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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