and budget. The commissioner shall inform the chairs and ranking minority members of the senate Health and Human Services Finance Division and the house of representatives Health and Human Services Finance Committee quarterly about transfers made under this provision. new text end

Sec. 14.

new text begin INDIRECT COSTS NOT TO FUND PROGRAMS. new text end

new text begin The commissioners of health and human services shall not use indirect cost allocations to pay for the operational costs of any program for which they are responsible. new text end

Sec. 15.

new text begin EXPIRATION OF UNCODIFIED LANGUAGE. new text end

new text begin All uncodified language contained in this article expires on June 30, 2015, unless a different expiration date is explicit. new text end

Sec. 16.

new text begin EFFECTIVE DATE. new text end

new text begin This article is effective July 1, 2013, unless a different effective date is specified. new text end

ARTICLE 15

REFORM 2020 CONTINGENT APPROPRIATIONS

Section 1.

new text begin HEALTH AND HUMAN SERVICES APPROPRIATIONS.new text end

new text begin The sums shown in the columns marked "Appropriations" are appropriated to the agencies and for the purposes specified in this article. The appropriations are from the general fund, or another named fund, and are available for the fiscal years indicated for each purpose. The figures "2014" and "2015" used in this article mean that the appropriations listed under them are available for the fiscal year ending June 30, 2014, or June 30, 2015, respectively. "The first year" is fiscal year 2014. "The second year" is fiscal year 2015. "The biennium" is fiscal years 2014 and 2015. new text end

new text begin APPROPRIATIONS new text end
new text begin Available for the Year new text end
new text begin Ending June 30 new text end
new text begin 2014 new text end new text begin 2015 new text end

Sec. 2.

new text begin COMMISSIONER OF HUMAN SERVICES new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation new text end

new text begin $ new text end new text begin 2,144,000 new text end new text begin $ new text end new text begin 214,000 new text end

new text begin Subd. 2. new text end

new text begin Central Office new text end

new text begin The amounts that may be spent from this appropriation for each purpose are as follows: new text end

new text begin (a) Operations new text end new text begin 2,909,000 new text end new text begin 8,957,000 new text end

new text begin Base Adjustment. The general fund base is decreased by $8,916,000 in fiscal year 2016 and $8,916,000 in fiscal year 2017. new text end

new text begin (b) Children and Families new text end new text begin 109,000 new text end new text begin 206,000 new text end
new text begin (c) Continuing Care new text end new text begin 2,849,000 new text end new text begin 3,574,000 new text end

new text begin Base Adjustment. The general fund base is decreased by $2,000 in fiscal year 2016 and by $27,000 in fiscal year 2017. new text end

new text begin (d) Group Residential Housing new text end new text begin (1,166,000) new text end new text begin (8,602,000) new text end
new text begin (e) Medical Assistance new text end new text begin (3,950,000) new text end new text begin (6,420,000) new text end
new text begin (f) Alternative Care new text end new text begin (7,386,000) new text end new text begin (6,851,000) new text end
new text begin (g) Child and Community Service Grants new text end new text begin 3,000,000 new text end new text begin 3,000,000 new text end
new text begin (h) Aging and Adult Services Grants new text end new text begin 5,365,000 new text end new text begin 5,936,000 new text end

new text begin Gaps Analysis. In fiscal year 2014, and in each even-numbered year thereafter, $435,000 is appropriated to conduct an analysis of gaps in long-term care services under Minnesota Statutes, section 144A.351. This is a biennial appropriation. The base is increased by $435,000 in fiscal year 2016. Notwithstanding any contrary provisions in this article, this provision does not expire. new text end

new text begin Base Adjustment. The general fund base is increased by $498,000 in fiscal year 2016, and decreased by $124,000 in fiscal year 2017. new text end

new text begin (i) Disabilities Grants new text end new text begin 414,000 new text end new text begin 414,000 new text end

Sec. 3.

new text begin FEDERAL APPROVAL. new text end

new text begin (a) The implementation of this article and article 2 is contingent on federal approval. new text end

new text begin (b) Upon full or partial approval of the waiver application, the commissioner of human services shall submit to the commissioner of management and budget a plan for implementing the provisions in this article that received federal approval as well as any provisions that do not require federal approval. The plan must: new text end

new text begin (1) include fiscal estimates that, with federal administrative reimbursement, do not increase the general fund appropriations to the commissioner of human services in fiscal years 2014 and 2015; and new text end

new text begin (2) include a fiscal estimate for the systems modernization appropriation, which cannot exceed $11,598,000 for the biennium ending June 30, 2015. new text end

new text begin (c) Upon approval by the commissioner of management and budget, the commissioner of human services may implement the plan. new text end

new text begin (d) The commissioner of management and budget must notify the chairs and ranking minority members of the legislative committees with jurisdiction over health and human services finance when the plan is approved. The plan must be made publicly available. new text end

Sec. 4.

new text begin IMPLEMENTATION OF REFORM 2020 CONTINGENT PROVISIONS AND ADJUSTMENTS TO APPROPRIATIONS AND PLANNING ESTIMATES. new text end

new text begin Upon approval of the plan in section 3, the commissioner of management and budget shall make necessary adjustments to the appropriations in this article to reflect the effective date of federal approval. The adjustments must include the nondedicated revenue attributable to the provisions of this article and the related planning estimates for fiscal years 2016 and 2017 must reflect the revised fiscal estimates attributable to the provisions in this article. The revised appropriations for fiscal years 2014 and 2015 shall be included in the forecast and must not increase the appropriations to the commissioner of human services for fiscal years 2014 and 2015. If the adjustments to the planning estimates for fiscal years 2016 and 2017 result in increased general fund expenditure estimates for the commissioner of human services attributable to the provisions in this article, when compared to the planning estimates attributable to the provision in this article made in the February 2013 forecast, none of the provisions in this article shall be implemented. new text end

ARTICLE 16

HUMAN SERVICES FORECAST ADJUSTMENTS

Section 1.

new text begin COMMISSIONER OF HUMAN SERVICES new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation new text end

new text begin $ new text end new text begin (161,031,000) new text end
new text begin Appropriations by Fund new text end
new text begin 2013 new text end
new text begin General Fund new text end new text begin (158,668,000) new text end
new text begin Health Care Access new text end new text begin (7,179,000) new text end
new text begin TANF new text end new text begin 4,816,000 new text end

new text begin Subd. 2. new text end

new text begin Forecasted Programs new text end

new text begin (a) MFIP/DWP Grants new text end
new text begin Appropriations by Fund new text end
new text begin General Fund new text end new text begin (8,211,000) new text end
new text begin TANF new text end new text begin 4,399,000 new text end
new text begin (b) MFIP Child Care Assistance Grants new text end new text begin 10,113,000 new text end
new text begin (c) General Assistance Grants new text end new text begin 3,230,000 new text end
new text begin (d) Minnesota Supplemental Aid Grants new text end new text begin (1,008,000) new text end
new text begin (e) Group Residential Housing Grants new text end new text begin (5,423,000) new text end
new text begin (f) MinnesotaCare Grants new text end new text begin (7,179,000) new text end

new text begin This appropriation is from the health care access fund. new text end

new text begin (g) Medical Assistance Grants new text end new text begin (159,733,000) new text end
new text begin (h) Alternative Care Grants new text end new text begin -0- new text end
new text begin (i) CD Entitlement Grants new text end new text begin 2,364,000 new text end

new text begin Subd. 3. new text end

new text begin Technical Activities new text end

new text begin 417,000 new text end

new text begin This appropriation is from the TANF fund. 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 17

NORTHSTAR CARE FOR CHILDREN

Section 1.

Minnesota Statutes 2012, section 256.0112, is amended by adding a subdivision to read:

new text begin Subd. 10. new text end

new text begin Contracts for child foster care services. new text end

new text begin When local agencies negotiate lead county contracts or purchase of service contracts for child foster care services, the foster care maintenance payment made on behalf of the child shall follow the provisions of Northstar Care for Children, chapter 256N. Foster care maintenance payments as defined in section 256N.02, subdivision 15, represent costs for activities similar in nature to those expected of parents and do not cover services rendered by the licensed or tribally approved foster parent, facility, or administrative costs or fees. Payments made to foster parents must follow the requirements of section 256N.26, subdivision 15. The legally responsible agency must provide foster parents with the assessment and notice as specified in section 256N.24. The financially responsible agency is permitted to make additional payments for specific services provided by the foster parents or facility, as permitted in section 256N.21, subdivision 5. These additional payments are not considered foster care maintenance. new text end

Sec. 2.

Minnesota Statutes 2012, section 256.82, subdivision 2, is amended to read:

Subd. 2.

Foster care maintenance payments.

deleted text begin Beginning January 1, 1986,deleted text end For the purpose of foster care maintenance payments under title IV-E of the Social Security Act, United States Code, title 42, sections 670 to 676, the county paying the maintenance costs must be reimbursed for the costs from the federal money available for the purpose. Beginning July 1, 1997, for the purposes of determining a child's eligibility under title IV-E of the Social Security Act, the placing agency shall use AFDC requirements in effect on July 16, 1996.

Sec. 3.

Minnesota Statutes 2012, section 256.82, subdivision 3, is amended to read:

Subd. 3.

Setting foster care standard rates.

new text begin (a) new text end The commissioner shall annually establish minimum deleted text begin standard maintenancedeleted text end rates for foster care maintenance deleted text begin anddeleted text end new text begin including supplementalnew text end difficulty of care payments for all children deleted text begin in foster caredeleted text end new text begin eligible for Northstar Care for Children under chapter 256Nnew text end .

new text begin (b) All children entering foster care on or after January 1, 2015, are eligible for Northstar Care for Children under chapter 256N.new text end Any increase in rates shall in no case exceed three percent per annum.

new text begin (c) All children in foster care on December 31, 2014, must remain in the pre-Northstar Care for Children foster care program under sections 256N.21, subdivision 6, and 260C.4411, subdivision 1. The rates for the pre-Northstar Care for Children foster care program shall remain those in effect on January 1, 2013. new text end

Sec. 4.

new text begin [256N.001] CITATION. new text end

new text begin Sections 256N.001 to 256N.28 may be cited as the "Northstar Care for Children Act." Sections 256N.001 to 256N.28 establish Northstar Care for Children, which authorizes certain benefits to support a child in need who is served by the Minnesota child welfare system and who is the responsibility of the state, local county social service agencies, or tribal social service agencies authorized under section 256.01, subdivision 14b, or are otherwise eligible for federal adoption assistance. A child eligible under this chapter has experienced a child welfare intervention that has resulted in the child being placed away from the child's parents' care and is receiving foster care services consistent with chapter 260B, 260C, or 260D, or is in the permanent care of relatives through a transfer of permanent legal and physical custody, or in the permanent care of adoptive parents. new text end

Sec. 5.

new text begin [256N.01] PUBLIC POLICY. new text end

new text begin (a) The legislature declares that the public policy of this state is to keep children safe from harm and to ensure that when children suffer harmful or injurious experiences in their lives, appropriate services are immediately available to keep them safe. new text end

new text begin (b) Children do best in permanent, safe, nurturing homes where they can maintain lifelong relationships with adults. Whenever safely possible, children are best served when they can be nurtured and raised by their parents. Where services cannot be provided to allow a child to remain safely at home, an out-of-home placement may be required. When this occurs, reunification should be sought if it can be accomplished safely. When it is not possible for parents to provide safety and permanency for their children, an alternative permanent home must quickly be made available to the child, drawing from kinship sources whenever possible. new text end

new text begin (c) Minnesota understands the importance of having a comprehensive approach to temporary out-of-home care and to permanent homes for children who cannot be reunited with their families. It is critical that stable benefits be available to caregivers to ensure that the child's needs can be met whether the child's situation and best interests call for temporary foster care, transfer of permanent legal and physical custody to a relative, or adoption. Northstar Care for Children focuses on the child's needs and strengths, and the actual level of care provided by the caregiver, without consideration for the type of placement setting. In this way caregivers are not faced with the burden of making specific long-term decisions based upon competing financial incentives. new text end

Sec. 6.

new text begin [256N.02] DEFINITIONS. new text end

new text begin Subdivision 1. new text end

new text begin Scope. new text end

new text begin For the purposes of sections 256N.001 to 256N.28, the terms defined in this section have the meanings given them. new text end

new text begin Subd. 2. new text end

new text begin Adoption assistance. new text end

new text begin "Adoption assistance" means medical coverage as allowable under section 256B.055 and reimbursement of nonrecurring expenses associated with adoption and may include financial support provided under agreement with the financially responsible agency, the commissioner, and the parents of an adoptive child whose special needs would otherwise make it difficult to place the child for adoption to assist with the cost of caring for the child. Financial support may include a basic rate payment and a supplemental difficulty of care rate. new text end

new text begin Subd. 3. new text end

new text begin Assessment. new text end

new text begin "Assessment" means the process under section 256N.24 that determines the benefits an eligible child may receive under section 256N.26. new text end

new text begin Subd. 4. new text end

new text begin At-risk child. new text end

new text begin "At-risk child" means a child who does not have a documented disability but who is at risk of developing a physical, mental, emotional, or behavioral disability based on being related within the first or second degree to persons who have an inheritable physical, mental, emotional, or behavioral disabling condition, or from a background which has the potential to cause the child to develop a physical, mental, emotional, or behavioral disability that the child is at risk of developing. The disability must manifest during childhood. new text end

new text begin Subd. 5. new text end

new text begin Basic rate. new text end

new text begin "Basic rate" means the maintenance payment made on behalf of a child to support the costs caregivers incur to provide for a child's needs consistent with the care parents customarily provide, including: food, clothing, shelter, daily supervision, school supplies, and a child's personal incidentals. It also supports typical travel to the child's home for visitation, and reasonable travel for the child to remain in the school in which the child is enrolled at the time of placement. new text end

new text begin Subd. 6. new text end

new text begin Caregiver. new text end

new text begin "Caregiver" means the foster parent or parents of a child in foster care who meet the requirements of emergency relative placement, licensed foster parents under chapter 245A, or foster parents licensed or approved by a tribe; the relative custodian or custodians; or the adoptive parent or parents who have legally adopted a child. new text end

new text begin Subd. 7. new text end

new text begin Commissioner. new text end

new text begin "Commissioner" means the commissioner of human services or any employee of the Department of Human Services to whom the commissioner has delegated appropriate authority. new text end

new text begin Subd. 8. new text end

new text begin County board. new text end

new text begin "County board" means the board of county commissioners in each county. new text end

new text begin Subd. 9. new text end

new text begin Disability. new text end

new text begin "Disability" means a physical, mental, emotional, or behavioral impairment that substantially limits one or more major life activities. Major life activities include, but are not limited to: thinking, walking, hearing, breathing, working, seeing, speaking, communicating, learning, developing and maintaining healthy relationships, safely caring for oneself, and performing manual tasks. The nature, duration, and severity of the impairment must be considered in determining if the limitation is substantial. new text end

new text begin Subd. 10. new text end

new text begin Financially responsible agency. new text end

new text begin "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 of transfer of permanent legal and physical custody of a child. new text end

new text begin Subd. 11. new text end

new text begin Guardianship assistance. new text end

new text begin "Guardianship assistance" means medical coverage, as allowable under section 256B.055, and reimbursement of nonrecurring expenses associated with obtaining permanent legal and physical custody of a child, and may include financial support provided under agreement with the financially responsible agency, the commissioner, and the relative who has received a transfer of permanent legal and physical custody of a child. Financial support may include a basic rate payment and a supplemental difficulty of care rate to assist with the cost of caring for the child. new text end

new text begin Subd. 12. new text end

new text begin Human services board. new text end

new text begin "Human services board" means a board established under section 402.02; Laws 1974, chapter 293; or Laws 1976, chapter 340. new text end

new text begin Subd. 13. new text end

new text begin Initial assessment. new text end

new text begin "Initial assessment" means the assessment conducted within the first 30 days of a child's initial placement into foster care under section 256N.24, subdivisions 4 and 5. new text end

new text begin Subd. 14. new text end

new text begin Legally responsible agency. new text end

new text begin "Legally responsible agency" means the Minnesota agency that is assigned responsibility for placement, care, and supervision of the child through a court order, voluntary placement agreement, or voluntary relinquishment. These agencies include local social service agencies under section 393.07, tribal social service agencies authorized in section 256.01, subdivision 14b, and Minnesota tribes that assume court jurisdiction when legal responsibility is transferred to the tribal social service agency through a Minnesota district court order. A Minnesota local social service agency is otherwise financially responsible. new text end

new text begin Subd. 15. new text end

new text begin Maintenance payments. new text end

new text begin "Maintenance payments" means the basic rate plus any supplemental difficulty of care rate under Northstar Care for Children. It specifically does not include the cost of initial clothing allowance, payment for social services, or administrative payments to a child-placing agency. Payments are paid consistent with section 256N.26. new text end

new text begin Subd. 16. new text end

new text begin Permanent legal and physical custody. new text end

new text begin "Permanent legal and physical custody" means a transfer of permanent legal and physical custody to a relative ordered by a Minnesota juvenile court under section 260C.515, subdivision 4, or 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 end

new text begin Subd. 17. new text end

new text begin Reassessment. new text end

new text begin "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 guardianship or 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 end

new text begin Subd. 18. new text end

new text begin Relative. new text end

new text begin "Relative," as described in section 260C.007, subdivision 27, means a person related to the child by blood, marriage, or adoption, or an individual who is an important friend with whom the child has resided or had significant contact. For an Indian child, relative includes members of the extended family as defined by the law or custom of the Indian child's tribe or, in the absence of law or custom, nieces, nephews, or first or second cousins, as provided in the Indian Child Welfare Act of 1978, United States Code, title 25, section 1903. new text end

new text begin Subd. 19. new text end

new text begin Relative custodian. new text end

new text begin "Relative custodian" means a person to whom permanent legal and physical custody of a child has been transferred under section 260C.515, subdivision 4, or 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 end

new text begin Subd. 20. new text end

new text begin Special assessment. new text end

new text begin "Special assessment" means an assessment performed under section 256N.24 that determines the benefits that an eligible child may receive under section 256N.26 at the time when a special assessment is required. A special assessment is used when a child's status within Northstar Care is shifted from a pre-Northstar Care program into Northstar Care for Children and when the commissioner determines that a special assessment is appropriate instead of assigning the transition child to a level under section 256N.28. new text end

new text begin Subd. 21. new text end

new text begin Supplemental difficulty of care rate. new text end

new text begin "Supplemental difficulty of care rate" means the supplemental payment under section 256N.26, if any, as determined by the financially responsible agency or the state, based upon an assessment under section 256N.24. The rate must support activities consistent with the care a parent provides a child with special needs and not the equivalent of a purchased service. The rate must consider the capacity and intensity of the activities associated with parenting duties provided in the home to nurture the child, preserve the child's connections, and support the child's functioning in the home and community. new text end

Sec. 7.

new text begin [256N.20] NORTHSTAR CARE FOR CHILDREN; GENERALLY. new text end

new text begin Subdivision 1. new text end

new text begin Eligibility. new text end

new text begin A child is eligible for Northstar Care for Children if the child is eligible for: new text end

new text begin (1) foster care under section 256N.21; new text end

new text begin (2) guardianship assistance under section 256N.22; or new text end

new text begin (3) adoption assistance under section 256N.23. new text end

new text begin Subd. 2. new text end

new text begin Assessments. new text end

new text begin Except as otherwise specified, a child eligible for Northstar Care for Children shall receive an assessment under section 256N.24. new text end

new text begin Subd. 3. new text end

new text begin Agreements. new text end

new text begin When a child is eligible for guardianship assistance or adoption assistance, negotiations with caregivers and the development of a written, binding agreement must be conducted under section 256N.25. new text end

new text begin Subd. 4. new text end

new text begin Benefits and payments. new text end

new text begin A child eligible for Northstar Care for Children is entitled to benefits specified in section 256N.26, based primarily on assessments under section 256N.24, and, if appropriate, negotiations and agreements under section 256N.25. Although paid to the caregiver, these benefits must be considered benefits of the child rather than of the caregiver. new text end

new text begin Subd. 5. new text end

new text begin Federal, state, and local shares. new text end

new text begin The cost of Northstar Care for Children must be shared among the federal government, state, counties of financial responsibility, and certain tribes as specified in section 256N.27. new text end

new text begin Subd. 6. new text end

new text begin Administration and appeals. new text end

new text begin The commissioner and financially responsible agency, or other agency designated by the commissioner, shall administer Northstar Care for Children according to section 256N.28. The notification and fair hearing process applicable to this chapter is defined in section 256N.28. new text end

new text begin Subd. 7. new text end

new text begin Transition. new text end

new text begin A child in foster care, relative custody assistance, or adoption assistance prior to January 1, 2015, who remains with the same caregivers continues to receive benefits under programs preceding Northstar Care for Children, unless the child moves to a new foster care placement, permanency is obtained for the child, or the commissioner initiates transition of a child receiving pre-Northstar Care for Children relative custody assistance, guardianship assistance, or adoption assistance under this chapter. Provisions for the transition to Northstar Care for Children for certain children in preceding programs are specified in section 256N.28, subdivisions 2 and 7. Additional provisions for children in: foster care are specified in section 256N.21, subdivision 6; relative custody assistance under section 257.85 are specified in section 256N.22, subdivision 12; and adoption assistance under chapter 259A are specified in section 256N.23, subdivision 13. new text end

Sec. 8.

new text begin [256N.21] ELIGIBILITY FOR FOSTER CARE BENEFITS. new text end

new text begin Subdivision 1. new text end

new text begin General eligibility requirements. new text end

new text begin (a) A child is eligible for foster care benefits under this section if the child meets the requirements of subdivision 2 on or after January 1, 2015. new text end

new text begin (b) The financially responsible agency shall make a title IV-E eligibility determination for all foster children meeting the requirements of subdivision 2, provided the agency has such authority under the state title IV-E plan. To be eligible for title IV-E foster care, a child must also meet any additional criteria specified in section 472 of the Social Security Act. new text end

new text begin (c) Except as provided under section 256N.26, subdivision 1 or 6, the foster care benefit to the child under this section must be determined under sections 256N.24 and 256N.26 through an individual assessment. Information from this assessment must be used to determine a potential future benefit under guardianship assistance or adoption assistance, if needed. new text end

new text begin (d) When a child is eligible for additional services, subdivisions 3 and 4 govern the co-occurrence of program eligibility. new text end

new text begin Subd. 2. new text end

new text begin Placement in foster care. new text end

new text begin To be eligible for foster care benefits under this section, the child must be in placement away from the child's legal parent or guardian and all of the following criteria must be met: new text end

new text begin (1) the legally responsible agency must have placement authority and care responsibility, including for a child 18 years old or older and under age 21, who maintains eligibility for foster care consistent with section 260C.451; new text end

new text begin (2) the legally responsible agency must have authority to place the child with a voluntary placement agreement or a court order, consistent with sections 260B.198, 260C.001, 260D.01, or continued eligibility consistent with section 260C.451; and new text end

new text begin (3) the child must be placed in an emergency relative placement under section 245A.035, a licensed foster family setting, foster residence setting, or treatment foster care setting licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, a family foster home licensed or approved by a tribal agency or, for a child 18 years old or older and under age 21, an unlicensed supervised independent living setting approved by the agency responsible for the youth's care. new text end

new text begin Subd. 3. new text end

new text begin Minor parent. new text end

new text begin A child who is a minor parent in placement with the minor parent's child in the same home is eligible for foster care benefits under this section. The foster care benefit is limited to the minor parent, unless the legally responsible agency has separate legal authority for placement of the minor parent's child. new text end

new text begin Subd. 4. new text end

new text begin Foster children ages 18 up to 21 placed in an unlicensed supervised independent living setting. new text end

new text begin A foster child 18 years old or older and under age 21 who maintains eligibility consistent with section 260C.451 and who is placed in an unlicensed supervised independent living setting shall receive the level of benefit under section 256N.26. new text end

new text begin Subd. 5. new text end

new text begin Excluded activities. new text end

new text begin The basic and supplemental difficulty of care payment represents costs for activities similar in nature to those expected of parents, and does not cover services rendered by the licensed or tribally approved foster parent, facility, or administrative costs or fees. The financially responsible agency may pay an additional fee for specific services provided by the licensed foster parent or facility. A foster parent or residence setting must distinguish such a service from the daily care of the child as assessed through the process under section 256N.24. new text end

new text begin Subd. 6. new text end

new text begin Transition from pre-Northstar Care for Children program. new text end

new text begin (a) Section 256.82 establishes the pre-Northstar Care for Children foster care program for all children residing in family foster care on December 31, 2014. Unless transitioned under paragraph (b), a child in foster care with the same caregiver receives benefits under this pre-Northstar Care for Children foster care program. new text end

new text begin (b) Transition from the pre-Northstar Care for Children foster care program to Northstar Care for Children takes place on or after January 1, 2015, when the child: new text end

new text begin (1) moves to a different foster home or unlicensed supervised independent living setting; new text end

new text begin (2) has permanent legal and physical custody transferred and, if applicable, meets eligibility requirements in section 256N.22; new text end

new text begin (3) is adopted and, if applicable, meets eligibility requirements in section 256N.23; or new text end

new text begin (4) re-enters foster care after reunification or a trial home visit. new text end

new text begin (c) Upon becoming eligible, a foster child must be assessed according to section 256N.24 and then transitioned into Northstar Care for Children according to section 256N.28. new text end

Sec. 9.

new text begin [256N.22] GUARDIANSHIP ASSISTANCE ELIGIBILITY. new text end

new text begin Subdivision 1. new text end

new text begin General eligibility requirements. new text end

new text begin (a) To be eligible for guardianship 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 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. Additionally, a child must: new text end

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

new text begin (2)(i) have resided in foster care for at least six consecutive months in the home of the prospective relative custodian; or new text end

new text begin (ii) have received an exemption from the requirement in item (i) from the court based on a determination that: new text end

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

new text begin (B) expedited permanency cannot be completed without provision of guardianship assistance; and new text end

new text begin (C) the prospective relative custodian is uniquely qualified to meet the child's needs on a permanent basis; new text end

new text begin (3) meet the agency determinations regarding permanency requirements in subdivision 2; new text end

new text begin (4) meet the applicable citizenship and immigration requirements in subdivision 3; new text end

new text begin (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 new text end

new text begin (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. new text end

new text begin (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. new text end

new text begin (c) To be eligible for title IV-E guardianship 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 guardianship assistance in section 473(d) of the Social Security Act is eligible for title IV-E guardianship 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 guardianship assistance is entitled to guardianship assistance paid through funds other than title IV-E. new text end

new text begin Subd. 2. new text end

new text begin Agency determinations regarding permanency. new text end

new text begin (a) To be eligible for guardianship assistance, the legally responsible agency must complete the following determinations regarding permanency for the child prior to the transfer of permanent legal and physical custody: new text end

new text begin (1) a determination that reunification and adoption are not appropriate permanency options for the child; and new text end

new text begin (2) a determination that the child demonstrates a strong attachment to the prospective relative custodian and the prospective relative custodian has a strong commitment to caring permanently for the child. new text end

new text begin (b) The legally responsible agency shall document the determinations in paragraph (a) and the supporting information for completing each determination in the case file and make them available for review as requested by the financially responsible agency and the commissioner during the guardianship assistance eligibility determination process. new text end

new text begin Subd. 3. new text end

new text begin Citizenship and immigration status. new text end

new text begin A child must be a citizen of the United States or otherwise be eligible for federal public benefits according to the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, as amended, in order to be eligible for guardianship assistance. new text end

new text begin Subd. 4. new text end

new text begin Background study. new text end

new text begin (a) A background study under section 245C.33 must be completed on each prospective relative custodian and any other adult residing in the home of the prospective relative custodian. A background study on the prospective relative custodian or adult residing in the household previously completed under section 245C.04 for the purposes of foster care licensure may be used for the purposes of this section, provided that the background study is current at the time of the application for guardianship assistance. new text end

new text begin (b) If the background study reveals: new text end

new text begin (1) a felony conviction at any time for: new text end

new text begin (i) child abuse or neglect; new text end

new text begin (ii) spousal abuse; new text end

new text begin (iii) a crime against a child, including child pornography; or new text end

new text begin (iv) a crime involving violence, including rape, sexual assault, or homicide, but not including other physical assault or battery; or new text end

new text begin (2) a felony conviction within the past five years for: new text end

new text begin (i) physical assault; new text end

new text begin (ii) battery; or new text end

new text begin (iii) a drug-related offense; new text end

new text begin the prospective relative custodian is prohibited from receiving guardianship assistance on behalf of an otherwise eligible child. new text end

new text begin Subd. 5. new text end

new text begin Responsibility for determining guardianship assistance eligibility. new text end

new text begin The commissioner shall determine eligibility for: new text end

new text begin (1) a child under the legal custody or responsibility of a Minnesota county social service agency who would otherwise remain in foster care; new text end

new text begin (2) a Minnesota child under tribal court jurisdiction who would otherwise remain in foster care; and new text end

new text begin (3) an Indian child being placed in Minnesota who meets title IV-E eligibility defined in section 473(d) of the Social Security Act. The agency or entity assuming responsibility for the child is responsible for the nonfederal share of the guardianship assistance payment. new text end

new text begin Subd. 6. new text end

new text begin Exclusions. new text end

new text begin (a) A child with a guardianship assistance agreement under Northstar Care for Children is not eligible for the Minnesota family investment program child-only grant under chapter 256J. new text end

new text begin (b) The commissioner shall not enter into a guardianship assistance agreement with: new text end

new text begin (1) a child's biological parent; new text end

new text begin (2) an individual assuming permanent legal and physical custody of a child or the equivalent under tribal code without involvement of the child welfare system; or new text end

new text begin (3) an individual assuming permanent legal and physical custody of a child who was placed in Minnesota by another state or a tribe outside of Minnesota. new text end

new text begin Subd. 7. new text end

new text begin Guardianship assistance eligibility determination. new text end

new text begin The financially responsible agency shall prepare a guardianship assistance eligibility determination for review and final approval by the commissioner. The eligibility determination must be completed according to requirements and procedures and on forms prescribed by the commissioner. Supporting documentation for the eligibility determination must be provided to the commissioner. The financially responsible agency and the commissioner must make every effort to establish a child's eligibility for title IV-E guardianship assistance. A child who is determined to be eligible for guardianship assistance must have a guardianship assistance agreement negotiated on the child's behalf according to section 256N.25. new text end

new text begin Subd. 8. new text end

new text begin Termination of agreement. new text end

new text begin (a) A guardianship assistance agreement must be terminated in any of the following circumstances: new text end

new text begin (1) the child has attained the age of 18, or up to age 21 when the child meets a condition for extension in subdivision 11; new text end

new text begin (2) the child has not attained the age of 18 years of age, but the commissioner determines the relative custodian is no longer legally responsible for support of the child; new text end

new text begin (3) the commissioner determines the relative custodian is no longer providing financial support to the child up to age 21; new text end

new text begin (4) the death of the child; or new text end

new text begin (5) the relative custodian requests in writing termination of the guardianship assistance agreement. new text end

new text begin (b) A relative custodian is considered no longer legally responsible for support of the child in any of the following circumstances: new text end

new text begin (1) permanent legal and physical custody or guardianship of the child is transferred to another individual; new text end

new text begin (2) the death of the relative custodian under subdivision 9; new text end

new text begin (3) the child enlists in the military; new text end

new text begin (4) the child gets married; or new text end

new text begin (5) the child is determined an emancipated minor through legal action. new text end

new text begin Subd. 9. new text end

new text begin Death of relative custodian or dissolution of custody. new text end

new text begin The guardianship assistance agreement ends upon death or dissolution of permanent legal and physical custody of both relative custodians in the case of assignment of custody to two individuals, or the sole relative custodian in the case of assignment of custody to one individual. Guardianship assistance eligibility may be continued according to subdivision 10. new text end

new text begin Subd. 10. new text end

new text begin Assigning a child's guardianship assistance to a court-appointed guardian or custodian. new text end

new text begin (a) Guardianship assistance may be continued with the written consent of the commissioner to an individual who is a guardian or custodian appointed by a court for the child upon the death of both relative custodians in the case of assignment of custody to two individuals, or the sole relative custodian in the case of assignment of custody to one individual, unless the child is under the custody of a county, tribal, or child-placing agency. new text end

new text begin (b) Temporary assignment of guardianship assistance may be approved for a maximum of six consecutive months from the death of the relative custodian or custodians as provided in paragraph (a) and must adhere to the policies and procedures prescribed by the commissioner. If a court has not appointed a permanent legal guardian or custodian within six months, the guardianship assistance must terminate and must not be resumed. new text end

new text begin (c) Upon assignment of assistance payments under this subdivision, assistance must be provided from funds other than title IV-E. new text end

new text begin Subd. 11. new text end

new text begin Extension of guardianship assistance after age 18. new text end

new text begin (a) Under the circumstances outlined in paragraph (e), a child may qualify for extension of the guardianship assistance agreement beyond the date the child attains age 18, up to the date the child attains the age of 21. new text end

new text begin (b) A request for extension of the guardianship assistance agreement must be completed in writing and submitted, including all supporting documentation, by the relative custodian to the commissioner at least 60 calendar days prior to the date that the current agreement will terminate. new text end

new text begin (c) A signed amendment to the current guardianship assistance agreement must be fully executed between the relative custodian and the commissioner at least ten business days prior to the termination of the current agreement. The request for extension and the fully executed amendment must be made according to requirements and procedures prescribed by the commissioner, including documentation of eligibility, and on forms prescribed by the commissioner. new text end

new text begin (d) If an agency is certifying a child for guardianship assistance and the child will attain the age of 18 within 60 calendar days of submission, the request for extension must be completed in writing and submitted, including all supporting documentation, with the guardianship assistance application. new text end

new text begin (e) A child who has attained the age of 16 prior to the effective date of the guardianship assistance agreement is eligible for extension of the agreement up to the date the child attains age 21 if the child: new text end

new text begin (1) is dependent on the relative custodian for care and financial support; and new text end

new text begin (2) meets at least one of the following conditions: new text end

new text begin (i) is completing a secondary education program or a program leading to an equivalent credential; new text end

new text begin (ii) is enrolled in an institution which provides postsecondary or vocational education; new text end

new text begin (iii) is participating in a program or activity designed to promote or remove barriers to employment; new text end

new text begin (iv) is employed for at least 80 hours per month; or new text end

new text begin (v) is incapable of doing any of the activities described in items (i) to (iv) due to a medical condition where incapability is supported by professional documentation according to the requirements and procedures prescribed by the commissioner. new text end

new text begin (f) A child who has not attained the age of 16 prior to the effective date of the guardianship assistance agreement is eligible for extension of the guardianship assistance agreement up to the date the child attains the age of 21 if the child is: new text end

new text begin (1) dependent on the relative custodian for care and financial support; and new text end

new text begin (2) possesses a physical or mental disability which impairs the capacity for independent living and warrants continuation of financial assistance, as determined by the commissioner. new text end

new text begin Subd. 12. new text end

new text begin Beginning guardianship assistance component of Northstar Care for Children. new text end

new text begin Effective November 27, 2014, a child who meets the eligibility criteria for guardianship assistance in subdivision 1 may have a guardianship assistance agreement negotiated on the child's behalf according to section 256N.25. The effective date of the agreement must be January 1, 2015, or the date of the court order transferring permanent legal and physical custody, whichever is later. Except as provided under section 256N.26, subdivision 1, paragraph (c), the rate schedule for an agreement under this subdivision is determined under section 256N.26 based on the age of the child on the date that the prospective relative custodian signs the agreement. new text end

new text begin Subd. 13. new text end

new text begin Transition to guardianship assistance under Northstar Care for Children. new text end

new text begin The commissioner may execute guardianship assistance agreements for a child with a relative custody agreement under section 257.85 executed on the child's behalf on or before November 26, 2014, in accordance with the priorities outlined in section 256N.28, subdivision 7, paragraph (b). To facilitate transition into the guardianship assistance program, the commissioner may waive any guardianship assistance eligibility requirements for a child with a relative custody agreement under section 257.85 executed on the child's behalf on or before November 26, 2014. Agreements negotiated under this subdivision must be done according to the process outlined in section 256N.28, subdivision 7. The maximum rate used in the negotiation process for an agreement under this subdivision must be as outlined in section 256N.28, subdivision 7. new text end

Sec. 10.

new text begin [256N.23] ADOPTION ASSISTANCE ELIGIBILITY. new text end

new text begin Subdivision 1. new text end

new text begin General eligibility requirements. new text end

new text begin (a) To be eligible for adoption assistance under this section, a child must: new text end

new text begin (1) be determined to be a child with special needs under subdivision 2; new text end

new text begin (2) meet the applicable citizenship and immigration requirements in subdivision 3; new text end

new text begin (3)(i) meet the criteria in section 473 of the Social Security Act; or new text end

new text begin (ii) have had foster care payments paid on the child's behalf while in out-of-home placement through the county or tribe and be either under the guardianship of the commissioner or under the jurisdiction of a Minnesota tribe and adoption, according to tribal law, is in the child's documented permanency plan; and new text end

new text begin (4) have a written, binding agreement under section 256N.25 among the adoptive parent, the financially responsible agency, or if there is no financially responsible agency, the agency designated by the commissioner, and the commissioner established prior to finalization of the adoption. new text end

new text begin (b) In addition to the requirements in paragraph (a), an eligible child's adoptive parent or parents must meet the applicable background study requirements in subdivision 4. new text end

new text begin (c) A child who meets all eligibility criteria except those specific to title IV-E adoption assistance shall receive adoption assistance paid through funds other than title IV-E. new text end

new text begin Subd. 2. new text end

new text begin Special needs determination. new text end

new text begin (a) A child is considered a child with special needs under this section if the requirements in paragraphs (b) to (g) are met. new text end

new text begin (b) There must be a determination that the child must not or should not be returned to the home of the child's parents as evidenced by: new text end

new text begin (1) a court-ordered termination of parental rights; new text end

new text begin (2) a petition to terminate parental rights; new text end

new text begin (3) consent of parent to adoption accepted by the court under chapter 260C; new text end

new text begin (4) in circumstances when tribal law permits the child to be adopted without a termination of parental rights, a judicial determination by a tribal court indicating the valid reason why the child cannot or should not return home; new text end

new text begin (5) a voluntary relinquishment under section 259.25 or 259.47 or, if relinquishment occurred in another state, the applicable laws in that state; or new text end

new text begin (6) the death of the legal parent or parents if the child has two legal parents. new text end

new text begin (c) There exists a specific factor or condition of which it is reasonable to conclude that the child cannot be placed with adoptive parents without providing adoption assistance as evidenced by: new text end

new text begin (1) a determination by the Social Security Administration that the child meets all medical or disability requirements of title XVI of the Social Security Act with respect to eligibility for Supplemental Security Income benefits; new text end

new text begin (2) a documented physical, mental, emotional, or behavioral disability not covered under clause (1); new text end

new text begin (3) a member of a sibling group being adopted at the same time by the same parent; new text end

new text begin (4) an adoptive placement in the home of a parent who previously adopted a sibling for whom they receive adoption assistance; or new text end

new text begin (5) documentation that the child is an at-risk child. new text end

new text begin (d) A reasonable but unsuccessful effort must have been made to place the child with adoptive parents without providing adoption assistance as evidenced by: new text end

new text begin (1) a documented search for an appropriate adoptive placement; or new text end

new text begin (2) a determination by the commissioner that a search under clause (1) is not in the best interests of the child. new text end

new text begin (e) The requirement for a documented search for an appropriate adoptive placement under paragraph (d), including the registration of the child with the state adoption exchange and other recruitment methods under paragraph (f), must be waived if: new text end

new text begin (1) the child is being adopted by a relative and it is determined by the child-placing agency that adoption by the relative is in the best interests of the child; new text end

new text begin (2) the child is being adopted by a foster parent with whom the child has developed significant emotional ties while in the foster parent's care as a foster child and it is determined by the child-placing agency that adoption by the foster parent is in the best interests of the child; or new text end

new text begin (3) the child is being adopted by a parent that previously adopted a sibling of the child, and it is determined by the child-placing agency that adoption by this parent is in the best interests of the child. new text end

new text begin For an Indian child covered by the Indian Child Welfare Act, a waiver must not be granted unless the child-placing agency has complied with the placement preferences required by the Indian Child Welfare Act, United States Code, title 25, section 1915(a). new text end

new text begin (f) To meet the requirement of a documented search for an appropriate adoptive placement under paragraph (d), clause (1), the child-placing agency minimally must: new text end

new text begin (1) conduct a relative search as required by section 260C.221 and give consideration to placement with a relative, as required by section 260C.212, subdivision 2; new text end

new text begin (2) comply with the placement preferences required by the Indian Child Welfare Act when the Indian Child Welfare Act, United States Code, title 25, section 1915(a), applies; new text end

new text begin (3) locate prospective adoptive families by registering the child on the state adoption exchange, as required under section 259.75; and new text end

new text begin (4) if registration with the state adoption exchange does not result in the identification of an appropriate adoptive placement, the agency must employ additional recruitment methods prescribed by the commissioner. new text end

new text begin (g) Once the legally responsible agency has determined that placement with an identified parent is in the child's best interests and made full written disclosure about the child's social and medical history, the agency must ask the prospective adoptive parent if the prospective adoptive parent is willing to adopt the child without receiving adoption assistance under this section. If the identified parent is either unwilling or unable to adopt the child without adoption assistance, the legally responsible agency must provide documentation as prescribed by the commissioner to fulfill the requirement to make a reasonable effort to place the child without adoption assistance. If the identified parent is willing to adopt the child without adoption assistance, the parent must provide a written statement to this effect to the legally responsible agency and the statement must be maintained in the permanent adoption record of the legally responsible agency. For children under guardianship of the commissioner, the legally responsible agency shall submit a copy of this statement to the commissioner to be maintained in the permanent adoption record. new text end

new text begin Subd. 3. new text end

new text begin Citizenship and immigration status. new text end

new text begin (a) A child must be a citizen of the United States or otherwise eligible for federal public benefits according to the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, as amended, in order to be eligible for the title IV-E adoption assistance program. new text end

new text begin (b) A child must be a citizen of the United States or meet the qualified alien requirements as defined in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, as amended, in order to be eligible for adoption assistance paid through funds other than title IV-E. new text end

new text begin Subd. 4. new text end

new text begin Background study. new text end

new text begin A background study under section 259.41 must be completed on each prospective adoptive parent. If the background study reveals: new text end

new text begin (1) a felony conviction at any time for: new text end

new text begin (i) child abuse or neglect; new text end

new text begin (ii) spousal abuse; new text end

new text begin (iii) a crime against a child, including child pornography; or new text end

new text begin (iv) a crime involving violence, including rape, sexual assault, or homicide, but not including other physical assault or battery; or new text end

new text begin (2) a felony conviction within the past five years for: new text end

new text begin (i) physical assault; new text end

new text begin (ii) battery; or new text end

new text begin (iii) a drug-related offense; new text end

new text begin the adoptive parent is prohibited from receiving adoption assistance on behalf of an otherwise eligible child. new text end

new text begin Subd. 5. new text end

new text begin Responsibility for determining adoption assistance eligibility. new text end

new text begin The commissioner must determine eligibility for: new text end

new text begin (1) a child under the guardianship of the commissioner who would otherwise remain in foster care; new text end

new text begin (2) a child who is not under the guardianship of the commissioner who meets title IV-E eligibility defined in section 473 of the Social Security Act and no state agency has legal responsibility for placement and care of the child; new text end

new text begin (3) a Minnesota child under tribal jurisdiction who would otherwise remain in foster care; and new text end

new text begin (4) an Indian child being placed in Minnesota who meets title IV-E eligibility defined in section 473 of the Social Security Act. The agency or entity assuming responsibility for the child is responsible for the nonfederal share of the adoption assistance payment. new text end

new text begin Subd. 6. new text end

new text begin Exclusions. new text end

new text begin The commissioner must not enter into an adoption assistance agreement with the following individuals: new text end

new text begin (1) a child's biological parent or stepparent; new text end

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

new text begin (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 new text end

new text begin (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; new text end

new text begin (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; new text end

new text begin (4) a child's legal custodian or guardian who is now adopting the child; or new text end

new text begin (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 end

new text begin Subd. 7. new text end

new text begin Adoption assistance eligibility determination. new text end

new text begin (a) The financially responsible agency shall prepare an adoption assistance eligibility determination for review and final approval by the commissioner. When there is no financially responsible agency, the adoption assistance eligibility determination must be completed by the agency designated by the commissioner. The eligibility determination must be completed according to requirements and procedures and on forms prescribed by the commissioner. The financially responsible agency and the commissioner shall make every effort to establish a child's eligibility for title IV-E adoption assistance. Documentation from a qualified expert for the eligibility determination must be provided to the commissioner to verify that a child meets the special needs criteria in subdivision 2. A child who is determined to be eligible for adoption assistance must have an adoption assistance agreement negotiated on the child's behalf according to section 256N.25. new text end

new text begin (b) Documentation from a qualified expert of a disability is limited to evidence deemed appropriate by the commissioner and must be submitted to the commissioner with the eligibility determination. Examples of appropriate documentation include, but are not limited to, medical records, psychological assessments, educational or early childhood evaluations, court findings, and social and medical history. new text end

new text begin (c) Documentation that the child is at risk of developing physical, mental, emotional, or behavioral disabilities must be submitted according to policies and procedures prescribed by the commissioner. new text end

new text begin Subd. 8. new text end

new text begin Termination of agreement. new text end

new text begin (a) An adoption assistance agreement must terminate in any of the following circumstances: new text end

new text begin (1) the child has attained the age of 18, or up to age 21 when the child meets a condition for extension in subdivision 12; new text end

new text begin (2) the child has not attained the age of 18, but the commissioner determines the adoptive parent is no longer legally responsible for support of the child; new text end

new text begin (3) the commissioner determines the adoptive parent is no longer providing financial support to the child up to age 21; new text end

new text begin (4) the death of the child; or new text end

new text begin (5) the adoptive parent requests in writing the termination of the adoption assistance agreement. new text end

new text begin (b) An adoptive parent is considered no longer legally responsible for support of the child in any of the following circumstances: new text end

new text begin (1) parental rights to the child are legally terminated or a court accepted the parent's consent to adoption under chapter 260C; new text end

new text begin (2) permanent legal and physical custody or guardianship of the child is transferred to another individual; new text end

new text begin (3) death of the adoptive parent under subdivision 9; new text end

new text begin (4) the child enlists in the military; new text end

new text begin (5) the child gets married; or new text end

new text begin (6) the child is determined an emancipated minor through legal action. new text end

new text begin Subd. 9. new text end

new text begin Death of adoptive parent or adoption dissolution. new text end

new text begin The adoption assistance agreement ends upon death or termination of parental rights of both adoptive parents in the case of a two-parent adoption, or the sole adoptive parent in the case of a single-parent adoption. The child's adoption assistance eligibility may be continued according to subdivision 10. new text end

new text begin Subd. 10. new text end

new text begin Continuing a child's title IV-E adoption assistance in a subsequent adoption. new text end

new text begin (a) The child maintains eligibility for title IV-E adoption assistance in a subsequent adoption if the following criteria are met: new text end

new text begin (1) the child is determined to be a child with special needs as outlined in subdivision 2; and new text end

new text begin (2) the subsequent adoptive parent resides in Minnesota. new text end

new text begin (b) If a child had a title IV-E adoption assistance agreement in effect prior to the death of the adoptive parent or dissolution of the adoption, and the subsequent adoptive parent resides outside of Minnesota, the commissioner is not responsible for determining whether the child meets the definition of special needs, entering into the adoption assistance agreement, and making any adoption assistance payments outlined in the new agreement unless a state agency in Minnesota has responsibility for placement and care of the child at the time of the subsequent adoption. If there is no state agency in Minnesota that has responsibility for placement and care of the child at the time of the subsequent adoption, the public child welfare agency in the subsequent adoptive parent's residence is responsible for determining whether the child meets the definition of special needs and entering into the adoption assistance agreement. new text end

new text begin Subd. 11. new text end

new text begin Assigning a child's adoption assistance to a court-appointed guardian or custodian. new text end

new text begin (a) State-funded adoption assistance may be continued with the written consent of the commissioner to an individual who is a guardian appointed by a court for the child upon the death of both the adoptive parents in the case of a two-parent adoption, or the sole adoptive parent in the case of a single-parent adoption, unless the child is under the custody of a state agency. new text end

new text begin (b) Temporary assignment of adoption assistance may be approved by the commissioner for a maximum of six consecutive months from the death of the adoptive parent or parents under subdivision 9 and must adhere to the requirements and procedures prescribed by the commissioner. If, within six months, the child has not been adopted by a person agreed upon by the commissioner, or a court has not appointed a permanent legal guardian under section 260C.325, 525.5-313, or similar law of another jurisdiction, the adoption assistance must terminate. new text end

new text begin (c) Upon assignment of payments under this subdivision, assistance must be from funds other than title IV-E. new text end

new text begin Subd. 12. new text end

new text begin Extension of adoption assistance agreement. new text end

new text begin (a) Under certain limited circumstances a child may qualify for extension of the adoption assistance agreement beyond the date the child attains age 18, up to the date the child attains the age of 21. new text end

new text begin (b) A request for extension of the adoption assistance agreement must be completed in writing and submitted, including all supporting documentation, by the adoptive parent to the commissioner at least 60 calendar days prior to the date that the current agreement will terminate. new text end

new text begin (c) A signed amendment to the current adoption assistance agreement must be fully executed between the adoptive parent and the commissioner at least ten business days prior to the termination of the current agreement. The request for extension and the fully executed amendment must be made according to the requirements and procedures prescribed by the commissioner, including documentation of eligibility, on forms prescribed by the commissioner. new text end

new text begin (d) If an agency is certifying a child for adoption assistance and the child will attain the age of 18 within 60 calendar days of submission, the request for extension must be completed in writing and submitted, including all supporting documentation, with the adoption assistance application. new text end

new text begin (e) A child who has attained the age of 16 prior to the finalization of the child's adoption is eligible for extension of the adoption assistance agreement up to the date the child attains age 21 if the child is: new text end

new text begin (1) dependent on the adoptive parent for care and financial support; and new text end

new text begin (2)(i) completing a secondary education program or a program leading to an equivalent credential; new text end

new text begin (ii) enrolled in an institution that provides postsecondary or vocational education; new text end

new text begin (iii) participating in a program or activity designed to promote or remove barriers to employment; new text end

new text begin (iv) employed for at least 80 hours per month; or new text end

new text begin (v) incapable of doing any of the activities described in items (i) to (iv) due to a medical condition where incapability is supported by documentation from an expert according to the requirements and procedures prescribed by the commissioner. new text end

new text begin (f) A child who has not attained the age of 16 prior to finalization of the child's adoption is eligible for extension of the adoption assistance agreement up to the date the child attains the age of 21 if the child is: new text end

new text begin (1) dependent on the adoptive parent for care and financial support; and new text end

new text begin (2)(i) enrolled in a secondary education program or a program leading to the equivalent; or new text end

new text begin (ii) possesses a physical or mental disability that impairs the capacity for independent living and warrants continuation of financial assistance as determined by the commissioner. new text end

new text begin Subd. 13. new text end

new text begin Beginning adoption assistance under Northstar Care for Children. new text end

new text begin Effective November 27, 2014, a child who meets the eligibility criteria for adoption assistance in subdivision 1, may have an adoption assistance agreement negotiated on the child's behalf according to section 256N.25, and the effective date of the agreement must be January 1, 2015, or the date of the court order finalizing the adoption, whichever is later. Except as provided under section 256N.26, subdivision 1, paragraph (c), the maximum rate schedule for the agreement must be determined according to section 256N.26 based on the age of the child on the date that the prospective adoptive parent or parents sign the agreement. new text end

new text begin Subd. 14. new text end

new text begin Transition to adoption assistance under Northstar Care for Children. new text end

new text begin The commissioner may offer adoption assistance agreements under this chapter to a child with an adoption assistance agreement under chapter 259A executed on the child's behalf on or before November 26, 2014, according to the priorities outlined in section 256N.28, subdivision 7, paragraph (b). To facilitate transition into the Northstar Care for Children adoption assistance program, the commissioner has the authority to waive any Northstar Care for Children adoption assistance eligibility requirements for a child with an adoption assistance agreement under chapter 259A executed on the child's behalf on or before November 26, 2014. Agreements negotiated under this subdivision must be in accordance with the process in section 256N.28, subdivision 7. The maximum rate used in the negotiation process for an agreement under this subdivision must be as outlined in section 256N.28, subdivision 7. new text end

Sec. 11.

new text begin [256N.24] ASSESSMENTS. new text end

new text begin Subdivision 1. new text end

new text begin Assessment. new text end

new text begin (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. new text end

new text begin (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. new text end

new text begin (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. new text end

new text begin (d) An assessment must not be completed for: new text end

new text begin (1) a child eligible for guardianship assistance under section 256N.22 or 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 new text end

new text begin (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 end

new text begin Subd. 2. new text end

new text begin Establishment of assessment tool, process, and requirements. new text end

new text begin Consistent with sections 256N.001 to 256N.28, the commissioner shall establish an assessment tool to determine the basic and supplemental difficulty of care, and shall establish the process to be followed and other requirements, including appropriate documentation, when conducting the initial assessment of a child entering Northstar Care for Children or when the special assessment and reassessments may be needed for children continuing in the program. The assessment tool must take into consideration the strengths and needs of the child and the extra parenting provided by the caregiver to meet the child's needs. new text end

new text begin Subd. 3. new text end

new text begin Child care allowance portion of assessment. new text end

new text begin (a) The assessment tool established under subdivision 2 must include consideration of the caregiver's need for child care under this subdivision, with greater consideration for children of younger ages. new text end

new text begin (b) The child's assessment must include consideration of the caregiver's need for child care if the following criteria are met: new text end

new text begin (1) the child is under age 13; new text end

new text begin (2) all available adult caregivers are employed or attending educational or vocational training programs; and new text end

new text begin (3) the caregiver does not receive child care assistance for the child under chapter 119B. new text end

new text begin (c) For children younger than seven years of age, the level determined by the non-child care portions of the assessment must be adjusted based on the average number of hours child care is needed each week due to employment or attending a training or educational program as follows: new text end

new text begin (1) fewer than ten hours or if the caregiver is participating in the child care assistance program under chapter 119B, no adjustment; new text end

new text begin (2) ten to 19 hours or if needed during school summer vacation or equivalent only, increase one level; new text end

new text begin (3) 20 to 29 hours, increase two levels; new text end

new text begin (4) 30 to 39 hours, increase three levels; and new text end

new text begin (5) 40 or more hours, increase four levels. new text end

new text begin (d) For children at least seven years of age but younger than 13, the level determined by the non-child care portions of the assessment must be adjusted based on the average number of hours child care is needed each week due to employment or attending a training or educational program as follows: new text end

new text begin (1) fewer than 20 hours, needed during school summer vacation or equivalent only, or if the caregiver is participating in the child care assistance program under chapter 119B, no adjustment; new text end

new text begin (2) 20 to 39 hours, increase one level; and new text end

new text begin (3) 40 or more hours, increase two levels. new text end

new text begin (e) When the child attains the age of seven, the child care allowance must be reduced by reducing the level to that available under paragraph (d). For children in foster care, benefits under section 256N.26 must be automatically reduced when the child turns seven. For children who receive guardianship assistance or adoption assistance, agreements must include similar provisions to ensure that the benefit provided to these children does not exceed the benefit provided to children in foster care. new text end

new text begin (f) When the child attains the age of 13, the child care allowance must be eliminated by reducing the level to that available prior to any consideration of the caregiver's need for child care. For children in foster care, benefits under section 256N.26 must be automatically reduced when the child attains the age of 13. For children who receive guardianship assistance or adoption assistance, agreements must include similar provisions to ensure that the benefit provided to these children does not exceed the benefit provided to children in foster care. new text end

new text begin (g) The child care allowance under this subdivision is not available to caregivers who receive the child care assistance under chapter 119B. A caregiver receiving a child care allowance under this subdivision must notify the commissioner if the caregiver subsequently receives the child care assistance program under chapter 119B, and the level must be reduced to that available prior to any consideration of the caregiver's need for child care. new text end

new text begin (h) In establishing the assessment tool under subdivision 2, the commissioner must design the tool so that the levels applicable to the non-child care portions of the assessment at a given age accommodate the requirements of this subdivision. new text end

new text begin Subd. 4. new text end

new text begin Extraordinary levels. new text end

new text begin (a) The assessment tool established under subdivision 2 must provide a mechanism through which up to five levels can be added to the supplemental difficulty of care for a particular child under section 256N.26, subdivision 4. In establishing the assessment tool, the commissioner must design the tool so that the levels applicable to the portions of the assessment other than the extraordinary levels can accommodate the requirements of this subdivision. new text end

new text begin (b) These extraordinary levels are available when all of the following circumstances apply: new text end

new text begin (1) the child has extraordinary needs as determined by the assessment tool provided for under subdivision 2, and the child meets other requirements established by the commissioner, such as a minimum score on the assessment tool; new text end

new text begin (2) the child's extraordinary needs require extraordinary care and intense supervision that is provided by the child's caregiver as part of the parental duties as described in the supplemental difficulty of care rate, section 256N.02, subdivision 21. This extraordinary care provided by the caregiver is required so that the child can be safely cared for in the home and community, and prevents residential placement; new text end

new text begin (3) the child is physically living in a foster family setting, as defined in Minnesota Rules, part 2960.3010, subpart 23, or physically living in the home with the adoptive parent or relative custodian; and new text end

new text begin (4) the child is receiving the services for which the child is eligible through medical assistance programs or other programs that provide necessary services for children with disabilities or other medical and behavioral conditions to live with the child's family, but the agency with caregiver's input has identified a specific support gap that cannot be met through home and community support waivers or other programs that are designed to provide support for children with special needs. new text end

new text begin (c) The agency completing an assessment, under subdivision 2, that suggests an extraordinary level must document as part of the assessment, the following: new text end

new text begin (1) the assessment tool that determined that the child's needs or disabilities require extraordinary care and intense supervision; new text end

new text begin (2) a summary of the extraordinary care and intense supervision that is provided by the caregiver as part of the parental duties as described in the supplemental difficulty of care rate, section 256N.02, subdivision 21; new text end

new text begin (3) confirmation that the child is currently physically residing in the foster family setting or in the home with the adoptive parent or relative custodian; new text end

new text begin (4) the efforts of the agency, caregiver, parents, and others to request support services in the home and community that would ease the degree of parental duties provided by the caregiver for the care and supervision of the child. This would include documentation of the services provided for the child's needs or disabilities, and the services that were denied or not available from the local social service agency, community agency, the local school district, local public health department, the parent or child's medical insurance provider; new text end

new text begin (5) the specific support gap identified that places the child's safety and well-being at risk in the home or community and is necessary to prevent residential placement; and new text end

new text begin (6) the extraordinary care and intense supervision provided by the foster, adoptive, or guardianship caregivers to maintain the child safely in the child's home and prevent residential placement that cannot be supported by medical assistance or other programs that provide services, necessary care for children with disabilities, or other medical or behavioral conditions in the home or community. new text end

new text begin (d) An agency completing an assessment under subdivision 2 that suggests an extraordinary level is appropriate must forward the assessment and required documentation to the commissioner. If the commissioner approves, the extraordinary levels must be retroactive to the date the assessment was forwarded. new text end

new text begin Subd. 5. new text end

new text begin Timing of initial assessment. new text end

new text begin For a child entering Northstar Care for Children under section 256N.21, the initial assessment must be completed within 30 days after the child is placed in foster care. new text end

new text begin Subd. 6. new text end

new text begin Completion of initial assessment. new text end

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

new text begin (b) Initial assessments are completed for foster children, eligible under section 256N.21. new text end

new text begin (c) The initial assessment must be completed by the financially responsible agency, in consultation with the legally responsible agency if different, within 30 days of the child's placement in foster care. new text end

new text begin (d) If the foster parent is unable or unwilling to cooperate with the assessment process, the child shall be assigned the basic level, level B under section 256N.26, subdivision 3. new text end

new text begin (e) Notice to the foster parent shall be provided as specified in subdivision 12. new text end

new text begin Subd. 7. new text end

new text begin Timing of special assessment. new text end

new text begin (a) A special assessment is required as part of the negotiation of the guardianship assistance agreement under section 256N.22 if: new text end

new text begin (1) the child was not placed in foster care with the prospective relative custodian or custodians prior to the negotiation of the guardianship assistance agreement under section 256N.25; or new text end

new text begin (2) any requirement for reassessment under subdivision 8 is met. new text end

new text begin (b) A special assessment is required as part of the negotiation of the adoption assistance agreement under section 256N.23 if: new text end

new text begin (1) the child was not placed in foster care with the prospective adoptive parent or parents prior to the negotiation of the adoption assistance agreement under section 256N.25; or new text end

new text begin (2) any requirement for reassessment under subdivision 8 is met. new text end

new text begin (c) A special assessment is required when a child transitions from a pre-Northstar Care for Children program into Northstar Care for Children if the commissioner determines that a special assessment is appropriate instead of assigning the transition child to a level under section 256N.28. new text end

new text begin (d) The special assessment must be completed prior to the establishment of a guardianship assistance or adoption assistance agreement on behalf of the child. new text end

new text begin Subd. 8. new text end

new text begin Completing the special assessment. new text end

new text begin (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. new text end

new text begin (b) If a new special assessment is required prior to the effective date of the guardianship 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 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. new text end

new text begin (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. new text end

new text begin (d) Notice to the prospective relative custodians or prospective adoptive parents must be provided as specified in subdivision 12. new text end

new text begin Subd. 9. new text end

new text begin Timing of and requests for reassessments. new text end

new text begin Reassessments for an eligible child must be completed within 30 days of any of the following events: new text end

new text begin (1) for a child in continuous foster care, when six months have elapsed since completion of the last assessment; new text end

new text begin (2) for a child in continuous foster care, change of placement location; new text end

new text begin (3) for a child in foster care, at the request of the financially responsible agency or legally responsible agency; new text end

new text begin (4) at the request of the commissioner; or new text end

new text begin (5) at the request of the caregiver under subdivision 9. new text end

new text begin Subd. 10. new text end

new text begin Caregiver requests for reassessments. new text end

new text begin (a) A caregiver may initiate a reassessment request for an eligible child in writing to the financially responsible agency or, if there is no financially responsible agency, the agency designated by the commissioner. The written request must include the reason for the request and the name, address, and contact information of the caregivers. For an eligible child with a guardianship assistance or adoption assistance agreement, the caregiver may request a reassessment if at least six months have elapsed since any previously requested review. For an eligible foster child, a foster parent may request reassessment in less than six months with written documentation that there have been significant changes in the child's needs that necessitate an earlier reassessment. new text end

new text begin (b) A caregiver may request a reassessment of an at-risk child for whom a guardianship assistance or adoption assistance agreement has been executed if the caregiver has satisfied the commissioner with written documentation from a qualified expert that the potential disability upon which eligibility for the agreement was based has manifested itself, consistent with section 256N.25, subdivision 3, paragraph (b). new text end

new text begin (c) If the reassessment cannot be completed within 30 days of the caregiver's request, the agency responsible for reassessment must notify the caregiver of the reason for the delay and a reasonable estimate of when the reassessment can be completed. new text end

new text begin Subd. 11. new text end

new text begin Completion of reassessment. new text end

new text begin (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. new text end

new text begin (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. new text end

new text begin (c) If reassessment is required after the effective date of the guardianship assistance agreement, the reassessment must be completed by the financially responsible agency. new text end

new text begin (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. new text end

new text begin (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 an adoption assistance or guardianship assistance 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 end

new text begin Subd. 12. new text end

new text begin Approval of initial assessments, special assessments, and reassessments. new text end

new text begin (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. new text end

new text begin (b) In cases where a special assessment or reassessment for guardian assistance and adoption assistance is required under subdivision 7 or 10, the commissioner shall review and approve the assessment as part of the eligibility determination process outlined in section 256N.22, subdivision 7, for guardianship assistance, or section 256N.23, subdivision 7, for adoption assistance. The assessment determines the maximum for the negotiated agreement amount under section 256N.25. new text end

new text begin (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 end

new text begin Subd. 13. new text end

new text begin Notice for caregiver. new text end

new text begin (a) The agency as defined in subdivision 5 or 10 that is responsible for completing the initial assessment or reassessment must provide the child's caregiver with written notice of the initial assessment or reassessment. new text end

new text begin (b) Initial assessment notices must be sent within 15 days of completion of the initial assessment and must minimally include the following: new text end

new text begin (1) a summary of the child's completed individual assessment used to determine the initial rating; new text end

new text begin (2) statement of rating and benefit level; new text end

new text begin (3) statement of the circumstances under which the agency must reassess the child; new text end

new text begin (4) procedure to seek reassessment; new text end

new text begin (5) notice that the caregiver has the right to a fair hearing review of the assessment and how to request a fair hearing, consistent with section 256.045, subdivision 3; and new text end

new text begin (6) the name, telephone number, and e-mail, if available, of a contact person at the agency completing the assessment. new text end

new text begin (c) Reassessment notices must be sent within 15 days after the completion of the reassessment and must minimally include the following: new text end

new text begin (1) a summary of the child's individual assessment used to determine the new rating; new text end

new text begin (2) any change in rating and its effective date; new text end

new text begin (3) procedure to seek reassessment; new text end

new text begin (4) notice that if a change in rating results in a reduction of benefits, the caregiver has the right to a fair hearing review of the assessment and how to request a fair hearing consistent with section 256.045, subdivision 3; new text end

new text begin (5) notice that a caregiver who requests a fair hearing of the reassessed rating within ten days may continue at the current rate pending the hearing, but the agency may recover any overpayment; and new text end

new text begin (6) name, telephone number, and e-mail, if available, of a contact person at the agency completing the reassessment. new text end

new text begin (d) Notice is not required for special assessments since the notice is part of the guardianship assistance or adoption assistance negotiated agreement completed according to section 256N.25. new text end

new text begin Subd. 14. new text end

new text begin Assessment tool determines rate of benefits. new text end

new text begin The assessment tool established by the commissioner in subdivision 2 determines the monthly benefit level for children in foster care. The monthly payment for guardian 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 end

Sec. 12.

new text begin [256N.25] AGREEMENTS. new text end

new text begin Subdivision 1. new text end

new text begin Agreement; guardianship assistance; adoption assistance. new text end

new text begin (a) In order to receive guardianship assistance or adoption assistance benefits on behalf of an eligible child, a written, binding agreement between the caregiver or caregivers, the financially responsible agency, or, if there is no financially responsible agency, the agency designated by the commissioner, and the commissioner must be established prior to finalization of the adoption or a transfer of permanent legal and physical custody. The agreement must be negotiated with the caregiver or caregivers under subdivision 2. new text end

new text begin (b) The agreement must be on a form approved by the commissioner and must specify the following: new text end

new text begin (1) duration of the agreement; new text end

new text begin (2) the nature and amount of any payment, services, and assistance to be provided under such agreement; new text end

new text begin (3) the child's eligibility for Medicaid services; new text end

new text begin (4) the terms of the payment, including any child care portion as specified in section 256N.24, subdivision 3; new text end

new text begin (5) eligibility for reimbursement of nonrecurring expenses associated with adopting or obtaining permanent legal and physical custody of the child, to the extent that the total cost does not exceed $2,000 per child; new text end

new text begin (6) that the agreement must remain in effect regardless of the state of which the adoptive parents or relative custodians are residents at any given time; new text end

new text begin (7) provisions for modification of the terms of the agreement, including renegotiation of the agreement; and new text end

new text begin (8) the effective date of the agreement. new text end

new text begin (c) The caregivers, the commissioner, and the financially responsible agency, or, if there is no financially responsible agency, the agency designated by the commissioner, must sign the agreement. A copy of the signed agreement must be given to each party. Once signed by all parties, the commissioner shall maintain the official record of the agreement. new text end

new text begin (d) The effective date of the guardianship assistance agreement must be the date of the court order that transfers permanent legal and physical custody to the relative. The effective date of the adoption assistance agreement is the date of the finalized adoption decree. new text end

new text begin (e) Termination or disruption of the preadoptive placement or the foster care placement prior to assignment of custody makes the agreement with that caregiver void. new text end

new text begin Subd. 2. new text end

new text begin Negotiation of agreement. new text end

new text begin (a) When a child is determined to be eligible for guardianship assistance or adoption assistance, the financially responsible agency, or, if there is no financially responsible agency, the agency designated by the commissioner, must negotiate with the caregiver to develop an agreement under subdivision 1. If and when the caregiver and agency reach concurrence as to the terms of the agreement, both parties shall sign the agreement. The agency must submit the agreement, along with the eligibility determination outlined in sections 256N.22, subdivision 7, and 256N.23, subdivision 7, to the commissioner for final review, approval, and signature according to subdivision 1. new text end

new text begin (b) A monthly payment is provided as part of the adoption assistance or guardianship assistance agreement to support the care of children unless the child is determined to be an at-risk child, in which case the special at-risk monthly payment under section 256N.26, subdivision 7, must be made until the caregiver obtains written documentation from a qualified expert that the potential disability upon which eligibility for the agreement was based has manifested itself. new text end

new text begin (1) The amount of the payment made on behalf of a child eligible for guardianship assistance or adoption assistance is determined through agreement between the prospective relative custodian or the adoptive parent and the financially responsible agency, or, if there is no financially responsible agency, the agency designated by the commissioner, using the assessment tool established by the commissioner in section 256N.24, subdivision 2, and the associated benefit and payments outlined in section 256N.26. Except as provided under section 256N.24, subdivision 1, paragraph (c), the assessment tool establishes the monthly benefit level for a child under foster care. The monthly payment under a guardianship assistance agreement or adoption assistance agreement may be negotiated up to the monthly benefit level under foster care. In no case may the amount of the payment under a guardianship assistance agreement or adoption assistance agreement exceed the foster care maintenance payment which would have been paid during the month if the child with respect to whom the guardianship assistance or adoption assistance payment is made had been in a foster family home in the state. new text end

new text begin (2) The rate schedule for the agreement is determined based on the age of the child on the date that the prospective adoptive parent or parents or relative custodian or custodians sign the agreement. new text end

new text begin (3) The income of the relative custodian or custodians or adoptive parent or parents must not be taken into consideration when determining eligibility for guardianship assistance or adoption assistance or the amount of the payments under section 256N.26. new text end

new text begin (4) With the concurrence of the relative custodian or adoptive parent, the amount of the payment may be adjusted periodically using the assessment tool established by the commissioner in section 256N.24, subdivision 2, and the agreement renegotiated under subdivision 3 when there is a change in the child's needs or the family's circumstances. new text end

new text begin (5) The guardianship assistance or adoption assistance agreement of a child who is identified as at-risk receives the special at-risk monthly payment under section 256N.26, subdivision 7, unless and until the potential disability manifests itself, as documented by an appropriate professional, and the commissioner authorizes commencement of payment by modifying the agreement accordingly. A relative custodian or adoptive parent of an at-risk child with a guardianship assistance or adoption assistance agreement may request a reassessment of the child under section 256N.24, subdivision 9, and renegotiation of the guardianship assistance or adoption assistance agreement under subdivision 3 to include a monthly payment, if the caregiver has written documentation from a qualified expert that the potential disability upon which eligibility for the agreement was based has manifested itself. Documentation of the disability must be limited to evidence deemed appropriate by the commissioner. new text end

new text begin (c) For guardianship assistance agreements: new text end

new text begin (1) the initial amount of the monthly guardianship assistance payment must be equivalent to the foster care rate in effect at the time that the agreement is signed less any offsets under section 256N.26, subdivision 11, or a lesser negotiated amount if agreed to by the prospective relative custodian and specified in that agreement, unless the child is identified as at-risk or the guardianship assistance agreement is entered into when a child is under the age of six; new text end

new text begin (2) an at-risk child must be assigned level A as outlined in section 256N.26 and receive the special at-risk monthly payment under section 256N.26, subdivision 7, unless and until the potential disability manifests itself, as documented by a qualified expert, and the commissioner authorizes commencement of payment by modifying the agreement accordingly; and new text end

new text begin (3) the amount of the monthly payment for a guardianship assistance agreement for a child, other than an at-risk child, who is under the age of six must be as specified in section 256N.26, subdivision 5. new text end

new text begin (d) For adoption assistance agreements: new text end

new text begin (1) for a child in foster care with the prospective adoptive parent immediately prior to adoptive placement, the initial amount of the monthly adoption assistance payment must be equivalent to the foster care rate in effect at the time that the agreement is signed less any offsets in section 256N.26, subdivision 11, or a lesser negotiated amount if agreed to by the prospective adoptive parents and specified in that agreement, unless the child is identified as at-risk or the adoption assistance agreement is entered into when a child is under the age of six; new text end

new text begin (2) an at-risk child must be assigned level A as outlined in section 256N.26 and receive the special at-risk monthly payment under section 256N.26, subdivision 7, unless and until the potential disability manifests itself, as documented by an appropriate professional, and the commissioner authorizes commencement of payment by modifying the agreement accordingly; new text end

new text begin (3) the amount of the monthly payment for an adoption assistance agreement for a child under the age of six, other than an at-risk child, must be as specified in section 256N.26, subdivision 5; new text end

new text begin (4) for a child who is in the guardianship assistance program immediately prior to adoptive placement, the initial amount of the adoption assistance payment must be equivalent to the guardianship assistance payment in effect at the time that the adoption assistance agreement is signed or a lesser amount if agreed to by the prospective adoptive parent and specified in that agreement; and new text end

new text begin (5) for a child who is not in foster care placement or the guardianship assistance program immediately prior to adoptive placement or negotiation of the adoption assistance agreement, the initial amount of the adoption assistance agreement must be determined using the assessment tool and process in this section and the corresponding payment amount outlined in section 256N.26. new text end

new text begin Subd. 3. new text end

new text begin Renegotiation of agreement. new text end

new text begin (a) A relative custodian or adoptive parent of a child with a guardianship assistance or adoption assistance agreement may request renegotiation of the agreement when there is a change in the needs of the child or in the family's circumstances. When a relative custodian or adoptive parent requests renegotiation of the agreement, a reassessment of the child must be completed consistent with section 256N.24, subdivisions 9 and 10. If the reassessment indicates that the child's level has changed, the financially responsible agency or, if there is no financially responsible agency, the agency designated by the commissioner or the commissioner's designee, and the caregiver must renegotiate the agreement to include a payment with the level determined through the reassessment process. The agreement must not be renegotiated unless the commissioner, the financially responsible agency, and the caregiver mutually agree to the changes. The effective date of any renegotiated agreement must be determined by the commissioner. new text end

new text begin (b) A relative custodian or adoptive parent of an at-risk child with a guardianship assistance or adoption assistance agreement may request renegotiation of the agreement to include a monthly payment higher than the special at-risk monthly payment under section 256N.26, subdivision 7, if the caregiver has written documentation from a qualified expert that the potential disability upon which eligibility for the agreement was based has manifested itself. Documentation of the disability must be limited to evidence deemed appropriate by the commissioner. Prior to renegotiating the agreement, a reassessment of the child must be conducted as outlined in section 256N.24, subdivision 9. The reassessment must be used to renegotiate the agreement to include an appropriate monthly payment. The agreement must not be renegotiated unless the commissioner, the financially responsible agency, and the caregiver mutually agree to the changes. The effective date of any renegotiated agreement must be determined by the commissioner. new text end

new text begin (c) Renegotiation of a guardianship assistance or adoption assistance agreement is required when one of the circumstances outlined in section 256N.26, subdivision 13, occurs. new text end

Sec. 13.

new text begin [256N.26] BENEFITS AND PAYMENTS. new text end

new text begin Subdivision 1. new text end

new text begin Benefits. new text end

new text begin (a) There are three benefits under Northstar Care for Children: medical assistance, basic payment, and supplemental difficulty of care payment. new text end

new text begin (b) A child is eligible for medical assistance under subdivision 2. new text end

new text begin (c) A child is eligible for the basic payment under subdivision 3, except for a child assigned level A under section 256N.24, subdivision 1, because the child is determined to be an at-risk child receiving guardianship assistance or adoption assistance. new text end

new text begin (d) A child, including a foster child age 18 to 21, is eligible for an additional supplemental difficulty of care payment under subdivision 4, as determined by the assessment under section 256N.24. new text end

new text begin (e) An eligible child entering guardianship assistance or adoption assistance under the age of six receives a basic payment and supplemental difficulty of care payment as specified in subdivision 5. new text end

new text begin (f) A child transitioning in from a pre-Northstar Care for Children program under section 256N.28, subdivision 7, shall receive basic and difficulty of care supplemental payments according to those provisions. new text end

new text begin Subd. 2. new text end

new text begin Medical assistance. new text end

new text begin Eligibility for medical assistance under this chapter must be determined according to section 256B.055. new text end

new text begin Subd. 3. new text end

new text begin Basic monthly rate. new text end

new text begin From January 1, 2015, to June 30, 2016, the basic monthly rate must be according to the following schedule: new text end

new text begin Ages 0-5 new text end new text begin $565 per month new text end
new text begin Ages 6-12 new text end new text begin $670 per month new text end
new text begin Ages 13 and older new text end new text begin $790 per month new text end

new text begin Subd. 4. new text end

new text begin Difficulty of care supplemental monthly rate. new text end

new text begin From January 1, 2015, to June 30, 2016, the supplemental difficulty of care monthly rate is determined by the following schedule: new text end

new text begin Level A new text end new text begin none (special rate under subdivision 7 applies) new text end
new text begin Level B new text end new text begin none (basic under subdivision 3 only) new text end
new text begin Level C new text end new text begin $100 per month new text end
new text begin Level D new text end new text begin $200 per month new text end
new text begin Level E new text end new text begin $300 per month new text end
new text begin Level F new text end new text begin $400 per month new text end
new text begin Level G new text end new text begin $500 per month new text end
new text begin Level H new text end new text begin $600 per month new text end
new text begin Level I new text end new text begin $700 per month new text end
new text begin Level J new text end new text begin $800 per month new text end
new text begin Level K new text end new text begin $900 per month new text end
new text begin Level L new text end new text begin $1,000 per month new text end
new text begin Level M new text end new text begin $1,100 per month new text end
new text begin Level N new text end new text begin $1,200 per month new text end
new text begin Level O new text end new text begin $1,300 per month new text end
new text begin Level P new text end new text begin $1,400 per month new text end
new text begin Level Q new text end new text begin $1,500 per month new text end

new text begin A child assigned level A is not eligible for either the basic or supplemental difficulty of care payment, while a child assigned level B is not eligible for the supplemental difficulty of care payment but is eligible for the basic monthly rate under subdivision 3. new text end

new text begin Subd. 5. new text end

new text begin Alternate rates for preschool entry and certain transitioned children. new text end

new text begin A child who entered the guardianship assistance or adoption assistance components of Northstar Care for Children while under the age of six shall receive 50 percent of the amount the child would otherwise be entitled to under subdivisions 3 and 4. The commissioner may also use the 50 percent rate for a child who was transitioned into those components through declaration of the commissioner under section 256N.28, subdivision 7. new text end

new text begin Subd. 6. new text end

new text begin Emergency foster care rate for initial placement. new text end

new text begin (a) A child who enters foster care due to immediate custody by a police officer or court order, consistent with section 260C.175, subdivisions 1 and 2, or equivalent provision under tribal code, shall receive the emergency foster care rate for up to 30 days. The emergency foster care rate cannot be extended beyond 30 days of the child's placement. new text end

new text begin (b) For this payment rate to be applied, at least one of three conditions must apply: new text end

new text begin (1) the child's initial placement must be in foster care in Minnesota; new text end

new text begin (2) the child's previous placement was more than two years ago; or new text end

new text begin (3) the child's previous placement was for fewer than 30 days and an assessment under section 256N.24 was not completed by an agency under section 256N.24. new text end

new text begin (c) The emergency foster care rate consists of the appropriate basic monthly rate under subdivision 3 plus a difficulty of care supplemental monthly rate of level D under subdivision 4. new text end

new text begin (d) The emergency foster care rate ends under any of three conditions: new text end

new text begin (1) when an assessment under section 256N.24 is completed; new text end

new text begin (2) when the placement ends; or new text end

new text begin (3) after 30 days have elapsed. new text end

new text begin (e) The financially responsible agency, in consultation with the legally responsible agency, if different, may replace the emergency foster care rate at any time by completing an initial assessment on which a revised difficulty of care supplemental monthly rate would be based. Consistent with section 256N.24, subdivision 9, the caregiver may request a reassessment in writing for an initial assessment to replace the emergency foster care rate. This written request would initiate an initial assessment under section 256N.24, subdivision 5. If the revised difficulty of care supplemental level based on the initial assessment is higher than level D, then the revised higher rate shall apply retroactively to the beginning of the placement. If the revised level is lower, the lower rate shall apply on the date the initial assessment was completed. new text end

new text begin (f) If a child remains in foster care placement for more than 30 days, the emergency foster care rate ends after the 30th day of placement and an assessment under section 256N.26 must be completed. new text end

new text begin Subd. 7. new text end

new text begin Special at-risk monthly payment for at-risk children in guardianship assistance and adoption assistance. new text end

new text begin A child eligible for guardianship assistance under section 256N.22 or adoption assistance under section 256N.23 who is determined to be an at-risk child shall receive a special at-risk monthly payment of $1 per month basic, unless and until the potential disability manifests itself and the agreement is renegotiated to include reimbursement. Such an at-risk child shall receive neither a supplemental difficulty of care monthly rate under subdivision 4 nor home and vehicle modifications under subdivision 10, but must be considered for medical assistance under subdivision 2. new text end

new text begin Subd. 8. new text end

new text begin Daily rates. new text end

new text begin (a) The commissioner shall establish prorated daily rates to the nearest cent for the monthly rates under subdivisions 3 to 7. Daily rates must be routinely used when a partial month is involved for foster care, guardianship assistance, or adoption assistance. new text end

new text begin (b) A full month payment is permitted if a foster child is temporarily absent from the foster home if the brief absence does not exceed 14 days and the child's placement continues with the same caregiver. new text end

new text begin Subd. 9. new text end

new text begin Revision. new text end

new text begin By April 1, 2016, for fiscal year 2017, and by each succeeding April 1 for the subsequent fiscal year, the commissioner shall review and revise the rates under subdivisions 3 to 7 based on the United States Department of Agriculture, Estimates of the Cost of Raising a Child, published by the United States Department of Agriculture, Agricultural Resources Service, Publication 1411. The revision shall be the average percentage by which costs increase for the age ranges represented in the United States Department of Agriculture, Estimates of the Cost of Raising a Child, except that in no instance must the increase be more than three percent per annum. The monthly rates must be revised to the nearest dollar and the daily rates to the nearest cent. new text end

new text begin Subd. 10. new text end

new text begin Home and vehicle modifications. new text end

new text begin (a) Except for a child assigned level A under section 256N.24, subdivision 1, paragraph (d), clause (1), a child who is eligible for an adoption assistance agreement may have reimbursement of home and vehicle modifications necessary to accommodate the child's special needs upon which eligibility for adoption assistance was based and included as part of the negotiation of the agreement under section 256N.25, subdivision 2. Reimbursement of home and vehicle modifications must not be available for a child who is assessed at level A under subdivision 1, unless and until the potential disability manifests itself and the agreement is renegotiated to include reimbursement. new text end

new text begin (b) Application for and reimbursement of modifications must be completed according to a process specified by the commissioner. The type and cost of each modification must be preapproved by the commissioner. The type of home and vehicle modifications must be limited to those specified by the commissioner. new text end

new text begin (c) Reimbursement for home modifications as outlined in this subdivision is limited to once every five years per child. Reimbursement for vehicle modifications as outlined in this subdivision is limited to once every five years per family. new text end

new text begin Subd. 11. new text end

new text begin Child income or income attributable to the child. new text end

new text begin (a) A monthly guardianship assistance or adoption assistance payment must be considered as income and resources attributable to the child. Guardianship assistance and adoption assistance are exempt from garnishment, except as permissible under the laws of the state where the child resides. new text end

new text begin (b) When a child is placed into foster care, any income and resources attributable to the child are treated as provided in sections 252.27 and 260C.331, or 260B.331, as applicable to the child being placed. new text end

new text begin (c) Consideration of income and resources attributable to the child must be part of the negotiation process outlined in section 256N.25, subdivision 2. In some circumstances, the receipt of other income on behalf of the child may impact the amount of the monthly payment received by the relative custodian or adoptive parent on behalf of the child through Northstar Care for Children. Supplemental Security Income (SSI), retirement survivor's disability insurance (RSDI), veteran's benefits, railroad retirement benefits, and black lung benefits are considered income and resources attributable to the child. new text end

new text begin Subd. 12. new text end

new text begin Treatment of Supplemental Security Income. new text end

new text begin If a child placed in foster care receives benefits through Supplemental Security Income (SSI) at the time of foster care placement or subsequent to placement in foster care, the financially responsible agency may apply to be the payee for the child for the duration of the child's placement in foster care. If a child continues to be eligible for SSI after finalization of the adoption or transfer of permanent legal and physical custody and is determined to be eligible for a payment under Northstar Care for Children, a permanent caregiver may choose to receive payment from both programs simultaneously. The permanent caregiver is responsible to report the amount of the payment to the Social Security Administration and the SSI payment will be reduced as required by the Social Security Administration. new text end

new text begin Subd. 13. new text end

new text begin Treatment of retirement survivor's disability insurance, veteran's benefits, railroad retirement benefits, and black lung benefits. new text end

new text begin (a) If a child placed in foster care receives retirement survivor's disability insurance, veteran's benefits, railroad retirement benefits, or black lung benefits at the time of foster care placement or subsequent to placement in foster care, the financially responsible agency may apply to be the payee for the child for the duration of the child's placement in foster care. If it is anticipated that a child will be eligible to receive retirement survivor's disability insurance, veteran's benefits, railroad retirement benefits, or black lung benefits after finalization of the adoption or assignment of permanent legal and physical custody, the permanent caregiver shall apply to be the payee of those benefits on the child's behalf. The monthly amount of the other benefits must be considered an offset to the amount of the payment the child is determined eligible for under Northstar Care for Children. new text end

new text begin (b) If a child becomes eligible for retirement survivor's disability insurance, veteran's benefits, railroad retirement benefits, or black lung benefits, after the initial amount of the payment under Northstar Care for Children is finalized, the permanent caregiver shall contact the commissioner to redetermine the payment under Northstar Care for Children. The monthly amount of the other benefits must be considered an offset to the amount of the payment the child is determined eligible for under Northstar Care for Children. new text end

new text begin (c) If a child ceases to be eligible for retirement survivor's disability insurance, veteran's benefits, railroad retirement benefits, or black lung benefits after the initial amount of the payment under Northstar Care for Children is finalized, the permanent caregiver shall contact the commissioner to redetermine the payment under Northstar Care for Children. The monthly amount of the payment under Northstar Care for Children must be the amount the child was determined to be eligible for prior to consideration of any offset. new text end

new text begin (d) If the monthly payment received on behalf of the child under retirement survivor's disability insurance, veteran's benefits, railroad retirement benefits, or black lung benefits changes after the adoption assistance or guardianship assistance agreement is finalized, the permanent caregiver shall notify the commissioner as to the new monthly payment amount, regardless of the amount of the change in payment. If the monthly payment changes by $75 or more, even if the change occurs incrementally over the duration of the term of the adoption assistance or guardianship assistance agreement, the monthly payment under Northstar Care for Children must be adjusted without further consent to reflect the amount of the increase or decrease in the offset amount. Any subsequent change to the payment must be reported and handled in the same manner. A change of monthly payments of less than $75 is not a permissible reason to renegotiate the adoption assistance or guardianship assistance agreement under section 256N.25, subdivision 3. The commissioner shall review and revise the limit at which the adoption assistance or guardian assistance agreement must be renegotiated in accordance with subdivision 9. new text end

new text begin Subd. 14. new text end

new text begin Treatment of child support and Minnesota family investment program. new text end

new text begin (a) If a child placed in foster care receives child support, the child support payment may be redirected to the financially responsible agency for the duration of the child's placement in foster care. In cases where the child qualifies for Northstar Care for Children by meeting the adoption assistance eligibility criteria or the guardianship assistance eligibility criteria, any court-ordered child support must not be considered income attributable to the child and must have no impact on the monthly payment. new text end

new text begin (b) Consistent with section 256J.24, a child eligible for Northstar Care for Children whose caregiver receives a payment on the child's behalf is excluded from a Minnesota family investment program assistance unit. new text end

new text begin Subd. 15. new text end

new text begin Payments. new text end

new text begin (a) Payments to caregivers under Northstar Care for Children must be made monthly. Consistent with section 256N.24, subdivision 12, the financially responsible agency must send the caregiver the required written notice within 15 days of a completed assessment or reassessment. new text end

new text begin (b) Unless paragraph (c) or (d) applies, the financially responsible agency shall pay foster parents directly for eligible children in foster care. new text end

new text begin (c) When the legally responsible agency is different than the financially responsible agency, the legally responsible agency may make the payments to the caregiver, provided payments are made on a timely basis. The financially responsible agency must pay the legally responsible agency on a timely basis. Caregivers must have access to the financially and legally responsible agencies' records of the transaction, consistent with the retention schedule for the payments. new text end

new text begin (d) For eligible children in foster care, the financially responsible agency may pay the foster parent's payment for a licensed child-placing agency instead of paying the foster parents directly. The licensed child-placing agency must timely pay the foster parents and maintain records of the transaction. Caregivers must have access to the financially responsible agency's records of the transaction and the child-placing agency's records of the transaction, consistent with the retention schedule for the payments. new text end

new text begin Subd. 16. new text end

new text begin Effect of benefit on other aid. new text end

new text begin Payments received under this section must not be considered as income for child care assistance under chapter 119B or any other financial benefit. Consistent with section 256J.24, a child receiving a maintenance payment under Northstar Care for Children is excluded from any Minnesota family investment program assistance unit. new text end

new text begin Subd. 17. new text end

new text begin Home and community-based services waiver for persons with disabilities. new text end

new text begin A child in foster care may qualify for home and community-based waivered services, consistent with section 256B.092 for developmental disabilities, or section 256B.49 for community alternative care, community alternatives for disabled individuals, or traumatic brain injury waivers. A waiver service must not be substituted for the foster care program. When the child is simultaneously eligible for waivered services and for benefits under Northstar Care for Children, the financially responsible agency must assess and provide basic and supplemental difficulty of care rates as determined by the assessment according to section 256N.24. If it is determined that additional services are needed to meet the child's needs in the home that is not or cannot be met by the foster care program, the need would be referred to the local waivered service program. new text end

new text begin Subd. 18. new text end

new text begin Overpayments. new text end

new text begin The commissioner has the authority to collect any amount of foster care payment, adoption assistance, or guardianship assistance paid to a caregiver in excess of the payment due. Payments covered by this subdivision include basic maintenance needs payments, supplemental difficulty of care payments, and reimbursement of home and vehicle modifications under subdivision 10. Prior to any collection, the commissioner or the commissioner's designee shall notify the caregiver in writing, including: new text end

new text begin (1) the amount of the overpayment and an explanation of the cause of overpayment; new text end

new text begin (2) clarification of the corrected amount; new text end

new text begin (3) a statement of the legal authority for the decision; new text end

new text begin (4) information about how the caregiver can correct the overpayment; new text end

new text begin (5) if repayment is required, when the payment is due and a person to contact to review a repayment plan; new text end

new text begin (6) a statement that the caregiver has a right to a fair hearing review by the department; and new text end

new text begin (7) the procedure for seeking a fair hearing review by the department. new text end

new text begin Subd. 19. new text end

new text begin Payee. new text end

new text begin For adoption assistance and guardianship assistance cases, the payment must only be made to the adoptive parent or relative custodian specified on the agreement. If there is more than one adoptive parent or relative custodian, both parties will be listed as the payee unless otherwise specified in writing according to policies outlined by the commissioner. In the event of divorce or separation of the caregivers, a change of payee must be made in writing according to policies outlined by the commissioner. If both caregivers are in agreement as to the change, it may be made according to a process outlined by the commissioner. If there is not agreement as to the change, a court order indicating the party who is to receive the payment is needed before a change can be processed. If the change of payee is disputed, the commissioner may withhold the payment until agreement is reached. A noncustodial caregiver may request notice in writing of review, modification, or termination of the adoption assistance or guardianship assistance agreement. In the event of the death of a payee, a change of payee consistent with sections 256N.22 and 256N.23 may be made in writing according to policies outlined by the commissioner. new text end

new text begin Subd. 20. new text end

new text begin Notification of change. new text end

new text begin (a) A caregiver who has an adoption assistance agreement or guardianship assistance agreement in place shall keep the agency administering the program informed of changes in status or circumstances which would make the child ineligible for the payments or eligible for payments in a different amount. new text end

new text begin (b) For the duration of the agreement, the caregiver agrees to notify the agency administering the program in writing within 30 days of any of the following: new text end

new text begin (1) a change in the child's or caregiver's legal name; new text end

new text begin (2) a change in the family's address; new text end

new text begin (3) a change in the child's legal custody status; new text end

new text begin (4) the child's completion of high school, if this occurs after the child attains age 18; new text end

new text begin (5) the end of the caregiver's legal responsibility to support the child based on termination of parental rights of the caregiver, transfer of guardianship to another person, or transfer of permanent legal and physical custody to another person; new text end

new text begin (6) the end of the caregiver's financial support of the child; new text end

new text begin (7) the death of the child; new text end

new text begin (8) the death of the caregiver; new text end

new text begin (9) the child enlists in the military; new text end

new text begin (10) the child gets married; new text end

new text begin (11) the child becomes an emancipated minor through legal action; new text end

new text begin (12) the caregiver separates or divorces; and new text end

new text begin (13) the child is residing outside the caregiver's home for a period of more than 30 consecutive days. new text end

new text begin Subd. 21. new text end

new text begin Correct and true information. new text end

new text begin The caregiver must be investigated for fraud if the caregiver reports information the caregiver knows is untrue, the caregiver fails to notify the commissioner of changes that may affect eligibility, or the agency administering the program receives relevant information that the caregiver did not report. new text end

new text begin Subd. 22. new text end

new text begin Termination notice for caregiver. new text end

new text begin The agency that issues the maintenance payment shall provide the child's caregiver with written notice of termination of payment. Termination notices must be sent at least 15 days before the final payment or, in the case of an unplanned termination, the notice is sent within three days of the end of the payment. The written notice must minimally include the following: new text end

new text begin (1) the date payment will end; new text end

new text begin (2) the reason payments will end and the event that is the basis to terminate payment; new text end

new text begin (3) a statement that the provider has a right to a fair hearing review by the department consistent with section 256.045, subdivision 3; new text end

new text begin (4) the procedure to request a fair hearing; and new text end

new text begin (5) the name, telephone number, and e-mail address of a contact person at the agency. new text end

Sec. 14.

new text begin [256N.27] FEDERAL, STATE, AND LOCAL SHARES. new text end

new text begin Subdivision 1. new text end

new text begin Federal share. new text end

new text begin For the purposes of determining a child's eligibility under title IV-E of the Social Security Act for a child in foster care, the financially responsible agency shall use the eligibility requirements outlined in section 472 of the Social Security Act. For a child who qualifies for guardianship assistance or adoption assistance, the financially responsible agency and the commissioner shall use the eligibility requirements outlined in section 473 of the Social Security Act. In each case, the agency paying the maintenance payments must be reimbursed for the costs from the federal money available for this purpose. new text end

new text begin Subd. 2. new text end

new text begin State share. new text end

new text begin The commissioner shall pay the state share of the maintenance payments as determined under subdivision 4, and an identical share of the pre-Northstar Care foster care program under section 260C.4411, subdivision 1, the relative custody assistance program under section 257.85, and the pre-Northstar Care for Children adoption assistance program under chapter 259A. The commissioner may transfer funds into the account if a deficit occurs. new text end

new text begin Subd. 3. new text end

new text begin Local share. new text end

new text begin (a) The financially responsible agency at the time of placement for foster care or finalization of the agreement for guardianship assistance or adoption assistance shall pay the local share of the maintenance payments as determined under subdivision 4, and an identical share of the pre-Northstar Care for Children foster care program under section 260C.4411, subdivision 1, the relative custody assistance program under section 257.85, and the pre-Northstar Care for Children adoption assistance program under chapter 259A. new text end

new text begin (b) The financially responsible agency shall pay the entire cost of any initial clothing allowance, administrative payments to child caring agencies specified in section 317A.907, or other support services it authorizes, except as provided under other provisions of law. new text end

new text begin (c) In cases of federally required adoption assistance where there is no financially responsible agency as provided in section 256N.24, subdivision 5, the commissioner shall pay the local share. new text end

new text begin (d) When an Indian child being placed in Minnesota meets title IV-E eligibility defined in section 473(d) of the Social Security Act and is receiving guardianship assistance or adoption assistance, the agency or entity assuming responsibility for the child is responsible for the nonfederal share of the payment. new text end

new text begin Subd. 4. new text end

new text begin Nonfederal share. new text end

new text begin (a) The commissioner shall establish a percentage share of the maintenance payments, reduced by federal reimbursements under title IV-E of the Social Security Act, to be paid by the state and to be paid by the financially responsible agency. new text end

new text begin (b) These state and local shares must initially be calculated based on the ratio of the average appropriate expenditures made by the state and all financially responsible agencies during calendar years 2011, 2012, 2013, and 2014. For purposes of this calculation, appropriate expenditures for the financially responsible agencies must include basic and difficulty of care payments for foster care reduced by federal reimbursements, but not including any initial clothing allowance, administrative payments to child care agencies specified in section 317A.907, child care, or other support or ancillary expenditures. For purposes of this calculation, appropriate expenditures for the state shall include adoption assistance and relative custody assistance, reduced by federal reimbursements. new text end

new text begin (c) For each of the periods January 1, 2015, to June 30, 2016, and fiscal years 2017, 2018, and 2019, the commissioner shall adjust this initial percentage of state and local shares to reflect the relative expenditure trends during calendar years 2011, 2012, 2013, and 2014, taking into account appropriations for Northstar Care for Children and the turnover rates of the components. In making these adjustments, the commissioner's goal shall be to make these state and local expenditures other than the appropriations for Northstar Care for Children to be the same as they would have been had Northstar Care for Children not been implemented, or if that is not possible, proportionally higher or lower, as appropriate. The state and local share percentages for fiscal year 2019 must be used for all subsequent years. new text end

new text begin Subd. 5. new text end

new text begin Adjustments for proportionate shares among financially responsible agencies. new text end

new text begin (a) The commissioner shall adjust the expenditures under subdivision 4 by each financially responsible agency so that its relative share is proportional to its foster care expenditures, with the goal of making the local share similar to what the county or tribe would have spent had Northstar Care for Children not been enacted. new text end

new text begin (b) For the period January 1, 2015, to June 30, 2016, the relative shares must be as determined under subdivision 4 for calendar years 2011, 2012, 2013, and 2014 compared with similar costs of all financially responsible agencies. new text end

new text begin (c) For subsequent fiscal years, the commissioner shall update the relative shares based on actual utilization of Northstar Care for Children by the financially responsible agencies during the previous period, so that those using relatively more than they did historically are adjusted upward and those using less are adjusted downward. new text end

new text begin (d) The commissioner must ensure that the adjustments are not unduly influenced by onetime events, anomalies, small changes that appear large compared to a narrow historic base, or fluctuations that are the results of the transfer of responsibilities to tribal social service agencies authorized in section 256.01, subdivision 14b, as part of the American Indian Child Welfare Initiative. new text end

Sec. 15.

new text begin [256N.28] ADMINISTRATION AND APPEALS. new text end

new text begin Subdivision 1. new text end

new text begin Responsibilities. new text end

new text begin (a) The financially responsible agency shall determine the eligibility for Northstar Care for Children for children in foster care under section 256N.21, and for those children determined eligible, shall further determine each child's eligibility for title IV-E of the Social Security Act, provided the agency has such authority under the state title IV-E plan. new text end

new text begin (b) Subject to commissioner review and approval, the financially responsible agency shall prepare the eligibility determination for Northstar Care for Children for children in guardianship assistance under section 256N.22 and children in adoption assistance under section 256N.23. The AFDC relatedness determination, when necessary to determine a child's eligibility for title IV-E funding, shall be made only by an authorized agency according to policies and procedures prescribed by the commissioner. new text end

new text begin (c) The financially responsible agency is responsible for the administration of Northstar Care for Children for children in foster care. The agency designated by the commissioner is responsible for assisting the commissioner with the administration of Northstar Care for Children for children in guardianship assistance and adoption assistance by conducting assessments, reassessments, negotiations, and other activities as specified by the commissioner under subdivision 2. new text end

new text begin Subd. 2. new text end

new text begin Procedures, requirements, and deadlines. new text end

new text begin The commissioner shall specify procedures, requirements, and deadlines for the administration of Northstar Care for Children in accordance with sections 256N.001 to 256N.28, including for children transitioning into Northstar Care for Children under subdivision 7. The commissioner shall periodically review all procedures, requirements, and deadlines, including the assessment tool and process under section 256N.24, in consultation with counties, tribes, and representatives of caregivers, and may alter them as needed. new text end

new text begin Subd. 3. new text end

new text begin Administration of title IV-E programs. new text end

new text begin The title IV-E foster care, guardianship assistance, and adoption assistance programs must operate within the statutes, rules, and policies set forth by the federal government in the Social Security Act. new text end

new text begin Subd. 4. new text end

new text begin Reporting. new text end

new text begin The commissioner shall specify required fiscal and statistical reports under section 256.01, subdivision 2, paragraph (q), and other reports as necessary. new text end

new text begin Subd. 5. new text end

new text begin Promotion of programs. new text end

new text begin Families who adopt a child under the commissioner's guardianship must be informed as to the adoption tax credit. The commissioner shall actively seek ways to promote the guardianship assistance and adoption assistance programs, including informing prospective caregivers of eligible children of the availability of guardianship assistance and adoption assistance. new text end

new text begin Subd. 6. new text end

new text begin Appeals and fair hearings. new text end

new text begin (a) A caregiver has the right to appeal to the commissioner under section 256.045 when eligibility for Northstar Care for Children is denied, and when payment or the agreement for an eligible child is modified or terminated. new text end

new text begin (b) A relative custodian or adoptive parent has additional rights to appeal to the commissioner pursuant to section 256.045. These rights include when the commissioner terminates or modifies the guardianship assistance or adoption assistance agreement or when the commissioner denies an application for guardianship assistance or adoption assistance. A prospective relative custodian or adoptive parent who disagrees with a decision by the commissioner before transfer of permanent legal and physical custody or finalization of the adoption may request review of the decision by the commissioner or may appeal the decision under section 256.045. A guardianship assistance or adoption assistance agreement must be signed and in effect before the court order that transfers permanent legal and physical custody or the adoption finalization; however, in some cases, there may be extenuating circumstances as to why an agreement was not entered into before finalization of permanency for the child. Caregivers who believe that extenuating circumstances exist in the case of their child may request a fair hearing. Caregivers have the responsibility of proving that extenuating circumstances exist. Caregivers must be required to provide written documentation of each eligibility criterion at the fair hearing. Examples of extenuating circumstances include: relevant facts regarding the child were known by the placing agency and not presented to the caregivers before transfer of permanent legal and physical custody or finalization of the adoption, or failure by the commissioner or a designee to advise potential caregivers about the availability of guardianship assistance or adoption assistance for children in the state foster care system. If an appeals judge finds through the fair hearing process that extenuating circumstances existed and that the child met all eligibility criteria at the time the transfer of permanent legal and physical custody was ordered or the adoption was finalized, the effective date and any associated federal financial participation shall be retroactive from the date of the request for a fair hearing. new text end

new text begin Subd. 7. new text end

new text begin Transitions from pre-Northstar Care for Children programs. new text end

new text begin (a) A child in foster care who remains with the same caregiver shall continue to receive benefits under the pre-Northstar Care for Children foster care program under section 256.82. Transitions to Northstar Care for Children must occur as provided in section 256N.21, subdivision 6. new text end

new text begin (b) The commissioner may seek to transition into Northstar Care for Children a child who is in pre-Northstar Care for Children relative custody assistance under section 257.85 or pre-Northstar Care for Children adoption assistance under chapter 259A, in accordance with these priorities, in order of priority: new text end

new text begin (1) financial and budgetary constraints; new text end

new text begin (2) complying with federal regulations; new text end

new text begin (3) converting pre-Northstar Care for Children relative custody assistance under section 257.85 to the guardianship assistance component of Northstar Care for Children; new text end

new text begin (4) improving permanency for a child or children; new text end

new text begin (5) maintaining permanency for a child or children; new text end

new text begin (6) accessing additional federal funds; and new text end

new text begin (7) administrative simplification. new text end

new text begin (c) Transitions shall be accomplished according to procedures, deadlines, and requirements specified by the commissioner under subdivision 2. new text end

new text begin (d) The commissioner may accomplish a transition of a child from pre-Northstar Care for Children relative custody assistance under section 257.85 to the guardianship assistance component of Northstar Care for Children by declaration and appropriate notice to the caregiver, provided that the benefit for a child under this paragraph is not reduced. new text end

new text begin (e) The commissioner may offer a transition of a child from pre-Northstar Care for Children adoption assistance under chapter 259A to the adoption assistance component of Northstar Care for Children by contacting the caregiver with an offer. The transition must be accomplished only when the caregiver agrees to the offer. The caregiver shall have a maximum of 90 days to review and accept the commissioner's offer. If the commissioner's offer is not accepted within 90 days, the pre-Northstar Care for Children adoption assistance agreement remains in effect until it terminates or a subsequent offer is made by the commissioner. new text end

new text begin (f) For a child transitioning into Northstar Care for Children, the commissioner shall assign an equivalent assessment level based on the most recently completed supplemental difficulty of care level assessment, unless the commissioner determines that arranging for a new assessment under section 256N.24 would be more appropriate based on the priorities specified in paragraph (b). new text end

new text begin (g) For a child transitioning into Northstar Care for Children, regardless of the age of the child, the commissioner shall use the rates under section 256N.26, subdivision 5, unless the rates under section 256N.26, subdivisions 3 and 4, are more appropriate based on the priorities specified in paragraph (b), as determined by the commissioner. new text end

new text begin Subd. 8. new text end

new text begin Purchase of child-specific adoption services. new text end

new text begin The commissioner may reimburse the placing agency for appropriate adoption services for children eligible under section 259A.75. new text end

Sec. 16.

Minnesota Statutes 2012, section 257.85, subdivision 2, is amended to read:

Subd. 2.

Scope.

The provisions of this section apply to those situations in which the legal and physical custody of a child is established with a relative or important friend with whom the child has resided or had significant contact according to section 260C.515, subdivision 4, by a district court order issued on or after July 1, 1997, new text begin but on or before November 26, 2014, new text end or a tribal court order issued on or after July 1, 2005, new text begin but on or before November 26, 2014, new text end when the child has been removed from the care of the parent by previous district or tribal court order.

Sec. 17.

Minnesota Statutes 2012, section 257.85, subdivision 5, is amended to read:

Subd. 5.

Relative custody assistance agreement.

(a) A relative custody assistance agreement will not be effective, unless it is signed by the local agency and the relative custodian no later than 30 days after the date of the order establishing permanent legal and physical custody, new text begin and on or before November 26, 2014, new text end except that a local agency may enter into a relative custody assistance agreement with a relative custodian more than 30 days after the date of the order if it certifies that the delay in entering the agreement was through no fault of the relative custodiannew text begin and the agreement is signed and in effect on or before November 26, 2014new text end . There must be a separate agreement for each child for whom the relative custodian is receiving relative custody assistance.

(b) Regardless of when the relative custody assistance agreement is signed by the local agency and relative custodian, the effective date of the agreement shall be the date of the order establishing permanent legal and physical custody.

(c) If MFIP is not the applicable program for a child at the time that a relative custody assistance agreement is entered on behalf of the child, when MFIP becomes the applicable program, if the relative custodian had been receiving custody assistance payments calculated based upon a different program, the amount of relative custody assistance payment under subdivision 7 shall be recalculated under the Minnesota family investment program.

(d) The relative custody assistance agreement shall be in a form specified by the commissioner and shall include provisions relating to the following:

(1) the responsibilities of all parties to the agreement;

(2) the payment terms, including the financial circumstances of the relative custodian, the needs of the child, the amount and calculation of the relative custody assistance payments, and that the amount of the payments shall be reevaluated annually;

(3) the effective date of the agreement, which shall also be the anniversary date for the purpose of submitting the annual affidavit under subdivision 8;

(4) that failure to submit the affidavit as required by subdivision 8 will be grounds for terminating the agreement;

(5) the agreement's expected duration, which shall not extend beyond the child's eighteenth birthday;

(6) any specific known circumstances that could cause the agreement or payments to be modified, reduced, or terminated and the relative custodian's appeal rights under subdivision 9;

(7) that the relative custodian must notify the local agency within 30 days of any of the following:

(i) a change in the child's status;

(ii) a change in the relationship between the relative custodian and the child;

(iii) a change in composition or level of income of the relative custodian's family;

(iv) a change in eligibility or receipt of benefits under MFIP, or other assistance program; and

(v) any other change that could affect eligibility for or amount of relative custody assistance;

(8) that failure to provide notice of a change as required by clause (7) will be grounds for terminating the agreement;

(9) that the amount of relative custody assistance is subject to the availability of state funds to reimburse the local agency making the payments;

(10) that the relative custodian may choose to temporarily stop receiving payments under the agreement at any time by providing 30 days' notice to the local agency and may choose to begin receiving payments again by providing the same notice but any payments the relative custodian chooses not to receive are forfeit; and

(11) that the local agency will continue to be responsible for making relative custody assistance payments under the agreement regardless of the relative custodian's place of residence.

Sec. 18.

Minnesota Statutes 2012, section 257.85, subdivision 6, is amended to read:

Subd. 6.

Eligibility criteria.

new text begin (a) new text end A local agency shall enter into a relative custody assistance agreement under subdivision 5 if it certifies that the following criteria are met:

(1) the juvenile court has determined or is expected to determine that the child, under the former or current custody of the local agency, cannot return to the home of the child's parents;

(2) the court, upon determining that it is in the child's best interests, has issued or is expected to issue an order transferring permanent legal and physical custody of the child; and

(3) the child either:

(i) is a member of a sibling group to be placed together; or

(ii) has a physical, mental, emotional, or behavioral disability that will require financial support.

When the local agency bases its certification that the criteria in clause (1) or (2) are met upon the expectation that the juvenile court will take a certain action, the relative custody assistance agreement does not become effective until and unless the court acts as expected.

new text begin (b) After November 26, 2014, new relative custody assistance agreements must not be executed. Agreements that were signed by all parties on or before November 26, 2014, and were not in effect because the proposed transfer of permanent legal and physical custody of the child did not occur on or before November 26, 2014, must be renegotiated under the terms of Northstar Care for Children in chapter 256N. new text end

Sec. 19.

new text begin [259A.12] NO NEW EXECUTION OF ADOPTION ASSISTANCE AGREEMENTS. new text end

new text begin After November 26, 2014, new adoption assistance agreements must not be executed under this section. Agreements that were signed on or before November 26, 2014, and were not in effect because the adoption finalization of the child did not occur on or before November 26, 2014, must be renegotiated according to the terms of Northstar Care for Children under chapter 256N. Agreements signed and in effect on or before November 26, 2014, must continue according to the terms of this section and applicable rules for the duration of the agreement, unless the commissioner and the adoptive parents choose to renegotiated the agreements under Northstar Care for Children consistent with section 256N.28, subdivision 7. After November 26, 2014, this section and associated rules must be referred to as the pre-Northstar Care for Children adoption assistance program and shall apply to children whose adoption assistance agreements were in effect on or before November 26, 2014, and whose adoptive parents have not renegotiated their agreements according to the terms of Northstar Care for Children. new text end

Sec. 20.

new text begin [260C.4411] PRE-NORTHSTAR CARE FOR CHILDREN FOSTER CARE PROGRAM. new text end

new text begin Subdivision 1. new text end

new text begin Pre-Northstar Care for Children foster care program. new text end

new text begin (a) For a child placed in family foster care on or before December 31, 2014, the county of financial responsibility under section 256G.02 or tribal agency authorized under section 256.01, subdivision 14b, shall pay the local share under section 256N.27, subdivision 3, for foster care maintenance including any difficulty of care as defined in Minnesota Rules, part 9560.0521, subparts 7 and 10. Family foster care includes: new text end

new text begin (1) emergency relative placement under section 245A.035; new text end

new text begin (2) licensed foster family settings, foster residence settings, or treatment foster care settings, licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, and served by a public or private child care agency authorized by Minnesota Rules, parts 9545.0755 to 9545.0845; new text end

new text begin (3) family foster care homes approved by a tribal agency; and new text end

new text begin (4) unlicensed supervised settings for foster youth ages 18 to 21. new text end

new text begin (b) The county of financial responsibility under section 256G.02 or tribal social services agency authorized in section 256.01, subdivision 14b, shall pay the entire cost of any initial clothing allowance, administrative payments to child care agencies specified in section 317A.907, or any other support services it authorizes, except as otherwise provided by law. new text end

new text begin (c) The rates for the pre-Northstar Care for Children foster care program remain those in effect on January 1, 2013, continuing the preexisting rate structure for foster children who remain with the same caregivers and do not transition into Northstar Care for Children under section 256N.21, subdivision 6. new text end

new text begin (d) Difficulty of care payments must be maintained consistent with Minnesota Rules, parts 9560.0652 and 9560.0653, using the established reassessment tool in Minnesota Rules, part 9560.0654. The preexisting rate structure for the pre-Northstar Care for Children foster care program must be maintained, provided that when the number of foster children in the program is less than ten percent of the population in 2012, the commissioner may apply the same assessment tool to both the pre-Northstar Care for Children foster care program and Northstar Care for Children under the authority granted in section 256N.24, subdivision 2. new text end

new text begin (e) The county of financial responsibility under section 256G.02 or tribal agency authorized under section 256.01, subdivision 14b, shall document the determined pre-Northstar Care for Children foster care rate in the case record, including a description of each condition on which the difficulty of care assessment is based. The difficulty of care rate is reassessed: new text end

new text begin (1) every 12 months; new text end

new text begin (2) at the request of the foster parent; or new text end

new text begin (3) if the child's level of need changes in the current foster home. new text end

new text begin (f) The pre-Northstar Care for Children foster care program must maintain the following existing program features: new text end

new text begin (1) monthly payments must be made to the family foster home provider; new text end

new text begin (2) notice and appeal procedures must be consistent with Minnesota Rules, part 9560.0665; and new text end

new text begin (3) medical assistance eligibility for foster children must continue to be determined according to section 256B.055. new text end

new text begin (g) The county of financial responsibility under section 256G.02 or tribal agency authorized under section 256.01, subdivision 14b, may continue existing program features, including: new text end

new text begin (1) establishing a local fund of county money through which the agency may reimburse foster parents for the cost of repairing damage done to the home and contents by the foster child and the additional care insurance premium cost of a child who possesses a permit or license to drive a car; and new text end

new text begin (2) paying a fee for specific services provided by the foster parent, based on the parent's skills, experience, or training. This fee must not be considered foster care maintenance. new text end

new text begin (h) The following events end the child's enrollment in the pre-Northstar Care for Children foster care program: new text end

new text begin (1) reunification with parent or other relative; new text end

new text begin (2) adoption or transfer of permanent legal and physical custody; new text end

new text begin (3) removal from the current foster home to a different foster home; new text end

new text begin (4) another event that ends the current placement episode; or new text end

new text begin (5) attaining the age of 21. new text end

new text begin Subd. 2. new text end

new text begin Consideration of other programs. new text end

new text begin (a) When a child in foster care is eligible to receive a grant of Retirement Survivors Disability Insurance (RSDI) or Supplemental Security Income for the aged, blind, and disabled, or a foster care maintenance payment under title IV-E of the Social Security Act, United States Code, title 42, sections 670 to 676, the child's needs must be met through these programs. Every effort must be made to establish a child's eligibility for a title IV-E grant to reimburse the county or tribe from the federal funds available for this purpose. new text end

new text begin (b) When a child in foster care qualifies for home and community-based waivered services under section 256B.49 for community alternative care (CAC), community alternatives for disabled individuals (CADI), or traumatic brain injury (TBI) waivers, this service does not substitute for the child foster care program. When a foster child is receiving waivered services benefits, the county of financial responsibility under section 256G.02 or tribal agency authorized under section 256.01, subdivision 14b, assesses and provides foster care maintenance including difficulty of care using the established tool in Minnesota Rules, part 9560.0654. If it is determined that additional services are needed to meet the child's needs in the home that are not or cannot be met by the foster care program, the needs must be referred to the waivered service program. new text end

Sec. 21.

new text begin [260C.4412] PAYMENT FOR RESIDENTIAL PLACEMENTS. new text end

new text begin When a child is placed in a foster care group residential setting under Minnesota Rules, parts 2960.0020 to 2960.0710, foster care maintenance payments must be made on behalf of the child to cover the cost of providing food, clothing, shelter, daily supervision, school supplies, child's personal incidentals and supports, reasonable travel for visitation, or other transportation needs associated with the items listed. Daily supervision in the group residential setting includes routine day-to-day direction and arrangements to ensure the well-being and safety of the child. It may also include reasonable costs of administration and operation of the facility. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2015. new text end

Sec. 22.

new text begin [260C.4413] INITIAL CLOTHING ALLOWANCE. new text end

new text begin (a) An initial clothing allowance must be available to a child eligible for: new text end

new text begin (1) the pre-Northstar Care for Children foster care program under section 260C.4411, subdivision 1; and new text end

new text begin (2) the Northstar Care for Children benefits under section 256N.21. new text end

new text begin (b) An initial clothing allowance must also be available for a foster child in a group residential setting based on the child's individual needs during the first 60 days of the child's initial placement. The agency must consider the parent's ability to provide for a child's clothing needs and the residential facility contracts. new text end

new text begin (c) The county of financial responsibility under section 256G.02 or tribal agency authorized under section 256.01, subdivision 14b, shall approve an initial clothing allowance consistent with the child's needs. The amount of the initial clothing allowance must not exceed the monthly basic rate for the child's age group under section 256N.26, subdivision 3. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2015. new text end

Sec. 23.

Minnesota Statutes 2012, section 260C.446, is amended to read:

260C.446 DISTRIBUTION OF FUNDS RECOVERED FOR ASSISTANCE FURNISHED.

When any amount shall be recovered from any source for assistance furnished under the provisions of sections 260C.001 to 260C.421 deleted text begin and 260C.441deleted text end , there shall be paid into the treasury of the state or county in the proportion in which they have respectively contributed toward the total assistance paid.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2015. new text end

Sec. 24.

new text begin REPEALER. new text end

new text begin (a) new text end new text begin Minnesota Statutes 2012, sections 256.82, subdivision 4; and 260C.441, new text end new text begin are repealed effective January 1, 2015. new text end

new text begin (b) new text end new text begin Minnesota Rules, parts 9560.0650, subparts 1, 3, and 6; 9560.0651; and 9560.0655, new text end new text begin are repealed effective January 1, 2015. new text end

Presented to the governor May 22, 2013

Signed by the governor May 23, 2013, 11:25 a.m.

Official Publication of the State of Minnesota
Revisor of Statutes