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

CHAPTER 71--S.F.No. 1458

An act

relating to state government; establishing the health and human services budget; modifying provisions governing children and family services, chemical and mental health services, withdrawal management programs, direct care and treatment, health care, continuing care, Department of Health and public health programs, health care delivery, health licensing boards, and MNsure; making changes to medical assistance, MFIP, Northstar Care for Children, MinnesotaCare, child care assistance, and group residential housing programs; establishing uniform requirements for public assistance programs related to income calculation, reporting income, and correcting overpayments and underpayments; modifying requirements for reporting maltreatment of minors and juvenile safety and placement; establishing the Minnesota ABLE plan and accounts; modifying child support provisions; establishing standards for withdrawal management programs; modifying requirements for background studies; making changes to provisions governing the health information exchange; providing for protection of born alive infants; authorizing rulemaking; requiring reports and studies; making technical changes; modifying certain fees for Department of Health programs; modifying fees of certain health-related licensing boards; making human services forecast adjustments; appropriating money;

amending Minnesota Statutes 2014, sections 13.46, subdivisions 2, 7; 13.461, by adding a subdivision; 16A.724, subdivision 2; 43A.241; 62A.02, subdivision 2; 62A.045; 62J.498; 62J.4981; 62J.4982, subdivisions 4, 5; 62J.692, subdivision 4; 62Q.37, subdivision 2; 62Q.55, subdivision 3; 62U.02, subdivisions 1, 2, 3, 4; 62U.04, subdivision 11; 62U.10, by adding subdivisions; 62V.03, subdivision 2; 62V.05, subdivisions 6, 7, 8, by adding a subdivision; 119B.011, subdivision 15; 119B.025, subdivision 1; 119B.035, subdivision 4; 119B.09, subdivision 4; 119B.125, by adding a subdivision; 119B.13, subdivision 6; 144.057, subdivision 1; 144.1501, subdivisions 1, 2, 3, 4; 144.291, subdivision 2; 144.293, subdivisions 5, 6, 8; 144.298, subdivisions 2, 3; 144.551, subdivision 1; 144.9501, subdivisions 6d, 22b, 26b, by adding subdivisions; 144.9505; 144.9508; 144A.071, subdivision 4a; 144A.70, subdivision 6, by adding a subdivision; 144A.71; 144A.72; 144A.73; 144A.75, subdivision 13; 144D.01, by adding a subdivision; 144E.001, by adding a subdivision; 144E.275, subdivision 1, by adding a subdivision; 145.4131, subdivision 1; 145.423; 145.56, subdivisions 2, 4; 145.928, subdivision 13, by adding a subdivision; 145.986, subdivisions 1a, 2, 4; 145A.131, subdivision 1; 148.52; 148.54; 148.57, subdivisions 1, 2, by adding a subdivision; 148.574; 148.575, subdivision 2; 148.577; 148.59; 148.603; 148E.075; 148E.080, subdivisions 1, 2; 148E.180, subdivisions 2, 5; 149A.20, subdivisions 5, 6; 149A.40, subdivision 11; 149A.65; 149A.92, subdivision 1; 149A.97, subdivision 7; 150A.06, subdivision 1b; 150A.091, subdivisions 4, 5, 11, by adding subdivisions; 150A.31; 151.01, subdivisions 15a, 27; 151.02; 151.065, subdivisions 1, 2, 3, 4; 151.102; 151.58, subdivisions 2, 5; 157.15, subdivision 8; 174.29, subdivision 1; 174.30, subdivisions 3, 4, by adding subdivisions; 245.4661, subdivisions 5, 6, by adding subdivisions; 245.467, subdivision 6; 245.4876, subdivision 7; 245.4889, subdivision 1, by adding a subdivision; 245A.06, by adding a subdivision; 245A.155, subdivisions 1, 2; 245A.65, subdivision 2; 245C.03, by adding subdivisions; 245C.04, by adding a subdivision; 245C.08, subdivision 1; 245C.10, by adding subdivisions; 245C.12; 245D.02, by adding a subdivision; 245D.05, subdivisions 1, 2; 245D.06, subdivisions 1, 2, 7; 245D.07, subdivision 2; 245D.071, subdivision 5; 245D.09, subdivisions 3, 5; 245D.22, subdivision 4; 245D.31, subdivisions 3, 4, 5; 246.18, subdivision 8; 246.54, subdivision 1; 252.27, subdivision 2a; 253B.18, subdivisions 4c, 5; 254B.05, subdivision 5, as amended; 254B.12, subdivision 2; 256.01, by adding subdivisions; 256.015, subdivision 7; 256.017, subdivision 1; 256.478; 256.741, subdivisions 1, 2; 256.969, subdivisions 1, 2b, 2d, 3a, 3c, 9; 256.975, by adding a subdivision; 256B.056, subdivision 5c; 256B.057, subdivision 9; 256B.059, subdivision 5; 256B.06, by adding a subdivision; 256B.0615, subdivision 3; 256B.0622, subdivisions 1, 2, 3, 4, 5, 7, 8, 9, 10, by adding a subdivision; 256B.0624, subdivision 7; 256B.0625, subdivisions 3b, 13, 13e, 13h, 17, 17a, 18a, 18e, 28a, 31, 48, 57, 58, by adding subdivisions; 256B.0631; 256B.072; 256B.0757; 256B.0913, subdivision 4; 256B.0915, subdivisions 3a, 3e, 3h; 256B.0916, subdivisions 2, 11, by adding a subdivision; 256B.431, subdivisions 2b, 36; 256B.434, subdivision 4, by adding a subdivision; 256B.441, subdivisions 1, 5, 6, 13, 14, 17, 30, 31, 33, 35, 40, 44, 46c, 48, 50, 51, 51a, 53, 54, 55a, 56, 63, by adding subdivisions; 256B.49, subdivision 26, by adding a subdivision; 256B.4913, subdivisions 4a, 5; 256B.4914, subdivisions 2, 6, 8, 10, 14, 15; 256B.492; 256B.50, subdivision 1; 256B.69, subdivisions 5a, 5i, 9c, 9d, by adding a subdivision; 256B.75; 256B.76, subdivisions 1, 2, 4, as amended; 256B.762; 256B.766; 256B.767; 256D.01, subdivision 1a; 256D.02, subdivision 8, by adding subdivisions; 256D.06, subdivision 1; 256D.405, subdivision 3; 256E.35, subdivision 2, by adding a subdivision; 256I.03, subdivisions 3, 7, by adding subdivisions; 256I.04, subdivisions 1, 1a, 2a, 2b, 2c, 3, 4, by adding subdivisions; 256I.05, subdivisions 1c, 1g, 2; 256I.06, subdivisions 2, 6, 7, 8; 256J.08, subdivisions 26, 86; 256J.21, subdivision 2, as amended; 256J.24, subdivision 5a; 256J.30, subdivisions 1, 9; 256J.33, subdivision 4; 256J.35; 256J.40; 256J.95, subdivision 19; 256K.45, subdivisions 1a, 6; 256L.01, subdivisions 3a, 5; 256L.03, subdivision 5; 256L.04, subdivisions 1c, 7b; 256L.05, subdivisions 3, 3a, 4, by adding a subdivision; 256L.06, subdivision 3; 256L.121, subdivision 1; 256L.15, subdivisions 1, 2; 256N.22, subdivisions 9, 10; 256N.24, subdivision 4; 256N.25, subdivision 1; 256N.27, subdivision 2; 256P.001; 256P.01, subdivision 3, by adding subdivisions; 256P.02, by adding a subdivision; 256P.03, subdivision 1; 256P.04, subdivisions 1, 4; 256P.05, subdivision 1; 257.75, subdivisions 3, 5; 259A.75; 260C.007, subdivisions 27, 32; 260C.203; 260C.212, subdivision 1, by adding subdivisions; 260C.221; 260C.331, subdivision 1; 260C.451, subdivisions 2, 6; 260C.515, subdivision 5; 260C.521, subdivisions 1, 2; 260C.607, subdivision 4; 518A.26, subdivision 14; 518A.32, subdivision 2; 518A.39, subdivision 1, by adding a subdivision; 518A.41, subdivisions 1, 3, 4, 14, 15; 518A.43, by adding a subdivision; 518A.46, subdivision 3, by adding a subdivision; 518A.51; 518A.53, subdivisions 1, 4, 10; 518A.60; 518C.802; 626.556, subdivisions 1, as amended, 2, 3, 6a, 7, as amended, 10, 10e, 10j, 10m, 11c, by adding subdivisions; 626.559, by adding a subdivision; Laws 2008, chapter 363, article 18, section 3, subdivision 5; Laws 2014, chapter 189, sections 5; 9; 10; 11; 16; 17; 18; 19; 23; 24; 27; 28; 29; 31; 43; 50; 51; 52; 73; Laws 2014, chapter 312, article 24, section 45, subdivision 2; proposing coding for new law in Minnesota Statutes, chapters 62A; 144; 144D; 148; 245; 245A; 256B; 256E; 256M; 256P; 518A; proposing coding for new law as Minnesota Statutes, chapters 245F; 256Q; repealing Minnesota Statutes 2014, sections 62V.11, subdivision 3; 148.57, subdivisions 3, 4; 148.571; 148.572; 148.573, subdivision 1; 148.575, subdivisions 1, 3, 5, 6; 148.576; 148E.060, subdivision 12; 148E.075, subdivisions 4, 5, 6, 7; 256.01, subdivision 35; 256.969, subdivisions 23, 30; 256B.434, subdivision 19b; 256B.441, subdivisions 14a, 19, 50a, 52, 55, 58, 62; 256B.69, subdivision 32; 256D.0513; 256D.06, subdivision 8; 256D.09, subdivision 6; 256D.49; 256J.38; 256L.02, subdivision 3; 256L.05, subdivisions 1b, 1c, 3c, 5; Laws 2012, chapter 247, article 4, section 47, as amended; Minnesota Rules, parts 3400.0170, subparts 5, 6, 12, 13; 8840.5900, subparts 12, 14.

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

ARTICLE 1

CHILDREN AND FAMILY SERVICES

Section 1.

Minnesota Statutes 2014, section 119B.125, is amended by adding a subdivision to read:

new text begin Subd. 7. new text end

new text begin Failure to comply with attendance record requirements. new text end

new text begin (a) In establishing an overpayment claim for failure to provide attendance records in compliance with section 119B.125, subdivision 6, the county or commissioner is limited to the six years prior to the date the county or the commissioner requested the attendance records. new text end

new text begin (b) The commissioner may periodically audit child care providers to determine compliance with section 119B.125, subdivision 6. new text end

new text begin (c) When the commissioner or county establishes an overpayment claim against a current or former provider, the commissioner or county must provide notice of the claim to the provider. A notice of overpayment claim must specify the reason for the overpayment, the authority for making the overpayment claim, the time period in which the overpayment occurred, the amount of the overpayment, and the provider's right to appeal. new text end

new text begin (d) The commissioner or county shall seek to recoup or recover overpayments paid to a current or former provider. new text end

new text begin (e) When a provider has been disqualified or convicted of fraud under section 256.98, theft under section 609.52, or a federal crime relating to theft of state funds or fraudulent billing for a program administered by the commissioner or a county, recoupment or recovery must be sought regardless of the amount of overpayment. new text end

Sec. 2.

Minnesota Statutes 2014, 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 new text begin or the commissioner new text end 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 new text begin or the commissioner new text end finds by a preponderance of the evidence that the provider intentionally gave the county materially false information on the provider's billing formsnew text begin , or provided false attendance records to a county or the commissionernew text end ;

(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 deleted text begin receipt ofdeleted text end new text begin :new text end

new text begin (i) new text end an order of suspension deleted text begin ordeleted text end new text begin of the provider's license issued by the commissioner;new text end

new text begin (ii) new text end an order of revocation of the provider's licensedeleted text begin ,deleted text end new text begin ;new text end or

deleted text begin 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; deleted text end new text begin (iii) a final order of conditional license issued by the commissioner for as long as the conditional license is in effect; new text end

(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 (e) For purposes of paragraph (d), clauses (3), (5), and (6), new text end the county new text begin or the commissioner new text end 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.

deleted text begin (e)deleted text end new text begin (f) new text end 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.

Sec. 3.

Minnesota Statutes 2014, section 245C.03, is amended by adding a subdivision to read:

new text begin Subd. 10. new text end

new text begin Providers of group residential housing or supplementary services. new text end

new text begin The commissioner shall conduct background studies on any individual required under section 256I.04 to have a background study completed under this chapter. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 4.

Minnesota Statutes 2014, section 245C.03, is amended by adding a subdivision to read:

new text begin Subd. 11. new text end

new text begin Child protection workers or social services staff having responsibility for child protective duties. new text end

new text begin (a) The commissioner must complete background studies, according to paragraph (b) and 245C.04, subdivision 10, when initiated by a county social services agency or by a local welfare agency according to section 626.559, subdivision 1b. new text end

new text begin (b) For background studies completed by the commissioner under this subdivision, the commissioner shall not make a disqualification decision, but shall provide the background study information received to the county that initiated the study. new text end

Sec. 5.

Minnesota Statutes 2014, section 245C.04, is amended by adding a subdivision to read:

new text begin Subd. 10. new text end

new text begin Child protection workers or social services staff having responsibility for child protective duties. new text end

new text begin The commissioner shall conduct background studies of employees of county social services and local welfare agencies having responsibility for child protection duties when the background study is initiated according to section 626.559, subdivision 1b. new text end

Sec. 6.

Minnesota Statutes 2014, section 245C.10, is amended by adding a subdivision to read:

new text begin Subd. 11. new text end

new text begin Providers of group residential housing or supplementary services. new text end

new text begin The commissioner shall recover the cost of background studies initiated by providers of group residential housing or supplementary services under section 256I.04 through a fee of no more than $20 per study. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 7.

Minnesota Statutes 2014, section 245C.10, is amended by adding a subdivision to read:

new text begin Subd. 12. new text end

new text begin Child protection workers or social services staff having responsibility for child protective duties. new text end

new text begin The commissioner shall recover the cost of background studies initiated by county social services agencies and local welfare agencies for individuals who are required to have a background study under section 626.559, subdivision 1b, through a fee of no more than $20 per study. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies. new text end

Sec. 8.

Minnesota Statutes 2014, section 256.01, is amended by adding a subdivision to read:

new text begin Subd. 12a. new text end

new text begin Department of Human Services child fatality and near fatality review team. new text end

new text begin The commissioner shall establish a Department of Human Services child fatality and near fatality review team to review child fatalities and near fatalities due to child maltreatment and child fatalities and near fatalities that occur in licensed facilities and are not due to natural causes. The review team shall assess the entire child protection services process from the point of a mandated reporter reporting the alleged maltreatment through the ongoing case management process. Department staff shall lead and conduct on-site local reviews and utilize supervisors from local county and tribal child welfare agencies as peer reviewers. The review process must focus on critical elements of the case and on the involvement of the child and family with the county or tribal child welfare agency. The review team shall identify necessary program improvement planning to address any practice issues identified and training and technical assistance needs of the local agency. Summary reports of each review shall be provided to the state child mortality review panel when completed. new text end

Sec. 9.

Minnesota Statutes 2014, section 256.017, subdivision 1, is amended to read:

Subdivision 1.

Authority and purpose.

The commissioner shall administer a compliance system for the Minnesota family investment program, the food stamp or food support program, emergency assistance, general assistance, medical assistance, emergency general assistance, Minnesota supplemental assistancenew text begin , group residential housingnew text end , preadmission screening, alternative care grants, the child care assistance program, and all other programs administered by the commissioner or on behalf of the commissioner under the powers and authorities named in section 256.01, subdivision 2. The purpose of the compliance system is to permit the commissioner to supervise the administration of public assistance programs and to enforce timely and accurate distribution of benefits, completeness of service and efficient and effective program management and operations, to increase uniformity and consistency in the administration and delivery of public assistance programs throughout the state, and to reduce the possibility of sanctions and fiscal disallowances for noncompliance with federal regulations and state statutes. The commissioner, or the commissioner's representative, may issue administrative subpoenas as needed in administering the compliance system.

The commissioner shall utilize training, technical assistance, and monitoring activities, as specified in section 256.01, subdivision 2, to encourage county agency compliance with written policies and procedures.

Sec. 10.

Minnesota Statutes 2014, section 256.741, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

(a) The term "direct support" as used in this chapter and chapters 257, 518, 518A, and 518C refers to an assigned support payment from an obligor which is paid directly to a recipient of public assistance.

(b) The term "public assistance" as used in this chapter and chapters 257, 518, 518A, and 518C, includes any form of assistance provided under the AFDC program formerly codified in sections 256.72 to 256.87, MFIP and MFIP-R formerly codified under chapter 256, MFIP under chapter 256J, work first program formerly codified under chapter 256K; child care assistance provided through the child care fund under chapter 119B; any form of medical assistance under chapter 256B; deleted text begin MinnesotaCare under chapter 256L;deleted text end and foster care as provided under title IV-E of the Social Security Act.new text begin MinnesotaCare and health plans subsidized by federal premium tax credits or federal cost-sharing reductions are not considered public assistance for purposes of a child support referral.new text end

(c) The term "child support agency" as used in this section refers to the public authority responsible for child support enforcement.

(d) The term "public assistance agency" as used in this section refers to a public authority providing public assistance to an individual.

(e) The terms "child support" and "arrears" as used in this section have the meanings provided in section 518A.26.

(f) The term "maintenance" as used in this section has the meaning provided in section 518.003.

Sec. 11.

Minnesota Statutes 2014, section 256.741, subdivision 2, is amended to read:

Subd. 2.

Assignment of support and maintenance rights.

(a) An individual receiving public assistance in the form of assistance under any of the following programs: the AFDC program formerly codified in sections 256.72 to 256.87, MFIP under chapter 256J, MFIP-R and MFIP formerly codified under chapter 256, or work first program formerly codified under chapter 256K is considered to have assigned to the state at the time of application all rights to child support and maintenance from any other person the applicant or recipient may have in the individual's own behalf or in the behalf of any other family member for whom application for public assistance is made. An assistance unit is ineligible for the Minnesota family investment program unless the caregiver assigns all rights to child support and maintenance benefits according to this section.

(1) The assignment is effective as to any current child support and current maintenance.

(2) Any child support or maintenance arrears that accrue while an individual is receiving public assistance in the form of assistance under any of the programs listed in this paragraph are permanently assigned to the state.

(3) The assignment of current child support and current maintenance ends on the date the individual ceases to receive or is no longer eligible to receive public assistance under any of the programs listed in this paragraph.

(b) An individual receiving public assistance in the form of medical assistancedeleted text begin , including MinnesotaCare,deleted text end is considered to have assigned to the state at the time of application all rights to medical support from any other person the individual may have in the individual's own behalf or in the behalf of any other family member for whom medical assistance is provided.

(1) An assignment made after September 30, 1997, is effective as to any medical support accruing after the date of medical assistance deleted text begin or MinnesotaCaredeleted text end eligibility.

(2) Any medical support arrears that accrue while an individual is receiving public assistance in the form of medical assistancedeleted text begin , including MinnesotaCare,deleted text end are permanently assigned to the state.

(3) The assignment of current medical support ends on the date the individual ceases to receive or is no longer eligible to receive public assistance in the form of medical assistance deleted text begin or MinnesotaCaredeleted text end .

(c) An individual receiving public assistance in the form of child care assistance under the child care fund pursuant to chapter 119B is considered to have assigned to the state at the time of application all rights to child care support from any other person the individual may have in the individual's own behalf or in the behalf of any other family member for whom child care assistance is provided.

(1) The assignment is effective as to any current child care support.

(2) Any child care support arrears that accrue while an individual is receiving public assistance in the form of child care assistance under the child care fund in chapter 119B are permanently assigned to the state.

(3) The assignment of current child care support ends on the date the individual ceases to receive or is no longer eligible to receive public assistance in the form of child care assistance under the child care fund under chapter 119B.

Sec. 12.

new text begin [256E.28] CHILD PROTECTION GRANTS TO ADDRESS CHILD WELFARE DISPARITIES. new text end

new text begin Subdivision 1. new text end

new text begin Child welfare disparities grant program established. new text end

new text begin The commissioner may award grants to eligible entities for the development, implementation, and evaluation of activities to address racial disparities and disproportionality in the child welfare system by: new text end

new text begin (1) identifying and addressing structural factors that contribute to inequities in outcomes; new text end

new text begin (2) identifying and implementing strategies to reduce racial disparities in treatment and outcomes; new text end

new text begin (3) using cultural values, beliefs, and practices of families, communities, and tribes for case planning, service design, and decision-making processes; new text end

new text begin (4) using placement and reunification strategies to maintain and support relationships and connections between parents, siblings, children, kin, significant others, and tribes; and new text end

new text begin (5) supporting families in the context of their communities and tribes to safely divert them from the child welfare system, whenever possible. new text end

new text begin Subd. 2. new text end

new text begin State-community partnerships; plan. new text end

new text begin The commissioner, in partnership with the legislative task force on child protection; culturally based community organizations; the Indian Affairs Council under section 3.922; the Council on Affairs of Chicano/Latino People under section 3.9223; the Council on Black Minnesotans under section 3.9225; the Council on Asian-Pacific Minnesotans under section 3.9226; the American Indian Child Welfare Advisory Council under section 260.835; counties; and tribal governments, shall develop and implement a comprehensive, coordinated plan to award funds under this section for the priority areas identified in subdivision 1. new text end

new text begin Subd. 3. new text end

new text begin Measurable outcomes. new text end

new text begin The commissioner, in consultation with the state-community partners listed in subdivision 2, shall establish measurable outcomes to determine the effectiveness of the grants and other activities funded under this section in reducing disparities identified in subdivision 1. The development of measurable outcomes must be completed before any funds are distributed under this section. new text end

new text begin Subd. 4. new text end

new text begin Process. new text end

new text begin (a) The commissioner, in consultation with the state-community partners listed in subdivision 2, shall develop the criteria and procedures to allocate competitive grants under this section. In developing the criteria, the commissioner shall establish an administrative cost limit for grant recipients. A county awarded a grant shall not spend more than three percent of the grant on administrative costs. When a grant is awarded, the commissioner must provide a grant recipient with information on the outcomes established according to subdivision 3. new text end

new text begin (b) A grant recipient must coordinate its activities with other entities receiving funds under this section that are in the grant recipient's service area. new text end

new text begin (c) Grant funds must not be used to supplant any state or federal funds received for child welfare services. new text end

new text begin Subd. 5. new text end

new text begin Grant program criteria. new text end

new text begin (a) The commissioner shall award competitive grants to eligible applicants for local or regional projects and initiatives directed at reducing disparities in the child welfare system. new text end

new text begin (b) The commissioner may award up to 20 percent of the funds available as planning grants. Planning grants must be used to address such areas as community assessment, coordination activities, and development of community-supported strategies. new text end

new text begin (c) Eligible applicants may include, but are not limited to, faith-based organizations, social service organizations, community nonprofit organizations, counties, and tribal governments. Applicants must submit proposals to the commissioner. A proposal must specify the strategies to be implemented to address one or more of the priority areas in subdivision 1 and must be targeted to achieve the outcomes established according to subdivision 3. new text end

new text begin (d) The commissioner shall give priority to applicants who demonstrate that their proposed project or initiative: new text end

new text begin (1) is supported by the community the applicant will serve; new text end

new text begin (2) is evidence-based; new text end

new text begin (3) is designed to complement other related community activities; new text end

new text begin (4) utilizes strategies that positively impact priority areas; new text end

new text begin (5) reflects culturally appropriate approaches; or new text end

new text begin (6) will be implemented through or with community-based organizations that reflect the culture of the population to be reached. new text end

new text begin Subd. 6. new text end

new text begin Evaluation. new text end

new text begin (a) Using the outcomes established according to subdivision 3, the commissioner shall conduct a biennial evaluation of the grant program funded under this section. Grant recipients shall cooperate with the commissioner in the evaluation and shall provide the commissioner with the information needed to conduct the evaluation. new text end

new text begin (b) The commissioner shall consult with the legislative task force on child protection during the evaluation process and shall submit a biennial evaluation report to the task force and to the chairs and ranking minority members of the house of representatives and senate committees with jurisdiction over child protection funding. new text end

new text begin Subd. 7. new text end

new text begin American Indian child welfare projects. new text end

new text begin Of the amount appropriated for purposes of this section, the commissioner shall award $75,000 to each tribe authorized to provide tribal delivery of child welfare services under section 256.01, subdivision 14b. To receive funds under this subdivision, a participating tribe is not required to apply to the commissioner for grant funds. Participating tribes are also eligible for competitive grant funds under this section. new text end

Sec. 13.

Minnesota Statutes 2014, section 256E.35, subdivision 2, is amended to read:

Subd. 2.

Definitions.

(a) The definitions in this subdivision apply to this section.

new text begin (b) "Eligible educational institution" means the following: new text end

new text begin (1) an institution of higher education described in section 101 or 102 of the Higher Education Act of 1965; or new text end

new text begin (2) an area vocational education school, as defined in subparagraph (C) or (D) of United States Code, title 20, chapter 44, section 2302 (3) (the Carl D. Perkins Vocational and Applied Technology Education Act), which is located within any state, as defined in United States Code, title 20, chapter 44, section 2302 (30). This clause is applicable only to the extent section 2302 is in effect on August 1, 2008. new text end

deleted text begin (b)deleted text end new text begin (c)new text end "Family asset account" means a savings account opened by a household participating in the Minnesota family assets for independence initiative.

deleted text begin (c)deleted text end new text begin (d)new text end "Fiduciary organization" means:

(1) a community action agency that has obtained recognition under section 256E.31;

(2) a federal community development credit union serving the seven-county metropolitan area; or

(3) a women-oriented economic development agency serving the seven-county metropolitan area.

new text begin (e) new text end new text begin "Financial coach" means a person who: new text end

new text begin (1) has completed an intensive financial literacy training workshop that includes curriculum on budgeting to increase savings, debt reduction and asset building, building a good credit rating, and consumer protection; new text end

new text begin (2) participates in ongoing statewide family assets for independence in Minnesota (FAIM) network training meetings under FAIM program supervision; and new text end

new text begin (3) provides financial coaching to program participants under subdivision 4a. new text end

deleted text begin (d)deleted text end new text begin (f)new text end "Financial institution" means a bank, bank and trust, savings bank, savings association, or credit union, the deposits of which are insured by the Federal Deposit Insurance Corporation or the National Credit Union Administration.

new text begin (g) "Household" means all individuals who share use of a dwelling unit as primary quarters for living and eating separate from other individuals. new text end

deleted text begin (e)deleted text end new text begin (h)new text end "Permissible use" means:

(1) postsecondary educational expenses at an eligible educational institution as defined in paragraph deleted text begin (g)deleted text end new text begin (b)new text end , including books, supplies, and equipment required for courses of instruction;

(2) acquisition costs of acquiring, constructing, or reconstructing a residence, including any usual or reasonable settlement, financing, or other closing costs;

(3) business capitalization expenses for expenditures on capital, plant, equipment, working capital, and inventory expenses of a legitimate business pursuant to a business plan approved by the fiduciary organization; and

(4) acquisition costs of a principal residence within the meaning of section 1034 of the Internal Revenue Code of 1986 which do not exceed 100 percent of the average area purchase price applicable to the residence determined according to section 143(e)(2) and (3) of the Internal Revenue Code of 1986.

deleted text begin (f) "Household" means all individuals who share use of a dwelling unit as primary quarters for living and eating separate from other individuals. deleted text end

deleted text begin (g) "Eligible educational institution" means the following: deleted text end

deleted text begin (1) an institution of higher education described in section 101 or 102 of the Higher Education Act of 1965; or deleted text end

deleted text begin (2) an area vocational education school, as defined in subparagraph (C) or (D) of United States Code, title 20, chapter 44, section 2302 (3) (the Carl D. Perkins Vocational and Applied Technology Education Act), which is located within any state, as defined in United States Code, title 20, chapter 44, section 2302 (30). This clause is applicable only to the extent section 2302 is in effect on August 1, 2008. deleted text end

Sec. 14.

Minnesota Statutes 2014, section 256E.35, is amended by adding a subdivision to read:

new text begin Subd. 4a. new text end

new text begin Financial coaching. new text end

new text begin A financial coach shall provide the following to program participants: new text end

new text begin (1) financial education relating to budgeting, debt reduction, asset-specific training, and financial stability activities; new text end

new text begin (2) asset-specific training related to buying a home, acquiring postsecondary education, or starting or expanding a small business; and new text end

new text begin (3) financial stability education and training to improve and sustain financial security. new text end

Sec. 15.

Minnesota Statutes 2014, section 256I.03, subdivision 3, is amended to read:

Subd. 3.

Group residential housing.

"Group residential housing" means a group living situation that provides at a minimum room and board to unrelated persons who meet the eligibility requirements of section 256I.04. deleted text begin This definition includes foster care settings or community residential settings for a single adult.deleted text end To receive payment for a group residence rate, the residence must meet the requirements under section 256I.04, deleted text begin subdivisiondeleted text end new text begin subdivisionsnew text end 2anew text begin to 2fnew text end .

Sec. 16.

Minnesota Statutes 2014, section 256I.03, subdivision 7, is amended to read:

Subd. 7.

Countable income.

"Countable income" means all income received by an applicant or recipient less any applicable exclusions or disregards. For a recipient of any cash benefit from the SSI program, countable income means the SSI benefit limit in effect at the time the person is deleted text begin in a GRHdeleted text end new text begin a recipient of group residential housingnew text end , less the medical assistance personal needs allowancenew text begin under section 256B.35new text end . If the SSI limit deleted text begin has beendeleted text end new text begin or benefit isnew text end reduced for a person due to events deleted text begin occurring prior to the persons entering the GRH settingdeleted text end new text begin other than receipt of additional incomenew text end , countable income means actual income less any applicable exclusions and disregards.

Sec. 17.

Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision to read:

new text begin Subd. 9. new text end

new text begin Direct contact. new text end

new text begin "Direct contact" means providing face-to-face care, training, supervision, counseling, consultation, or medication assistance to recipients of group residential housing. new text end

Sec. 18.

Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision to read:

new text begin Subd. 10. new text end

new text begin Habitability inspection. new text end

new text begin "Habitability inspection" means an inspection to determine whether the housing occupied by an individual meets the habitability standards specified by the commissioner. The standards must be provided to the applicant in writing and posted on the Department of Human Services Web site. new text end

Sec. 19.

Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision to read:

new text begin Subd. 11. new text end

new text begin Long-term homelessness. new text end

new text begin "Long-term homelessness" means lacking a permanent place to live: new text end

new text begin (1) continuously for one year or more; or new text end

new text begin (2) at least four times in the past three years. new text end

Sec. 20.

Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision to read:

new text begin Subd. 12. new text end

new text begin Professional statement of need. new text end

new text begin "Professional statement of need" means a statement about an individual's illness, injury, or incapacity that is signed by a qualified professional. The statement must specify that the individual has an illness or incapacity which limits the individual's ability to work and provide self-support. The statement must also specify that the individual needs assistance to access or maintain housing, as evidenced by the need for two or more of the following services: new text end

new text begin (1) tenancy supports to assist an individual with finding the individual's own home, landlord negotiation, securing furniture and household supplies, understanding and maintaining tenant responsibilities, conflict negotiation, and budgeting and financial education; new text end

new text begin (2) supportive services to assist with basic living and social skills, household management, monitoring of overall well-being, and problem solving; new text end

new text begin (3) employment supports to assist with maintaining or increasing employment, increasing earnings, understanding and utilizing appropriate benefits and services, improving physical or mental health, moving toward self-sufficiency, and achieving personal goals; or new text end

new text begin (4) health supervision services to assist in the preparation and administration of medications other than injectables, the provision of therapeutic diets, taking vital signs, or providing assistance in dressing, grooming, bathing, or with walking devices. new text end

Sec. 21.

Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision to read:

new text begin Subd. 13. new text end

new text begin Prospective budgeting. new text end

new text begin "Prospective budgeting" means estimating the amount of monthly income a person will have in the payment month. new text end

Sec. 22.

Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision to read:

new text begin Subd. 14. new text end

new text begin Qualified professional. new text end

new text begin "Qualified professional" means an individual as defined in section 256J.08, subdivision 73a, or Minnesota Rules, part 9530.6450, subpart 3, 4, or 5; or an individual approved by the director of human services or a designee of the director. new text end

Sec. 23.

Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision to read:

new text begin Subd. 15. new text end

new text begin Supportive housing. new text end

new text begin "Supportive housing" means housing with support services according to the continuum of care coordinated assessment system established under Code of Federal Regulations, title 24, section 578.3. new text end

Sec. 24.

Minnesota Statutes 2014, section 256I.04, subdivision 1, is amended to read:

Subdivision 1.

Individual eligibility requirements.

An individual is eligible for and entitled to a group residential housing payment to be made on the individual's behalf if the agency has approved the individual's residence in a group residential housing setting and the individual meets the requirements in paragraph (a) or (b).

(a) The individual is aged, blind, or is over 18 years of age and disabled as determined under the criteria used by the title II program of the Social Security Act, and meets the resource restrictions and standards of section 256P.02, and the individual's countable income after deducting the (1) exclusions and disregards of the SSI program, (2) the medical assistance personal needs allowance under section 256B.35, and (3) an amount equal to the income actually made available to a community spouse by an elderly waiver participant under the provisions of sections 256B.0575, paragraph (a), clause (4), and 256B.058, subdivision 2, is less than the monthly rate specified in the agency's agreement with the provider of group residential housing in which the individual resides.

(b) The individual meets a category of eligibility under section 256D.05, subdivision 1, paragraph (a),new text begin clauses (1), (3), (5) to (9), and (14), and paragraph (b), if applicable,new text end and the individual's resources are less than the standards specified by section 256P.02, and the individual's countable income as determined under sections 256D.01 to 256D.21, less the medical assistance personal needs allowance under section 256B.35 is less than the monthly rate specified in the agency's agreement with the provider of group residential housing in which the individual resides.

new text begin EFFECTIVE DATE. new text end

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

Sec. 25.

Minnesota Statutes 2014, section 256I.04, subdivision 1a, is amended to read:

Subd. 1a.

County approval.

(a) A county agency may not approve a group residential housing payment for an individual in any setting with a rate in excess of the MSA equivalent rate for more than 30 days in a calendar year unless the deleted text begin county agency has developed or approveddeleted text end new text begin individual hasnew text end a deleted text begin plan for the individual which specifies that:deleted text end

deleted text begin (1) the individual has an illness or incapacity which prevents the person from living independently in the community; and deleted text end

deleted text begin (2) the individual's illness or incapacity requires the services which are available in the group residence. deleted text end

deleted text begin The plan must be signed or countersigned by any of the following employees of the county of financial responsibility: the director of human services or a designee of the director; a social worker; or a case aidedeleted text end new text begin professional statement of need under section 256I.03, subdivision 12new text end .

(b) If a county agency determines that an applicant is ineligible due to not meeting eligibility requirements under this section, a county agency may accept a signed personal statement from the applicant in lieu of documentation verifying ineligibility.

new text begin (c) Effective July 1, 2016, to be eligible for supplementary service payments, providers must enroll in the provider enrollment system identified by the commissioner. new text end

Sec. 26.

Minnesota Statutes 2014, section 256I.04, subdivision 2a, is amended to read:

Subd. 2a.

License requirednew text begin ; staffing qualificationsnew text end .

deleted text begin A countydeleted text end new text begin (a) Except as provided in paragraph (b), annew text end agency may not enter into an agreement with an establishment to provide group residential housing unless:

(1) the establishment is licensed by the Department of Health as a hotel and restaurant; a board and lodging establishment; deleted text begin a residential care home;deleted text end a boarding care home before March 1, 1985; or a supervised living facility, and the service provider for residents of the facility is licensed under chapter 245A. However, an establishment licensed by the Department of Health to provide lodging need not also be licensed to provide board if meals are being supplied to residents under a contract with a food vendor who is licensed by the Department of Health;

(2) the residence is: (i) licensed by the commissioner of human services under Minnesota Rules, parts 9555.5050 to 9555.6265; (ii) certified by a county human services agency prior to July 1, 1992, using the standards under Minnesota Rules, parts 9555.5050 to 9555.6265; (iii) deleted text begin a residencedeleted text end licensed by the commissioner under Minnesota Rules, parts 2960.0010 to 2960.0120, with a variance under section 245A.04, subdivision 9; or (iv) licensed under section 245D.02, subdivision 4a, as a community residential setting by the commissioner of human services;new text begin ornew text end

(3) the establishment is registered under chapter 144D and provides three meals a daydeleted text begin , or is an establishment voluntarily registered under section 144D.025 as a supportive housing establishment; ordeleted text end new text begin .new text end

deleted text begin (4) an establishment voluntarily registered under section 144D.025, other than a supportive housing establishment under clause (3), is not eligible to provide group residential housing. deleted text end

new text begin (b) new text end The requirements under deleted text begin clauses (1) to (4)deleted text end new text begin paragraph (a)new text end do not apply to establishments exempt from state licensure because they arenew text begin :new text end

new text begin (1)new text end located on Indian reservations and subject to tribal health and safety requirementsdeleted text begin .deleted text end new text begin ; ornew text end

new text begin (2) a supportive housing establishment that has an approved habitability inspection and an individual lease agreement and that serves people who have experienced long-term homelessness and were referred through a coordinated assessment in section 256I.03, subdivision 15. new text end

new text begin (c) Supportive housing establishments and emergency shelters must participate in the homeless management information system. new text end

new text begin (d) Effective July 1, 2016, an agency shall not have an agreement with a provider of group residential housing or supplementary services unless all staff members who have direct contact with recipients: new text end

new text begin (1) have skills and knowledge acquired through one or more of the following: new text end

new text begin (i) a course of study in a health- or human services-related field leading to a bachelor of arts, bachelor of science, or associate's degree; new text end

new text begin (ii) one year of experience with the target population served; new text end

new text begin (iii) experience as a certified peer specialist according to section 256B.0615; or new text end

new text begin (iv) meeting the requirements for unlicensed personnel under sections 144A.43 to 144A.483; new text end

new text begin (2) hold a current Minnesota driver's license appropriate to the vehicle driven if transporting recipients; new text end

new text begin (3) complete training on vulnerable adults mandated reporting and child maltreatment mandated reporting, where applicable; and new text end

new text begin (4) complete group residential housing orientation training offered by the commissioner. new text end

Sec. 27.

Minnesota Statutes 2014, section 256I.04, subdivision 2b, is amended to read:

Subd. 2b.

Group residential housing agreements.

new text begin (a) new text end Agreements between deleted text begin county deleted text end agencies and providers of group residential housing new text begin or supplementary services new text end must be in writingnew text begin on a form developed and approved by the commissionernew text end and must specify the name and address under which the establishment subject to the agreement does business and under which the establishment, or service provider, if different from the group residential housing establishment, is licensed by the Department of Health or the Department of Human Services; the specific license or registration from the Department of Health or the Department of Human Services held by the provider and the number of beds subject to that license; the address of the location or locations at which group residential housing is provided under this agreement; the per diem and monthly rates that are to be paid from group residential housing new text begin or supplementary service new text end funds for each eligible resident at each location; the number of beds at each location which are subject to the deleted text begin group residential housingdeleted text end agreement; whether the license holder is a not-for-profit corporation under section 501(c)(3) of the Internal Revenue Code; and a statement that the agreement is subject to the provisions of sections 256I.01 to 256I.06 and subject to any changes to those sections.

new text begin (b) Providers are required to verify the following minimum requirements in the agreement: new text end

new text begin (1) current license or registration, including authorization if managing or monitoring medications; new text end

new text begin (2) all staff who have direct contact with recipients meet the staff qualifications; new text end

new text begin (3) the provision of group residential housing; new text end

new text begin (4) the provision of supplementary services, if applicable; new text end

new text begin (5) reports of adverse events, including recipient death or serious injury; and new text end

new text begin (6) submission of residency requirements that could result in recipient eviction. new text end

deleted text begin Group residential housingdeleted text end new text begin (c)new text end Agreements may be terminated with or without cause by deleted text begin eitherdeleted text end the deleted text begin countydeleted text end new text begin commissioner, the agency,new text end or the provider with two calendar months prior notice.new text begin The commissioner may immediately terminate an agreement under subdivision 2d.new text end

Sec. 28.

Minnesota Statutes 2014, section 256I.04, subdivision 2c, is amended to read:

Subd. 2c.

deleted text begin Crisis sheltersdeleted text end new text begin Background study requirementsnew text end .

deleted text begin Secure crisis shelters for battered women and their children designated by the Minnesota Department of Corrections are not group residences under this chapter. deleted text end new text begin (a) Effective July 1, 2016, a provider of group residential housing or supplementary services must initiate background studies in accordance with chapter 245C of the following individuals: new text end

new text begin (1) controlling individuals as defined in section 245A.02; new text end

new text begin (2) managerial officials as defined in section 245A.02; and new text end

new text begin (3) all employees and volunteers of the establishment who have direct contact with recipients, or who have unsupervised access to recipients, their personal property, or their private data. new text end

new text begin (b) The provider of group residential housing or supplementary services must maintain compliance with all requirements established for entities initiating background studies under chapter 245C. new text end

new text begin (c) Effective July 1, 2017, a provider of group residential housing or supplementary services must demonstrate that all individuals required to have a background study according to paragraph (a) have a notice stating either that: new text end

new text begin (1) the individual is not disqualified under section 245C.14; or new text end

new text begin (2) the individual is disqualified, but the individual has been issued a set-aside of the disqualification for that setting under section 245C.22. new text end

Sec. 29.

Minnesota Statutes 2014, section 256I.04, is amended by adding a subdivision to read:

new text begin Subd. 2d. new text end

new text begin Conditions of payment; commissioner's right to suspend or terminate agreement. new text end

new text begin (a) Group residential housing or supplementary services must be provided to the satisfaction of the commissioner, as determined at the sole discretion of the commissioner's authorized representative, and in accordance with all applicable federal, state, and local laws, ordinances, rules, and regulations, including business registration requirements of the Office of the Secretary of State. A provider shall not receive payment for services or housing found by the commissioner to be performed or provided in violation of federal, state, or local law, ordinance, rule, or regulation. new text end

new text begin (b) The commissioner has the right to suspend or terminate the agreement immediately when the commissioner determines the health or welfare of the housing or service recipients is endangered, or when the commissioner has reasonable cause to believe that the provider has breached a material term of the agreement under subdivision 2b. new text end

new text begin (c) Notwithstanding paragraph (b), if the commissioner learns of a curable material breach of the agreement by the provider, the commissioner shall provide the provider with a written notice of the breach and allow ten days to cure the breach. If the provider does not cure the breach within the time allowed, the provider shall be in default of the agreement and the commissioner may terminate the agreement immediately thereafter. If the provider has breached a material term of the agreement and cure is not possible, the commissioner may immediately terminate the agreement. new text end

Sec. 30.

Minnesota Statutes 2014, section 256I.04, is amended by adding a subdivision to read:

new text begin Subd. 2e. new text end

new text begin Providers holding health or human services licenses. new text end

new text begin (a) Except for facilities with only a board and lodging license, when group residential housing or supplementary service staff are also operating under a license issued by the Department of Health or the Department of Human Services, the minimum staff qualification requirements for the setting shall be the qualifications listed under the related licensing standards. new text end

new text begin (b) A background study completed for the licensed service must also satisfy the background study requirements under this section, if the provider has established the background study contact person according to chapter 245C and as directed by the Department of Human Services. new text end

Sec. 31.

Minnesota Statutes 2014, section 256I.04, is amended by adding a subdivision to read:

new text begin Subd. 2f. new text end

new text begin Required services. new text end

new text begin In licensed and registered settings under subdivision 2a, providers shall ensure that participants have at a minimum: new text end

new text begin (1) food preparation and service for three nutritional meals a day on site; new text end

new text begin (2) a bed, clothing storage, linen, bedding, laundering, and laundry supplies or service; new text end

new text begin (3) housekeeping, including cleaning and lavatory supplies or service; and new text end

new text begin (4) maintenance and operation of the building and grounds, including heat, water, garbage removal, electricity, telephone for the site, cooling, supplies, and parts and tools to repair and maintain equipment and facilities. new text end

Sec. 32.

Minnesota Statutes 2014, section 256I.04, is amended by adding a subdivision to read:

new text begin Subd. 2g. new text end

new text begin Crisis shelters. new text end

new text begin Secure crisis shelters for battered women and their children designated by the Minnesota Department of Corrections are not group residences under this chapter. new text end

Sec. 33.

Minnesota Statutes 2014, section 256I.04, subdivision 3, is amended to read:

Subd. 3.

Moratorium on development of group residential housing beds.

(a) deleted text begin Countydeleted text end Agencies shall not enter into agreements for new group residential housing beds with total rates in excess of the MSA equivalent rate except:

(1) for group residential housing establishments licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, provided the facility is needed to meet the census reduction targets for persons with developmental disabilities at regional treatment centers;

(2) up to 80 beds in a single, specialized facility located in Hennepin County that will provide housing for chronic inebriates who are repetitive users of detoxification centers and are refused placement in emergency shelters because of their state of intoxication, and planning for the specialized facility must have been initiated before July 1, 1991, in anticipation of receiving a grant from the Housing Finance Agency under section 462A.05, subdivision 20a, paragraph (b);

(3) notwithstanding the provisions of subdivision 2a, for up to 190 supportive housing units in Anoka, Dakota, Hennepin, or Ramsey County for homeless adults with a mental illness, a history of substance abuse, or human immunodeficiency virus or acquired immunodeficiency syndrome. For purposes of this section, "homeless adult" means a person who is living on the street or in a shelter or discharged from a regional treatment center, community hospital, or residential treatment program and has no appropriate housing available and lacks the resources and support necessary to access appropriate housing. At least 70 percent of the supportive housing units must serve homeless adults with mental illness, substance abuse problems, or human immunodeficiency virus or acquired immunodeficiency syndrome who are about to be or, within the previous six months, has been discharged from a regional treatment center, or a state-contracted psychiatric bed in a community hospital, or a residential mental health or chemical dependency treatment program. If a person meets the requirements of subdivision 1, paragraph (a), and receives a federal or state housing subsidy, the group residential housing rate for that person is limited to the supplementary rate under section 256I.05, subdivision 1a, and is determined by subtracting the amount of the person's countable income that exceeds the MSA equivalent rate from the group residential housing supplementary rate. A resident in a demonstration project site who no longer participates in the demonstration program shall retain eligibility for a group residential housing payment in an amount determined under section 256I.06, subdivision 8, using the MSA equivalent rate. Service funding under section 256I.05, subdivision 1a, will end June 30, 1997, if federal matching funds are available and the services can be provided through a managed care entity. If federal matching funds are not available, then service funding will continue under section 256I.05, subdivision 1a;

(4) for an additional two beds, resulting in a total of 32 beds, for a facility located in Hennepin County providing services for recovering and chemically dependent men that has had a group residential housing contract with the county and has been licensed as a board and lodge facility with special services since 1980;

(5) for a group residential housing provider located in the city of St. Cloud, or a county contiguous to the city of St. Cloud, that operates a 40-bed facility, that received financing through the Minnesota Housing Finance Agency Ending Long-Term Homelessness Initiative and serves chemically dependent clientele, providing 24-hour-a-day supervision;

(6) for a new 65-bed facility in Crow Wing County that will serve chemically dependent persons, operated by a group residential housing provider that currently operates a 304-bed facility in Minneapolis, and a 44-bed facility in Duluth;

(7) for a group residential housing provider that operates two ten-bed facilities, one located in Hennepin County and one located in Ramsey County, that provide community support and 24-hour-a-day supervision to serve the mental health needs of individuals who have chronically lived unsheltered; and

(8) for a group residential facility in Hennepin County with a capacity of up to 48 beds that has been licensed since 1978 as a board and lodging facility and that until August 1, 2007, operated as a licensed chemical dependency treatment program.

(b) deleted text begin A countydeleted text end new text begin Annew text end agency may enter into a group residential housing agreement for beds with rates in excess of the MSA equivalent rate in addition to those currently covered under a group residential housing agreement if the additional beds are only a replacement of beds with rates in excess of the MSA equivalent rate which have been made available due to closure of a setting, a change of licensure or certification which removes the beds from group residential housing payment, or as a result of the downsizing of a group residential housing setting. The transfer of available beds from one deleted text begin countydeleted text end new text begin agencynew text end to another can only occur by the agreement of both deleted text begin countiesdeleted text end new text begin agenciesnew text end .

Sec. 34.

Minnesota Statutes 2014, section 256I.04, subdivision 4, is amended to read:

Subd. 4.

Rental assistance.

For participants in the Minnesota supportive housing demonstration program under subdivision 3, paragraph (a), clause (5), notwithstanding the provisions of section 256I.06, subdivision 8, the amount of the group residential housing payment for room and board must be calculated by subtracting 30 percent of the recipient's adjusted income as defined by the United States Department of Housing and Urban Development for the Section 8 program from the fair market rent established for the recipient's living unit by the federal Department of Housing and Urban Development. This payment shall be regarded as a state housing subsidy for the purposes of subdivision 3. Notwithstanding the provisions of section 256I.06, subdivision 6, the recipient's countable income will only be adjusted when a change of greater than $100 in a month occurs or upon annual redetermination of eligibility, whichever is sooner. deleted text begin The commissioner is directed to study the feasibility of developing a rental assistance program to serve persons traditionally served in group residential housing settings and report to the legislature by February 15, 1999.deleted text end

Sec. 35.

Minnesota Statutes 2014, section 256I.05, subdivision 1c, is amended to read:

Subd. 1c.

Rate increases.

deleted text begin A countydeleted text end new text begin Annew text end agency may not increase the rates negotiated for group residential housing above those in effect on June 30, 1993, except as provided in paragraphs (a) to (f).

(a) deleted text begin A countydeleted text end new text begin An agencynew text end may increase the rates for group residential housing settings to the MSA equivalent rate for those settings whose current rate is below the MSA equivalent rate.

(b) deleted text begin A countydeleted text end new text begin Annew text end agency may increase the rates for residents in adult foster care whose difficulty of care has increased. The total group residential housing rate for these residents must not exceed the maximum rate specified in subdivisions 1 and 1a. deleted text begin County deleted text end Agencies must not include nor increase group residential housing difficulty of care rates for adults in foster care whose difficulty of care is eligible for funding by home and community-based waiver programs under title XIX of the Social Security Act.

(c) The room and board rates will be increased each year when the MSA equivalent rate is adjusted for SSI cost-of-living increases by the amount of the annual SSI increase, less the amount of the increase in the medical assistance personal needs allowance under section 256B.35.

(d) When a group residential housing rate is used to pay for an individual's room and board, or other costs necessary to provide room and board, the rate payable to the residence must continue for up to 18 calendar days per incident that the person is temporarily absent from the residence, not to exceed 60 days in a calendar year, if the absence or absences have received the prior approval of the county agency's social service staff. Prior approval is not required for emergency absences due to crisis, illness, or injury.

(e) For facilities meeting substantial change criteria within the prior year. Substantial change criteria exists if the group residential housing establishment experiences a 25 percent increase or decrease in the total number of its beds, if the net cost of capital additions or improvements is in excess of 15 percent of the current market value of the residence, or if the residence physically moves, or changes its licensure, and incurs a resulting increase in operation and property costs.

(f) Until June 30, 1994, deleted text begin a countydeleted text end new text begin annew text end agency may increase by up to five percent the total rate paid for recipients of assistance under sections 256D.01 to 256D.21 or 256D.33 to 256D.54 who reside in residences that are licensed by the commissioner of health as a boarding care home, but are not certified for the purposes of the medical assistance program. However, an increase under this clause must not exceed an amount equivalent to 65 percent of the 1991 medical assistance reimbursement rate for nursing home resident class A, in the geographic grouping in which the facility is located, as established under Minnesota Rules, parts 9549.0050 to 9549.0058.

Sec. 36.

Minnesota Statutes 2014, section 256I.05, subdivision 1g, is amended to read:

Subd. 1g.

Supplementary service rate for certain facilities.

deleted text begin On or after July 1, 2005, a countydeleted text end new text begin Annew text end agency may negotiate a supplementary service rate for recipients of assistance under section 256I.04, subdivision 1, paragraphnew text begin (a) ornew text end (b), who deleted text begin relocate from a homeless shelter licensed and registered prior to December 31, 1996, by the Minnesota Department of Health under section 157.17, todeleted text end new text begin have experienced long-term homelessness and who live innew text end a supportive housing establishment deleted text begin developed and funded in whole or in part with funds provided specifically as part of the plan to end long-term homelessness required under Laws 2003, chapter 128, article 15, section 9, not to exceed $456.75deleted text end new text begin under section 256I.04, subdivision 2a, paragraph (b), clause (2)new text end .

Sec. 37.

Minnesota Statutes 2014, section 256I.06, subdivision 2, is amended to read:

Subd. 2.

Time of payment.

A county agency may make payments to a group residence in advance for an individual whose stay in the group residence is expected to last beyond the calendar month for which the payment is made deleted text begin and who does not expect to receive countable earned income during the month for which the payment is madedeleted text end . Group residential housing payments made by a county agency on behalf of an individual who is not expected to remain in the group residence beyond the month for which payment is made must be made subsequent to the individual's departure from the group residence. deleted text begin Group residential housing payments made by a county agency on behalf of an individual with countable earned income must be made subsequent to receipt of a monthly household report form.deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective April 1, 2016. new text end

Sec. 38.

Minnesota Statutes 2014, section 256I.06, subdivision 6, is amended to read:

Subd. 6.

Reports.

Recipients must report changes in circumstances that affect eligibility or group residential housing payment amountsnew text begin , other than changes in earned income,new text end within ten days of the change. Recipients with countable earned income must complete a deleted text begin monthlydeleted text end household report formnew text begin at least once every six monthsnew text end . If the report form is not received before the end of the month in which it is due, the county agency must terminate eligibility for group residential housing payments. The termination shall be effective on the first day of the month following the month in which the report was due. If a complete report is received within the month eligibility was terminated, the individual is considered to have continued an application for group residential housing payment effective the first day of the month the eligibility was terminated.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective April 1, 2016. new text end

Sec. 39.

Minnesota Statutes 2014, section 256I.06, subdivision 7, is amended to read:

Subd. 7.

Determination of rates.

Thenew text begin agency in thenew text end county in which a deleted text begin group deleted text end residence is located deleted text begin willdeleted text end new text begin shallnew text end determine the amount of group residential housing rate to be paid on behalf of an individual in the deleted text begin groupdeleted text end residence regardless of the individual's deleted text begin countydeleted text end new text begin agencynew text end of financial responsibility.

Sec. 40.

Minnesota Statutes 2014, section 256I.06, subdivision 8, is amended to read:

Subd. 8.

Amount of group residential housing payment.

new text begin (a) new text end The amount of a group residential housing payment to be made on behalf of an eligible individual is determined by subtracting the individual's countable income under section 256I.04, subdivision 1, for a whole calendar month from the group residential housing charge for that same month. The group residential housing charge is determined by multiplying the group residential housing rate times the period of time the individual was a resident or temporarily absent under section 256I.05, subdivision 1c, paragraph (d).

new text begin (b) For an individual with earned income under paragraph (a), prospective budgeting must be used to determine the amount of the individual's payment for the following six-month period. An increase in income shall not affect an individual's eligibility or payment amount until the month following the reporting month. A decrease in income shall be effective the first day of the month after the month in which the decrease is reported. new text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraph (b) is effective April 1, 2016. new text end

Sec. 41.

Minnesota Statutes 2014, section 256J.21, subdivision 2, as amended by Laws 2015, chapter 21, article 1, section 60, 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, payments for family foster care for children under section 260C.4411 or chapter 256N, 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) adoption or kinship assistance payments under chapter 256N or 259A and Minnesota permanency demonstration title IV-E waiver 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;

(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 NCCC; deleted text begin anddeleted text end

(48) housing assistance grants under section 256J.35, paragraph (a)new text begin ; andnew text end

new text begin (49) child support payments of up to $100 for an assistance unit with one child and up to $200 for an assistance unit with two or more childrennew text end .

Sec. 42.

Minnesota Statutes 2014, section 256J.24, subdivision 5a, is amended to read:

Subd. 5a.

Food portion of MFIP transitional standard.

The commissioner shall adjust the food portion of the MFIP transitional standard as needed to reflect adjustments to the Supplemental Nutrition Assistance Programnew text begin and maintain compliance with federal waivers related to the Supplemental Nutrition Assistance Program under the United States Department of Agriculturenew text end . The commissioner shall publish the transitional standard including a breakdown of the cash and food portions for an assistance unit of sizes one to ten in the State Register whenever an adjustment is made.

Sec. 43.

Minnesota Statutes 2014, section 256J.33, subdivision 4, is amended to read:

Subd. 4.

Monthly income test.

A county agency must apply the monthly income test retrospectively for each month of MFIP eligibility. An assistance unit is not eligible when the countable income equals or exceeds the MFIP standard of need or the family wage level for the assistance unit. The income applied against the monthly income test must include:

(1) gross earned income from employment, prior to mandatory payroll deductions, voluntary payroll deductions, wage authorizations, and after the disregards in section 256J.21, subdivision 4, and the allocations in section 256J.36, unless the employment income is specifically excluded under section 256J.21, subdivision 2;

(2) gross earned income from self-employment less deductions for self-employment expenses in section 256J.37, subdivision 5, but prior to any reductions for personal or business state and federal income taxes, personal FICA, personal health and life insurance, and after the disregards in section 256J.21, subdivision 4, and the allocations in section 256J.36;

(3) unearned income after deductions for allowable expenses in section 256J.37, subdivision 9, and allocations in section 256J.36, unless the income has been specifically excluded in section 256J.21, subdivision 2;

(4) gross earned income from employment as determined under clause (1) which is received by a member of an assistance unit who is a minor child or minor caregiver and less than a half-time student;

(5) child support deleted text begin anddeleted text end new text begin received by an assistance unit, excluded under section 256J.21, subdivision 2, clause (49), or section 256P.06, subdivision 3, clause (2), item (xvi);new text end

new text begin (6) new text end spousal support received by an assistance unit;

deleted text begin (6)deleted text end new text begin (7)new text end the income of a parent when that parent is not included in the assistance unit;

deleted text begin (7)deleted text end new text begin (8)new text end the income of an eligible relative and spouse who seek to be included in the assistance unit; and

deleted text begin (8)deleted text end new text begin (9)new text end the unearned income of a minor child included in the assistance unit.

Sec. 44.

Minnesota Statutes 2014, section 256K.45, subdivision 1a, is amended to read:

Subd. 1a.

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 deleted text begin 21deleted text end new text begin 24new text end 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 deleted text begin 21deleted text end new text begin 24 new text end 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.

Sec. 45.

Minnesota Statutes 2014, section 256K.45, subdivision 6, is amended to read:

Subd. 6.

Funding.

Funds appropriated for this section may be expended on programs described under subdivisions 3 to 5, technical assistance, and capacity building to meet the greatest need on a statewide basisnew text begin . The commissioner will provide outreach, technical assistance, and program development support to increase capacity to new and existing service providers to better meet needs statewide, particularly in areas where services for homeless youth have not been established, especially in greater Minnesotanew text end .

Sec. 46.

new text begin [256M.41] CHILD PROTECTION GRANT ALLOCATION. new text end

new text begin Subdivision 1. new text end

new text begin Formula for county staffing funds. new text end

new text begin (a) The commissioner shall allocate state funds appropriated under this section to each county board on a calendar year basis in an amount determined according to the following formula: new text end

new text begin (1) 50 percent must be distributed on the basis of the child population residing in the county as determined by the most recent data of the state demographer; new text end

new text begin (2) 25 percent must be distributed on the basis of the number of screened-in reports of child maltreatment under sections 626.556 and 626.5561, and in the county as determined by the most recent data of the commissioner; and new text end

new text begin (3) 25 percent must be distributed on the basis of the number of open child protection case management cases in the county as determined by the most recent data of the commissioner. new text end

new text begin (b) Notwithstanding this subdivision, no county shall be awarded an allocation of less than $75,000. new text end

new text begin Subd. 2. new text end

new text begin Prohibition on supplanting existing funds. new text end

new text begin Funds received under this section must be used to address staffing for child protection or expand child protection services. Funds must not be used to supplant current county expenditures for these purposes. new text end

new text begin Subd. 3. new text end

new text begin Payments based on performance. new text end

new text begin (a) The commissioner shall make payments under this section to each county board on a calendar year basis in an amount determined under paragraph (b). new text end

new text begin (b) Calendar year allocations under subdivision 1 shall be paid to counties in the following manner: new text end

new text begin (1) 80 percent of the allocation as determined in subdivision 1 must be paid to counties on or before July 10 of each year; new text end

new text begin (2) ten percent of the allocation shall be withheld until the commissioner determines if the county has met the performance outcome threshold of 90 percent based on face-to-face contact with alleged child victims. In order to receive the performance allocation, the county child protection workers must have a timely face-to-face contact with at least 90 percent of all alleged child victims of screened-in maltreatment reports. The standard requires that each initial face-to-face contact occur consistent with timelines defined in section 626.556, subdivision 10, paragraph (i). The commissioner shall make threshold determinations in January of each year and payments to counties meeting the performance outcome threshold shall occur in February of each year. Any withheld funds from this appropriation for counties that do not meet this requirement shall be reallocated by the commissioner to those counties meeting the requirement; and new text end

new text begin (3) ten percent of the allocation shall be withheld until the commissioner determines that the county has met the performance outcome threshold of 90 percent based on face-to-face visits by the case manager. In order to receive the performance allocation, the total number of visits made by caseworkers on a monthly basis to children in foster care and children receiving child protection services while residing in their home must be at least 90 percent of the total number of such visits that would occur if every child were visited once per month. The commissioner shall make such determinations in January of each year and payments to counties meeting the performance outcome threshold shall occur in February of each year. Any withheld funds from this appropriation for counties that do not meet this requirement shall be reallocated by the commissioner to those counties meeting the requirement. For 2015, the commissioner shall only apply the standard for monthly foster care visits. new text end

new text begin (c) The commissioner shall work with stakeholders and the Human Services Performance Council under section 402A.16 to develop recommendations for specific outcome measures that counties should meet in order to receive funds withheld under paragraph (b), and include in those recommendations a determination as to whether the performance measures under paragraph (b) should be modified or phased out. The commissioner shall report the recommendations to the legislative committees having jurisdiction over child protection issues by January 1, 2018. new text end

Sec. 47.

Minnesota Statutes 2014, section 256N.22, subdivision 9, is amended to read:

Subd. 9.

Death new text begin or incapacity new text end of relative custodian or deleted text begin dissolutiondeleted text end new text begin modification new text end of custody.

The Northstar kinship assistance agreement ends upon death or deleted text begin dissolution deleted text end new text begin incapacity of the relative custodian or modification new text end of new text begin the order for new text end permanent legal and physical custody deleted text begin of both relative custodians in the case of assignment of custody to two individuals, or the sole relative custodian in the case of assignment of custody to one individualdeleted text end new text begin in which legal or physical custody is removed from the relative custodiannew text end . new text begin In the case of a relative custodian's death or incapacity, new text end Northstar kinship assistance eligibility may be continued according to subdivision 10.

Sec. 48.

Minnesota Statutes 2014, section 256N.22, subdivision 10, is amended to read:

Subd. 10.

Assigning a new text begin successor relative custodian for a new text end child's Northstar kinship assistance deleted text begin to a court-appointed guardian or custodiandeleted text end .

(a) deleted text begin Northstar kinship assistance may be continued with the written consent of the commissioner todeleted text end new text begin In the event of the death or incapacity of the relative custodian, eligibility for Northstar kinship assistance and title IV-E assistance, if applicable, is not affected if the relative custodian is replaced by a successor named in the Northstar kinship assistance benefit agreement. Northstar kinship assistance shall be paid to a named successor who is not the child's legal parent, biological parent or stepparent, or other adult living in the home of the legal parent, biological parent, or stepparent. new text end

new text begin (b) In order to receive Northstar kinship assistance, a named successor must: new text end

new text begin (1) meet the background study requirements in subdivision 4; new text end

new text begin (2) renegotiate the agreement consistent with section 256N.25, subdivision 2, including cooperating with an assessment under section 256N.24; new text end

new text begin (3) be ordered by the court to be the child's legal relative custodian in a modification proceeding under section 260C.521, subdivision 2; and new text end

new text begin (4) satisfy the requirements in this paragraph within one year of the relative custodian's death or incapacity unless the commissioner certifies that the named successor made reasonable attempts to satisfy the requirements within one year and failure to satisfy the requirements was not the responsibility of the named successor. new text end

new text begin (c) Payment of Northstar kinship assistance to the successor guardian may be temporarily approved through the policies, procedures, requirements, and deadlines under section 256N.28, subdivision 2. Ongoing payment shall begin in the month when all the requirements in paragraph (b) are satisfied. new text end

new text begin (d) Continued payment of Northstar kinship assistance may occur in the event of the death or incapacity of the relative custodian when no successor has been named in the benefit agreement when the commissioner gives written consent tonew text end an individual who is a guardian or custodian appointed by a court for the child upon the death of both relative custodians in the case of assignment of custody to two individuals, or the sole relative custodian in the case of assignment of custody to one individual, unless the child is under the custody of a county, tribal, or child-placing agency.

deleted text begin (b)deleted text end new text begin (e)new text end Temporary assignment of Northstar kinship assistance may be approved for a maximum of six consecutive months from the death new text begin or incapacity new text end of the relative custodian or custodians as provided in paragraph (a) and must adhere to the policies deleted text begin anddeleted text end new text begin , new text end proceduresnew text begin , requirements, and deadlines under section 256N.28, subdivision 2, that are new text end prescribed by the commissioner. If a court has not appointed a permanent legal guardian or custodian within six months, the Northstar kinship assistance must terminate and must not be resumed.

deleted text begin (c)deleted text end new text begin (f)new text end Upon assignment of assistance payments under deleted text begin this subdivisiondeleted text end new text begin paragraphs (d) and (e)new text end , assistance must be provided from funds other than title IV-E.

Sec. 49.

Minnesota Statutes 2014, section 256N.24, subdivision 4, is amended to read:

Subd. 4.

Extraordinary levels.

(a) The assessment tool established under subdivision 2 must provide a mechanism through which up to five levels can be added to the supplemental difficulty of care for a particular child under section 256N.26, subdivision 4. In establishing the assessment tool, the commissioner must design the tool so that the levels applicable to the portions of the assessment other than the extraordinary levels can accommodate the requirements of this subdivision.

(b) These extraordinary levels are available when all of the following circumstances apply:

(1) the child has extraordinary needs as determined by the assessment tool provided for under subdivision 2, and the child meets other requirements established by the commissioner, such as a minimum score on the assessment tool;

(2) the child's extraordinary needs require extraordinary care and intense supervision that is provided by the child's caregiver as part of the parental duties as described in the supplemental difficulty of care rate, section 256N.02, subdivision 21. This extraordinary care provided by the caregiver is required so that the child can be safely cared for in the home and community, and prevents residential placement;

(3) the child is physically living in a foster family setting, as defined in Minnesota Rules, part 2960.3010, subpart 23, new text begin in a foster residence setting, new text end or physically living in the home with the adoptive parent or relative custodian; and

(4) the child is receiving the services for which the child is eligible through medical assistance programs or other programs that provide necessary services for children with disabilities or other medical and behavioral conditions to live with the child's family, but the agency with caregiver's input has identified a specific support gap that cannot be met through home and community support waivers or other programs that are designed to provide support for children with special needs.

(c) The agency completing an assessment, under subdivision 2, that suggests an extraordinary level must document as part of the assessment, the following:

(1) the assessment tool that determined that the child's needs or disabilities require extraordinary care and intense supervision;

(2) a summary of the extraordinary care and intense supervision that is provided by the caregiver as part of the parental duties as described in the supplemental difficulty of care rate, section 256N.02, subdivision 21;

(3) confirmation that the child is currently physically residing in the foster family setting or in the home with the adoptive parent or relative custodian;

(4) the efforts of the agency, caregiver, parents, and others to request support services in the home and community that would ease the degree of parental duties provided by the caregiver for the care and supervision of the child. This would include documentation of the services provided for the child's needs or disabilities, and the services that were denied or not available from the local social service agency, community agency, the local school district, local public health department, the parent, or child's medical insurance provider;

(5) the specific support gap identified that places the child's safety and well-being at risk in the home or community and is necessary to prevent residential placement; and

(6) the extraordinary care and intense supervision provided by the foster, adoptive, or guardianship caregivers to maintain the child safely in the child's home and prevent residential placement that cannot be supported by medical assistance or other programs that provide services, necessary care for children with disabilities, or other medical or behavioral conditions in the home or community.

(d) An agency completing an assessment under subdivision 2 that suggests an extraordinary level is appropriate must forward the assessment and required documentation to the commissioner. If the commissioner approves, the extraordinary levels must be retroactive to the date the assessment was forwarded.

Sec. 50.

Minnesota Statutes 2014, section 256N.25, subdivision 1, is amended to read:

Subdivision 1.

Agreement; Northstar kinship assistance; adoption assistance.

(a) In order to receive Northstar kinship assistance or adoption assistance benefits on behalf of an eligible child, a written, binding agreement between the caregiver or caregivers, the financially responsible agency, or, if there is no financially responsible agency, the agency designated by the commissioner, and the commissioner must be established prior to finalization of the adoption or a transfer of permanent legal and physical custody. The agreement must be negotiated with the caregiver or caregivers under subdivision 2new text begin and renegotiated under subdivision 3, if applicablenew text end .

(b) The agreement must be on a form approved by the commissioner and must specify the following:

(1) duration of the agreement;

(2) the nature and amount of any payment, services, and assistance to be provided under such agreement;

(3) the child's eligibility for Medicaid services;

(4) the terms of the payment, including any child care portion as specified in section 256N.24, subdivision 3;

(5) eligibility for reimbursement of nonrecurring expenses associated with adopting or obtaining permanent legal and physical custody of the child, to the extent that the total cost does not exceed $2,000 per child;

(6) that the agreement must remain in effect regardless of the state of which the adoptive parents or relative custodians are residents at any given time;

(7) provisions for modification of the terms of the agreement, including renegotiation of the agreement; deleted text begin anddeleted text end

(8) the effective date of the agreementnew text begin ; andnew text end

new text begin (9) the successor relative custodian or custodians for Northstar kinship assistance, when applicable. The successor relative custodian or custodians may be added or changed by mutual agreement under subdivision 3new text end .

(c) The caregivers, the commissioner, and the financially responsible agency, or, if there is no financially responsible agency, the agency designated by the commissioner, must sign the agreement. A copy of the signed agreement must be given to each party. Once signed by all parties, the commissioner shall maintain the official record of the agreement.

(d) The effective date of the Northstar kinship assistance agreement must be the date of the court order that transfers permanent legal and physical custody to the relative. The effective date of the adoption assistance agreement is the date of the finalized adoption decree.

(e) Termination or disruption of the preadoptive placement or the foster care placement prior to assignment of custody makes the agreement with that caregiver void.

Sec. 51.

Minnesota Statutes 2014, section 256N.27, subdivision 2, is amended to read:

Subd. 2.

State share.

The commissioner shall pay the state share of the maintenance payments as determined under subdivision 4, and an identical share of the pre-Northstar Care foster care program under section 260C.4411, subdivision 1, the relative custody assistance program under section 257.85, and the pre-Northstar Care for Children adoption assistance program under chapter 259A. deleted text begin The commissioner may transfer funds into the account if a deficit occurs.deleted text end

Sec. 52.

Minnesota Statutes 2014, section 257.75, subdivision 3, is amended to read:

Subd. 3.

Effect of recognition.

new text begin (a) new text end Subject to subdivision 2 and section 257.55, subdivision 1, paragraph (g) or (h), the recognition has the force and effect of a judgment or order determining the existence of the parent and child relationship under section 257.66. If the conditions in section 257.55, subdivision 1, paragraph (g) or (h), exist, the recognition creates only a presumption of paternity for purposes of sections 257.51 to 257.74. Once a recognition has been properly executed and filed with the state registrar of vital statistics, if there are no competing presumptions of paternity, a judicial or administrative court may not allow further action to determine parentage regarding the signator of the recognition. An action to determine custody and parenting time may be commenced pursuant to chapter 518 without an adjudication of parentage. Until deleted text begin andeleted text end new text begin a temporary or permanent new text end order is entered granting custody to another, the mother has sole custody.

new text begin (b) Following commencement of an action to determine custody or parenting time under chapter 518, the court may, pursuant to section 518.131, grant temporary parenting time rights and temporary custody to either parent. new text end

new text begin (c) new text end The recognition is:

(1) a basis for bringing an action new text begin for the following:new text end

new text begin (i) new text end to award new text begin temporary custody or parenting time pursuant to section 518.131;new text end

new text begin (ii) to award permanent new text end custody or parenting time to either parentdeleted text begin ,deleted text end new text begin ;new text end

new text begin (iii) new text end establishing a child support obligation which may include up to the two years immediately preceding the commencement of the actiondeleted text begin ,deleted text end new text begin ;new text end

new text begin (iv)new text end ordering a contribution by a parent under section 256.87deleted text begin , ordeleted text end new text begin ;new text end

new text begin (v)new text end ordering a contribution to the reasonable expenses of the mother's pregnancy and confinement, as provided under section 257.66, subdivision 3deleted text begin ,deleted text end new text begin ;new text end or

new text begin (vi) new text end ordering reimbursement for the costs of blood or genetic testing, as provided under section 257.69, subdivision 2;

(2) determinative for all other purposes related to the existence of the parent and child relationship; and

(3) entitled to full faith and credit in other jurisdictions.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2016. new text end

Sec. 53.

Minnesota Statutes 2014, section 257.75, subdivision 5, is amended to read:

Subd. 5.

Recognition form.

new text begin (a) new text end The commissioner of human services shall prepare a form for the recognition of parentage under this section. In preparing the form, the commissioner shall consult with the individuals specified in subdivision 6. The recognition form must be drafted so that the force and effect of the recognition, the alternatives to executing a recognition, deleted text begin anddeleted text end the benefits and responsibilities of establishing paternitynew text begin , and the limitations of the recognition of parentage for purposes of exercising and enforcing custody or parenting timenew text end are clear and understandable. deleted text begin The form must include a notice regarding the finality of a recognition and the revocation procedure under subdivision 2. The form must include a provision for each parent to verify that the parent has read or viewed the educational materials prepared by the commissioner of human services describing the recognition of paternity. The individual providing the form to the parents for execution shall provide oral notice of the rights, responsibilities, and alternatives to executing the recognition. Notice may be provided by audiotape, videotape, or similar means. Each parent must receive a copy of the recognition.deleted text end

new text begin (b) The form must include the following: new text end

new text begin (1) a notice regarding the finality of a recognition and the revocation procedure under subdivision 2; new text end

new text begin (2) a notice, in large print, that the recognition does not establish an enforceable right to legal custody, physical custody, or parenting time until such rights are awarded pursuant to a court action to establish custody and parenting time; new text end

new text begin (3) a notice stating that when a court awards custody and parenting time under chapter 518, there is no presumption for or against joint physical custody, except when domestic abuse, as defined in section 518B.01, subdivision 2, paragraph (a), has occurred between the parties; new text end

new text begin (4) a notice that the recognition of parentage is a basis for: new text end

new text begin (i) bringing a court action to award temporary or permanent custody or parenting time; new text end

new text begin (ii) establishing a child support obligation that may include the two years immediately preceding the commencement of the action; new text end

new text begin (iii) ordering a contribution by a parent under section 256.87; new text end

new text begin (iv) ordering a contribution to the reasonable expenses of the mother's pregnancy and confinement, as provided under section 257.66, subdivision 3; and new text end

new text begin (v) ordering reimbursement for the costs of blood or genetic testing, as provided under section 257.69, subdivision 2; and new text end

new text begin (5) a provision for each parent to verify that the parent has read or viewed the educational materials prepared by the commissioner of human services describing the recognition of paternity. new text end

new text begin (c) The individual providing the form to the parents for execution shall provide oral notice of the rights, responsibilities, and alternatives to executing the recognition. Notice may be provided in audio or video format, or by other similar means. Each parent must receive a copy of the recognition. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2016. new text end

Sec. 54.

Minnesota Statutes 2014, section 259A.75, is amended to read:

259A.75 REIMBURSEMENT OF CERTAIN AGENCY COSTS; PURCHASE OF SERVICE CONTRACTSnew text begin AND TRIBAL CUSTOMARY ADOPTIONSnew text end .

Subdivision 1.

General information.

(a) Subject to the procedures required by the commissioner and the provisions of this section, a Minnesota county deleted text begin or tribal social services agencydeleted text end shall receive a reimbursement from the commissioner equal to 100 percent of the reasonable and appropriate cost for contracted adoption placement services identified for a specific child that are not reimbursed under other federal or state funding sources.

(b) The commissioner may spend up to $16,000 for each purchase of service contract. Only one contract per child per adoptive placement is permitted. Funds encumbered and obligated under the contract for the child remain available until the terms of the contract are fulfilled or the contract is terminated.

(c) The commissioner shall set aside an amount not to exceed five percent of the total amount of the fiscal year appropriation from the state for the adoption assistance program to reimbursenew text begin a Minnesota county or tribal social servicesnew text end placing deleted text begin agenciesdeleted text end new text begin agency new text end for child-specific adoption placement services. When adoption assistance payments for children's needs exceed 95 percent of the total amount of the fiscal year appropriation from the state for the adoption assistance program, the amount of reimbursement available to placing agencies for adoption services is reduced correspondingly.

Subd. 2.

new text begin Purchase of service contract new text end child eligibility criteria.

(a) A child who is the subject of a purchase of service contract must:

(1) have the goal of adoption, which may include an adoption in accordance with tribal law;

(2) be under the guardianship of the commissioner of human services or be a ward of tribal court pursuant to section 260.755, subdivision 20; and

(3) meet all of the special needs criteria according to section 259A.10, subdivision 2.

(b) A child under the guardianship of the commissioner must have an identified adoptive parent and a fully executed adoption placement agreement according to section 260C.613, subdivision 1, paragraph (a).

Subd. 3.

Agency eligibility criteria.

(a) A Minnesota county deleted text begin or tribaldeleted text end social services agency shall receive reimbursement for child-specific adoption placement services for an eligible child that it purchases from a private adoption agency licensed in Minnesota or any other state or tribal social services agency.

(b) Reimbursement for adoption services is available only for services provided prior to the date of the adoption decree.

Subd. 4.

Application and eligibility determination.

(a) A county deleted text begin or tribaldeleted text end social services agency may request reimbursement of costs for adoption placement services by submitting a complete purchase of service application, according to the requirements and procedures and on forms prescribed by the commissioner.

(b) The commissioner shall determine eligibility for reimbursement of adoption placement services. If determined eligible, the commissioner of human services shall sign the purchase of service agreement, making this a fully executed contract. No reimbursement under this section shall be made to an agency for services provided prior to the fully executed contract.

(c) Separate purchase of service agreements shall be made, and separate records maintained, on each child. Only one agreement per child per adoptive placement is permitted. For siblings who are placed together, services shall be planned and provided to best maximize efficiency of the contracted hours.

Subd. 5.

Reimbursement process.

(a) The agency providing adoption services is responsible to track and record all service activity, including billable hours, on a form prescribed by the commissioner. The agency shall submit this form to the state for reimbursement after services have been completed.

(b) The commissioner shall make the final determination whether or not the requested reimbursement costs are reasonable and appropriate and if the services have been completed according to the terms of the purchase of service agreement.

Subd. 6.

Retention of purchase of service records.

Agencies entering into purchase of service contracts shall keep a copy of the agreements, service records, and all applicable billing and invoicing according to the department's record retention schedule. Agency records shall be provided upon request by the commissioner.

new text begin Subd. 7. new text end

new text begin Tribal customary adoptions. new text end

new text begin (a) The commissioner shall enter into grant contracts with Minnesota tribal social services agencies to provide child-specific recruitment and adoption placement services for Indian children under the jurisdiction of tribal court. new text end

new text begin (b) Children served under these grant contracts must meet the child eligibility criteria in subdivision 2. new text end

Sec. 55.

Minnesota Statutes 2014, section 260C.007, subdivision 27, is amended to read:

Subd. 27.

Relative.

"Relative" means a person related to the child by blood, marriage, or adoptiondeleted text begin ,deleted text end new text begin ; the legal parent, guardian, or custodian of the child's siblings;new text end or an individual who is an important friend with whom the child has resided or had significant contact. For an Indian child, relative includes members of the extended family as defined by the law or custom of the Indian child's tribe or, in the absence of law or custom, nieces, nephews, or first or second cousins, as provided in the Indian Child Welfare Act of 1978, United States Code, title 25, section 1903.

Sec. 56.

Minnesota Statutes 2014, section 260C.007, subdivision 32, is amended to read:

Subd. 32.

Sibling.

"Sibling" means one of two or more individuals who have one or both parents in common through blood, marriage, or adoptiondeleted text begin , includingdeleted text end new text begin . This includes new text end siblings as defined by the child's tribal code or custom.new text begin Sibling also includes an individual who would have been considered a sibling but for a termination of parental rights of one or both parents, suspension of parental rights under tribal code, or other disruption of parental rights such as the death of a parent.new text end

Sec. 57.

Minnesota Statutes 2014, section 260C.203, is amended to read:

260C.203 ADMINISTRATIVE OR COURT REVIEW OF PLACEMENTS.

(a) Unless the court is conducting the reviews required under section 260C.202, there shall be an administrative review of the out-of-home placement plan of each child placed in foster care no later than 180 days after the initial placement of the child in foster care and at least every six months thereafter if the child is not returned to the home of the parent or parents within that time. The out-of-home placement plan must be monitored and updated at each administrative review. The administrative review shall be conducted by the responsible social services agency using a panel of appropriate persons at least one of whom is not responsible for the case management of, or the delivery of services to, either the child or the parents who are the subject of the review. The administrative review shall be open to participation by the parent or guardian of the child and the child, as appropriate.

(b) As an alternative to the administrative review required in paragraph (a), the court may, as part of any hearing required under the Minnesota Rules of Juvenile Protection Procedure, conduct a hearing to monitor and update the out-of-home placement plan pursuant to the procedure and standard in section 260C.201, subdivision 6, paragraph (d). The party requesting review of the out-of-home placement plan shall give parties to the proceeding notice of the request to review and update the out-of-home placement plan. A court review conducted pursuant to section 260C.141, subdivision 2; 260C.193; 260C.201, subdivision 1; 260C.202; 260C.204; 260C.317; or 260D.06 shall satisfy the requirement for the review so long as the other requirements of this section are met.

(c) As appropriate to the stage of the proceedings and relevant court orders, the responsible social services agency or the court shall review:

(1) the safety, permanency needs, and well-being of the child;

(2) the continuing necessity for and appropriateness of the placement;

(3) the extent of compliance with the out-of-home placement plan;

(4) the extent of progress that has been made toward alleviating or mitigating the causes necessitating placement in foster care;

(5) the projected date by which the child may be returned to and safely maintained in the home or placed permanently away from the care of the parent or parents or guardian; and

(6) the appropriateness of the services provided to the child.

(d) When a child is age deleted text begin 16deleted text end new text begin 14new text end or older, in addition to any administrative review conducted by the agency, at the in-court review required under section 260C.317, subdivision 3, clause (3), or 260C.515, subdivision 5 or 6, the court shall review the independent living plan required under section 260C.212, subdivision 1, paragraph (c), clause deleted text begin (11)deleted text end new text begin (12)new text end , and the provision of services to the child related to the well-being of the child as the child prepares to leave foster care. The review shall include the actual plans related to each item in the plan necessary to the child's future safety and well-being when the child is no longer in foster care.

(e) At the court review required under paragraph (d) for a child age deleted text begin 16deleted text end new text begin 14new text end or older, the following procedures apply:

(1) six months before the child is expected to be discharged from foster care, the responsible social services agency shall give the written notice required under section 260C.451, subdivision 1, regarding the right to continued access to services for certain children in foster care past age 18 and of the right to appeal a denial of social services under section 256.045. The agency shall file a copy of the notice, including the right to appeal a denial of social services, with the court. If the agency does not file the notice by the time the child is age 17-1/2, the court shall require the agency to give it;

(2) consistent with the requirements of the independent living plan, the court shall review progress toward or accomplishment of the following goals:

(i) the child has obtained a high school diploma or its equivalent;

(ii) the child has completed a driver's education course or has demonstrated the ability to use public transportation in the child's community;

(iii) the child is employed or enrolled in postsecondary education;

(iv) the child has applied for and obtained postsecondary education financial aid for which the child is eligible;

(v) the child has health care coverage and health care providers to meet the child's physical and mental health needs;

(vi) the child has applied for and obtained disability income assistance for which the child is eligible;

(vii) the child has obtained affordable housing with necessary supports, which does not include a homeless shelter;

(viii) the child has saved sufficient funds to pay for the first month's rent and a damage deposit;

(ix) the child has an alternative affordable housing plan, which does not include a homeless shelter, if the original housing plan is unworkable;

(x) the child, if male, has registered for the Selective Service; and

(xi) the child has a permanent connection to a caring adult; and

(3) the court shall ensure that the responsible agency in conjunction with the placement provider assists the child in obtaining the following documents prior to the child's leaving foster care: a Social Security card; the child's birth certificate; a state identification card or driver's license, new text begin tribal enrollment identification card, new text end green card, or school visa; the child's school, medical, and dental records; a contact list of the child's medical, dental, and mental health providers; and contact information for the child's siblings, if the siblings are in foster care.

(f) For a child who will be discharged from foster care at age 18 or older, the responsible social services agency is required to develop a personalized transition plan as directed by the youth. The transition plan must be developed during the 90-day period immediately prior to the expected date of discharge. The transition plan must be as detailed as the child may elect and include specific options on housing, health insurance, education, local opportunities for mentors and continuing support services, and work force supports and employment services. The agency shall ensure that the youth receives, at no cost to the youth, a copy of the youth's consumer credit report as defined in section 13C.001 and assistance in interpreting and resolving any inaccuracies in the report. The plan must include information on the importance of designating another individual to make health care treatment decisions on behalf of the child if the child becomes unable to participate in these decisions and the child does not have, or does not want, a relative who would otherwise be authorized to make these decisions. The plan must provide the child with the option to execute a health care directive as provided under chapter 145C. The agency shall also provide the youth with appropriate contact information if the youth needs more information or needs help dealing with a crisis situation through age 21.

Sec. 58.

Minnesota Statutes 2014, section 260C.212, subdivision 1, is amended to read:

Subdivision 1.

Out-of-home placement; plan.

(a) An out-of-home placement plan shall be prepared within 30 days after any child is placed in foster care by court order or a voluntary placement agreement between the responsible social services agency and the child's parent pursuant to section 260C.227 or chapter 260D.

(b) An out-of-home placement plan means a written document which is prepared by the responsible social services agency jointly with the parent or parents or guardian of the child and in consultation with the child's guardian ad litem, the child's tribe, if the child is an Indian child, the child's foster parent or representative of the foster care facility, and, where appropriate, the child. new text begin When a child is age 14 or older, the child may include two other individuals on the team preparing the child's out-of-home placement plan. new text end For a child in voluntary foster care for treatment under chapter 260D, preparation of the out-of-home placement plan shall additionally include the child's mental health treatment provider. As appropriate, the plan shall be:

(1) submitted to the court for approval under section 260C.178, subdivision 7;

(2) ordered by the court, either as presented or modified after hearing, under section 260C.178, subdivision 7, or 260C.201, subdivision 6; and

(3) signed by the parent or parents or guardian of the child, the child's guardian ad litem, a representative of the child's tribe, the responsible social services agency, and, if possible, the child.

(c) The out-of-home placement plan shall be explained to all persons involved in its implementation, including the child who has signed the plan, and shall set forth:

(1) a description of the foster care home or facility selected, including how the out-of-home placement plan is designed to achieve a safe placement for the child in the least restrictive, most family-like, setting available which is in close proximity to the home of the parent or parents or guardian of the child when the case plan goal is reunification, and how the placement is consistent with the best interests and special needs of the child according to the factors under subdivision 2, paragraph (b);

(2) the specific reasons for the placement of the child in foster care, and when reunification is the plan, a description of the problems or conditions in the home of the parent or parents which necessitated removal of the child from home and the changes the parent or parents must make in order for the child to safely return home;

(3) a description of the services offered and provided to prevent removal of the child from the home and to reunify the family including:

(i) the specific actions to be taken by the parent or parents of the child to eliminate or correct the problems or conditions identified in clause (2), and the time period during which the actions are to be taken; and

(ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made to achieve a safe and stable home for the child including social and other supportive services to be provided or offered to the parent or parents or guardian of the child, the child, and the residential facility during the period the child is in the residential facility;

(4) a description of any services or resources that were requested by the child or the child's parent, guardian, foster parent, or custodian since the date of the child's placement in the residential facility, and whether those services or resources were provided and if not, the basis for the denial of the services or resources;

(5) the visitation plan for the parent or parents or guardian, other relatives as defined in section 260C.007, subdivision 27, and siblings of the child if the siblings are not placed together in foster care, and whether visitation is consistent with the best interest of the child, during the period the child is in foster care;

(6) when a child cannot return to or be in the care of either parent, documentation of steps to finalize new text begin adoption as new text end the permanency plan for the childdeleted text begin , including: (i)deleted text end new text begin through new text end reasonable efforts to place the child for adoption. At a minimum, the documentation must include consideration of whether adoption is in the best interests of the child, child-specific recruitment efforts such as relative search and the use of state, regional, and national adoption exchanges to facilitate orderly and timely placements in and outside of the state. A copy of this documentation shall be provided to the court in the review required under section 260C.317, subdivision 3, paragraph (b); deleted text begin anddeleted text end

deleted text begin (ii) documentation necessary to support the requirements of the kinship placement agreement under section 256N.22 when adoption is determined not to be in the child's best interests; deleted text end new text begin (7) when a child cannot return to or be in the care of either parent, documentation of steps to finalize the transfer of permanent legal and physical custody to a relative as the permanency plan for the child. This documentation must support the requirements of the kinship placement agreement under section 256N.22 and must include the reasonable efforts used to determine that it is not appropriate for the child to return home or be adopted, and reasons why permanent placement with a relative through a Northstar kinship assistance arrangement is in the child's best interest; how the child meets the eligibility requirements for Northstar kinship assistance payments; agency efforts to discuss adoption with the child's relative foster parent and reasons why the relative foster parent chose not to pursue adoption, if applicable; and agency efforts to discuss with the child's parent or parents the permanent transfer of permanent legal and physical custody or the reasons why these efforts were not made; new text end

deleted text begin (7)deleted text end new text begin (8)new text end efforts to ensure the child's educational stability while in foster care, including:

(i) efforts to ensure that the child remains in the same school in which the child was enrolled prior to placement or upon the child's move from one placement to another, including efforts to work with the local education authorities to ensure the child's educational stability; or

(ii) if it is not in the child's best interest to remain in the same school that the child was enrolled in prior to placement or move from one placement to another, efforts to ensure immediate and appropriate enrollment for the child in a new school;

deleted text begin (8)deleted text end new text begin (9)new text end the educational records of the child including the most recent information available regarding:

(i) the names and addresses of the child's educational providers;

(ii) the child's grade level performance;

(iii) the child's school record;

(iv) a statement about how the child's placement in foster care takes into account proximity to the school in which the child is enrolled at the time of placement; and

(v) any other relevant educational information;

deleted text begin (9)deleted text end new text begin (10)new text end the efforts by the local agency to ensure the oversight and continuity of health care services for the foster child, including:

(i) the plan to schedule the child's initial health screens;

(ii) how the child's known medical problems and identified needs from the screens, including any known communicable diseases, as defined in section 144.4172, subdivision 2, will be monitored and treated while the child is in foster care;

(iii) how the child's medical information will be updated and shared, including the child's immunizations;

(iv) who is responsible to coordinate and respond to the child's health care needs, including the role of the parent, the agency, and the foster parent;

(v) who is responsible for oversight of the child's prescription medications;

(vi) how physicians or other appropriate medical and nonmedical professionals will be consulted and involved in assessing the health and well-being of the child and determine the appropriate medical treatment for the child; and

(vii) the responsibility to ensure that the child has access to medical care through either medical insurance or medical assistance;

deleted text begin (10)deleted text end new text begin (11)new text end the health records of the child including information available regarding:

(i) the names and addresses of the child's health care and dental care providers;

(ii) a record of the child's immunizations;

(iii) the child's known medical problems, including any known communicable diseases as defined in section 144.4172, subdivision 2;

(iv) the child's medications; and

(v) any other relevant health care information such as the child's eligibility for medical insurance or medical assistance;

deleted text begin (11)deleted text end new text begin (12)new text end an independent living plan for a child age deleted text begin 16deleted text end new text begin 14new text end or older. The plan should include, but not be limited to, the following objectives:

(i) educational, vocational, or employment planning;

(ii) health care planning and medical coverage;

(iii) transportation including, where appropriate, assisting the child in obtaining a driver's license;

(iv) money management, including the responsibility of the agency to ensure that the youth annually receives, at no cost to the youth, a consumer report as defined under section 13C.001 and assistance in interpreting and resolving any inaccuracies in the report;

(v) planning for housing;

(vi) social and recreational skills; deleted text begin anddeleted text end

(vii) establishing and maintaining connections with the child's family and community; and

new text begin (viii) regular opportunities to engage in age-appropriate or developmentally appropriate activities typical for the child's age group, taking into consideration the capacities of the individual child; and new text end

deleted text begin (12)deleted text end new text begin (13)new text end for a child in voluntary foster care for treatment under chapter 260D, diagnostic and assessment information, specific services relating to meeting the mental health care needs of the child, and treatment outcomes.

(d) The parent or parents or guardian and the child each shall have the right to legal counsel in the preparation of the case plan and shall be informed of the right at the time of placement of the child. The child shall also have the right to a guardian ad litem. If unable to employ counsel from their own resources, the court shall appoint counsel upon the request of the parent or parents or the child or the child's legal guardian. The parent or parents may also receive assistance from any person or social services agency in preparation of the case plan.

After the plan has been agreed upon by the parties involved or approved or ordered by the court, the foster parents shall be fully informed of the provisions of the case plan and shall be provided a copy of the plan.

Upon discharge from foster care, the parent, adoptive parent, or permanent legal and physical custodian, as appropriate, and the child, if appropriate, must be provided with a current copy of the child's health and education record.

Sec. 59.

Minnesota Statutes 2014, section 260C.212, is amended by adding a subdivision to read:

new text begin Subd. 13. new text end

new text begin Protecting missing and runaway children and youth at risk of sex trafficking. new text end

new text begin (a) The local social services agency shall expeditiously locate any child missing from foster care. new text end

new text begin (b) The local social services agency shall report immediately, but no later than 24 hours, after receiving information on a missing or abducted child to the local law enforcement agency for entry into the National Crime Information Center (NCIC) database of the Federal Bureau of Investigation, and to the National Center for Missing and Exploited Children. new text end

new text begin (c) The local social services agency shall not discharge a child from foster care or close the social services case until diligent efforts have been exhausted to locate the child and the court terminates the agency's jurisdiction. new text end

new text begin (d) The local social services agency shall determine the primary factors that contributed to the child's running away or otherwise being absent from care and, to the extent possible and appropriate, respond to those factors in current and subsequent placements. new text end

new text begin (e) The local social services agency shall determine what the child experienced while absent from care, including screening the child to determine if the child is a possible sex trafficking victim as defined in section 609.321, subdivision 7b. new text end

new text begin (f) The local social services agency shall report immediately, but no later than 24 hours, to the local law enforcement agency any reasonable cause to believe a child is, or is at risk of being, a sex trafficking victim. new text end

new text begin (g) The local social services agency shall determine appropriate services as described in section 145.4717 with respect to any child for whom the local social services agency has responsibility for placement, care, or supervision when the local social services agency has reasonable cause to believe the child is, or is at risk of being, a sex trafficking victim. new text end

Sec. 60.

Minnesota Statutes 2014, section 260C.212, is amended by adding a subdivision to read:

new text begin Subd. 14. new text end

new text begin Support age-appropriate and developmentally appropriate activities for foster children. new text end

new text begin Responsible social services agencies and child-placing agencies shall support a foster child's emotional and developmental growth by permitting the child to participate in activities or events that are generally accepted as suitable for children of the same chronological age or are developmentally appropriate for the child. Foster parents and residential facility staff are permitted to allow foster children to participate in extracurricular, social, or cultural activities that are typical for the child's age by applying reasonable and prudent parenting standards. Reasonable and prudent parenting standards are characterized by careful and sensible parenting decisions that maintain the child's health and safety, and are made in the child's best interest. new text end

Sec. 61.

Minnesota Statutes 2014, section 260C.221, is amended to read:

260C.221 RELATIVE SEARCH.

(a) The responsible social services agency shall exercise due diligence to identify and notify adult relatives prior to placement or within 30 days after the child's removal from the parent. The county agency shall consider placement with a relative under this section without delay and whenever the child must move from or be returned to foster care. The relative search required by this section shall be comprehensive in scope. After a finding that the agency has made reasonable efforts to conduct the relative search under this paragraph, the agency has the continuing responsibility to appropriately involve relatives, who have responded to the notice required under this paragraph, in planning for the child and to continue to consider relatives according to the requirements of section 260C.212, subdivision 2. At any time during the course of juvenile protection proceedings, the court may order the agency to reopen its search for relatives when it is in the child's best interest to do so.

new text begin (b)new text end The relative search required by this section shall include both maternal deleted text begin relatives deleted text end and paternal new text begin adult new text end relatives of the childnew text begin ; all adult grandparents; all legal parents, guardians or custodians; the child's siblings; and any other adult relatives suggested by the child's parents, subject to the exceptions due to family violence in paragraph (c)new text end . The search shall also include getting information from the child in an age-appropriate manner about who the child considers to be family members and important friends with whom the child has resided or had significant contact. The relative search required under this section must fulfill the agency's duties under the Indian Child Welfare Act regarding active efforts to prevent the breakup of the Indian family under United States Code, title 25, section 1912(d), and to meet placement preferences under United States Code, title 25, section 1915. The relatives must be notified:

(1) of the need for a foster home for the child, the option to become a placement resource for the child, and the possibility of the need for a permanent placement for the child;

(2) of their responsibility to keep the responsible social services agency and the court informed of their current address in order to receive notice in the event that a permanent placement is sought for the child and to receive notice of the permanency progress review hearing under section 260C.204. A relative who fails to provide a current address to the responsible social services agency and the court forfeits the right to receive notice of the possibility of permanent placement and of the permanency progress review hearing under section 260C.204. A decision by a relative not to be identified as a potential permanent placement resource or participate in planning for the child at the beginning of the case shall not affect whether the relative is considered for placement of the child with that relative later;

(3) that the relative may participate in the care and planning for the child, including that the opportunity for such participation may be lost by failing to respond to the notice sent under this subdivision. "Participate in the care and planning" includes, but is not limited to, participation in case planning for the parent and child, identifying the strengths and needs of the parent and child, supervising visits, providing respite and vacation visits for the child, providing transportation to appointments, suggesting other relatives who might be able to help support the case plan, and to the extent possible, helping to maintain the child's familiar and regular activities and contact with friends and relatives;

(4) of the family foster care licensing requirements, including how to complete an application and how to request a variance from licensing standards that do not present a safety or health risk to the child in the home under section 245A.04 and supports that are available for relatives and children who reside in a family foster home; and

(5) of the relatives' right to ask to be notified of any court proceedings regarding the child, to attend the hearings, and of a relative's right or opportunity to be heard by the court as required under section 260C.152, subdivision 5.

deleted text begin (b)deleted text end new text begin (c)new text end A responsible social services agency may disclose private data, as defined in sections 13.02 and 626.556, to relatives of the child for the purpose of locating and assessing a suitable placement and may use any reasonable means of identifying and locating relatives including the Internet or other electronic means of conducting a search. The agency shall disclose data that is necessary to facilitate possible placement with relatives and to ensure that the relative is informed of the needs of the child so the relative can participate in planning for the child and be supportive of services to the child and family. If the child's parent refuses to give the responsible social services agency information sufficient to identify the maternal and paternal relatives of the child, the agency shall ask the juvenile court to order the parent to provide the necessary information. If a parent makes an explicit request that a specific relative not be contacted or considered for placement due to safety reasons including past family or domestic violence, the agency shall bring the parent's request to the attention of the court to determine whether the parent's request is consistent with the best interests of the child and the agency shall not contact the specific relative when the juvenile court finds that contacting the specific relative would endanger the parent, guardian, child, sibling, or any family member.

deleted text begin (c)deleted text end new text begin (d)new text end At a regularly scheduled hearing not later than three months after the child's placement in foster care and as required in section 260C.202, the agency shall report to the court:

(1) its efforts to identify maternal and paternal relatives of the child and to engage the relatives in providing support for the child and family, and document that the relatives have been provided the notice required under paragraph (a); and

(2) its decision regarding placing the child with a relative as required under section 260C.212, subdivision 2, and to ask relatives to visit or maintain contact with the child in order to support family connections for the child, when placement with a relative is not possible or appropriate.

deleted text begin (d)deleted text end new text begin (e)new text end Notwithstanding chapter 13, the agency shall disclose data about particular relatives identified, searched for, and contacted for the purposes of the court's review of the agency's due diligence.

deleted text begin (e)deleted text end new text begin (f)new text end When the court is satisfied that the agency has exercised due diligence to identify relatives and provide the notice required in paragraph (a), the court may find that reasonable efforts have been made to conduct a relative search to identify and provide notice to adult relatives as required under section 260.012, paragraph (e), clause (3). If the court is not satisfied that the agency has exercised due diligence to identify relatives and provide the notice required in paragraph (a), the court may order the agency to continue its search and notice efforts and to report back to the court.

deleted text begin (f)deleted text end new text begin (g)new text end When the placing agency determines that permanent placement proceedings are necessary because there is a likelihood that the child will not return to a parent's care, the agency must send the notice provided in paragraph deleted text begin (g)deleted text end new text begin (h)new text end , may ask the court to modify the duty of the agency to send the notice required in paragraph deleted text begin (g)deleted text end new text begin (h)new text end , or may ask the court to completely relieve the agency of the requirements of paragraph deleted text begin (g)deleted text end new text begin (h)new text end . The relative notification requirements of paragraph deleted text begin (g)deleted text end new text begin (h)new text end do not apply when the child is placed with an appropriate relative or a foster home that has committed to adopting the child or taking permanent legal and physical custody of the child and the agency approves of that foster home for permanent placement of the child. The actions ordered by the court under this section must be consistent with the best interests, safety, permanency, and welfare of the child.

deleted text begin (g)deleted text end new text begin (h)new text end Unless required under the Indian Child Welfare Act or relieved of this duty by the court under paragraph deleted text begin (e)deleted text end new text begin (f)new text end , when the agency determines that it is necessary to prepare for permanent placement determination proceedings, or in anticipation of filing a termination of parental rights petition, the agency shall send notice to the relatives, any adult with whom the child is currently residing, any adult with whom the child has resided for one year or longer in the past, and any adults who have maintained a relationship or exercised visitation with the child as identified in the agency case plan. The notice must state that a permanent home is sought for the child and that the individuals receiving the notice may indicate to the agency their interest in providing a permanent home. The notice must state that within 30 days of receipt of the notice an individual receiving the notice must indicate to the agency the individual's interest in providing a permanent home for the child or that the individual may lose the opportunity to be considered for a permanent placement.

Sec. 62.

Minnesota Statutes 2014, section 260C.331, subdivision 1, is amended to read:

Subdivision 1.

Care, examination, or treatment.

(a) Except where parental rights are terminated,

(1) whenever legal custody of a child is transferred by the court to a responsible social services agency,

(2) whenever legal custody is transferred to a person other than the responsible social services agency, but under the supervision of the responsible social services agency, or

(3) whenever a child is given physical or mental examinations or treatment under order of the court, and no provision is otherwise made by law for payment for the care, examination, or treatment of the child, these costs are a charge upon the welfare funds of the county in which proceedings are held upon certification of the judge of juvenile court.

(b) The court shall order, and the responsible social services agency shall require, the parents or custodian of a child, while the child is under the age of 18, to use the total income and resources attributable to the child for the period of care, examination, or treatment, except for clothing and personal needs allowance as provided in section 256B.35, to reimburse the county for the cost of care, examination, or treatment. Income and resources attributable to the child include, but are not limited to, Social Security benefits, Supplemental Security Income (SSI), veterans benefits, railroad retirement benefits and child support. When the child is over the age of 18, and continues to receive care, examination, or treatment, the court shall order, and the responsible social services agency shall require, reimbursement from the child for the cost of care, examination, or treatment from the income and resources attributable to the child less the clothing and personal needs allowance. Income does not include earnings from a child over the age of 18 who is working as part of a plan under section 260C.212, subdivision 1, paragraph (c), clause deleted text begin (11)deleted text end new text begin (12)new text end , to transition from foster care, or the income and resources from sources other than Supplemental Security Income and child support that are needed to complete the requirements listed in section 260C.203.

(c) If the income and resources attributable to the child are not enough to reimburse the county for the full cost of the care, examination, or treatment, the court shall inquire into the ability of the parents to support the child and, after giving the parents a reasonable opportunity to be heard, the court shall order, and the responsible social services agency shall require, the parents to contribute to the cost of care, examination, or treatment of the child. When determining the amount to be contributed by the parents, the court shall use a fee schedule based upon ability to pay that is established by the responsible social services agency and approved by the commissioner of human services. The income of a stepparent who has not adopted a child shall be excluded in calculating the parental contribution under this section.

(d) The court shall order the amount of reimbursement attributable to the parents or custodian, or attributable to the child, or attributable to both sources, withheld under chapter 518A from the income of the parents or the custodian of the child. A parent or custodian who fails to pay without good reason may be proceeded against for contempt, or the court may inform the county attorney, who shall proceed to collect the unpaid sums, or both procedures may be used.

(e) If the court orders a physical or mental examination for a child, the examination is a medically necessary service for purposes of determining whether the service is covered by a health insurance policy, health maintenance contract, or other health coverage plan. Court-ordered treatment shall be subject to policy, contract, or plan requirements for medical necessity. Nothing in this paragraph changes or eliminates benefit limits, conditions of coverage, co-payments or deductibles, provider restrictions, or other requirements in the policy, contract, or plan that relate to coverage of other medically necessary services.

(f) Notwithstanding paragraph (b), (c), or (d), a parent, custodian, or guardian of the child is not required to use income and resources attributable to the child to reimburse the county for costs of care and is not required to contribute to the cost of care of the child during any period of time when the child is returned to the home of that parent, custodian, or guardian pursuant to a trial home visit under section 260C.201, subdivision 1, paragraph (a).

Sec. 63.

Minnesota Statutes 2014, section 260C.451, subdivision 2, is amended to read:

Subd. 2.

Independent living plan.

Upon the request of any child in foster care immediately prior to the child's 18th birthday and who is in foster care at the time of the request, the responsible social services agency shall, in conjunction with the child and other appropriate parties, update the independent living plan required under section 260C.212, subdivision 1, paragraph (c), clause deleted text begin (11)deleted text end new text begin (12)new text end , related to the child's employment, vocational, educational, social, or maturational needs. The agency shall provide continued services and foster care for the child including those services that are necessary to implement the independent living plan.

Sec. 64.

Minnesota Statutes 2014, section 260C.451, subdivision 6, is amended to read:

Subd. 6.

Reentering foster care and accessing services after age 18.

(a) Upon request of an individual between the ages of 18 and 21 who had been under the guardianship of the commissioner and who has left foster care without being adopted, the responsible social services agency which had been the commissioner's agent for purposes of the guardianship shall develop with the individual a plan to increase the individual's ability to live safely and independently using the plan requirements of section 260C.212, subdivision 1, paragraph deleted text begin (b)deleted text end new text begin (c)new text end , clause deleted text begin (11)deleted text end new text begin (12)new text end , and to assist the individual to meet one or more of the eligibility criteria in subdivision 4 if the individual wants to reenter foster care. The agency shall provide foster care as required to implement the plan. The agency shall enter into a voluntary placement agreement under section 260C.229 with the individual if the plan includes foster care.

(b) Individuals who had not been under the guardianship of the commissioner of human services prior to age 18 and are between the ages of 18 and 21 may ask to reenter foster care after age 18 and, to the extent funds are available, the responsible social services agency that had responsibility for planning for the individual before discharge from foster care may provide foster care or other services to the individual for the purpose of increasing the individual's ability to live safely and independently and to meet the eligibility criteria in subdivision 3a, if the individual:

(1) was in foster care for the six consecutive months prior to the person's 18th birthday and was not discharged home, adopted, or received into a relative's home under a transfer of permanent legal and physical custody under section 260C.515, subdivision 4; or

(2) was discharged from foster care while on runaway status after age 15.

(c) In conjunction with a qualifying and eligible individual under paragraph (b) and other appropriate persons, the responsible social services agency shall develop a specific plan related to that individual's vocational, educational, social, or maturational needs and, to the extent funds are available, provide foster care as required to implement the plan. The agency shall enter into a voluntary placement agreement with the individual if the plan includes foster care.

(d) Youth who left foster care while under guardianship of the commissioner of human services retain eligibility for foster care for placement at any time between the ages of 18 and 21.

Sec. 65.

Minnesota Statutes 2014, section 260C.515, subdivision 5, is amended to read:

Subd. 5.

Permanent custody to agency.

The court may order permanent custody to the responsible social services agency for continued placement of the child in foster care but only if it approves the responsible social services agency's compelling reasons that no other permanency disposition order is in the child's best interests and:

(1) the child has reached age deleted text begin 12deleted text end new text begin 16 and has been asked about the child's desired permanency outcomenew text end ;

deleted text begin (2) the child is a sibling of a child described in clause (1) and the siblings have a deleted text end deleted text begin significant positive relationship and are ordered into the same foster home; deleted text end

deleted text begin (3)deleted text end new text begin (2)new text end the responsible social services agency has made reasonable efforts to locate and place the child with an adoptive family or a fit and willing relative who would either agree to adopt the child or to a transfer of permanent legal and physical custody of the child, but these efforts have not proven successful; and

deleted text begin (4)deleted text end new text begin (3)new text end the parent will continue to have visitation or contact with the child and will remain involved in planning for the child.

Sec. 66.

Minnesota Statutes 2014, section 260C.521, subdivision 1, is amended to read:

Subdivision 1.

Child in permanent custody of responsible social services agency.

(a) Court reviews of an order for permanent custody to the responsible social services agency for placement of the child in foster care must be conducted at least yearly at an in-court appearance hearing.

(b) The purpose of the review hearing is to ensure:

(1) the order for permanent custody to the responsible social services agency for placement of the child in foster care continues to be in the best interests of the child and that no other permanency disposition order is in the best interests of the child;

(2) that the agency is assisting the child to build connections to the child's family and community; and

(3) that the agency is appropriately planning with the child for development of independent living skills for the child and, as appropriate, for the orderly and successful transition to independent living that may occur if the child continues in foster care without another permanency disposition order.

(c) The court must review the child's out-of-home placement plan and the reasonable efforts of the agency to finalize an alternative permanent plan for the child including the agency's efforts to:

(1) ensure that permanent custody to the agency with placement of the child in foster care continues to be the most appropriate legal arrangement for meeting the child's need for permanency and stability or, if not, to identify and attempt to finalize another permanency disposition order under this chapter that would better serve the child's needs and best interests;

(2) identify a specific foster home for the child, if one has not already been identified;

(3) support continued placement of the child in the identified home, if one has been identified;

(4) ensure appropriate services are provided to address the physical health, mental health, and educational needs of the child during the period of foster care and also ensure appropriate services or assistance to maintain relationships with appropriate family members and the child's community; and

(5) plan for the child's independence upon the child's leaving foster care living as required under section 260C.212, subdivision 1.

(d) The court may find that the agency has made reasonable efforts to finalize the permanent plan for the child when:

(1) the agency has made reasonable efforts to identify a more legally permanent home for the child than is provided by an order for permanent custody to the agency for placement in foster care; deleted text begin anddeleted text end

new text begin (2) the child has been asked about the child's desired permanency outcome; and new text end

deleted text begin (2)deleted text end new text begin (3)new text end the agency's engagement of the child in planning for independent living is reasonable and appropriate.

Sec. 67.

Minnesota Statutes 2014, section 260C.521, subdivision 2, is amended to read:

Subd. 2.

Modifying order for permanent legal and physical custody to a relative.

new text begin (a) new text end An order for a relative to have permanent legal and physical custody of a child may be modified using standards under sections 518.18 and 518.185.

new text begin (b) When a child is receiving Northstar kinship assistance under chapter 256N, if a relative named as permanent legal and physical custodian in an order made under this chapter becomes incapacitated or dies, a successor custodian named in the Northstar Care for Children kinship assistance benefit agreement under section 256N.25 may file a request to modify the order for permanent legal and physical custody to name the successor custodian as the permanent legal and physical custodian of the child. The court may modify the order to name the successor custodian as the permanent legal and physical custodian upon reviewing the background study required under section 245C.33 if the court finds the modification is in the child's best interests. new text end

new text begin (c)new text end The social services agency is a party to the proceeding and must receive notice.

Sec. 68.

Minnesota Statutes 2014, section 260C.607, subdivision 4, is amended to read:

Subd. 4.

Content of review.

(a) The court shall review:

(1) the agency's reasonable efforts under section 260C.605 to finalize an adoption for the child as appropriate to the stage of the case; and

(2) the child's current out-of-home placement plan required under section 260C.212, subdivision 1, to ensure the child is receiving all services and supports required to meet the child's needs as they relate to the child's:

(i) placement;

(ii) visitation and contact with siblings;

(iii) visitation and contact with relatives;

(iv) medical, mental, and dental health; and

(v) education.

(b) When the child is age deleted text begin 16deleted text end new text begin 14new text end and older, and as long as the child continues in foster care, the court shall also review the agency's planning for the child's independent living after leaving foster care including how the agency is meeting the requirements of section 260C.212, subdivision 1, paragraph (c), clause deleted text begin (11)deleted text end new text begin (12)new text end . The court shall use the review requirements of section 260C.203 in any review conducted under this paragraph.

Sec. 69.

Minnesota Statutes 2014, section 518A.26, subdivision 14, is amended to read:

Subd. 14.

Obligor.

"Obligor" means a person obligated to pay maintenance or support. deleted text begin A person who has primary physical custody of a child is presumed not to be an obligor for purposes of a child support order under section 518A.34, unless section 518A.36, subdivision 3, applies or the court makes specific written findings to overcome this presumption.deleted text end For purposes of ordering medical support under section 518A.41, a parent who has primary physical custody of a child may be an obligor subject to a payment agreement under section 518A.69.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2016. new text end

Sec. 70.

Minnesota Statutes 2014, section 518A.32, subdivision 2, is amended to read:

Subd. 2.

Methods.

Determination of potential income must be made according to one of three methods, as appropriate:

(1) the parent's probable earnings level based on employment potential, recent work history, and occupational qualifications in light of prevailing job opportunities and earnings levels in the community;

(2) if a parent is receiving unemployment compensation or workers' compensation, that parent's income may be calculated using the actual amount of the unemployment compensation or workers' compensation benefit received; or

(3) the amount of income a parent could earn working deleted text begin full time at 150deleted text end new text begin 30 hours per week at 100new text end percent of the current federal or state minimum wage, whichever is higher.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2016. new text end

Sec. 71.

Minnesota Statutes 2014, section 518A.39, subdivision 1, is amended to read:

Subdivision 1.

Authority.

After an order under this chapter or chapter 518 for maintenance or support money, temporary or permanent, or for the appointment of trustees to receive property awarded as maintenance or support money, the court may from time to time, on motion of either of the parties, a copy of which is served on the public authority responsible for child support enforcement if payments are made through it, or on motion of the public authority responsible for support enforcement, modify the order respecting the amount of maintenance or support moneynew text begin or medical supportnew text end , and the payment of it, and also respecting the appropriation and payment of the principal and income of property held in trust, and may make an order respecting these matters which it might have made in the original proceeding, except as herein otherwise provided. A party or the public authority also may bring a motion for contempt of court if the obligor is in arrears in support or maintenance payments.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2016. new text end

Sec. 72.

Minnesota Statutes 2014, section 518A.39, is amended by adding a subdivision to read:

new text begin Subd. 8. new text end

new text begin Medical support-only modification. new text end

new text begin (a) The medical support terms of a support order and determination of the child dependency tax credit may be modified without modification of the full order for support or maintenance, if the order has been established or modified in its entirety within three years from the date of the motion, and upon a showing of one or more of the following: new text end

new text begin (1) a change in the availability of appropriate health care coverage or a substantial increase or decrease in health care coverage costs; new text end

new text begin (2) a change in the eligibility for medical assistance under chapter 256B; new text end

new text begin (3) a party's failure to carry court-ordered coverage, or to provide other medical support as ordered; new text end

new text begin (4) the federal child dependency tax credit is not ordered for the same parent who is ordered to carry health care coverage; or new text end

new text begin (5) the federal child dependency tax credit is not addressed in the order and the noncustodial parent is ordered to carry health care coverage. new text end

new text begin (b) For a motion brought under this subdivision, a modification of the medical support terms of an order may be made retroactive only with respect to any period during which the petitioning party has pending a motion for modification, but only from the date of service of notice of the motion on the responding party and on the public authority if public assistance is being furnished or the county attorney is the attorney of record. new text end

new text begin (c) The court need not hold an evidentiary hearing on a motion brought under this subdivision for modification of medical support only. new text end

new text begin (d) Sections 518.14 and 518A.735 shall govern the award of attorney fees for motions brought under this subdivision. new text end

new text begin (e) The PICS originally stated in the order being modified shall be used to determine the modified medical support order under section 518A.41 for motions brought under this subdivision. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2016. new text end

Sec. 73.

Minnesota Statutes 2014, section 518A.41, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

The definitions in this subdivision apply to this chapter and chapter 518.

(a) "Health care coverage" means medical, dental, or other health care benefits that are provided by one or more health plans. Health care coverage does not include any form of public coverage.

(b) "Health carrier" means a carrier as defined in sections 62A.011, subdivision 2, and 62L.02, subdivision 16.

(c) "Health plan" means a plan, other than any form of public coverage, that provides medical, dental, or other health care benefits and is:

(1) provided on an individual or group basis;

(2) provided by an employer or union;

(3) purchased in the private market; or

(4) available to a person eligible to carry insurance for the joint child, including a party's spouse or parent.

Health plan includes, but is not limited to, a plan meeting the definition under section 62A.011, subdivision 3, except that the exclusion of coverage designed solely to provide dental or vision care under section 62A.011, subdivision 3, clause (6), does not apply to the definition of health plan under this section; a group health plan governed under the federal Employee Retirement Income Security Act of 1974 (ERISA); a self-insured plan under sections 43A.23 to 43A.317 and 471.617; and a policy, contract, or certificate issued by a community-integrated service network licensed under chapter 62N.

(d) "Medical support" means providing health care coverage for a joint child by carrying health care coverage for the joint child or by contributing to the cost of health care coverage, public coverage, unreimbursed medical expenses, and uninsured medical expenses of the joint child.

(e) "National medical support notice" means an administrative notice issued by the public authority to enforce health insurance provisions of a support order in accordance with Code of Federal Regulations, title 45, section 303.32, in cases where the public authority provides support enforcement services.

(f) "Public coverage" means health care benefits provided by any form of medical assistance under chapter 256B deleted text begin or MinnesotaCare under chapter 256Ldeleted text end .new text begin Public coverage does not include MinnesotaCare or health plans subsidized by federal premium tax credits or federal cost-sharing reductions.new text end

(g) "Uninsured medical expenses" means a joint child's reasonable and necessary health-related expenses if the joint child is not covered by a health plan or public coverage when the expenses are incurred.

(h) "Unreimbursed medical expenses" means a joint child's reasonable and necessary health-related expenses if a joint child is covered by a health plan or public coverage and the plan or coverage does not pay for the total cost of the expenses when the expenses are incurred. Unreimbursed medical expenses do not include the cost of premiums. Unreimbursed medical expenses include, but are not limited to, deductibles, co-payments, and expenses for orthodontia, and prescription eyeglasses and contact lenses, but not over-the-counter medications if coverage is under a health plan.

Sec. 74.

Minnesota Statutes 2014, section 518A.41, subdivision 3, is amended to read:

Subd. 3.

Determining appropriate health care coverage.

In determining whether a parent has appropriate health care coverage for the joint child, the court must consider the following factors:

(1) comprehensiveness of health care coverage providing medical benefits. Dependent health care coverage providing medical benefits is presumed comprehensive if it includes medical and hospital coverage and provides for preventive, emergency, acute, and chronic carenew text begin ; or if it meets the minimum essential coverage definition in United States Code, title 26, section 5000A(f)new text end . If both parents have health care coverage providing medical benefits that is presumed comprehensive under this paragraph, the court must determine which parent's coverage is more comprehensive by considering what other benefits are included in the coverage;

(2) accessibility. Dependent health care coverage is accessible if the covered joint child can obtain services from a health plan provider with reasonable effort by the parent with whom the joint child resides. Health care coverage is presumed accessible if:

(i) primary care is available within 30 minutes or 30 miles of the joint child's residence and specialty care is available within 60 minutes or 60 miles of the joint child's residence;

(ii) the health care coverage is available through an employer and the employee can be expected to remain employed for a reasonable amount of time; and

(iii) no preexisting conditions exist to unduly delay enrollment in health care coverage;

(3) the joint child's special medical needs, if any; and

(4) affordability. Dependent health care coverage is affordable if it is reasonable in cost. If both parents have health care coverage available for a joint child that is comparable with regard to comprehensiveness of medical benefits, accessibility, and the joint child's special needs, the least costly health care coverage is presumed to be the most appropriate health care coverage for the joint child.

Sec. 75.

Minnesota Statutes 2014, section 518A.41, subdivision 4, is amended to read:

Subd. 4.

Ordering health care coverage.

(a) If a joint child is presently enrolled in health care coverage, the court must order that the parent who currently has the joint child enrolled continue that enrollment unless the parties agree otherwise or a party requests a change in coverage and the court determines that other health care coverage is more appropriate.

(b) If a joint child is not presently enrolled in health care coverage providing medical benefits, upon motion of a parent or the public authority, the court must determine whether one or both parents have appropriate health care coverage providing medical benefits for the joint child.

(c) If only one parent has appropriate health care coverage providing medical benefits available, the court must order that parent to carry the coverage for the joint child.

(d) If both parents have appropriate health care coverage providing medical benefits available, the court must order the parent with whom the joint child resides to carry the coverage for the joint child, unless:

(1) a party expresses a preference for health care coverage providing medical benefits available through the parent with whom the joint child does not reside;

(2) the parent with whom the joint child does not reside is already carrying dependent health care coverage providing medical benefits for other children and the cost of contributing to the premiums of the other parent's coverage would cause the parent with whom the joint child does not reside extreme hardship; or

(3) the parties agree as to which parent will carry health care coverage providing medical benefits and agree on the allocation of costs.

(e) If the exception in paragraph (d), clause (1) or (2), applies, the court must determine which parent has the most appropriate coverage providing medical benefits available and order that parent to carry coverage for the joint child.

(f) If neither parent has appropriate health care coverage available, the court must order the parents to:

(1) contribute toward the actual health care costs of the joint children based on a pro rata share; or

(2) if the joint child is receiving any form of public coverage, the parent with whom the joint child does not reside shall contribute a monthly amount toward the actual cost of public coverage. The amount of the noncustodial parent's contribution is determined by applying the noncustodial parent's PICS to the premium deleted text begin schedule for public coveragedeleted text end new text begin scale for MinnesotaCare under section 256L.15, subdivision 2, paragraph (d)new text end . If the noncustodial parent's PICS meets the eligibility requirements for deleted text begin public coveragedeleted text end new text begin MinnesotaCarenew text end , the contribution is the amount the noncustodial parent would pay for the child's premium. If the noncustodial parent's PICS exceeds the eligibility requirements deleted text begin for public coveragedeleted text end , the contribution is the amount of the premium for the highest eligible income on the deleted text begin appropriate deleted text end premium deleted text begin schedule for public coveragedeleted text end new text begin scale for MinnesotaCare under section 256L.15, subdivision 2, paragraph (d)new text end . For purposes of determining the premium amount, the noncustodial parent's household size is equal to one parent plus the child or children who are the subject of the child support order. The custodial parent's obligation is determined under the requirements for public coverage as set forth in chapter 256B deleted text begin or 256L.deleted text end new text begin ; ornew text end

new text begin (3) if the noncustodial parent's PICS meet the eligibility requirement for public coverage under chapter 256B or the noncustodial parent receives public assistance, the noncustodial parent must not be ordered to contribute toward the cost of public coverage. new text end

(g) If neither parent has appropriate health care coverage available, the court may order the parent with whom the child resides to apply for public coverage for the child.

(h) The commissioner of human services must publish a table with the premium schedule for public coverage and update the chart for changes to the schedule by July 1 of each year.

(i) If a joint child is not presently enrolled in health care coverage providing dental benefits, upon motion of a parent or the public authority, the court must determine whether one or both parents have appropriate dental health care coverage for the joint child, and the court may order a parent with appropriate dental health care coverage available to carry the coverage for the joint child.

(j) If a joint child is not presently enrolled in available health care coverage providing benefits other than medical benefits or dental benefits, upon motion of a parent or the public authority, the court may determine whether that other health care coverage for the joint child is appropriate, and the court may order a parent with that appropriate health care coverage available to carry the coverage for the joint child.

new text begin EFFECTIVE DATE. new text end

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

Sec. 76.

Minnesota Statutes 2014, section 518A.41, subdivision 14, is amended to read:

Subd. 14.

Child support enforcement services.

The public authority must take necessary steps to establish deleted text begin and enforcedeleted text end new text begin , enforce, and modifynew text end an order for medical support if the joint child receives public assistance or a party completes an application for services from the public authority under section 518A.51.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2016. new text end

Sec. 77.

Minnesota Statutes 2014, section 518A.41, subdivision 15, is amended to read:

Subd. 15.

Enforcement.

(a) Remedies available for collecting and enforcing child support apply to medical support.

(b) For the purpose of enforcement, the following are additional support:

(1) the costs of individual or group health or hospitalization coverage;

(2) dental coverage;

(3) medical costs ordered by the court to be paid by either party, including health care coverage premiums paid by the obligee because of the obligor's failure to obtain coverage as ordered; and

(4) liabilities established under this subdivision.

(c) A party who fails to carry court-ordered dependent health care coverage is liable for the joint child's uninsured medical expenses unless a court order provides otherwise. A party's failure to carry court-ordered coverage, or to provide other medical support as ordered, is a basis for modification of deleted text begin adeleted text end new text begin medicalnew text end support deleted text begin orderdeleted text end under section 518A.39, subdivision deleted text begin 2deleted text end new text begin 8, unless it meets the presumption in section 518A.39, subdivision 2new text end .

(d) Payments by the health carrier or employer for services rendered to the dependents that are directed to a party not owed reimbursement must be endorsed over to and forwarded to the vendor or appropriate party or the public authority. A party retaining insurance reimbursement not owed to the party is liable for the amount of the reimbursement.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2016. new text end

Sec. 78.

Minnesota Statutes 2014, section 518A.43, is amended by adding a subdivision to read:

new text begin Subd. 1a. new text end

new text begin Income disparity between parties. new text end

new text begin The court may deviate from the presumptive child support obligation under section 518A.34 and elect not to order a party who has between ten and 45 percent parenting time to pay basic support where such a significant disparity of income exists between the parties that an order directing payment of basic support would be detrimental to the parties' joint child. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2016. new text end

Sec. 79.

Minnesota Statutes 2014, section 518A.46, subdivision 3, is amended to read:

Subd. 3.

Contents of pleadings.

(a) In cases involving establishment or modification of a child support order, the initiating party shall include the following information, if known, in the pleadings:

(1) names, addresses, and dates of birth of the parties;

(2) Social Security numbers of the parties and the minor children of the parties, which information shall be considered private information and shall be available only to the parties, the court, and the public authority;

(3) other support obligations of the obligor;

(4) names and addresses of the parties' employers;

(5) gross income of the parties as calculated in section 518A.29;

(6) amounts and sources of any other earnings and income of the parties;

(7) health insurance coverage of parties;

(8) types and amounts of public assistance received by the parties, including Minnesota family investment plan, child care assistance, medical assistance, deleted text begin MinnesotaCare,deleted text end title IV-E foster care, or other form of assistance as defined in section 256.741, subdivision 1; and

(9) any other information relevant to the computation of the child support obligation under section 518A.34.

(b) For all matters scheduled in the expedited process, whether or not initiated by the public authority, the nonattorney employee of the public authority shall file with the court and serve on the parties the following information:

(1) information pertaining to the income of the parties available to the public authority from the Department of Employment and Economic Development;

(2) a statement of the monthly amount of child support, medical support, child care, and arrears currently being charged the obligor on Minnesota IV-D cases;

(3) a statement of the types and amount of any public assistance, as defined in section 256.741, subdivision 1, received by the parties; and

(4) any other information relevant to the determination of support that is known to the public authority and that has not been otherwise provided by the parties.

The information must be filed with the court or child support magistrate at least five days before any hearing involving child support, medical support, or child care reimbursement issues.

Sec. 80.

Minnesota Statutes 2014, section 518A.46, is amended by adding a subdivision to read:

new text begin Subd. 3a. new text end

new text begin Contents of pleadings for medical support modifications. new text end

new text begin (a) In cases involving modification of only the medical support portion of a child support order under section 518A.39, subdivision 8, the initiating party shall include the following information, if known, in the pleadings: new text end

new text begin (1) names, addresses, and dates of birth of the parties; new text end

new text begin (2) Social Security numbers of the parties and the minor children of the parties, which shall be considered private information and shall be available only to the parties, the court, and the public authority; new text end

new text begin (3) names and addresses of the parties' employers; new text end

new text begin (4) gross income of the parties as stated in the order being modified; new text end

new text begin (5) health insurance coverage of the parties; and new text end

new text begin (6) any other information relevant to the determination of the medical support obligation under section 518A.41. new text end

new text begin (b) For all matters scheduled in the expedited process, whether or not initiated by the public authority, the nonattorney employee of the public authority shall file with the court and serve on the parties the following information: new text end

new text begin (1) a statement of the monthly amount of child support, medical support, child care, and arrears currently being charged the obligor on Minnesota IV-D cases; new text end

new text begin (2) a statement of the amount of medical assistance received by the parties; and new text end

new text begin (3) any other information relevant to the determination of medical support that is known to the public authority and that has not been otherwise provided by the parties. new text end

new text begin The information must be filed with the court or child support magistrate at least five days before the hearing on the motion to modify medical support. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2016. new text end

Sec. 81.

Minnesota Statutes 2014, section 518A.51, is amended to read:

518A.51 FEES FOR IV-D SERVICES.

(a) When a recipient of IV-D services is no longer receiving assistance under the state's title IV-A, IV-E foster care,new text begin ornew text end medical assistancedeleted text begin , or MinnesotaCaredeleted text end programs, the public authority responsible for child support enforcement must notify the recipient, within five working days of the notification of ineligibility, that IV-D services will be continued unless the public authority is notified to the contrary by the recipient. The notice must include the implications of continuing to receive IV-D services, including the available services and fees, cost recovery fees, and distribution policies relating to fees.

deleted text begin (b) An application fee of $25 shall be paid by the person who applies for child support and maintenance collection services, except persons who are receiving public assistance as defined in section 256.741 and the diversionary work program under section 256J.95, persons who transfer from public assistance to nonpublic assistance status, and minor parents and parents enrolled in a public secondary school, area learning center, or alternative learning program approved by the commissioner of education. deleted text end

deleted text begin (c)deleted text end new text begin (b)new text end In the case of an individual who has never received assistance under a state program funded under title IV-A of the Social Security Act and for whom the public authority has collected at least $500 of support, the public authority must impose an annual federal collections fee of $25 for each case in which services are furnished. This fee must be retained by the public authority from support collected on behalf of the individual, but not from the first $500 collected.

deleted text begin (d)deleted text end new text begin (c)new text end When the public authority provides full IV-D services to an obligee who has applied for those services, upon written notice to the obligee, the public authority must charge a cost recovery fee of two percent of the amount collected. This fee must be deducted from the amount of the child support and maintenance collected and not assigned under section 256.741 before disbursement to the obligee. This fee does not apply to an obligee who:

(1) is currently receiving assistance under the state's title IV-A, IV-E foster care,new text begin or new text end medical assistancedeleted text begin , or MinnesotaCaredeleted text end programs; or

(2) has received assistance under the state's title IV-A or IV-E foster care programs, until the person has not received this assistance for 24 consecutive months.

deleted text begin (e)deleted text end new text begin (d)new text end When the public authority provides full IV-D services to an obligor who has applied for such services, upon written notice to the obligor, the public authority must charge a cost recovery fee of two percent of the monthly court-ordered child support and maintenance obligation. The fee may be collected through income withholding, as well as by any other enforcement remedy available to the public authority responsible for child support enforcement.

deleted text begin (f)deleted text end new text begin (e)new text end Fees assessed by state and federal tax agencies for collection of overdue support owed to or on behalf of a person not receiving public assistance must be imposed on the person for whom these services are provided. The public authority upon written notice to the obligee shall assess a fee of $25 to the person not receiving public assistance for each successful federal tax interception. The fee must be withheld prior to the release of the funds received from each interception and deposited in the general fund.

deleted text begin (g)deleted text end new text begin (f)new text end Federal collections fees collected under paragraph deleted text begin (c)deleted text end new text begin (b)new text end and cost recovery fees collected under paragraphsnew text begin (c) andnew text end (d) deleted text begin and (e)deleted text end retained by the commissioner of human services shall be considered child support program income according to Code of Federal Regulations, title 45, section 304.50, and shall be deposited in the special revenue fund account established under paragraph deleted text begin (i)deleted text end new text begin (h)new text end . The commissioner of human services must elect to recover costs based on either actual or standardized costs.

deleted text begin (h)deleted text end new text begin (g)new text end The limitations of this section on the assessment of fees shall not apply to the extent inconsistent with the requirements of federal law for receiving funds for the programs under title IV-A and title IV-D of the Social Security Act, United States Code, title 42, sections 601 to 613 and United States Code, title 42, sections 651 to 662.

deleted text begin (i)deleted text end new text begin (h)new text end The commissioner of human services is authorized to establish a special revenue fund account to receive the federal collections fees collected under paragraph deleted text begin (c) deleted text end new text begin (b)new text end and cost recovery fees collected under paragraphsnew text begin (c) andnew text end (d) deleted text begin and (e)deleted text end .

deleted text begin (j)deleted text end new text begin (i)new text end The nonfederal share of the cost recovery fee revenue must be retained by the commissioner and distributed as follows:

(1) one-half of the revenue must be transferred to the child support system special revenue account to support the state's administration of the child support enforcement program and its federally mandated automated system;

(2) an additional portion of the revenue must be transferred to the child support system special revenue account for expenditures necessary to administer the fees; and

(3) the remaining portion of the revenue must be distributed to the counties to aid the counties in funding their child support enforcement programs.

deleted text begin (k)deleted text end new text begin (j)new text end The nonfederal share of the federal collections fees must be distributed to the counties to aid them in funding their child support enforcement programs.

deleted text begin (l)deleted text end new text begin (k)new text end The commissioner of human services shall distribute quarterly any of the funds dedicated to the counties under paragraphsnew text begin (i) andnew text end (j) deleted text begin and (k)deleted text end using the methodology specified in section 256.979, subdivision 11. The funds received by the counties must be reinvested in the child support enforcement program and the counties must not reduce the funding of their child support programs by the amount of the funding distributed.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016, except that the amendments striking MinnesotaCare are effective July 1, 2015. new text end

Sec. 82.

Minnesota Statutes 2014, section 518A.53, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

(a) For the purpose of this section, the following terms have the meanings provided in this subdivision unless otherwise stated.

(b) "Payor of funds" means any person or entity that provides funds to an obligor, including an employer as defined under chapter 24 of the Internal Revenue Code, section 3401(d), an independent contractor, payor of worker's compensation benefits or unemployment benefits, or a financial institution as defined in section 13B.06.

(c) "Business day" means a day on which state offices are open for regular business.

(d) "Arrears" deleted text begin means amounts owed under a support order that are past duedeleted text end new text begin has the meaning given in section 518A.26, subdivision 3new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 83.

Minnesota Statutes 2014, section 518A.53, subdivision 4, is amended to read:

Subd. 4.

Collection services.

(a) The commissioner of human services shall prepare and make available to the courts a notice of services that explains child support and maintenance collection services available through the public authority, including income withholding, and the fees for such services. Upon receiving a petition for dissolution of marriage or legal separation, the court administrator shall promptly send the notice of services to the petitioner and respondent at the addresses stated in the petition.

(b) Either the obligee or obligor may at any time apply to the public authority for either full IV-D services or for income withholding only services.

(c) For those persons applying for income withholding only services, a monthly service fee of $15 must be charged to the obligor. This fee is in addition to the amount of the support order and shall be withheld through income withholding. The public authority shall explain the service options in this section to the affected parties and encourage the application for full child support collection services.

(d) If the obligee is not a current recipient of public assistance as defined in section 256.741, the person who applied for services may at any time choose to terminate either full IV-D services or income withholding only services regardless of whether income withholding is currently in place. The obligee or obligor may reapply for either full IV-D services or income withholding only services at any time. deleted text begin Unless the applicant is a recipient of public assistance as defined in section 256.741, a $25 application fee shall be charged at the time of each application.deleted text end

(e) When a person terminates IV-D services, if an arrearage for public assistance as defined in section 256.741 exists, the public authority may continue income withholding, as well as use any other enforcement remedy for the collection of child support, until all public assistance arrears are paid in full. Income withholding shall be in an amount equal to 20 percent of the support order in effect at the time the services terminatednew text begin , unless the court has ordered a specific monthly payback amount to be applied toward the arrears. If a support order includes a specific monthly payback amount, income withholding shall be for the specific monthly payback amount orderednew text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 84.

Minnesota Statutes 2014, section 518A.53, subdivision 10, is amended to read:

Subd. 10.

Arrearage order.

(a) This section does not prevent the court from ordering the payor of funds to withhold amounts to satisfy the obligor's previous arrearage in support order payments. This remedy shall not operate to exclude availability of other remedies to enforce judgments. The employer or payor of funds shall withhold from the obligor's income an additional amount equal to 20 percent of the monthly child support or maintenance obligation until the arrearage is paidnew text begin , unless the court has ordered a specific monthly payback amount toward the arrears. If a support order includes a specific monthly payback amount, the employer or payor of funds shall withhold from the obligor's income an additional amount equal to the specific monthly payback amount ordered until all arrearages are paidnew text end .

(b) Notwithstanding any law to the contrary, funds from income sources included in section 518A.26, subdivision 8, whether periodic or lump sum, are not exempt from attachment or execution upon a judgment for child support arrearage.

(c) Absent an order to the contrary, if an arrearage exists at the time a support order would otherwise terminate, income withholding shall continue in effect or may be implemented in an amount equal to the support order plus an additional 20 percent of the monthly child support obligation, until all arrears have been paid in full.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 85.

Minnesota Statutes 2014, 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 suspensiondeleted text begin ,deleted text end new text begin and new text end credit bureau reporting, deleted text begin and additional income withholding under section 518A.53, subdivision 10, paragraph (a), deleted text end 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.

(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:

(1) the arrearage is under $500; or

(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.

(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.

(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 begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 86.

new text begin [518A.685] CONSUMER REPORTING AGENCY; REPORTING ARREARS. new text end

new text begin (a) If a public authority determines that an obligor has not paid the current monthly support obligation plus any required arrearage payment for three months, the public authority must report this information to a consumer reporting agency. new text end

new text begin (b) Before reporting that an obligor is in arrears for court-ordered child support, the public authority must: new text end

new text begin (1) provide written notice to the obligor that the public authority intends to report the arrears to a consumer reporting agency; and new text end

new text begin (2) mail the written notice to the obligor's last known mailing address at least 30 days before the public authority reports the arrears to a consumer reporting agency. new text end

new text begin (c) The obligor may, within 21 days of receipt of the notice, do the following to prevent the public authority from reporting the arrears to a consumer reporting agency: new text end

new text begin (1) pay the arrears in full; or new text end

new text begin (2) request an administrative review. An administrative review is limited to issues of mistaken identity, a pending legal action involving the arrears, or an incorrect arrears balance. new text end

new text begin (d) If the public authority has reported that an obligor is in arrears for court-ordered child support and subsequently determines that the obligor has paid the court-ordered child support arrears in full, or is paying the current monthly support obligation plus any required arrearage payment, the public authority must report to the consumer reporting agency that the obligor is currently paying child support as ordered by the court. new text end

new text begin (e) A public authority that reports arrearage information under this section must make monthly reports to a consumer reporting agency. The monthly report must be consistent with credit reporting industry standards for child support. new text end

new text begin (f) For purposes of this section, "consumer reporting agency" has the meaning given in section 13C.001, subdivision 4, and United States Code, title 15, section 1681a(f). new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 87.

Minnesota Statutes 2014, section 518C.802, is amended to read:

518C.802 CONDITIONS OF RENDITION.

(a) Before making demand that the governor of another state surrender an individual charged criminally in this state with having failed to provide for the support of an obligee, the governor of this state may require a prosecutor of this state to demonstrate that at least 60 days previously the obligee had initiated proceedings for support pursuant to this chapter or that the proceeding would be of no avail.

(b) If, under this chapter or a law substantially similar to this chapter, deleted text begin the Uniform Reciprocal Enforcement of Support Act, or the Revised Uniform Reciprocal Enforcement of Support Act,deleted text end the governor of another state makes a demand that the governor of this state surrender an individual charged criminally in that state with having failed to provide for the support of a child or other individual to whom a duty of support is owed, the governor may require a prosecutor to investigate the demand and report whether a proceeding for support has been initiated or would be effective. If it appears that a proceeding would be effective but has not been initiated, the governor may delay honoring the demand for a reasonable time to permit the initiation of a proceeding.

(c) If a proceeding for support has been initiated and the individual whose rendition is demanded prevails, the governor may decline to honor the demand. If the petitioner prevails and the individual whose rendition is demanded is subject to a support order, the governor may decline to honor the demand if the individual is complying with the support order.

Sec. 88.

Minnesota Statutes 2014, section 626.556, subdivision 1, as amended by Laws 2015, chapter 4, section 1, is amended to read:

Subdivision 1.

Public policy.

(a) The legislature hereby declares that the public policy of this state is to protect children whose health or welfare may be jeopardized through physical abuse, neglect, or sexual abuse. While it is recognized that most parents want to keep their children safe, sometimes circumstances or conditions interfere with their ability to do so. When this occurs, the health and safety of the children deleted text begin shalldeleted text end new text begin mustnew text end be of paramount concern. Intervention and prevention efforts deleted text begin shalldeleted text end new text begin mustnew text end address immediate concerns for child safety and the ongoing risk of abuse or neglect and should engage the protective capacities of families. In furtherance of this public policy, it is the intent of the legislature under this section to:

(1) protect children and promote child safety;

(2) strengthen the family;

(3) make the home, school, and community safe for children by promoting responsible child care in all settings; and

(4) provide, when necessary, a safe temporary or permanent home environment for physically or sexually abused or neglected children.

(b) In addition, it is the policy of this state to:

(1) require the reporting of neglect or physical or sexual abuse of children in the home, school, and community settings;

(2) provide for the voluntary reporting of abuse or neglect of children; deleted text begin to require a family assessment, when appropriate, as the preferred response to reports not alleging substantial child endangerment;deleted text end

(3) require an investigation when the report alleges new text begin sexual abuse or new text end substantial child endangerment;

new text begin (4) provide a family assessment, if appropriate, when the report does not allege sexual abuse or substantial child endangerment; new text end and

deleted text begin (4)deleted text end new text begin (5)new text end provide protective, family support, and family preservation services when needed in appropriate cases.

Sec. 89.

Minnesota Statutes 2014, section 626.556, subdivision 2, is amended to read:

Subd. 2.

Definitions.

As used in this section, the following terms have the meanings given them unless the specific content indicates otherwise:

(a) "Family assessment" means a comprehensive assessment of child safety, risk of subsequent child maltreatment, and family strengths and needs that is applied to a child maltreatment report that does not allegenew text begin sexual abuse ornew text end substantial child endangerment. Family assessment does not include a determination as to whether child maltreatment occurred but does determine the need for services to address the safety of family members and the risk of subsequent maltreatment.

(b) "Investigation" means fact gathering related to the current safety of a child and the risk of subsequent maltreatment that determines whether child maltreatment occurred and whether child protective services are needed. An investigation must be used when reports involvenew text begin sexual abuse ornew text end substantial child endangerment, and for reports of maltreatment in facilities required to be licensed under chapter 245A or 245D; under sections 144.50 to 144.58 and 241.021; in a school as defined in sections 120A.05, subdivisions 9, 11, and 13, and 124D.10; or in a nonlicensed personal care provider association as defined in section 256B.0625, subdivision 19a.

(c) "Substantial child endangerment" means a person responsible for a child's care, deleted text begin and in the case of sexual abuse includes a person who has a significant relationship to the child as defined in section 609.341, or a person in a position of authority as defined in section 609.341, whodeleted text end by act or omissionnew text begin ,new text end commits or attempts to commit an act against a child under their care that constitutes any of the following:

(1) egregious harm as defined in section 260C.007, subdivision 14;

(2) deleted text begin sexual abuse as defined in paragraph (d);deleted text end

deleted text begin (3)deleted text end abandonment under section 260C.301, subdivision 2;

deleted text begin (4)deleted text end new text begin (3)new text end neglect as defined in paragraph (f), clause (2), that substantially endangers the child's physical or mental health, including a growth delay, which may be referred to as failure to thrive, that has been diagnosed by a physician and is due to parental neglect;

deleted text begin (5)deleted text end new text begin (4)new text end murder in the first, second, or third degree under section 609.185, 609.19, or 609.195;

deleted text begin (6)deleted text end new text begin (5)new text end manslaughter in the first or second degree under section 609.20 or 609.205;

deleted text begin (7)deleted text end new text begin (6)new text end assault in the first, second, or third degree under section 609.221, 609.222, or 609.223;

deleted text begin (8)deleted text end new text begin (7)new text end solicitation, inducement, and promotion of prostitution under section 609.322;

deleted text begin (9)deleted text end new text begin (8)new text end criminal sexual conduct under sections 609.342 to 609.3451;

deleted text begin (10)deleted text end new text begin (9)new text end solicitation of children to engage in sexual conduct under section 609.352;

deleted text begin (11)deleted text end new text begin (10)new text end malicious punishment or neglect or endangerment of a child under section 609.377 or 609.378;

deleted text begin (12)deleted text end new text begin (11)new text end use of a minor in sexual performance under section 617.246; or

deleted text begin (13)deleted text end new text begin (12)new text end parental behavior, status, or condition which mandates that the county attorney file a termination of parental rights petition under section 260C.503, subdivision 2.

(d) "Sexual abuse" means the subjection of a child by a person responsible for the child's care, by a person who has a significant relationship to the child, as defined in section 609.341, or by a person in a position of authority, as defined in section 609.341, subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual conduct in the first degree), 609.343 (criminal sexual conduct in the second degree), 609.344 (criminal sexual conduct in the third degree), 609.345 (criminal sexual conduct in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual abuse also includes any act which involves a minor which constitutes a violation of prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes threatened sexual abuse which includes the status of a parent or household member who has committed a violation which requires registration as an offender under section 243.166, subdivision 1b, paragraph (a) or (b), or required registration under section 243.166, subdivision 1b, paragraph (a) or (b).

(e) "Person responsible for the child's care" means (1) an individual functioning within the family unit and having responsibilities for the care of the child such as a parent, guardian, or other person having similar care responsibilities, or (2) an individual functioning outside the family unit and having responsibilities for the care of the child such as a teacher, school administrator, other school employees or agents, or other lawful custodian of a child having either full-time or short-term care responsibilities including, but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching, and coaching.

(f) "Neglect" means the commission or omission of any of the acts specified under clauses (1) to (9), other than by accidental means:

(1) failure by a person responsible for a child's care to supply a child with necessary food, clothing, shelter, health, medical, or other care required for the child's physical or mental health when reasonably able to do so;

(2) failure to protect a child from conditions or actions that seriously endanger the child's physical or mental health when reasonably able to do so, including a growth delay, which may be referred to as a failure to thrive, that has been diagnosed by a physician and is due to parental neglect;

(3) failure to provide for necessary supervision or child care arrangements appropriate for a child after considering factors as the child's age, mental ability, physical condition, length of absence, or environment, when the child is unable to care for the child's own basic needs or safety, or the basic needs or safety of another child in their care;

(4) failure to ensure that the child is educated as defined in sections 120A.22 and 260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's child with sympathomimetic medications, consistent with section 125A.091, subdivision 5;

(5) nothing in this section shall be construed to mean that a child is neglected solely because the child's parent, guardian, or other person responsible for the child's care in good faith selects and depends upon spiritual means or prayer for treatment or care of disease or remedial care of the child in lieu of medical care; except that a parent, guardian, or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report if a lack of medical care may cause serious danger to the child's health. This section does not impose upon persons, not otherwise legally responsible for providing a child with necessary food, clothing, shelter, education, or medical care, a duty to provide that care;

(6) prenatal exposure to a controlled substance, as defined in section 253B.02, subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal symptoms in the child at birth, results of a toxicology test performed on the mother at delivery or the child at birth, medical effects or developmental delays during the child's first year of life that medically indicate prenatal exposure to a controlled substance, or the presence of a fetal alcohol spectrum disorder;

(7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);

(8) chronic and severe use of alcohol or a controlled substance by a parent or person responsible for the care of the child that adversely affects the child's basic needs and safety; or

(9) emotional harm from a pattern of behavior which contributes to impaired emotional functioning of the child which may be demonstrated by a substantial and observable effect in the child's behavior, emotional response, or cognition that is not within the normal range for the child's age and stage of development, with due regard to the child's culture.

(g) "Physical abuse" means any physical injury, mental injury, or threatened injury, inflicted by a person responsible for the child's care on a child other than by accidental means, or any physical or mental injury that cannot reasonably be explained by the child's history of injuries, or any aversive or deprivation procedures, or regulated interventions, that have not been authorized under section 125A.0942 or 245.825.

Abuse does not include reasonable and moderate physical discipline of a child administered by a parent or legal guardian which does not result in an injury. Abuse does not include the use of reasonable force by a teacher, principal, or school employee as allowed by section 121A.582. Actions which are not reasonable and moderate include, but are not limited to, any of the following deleted text begin that are done in anger or without regard to the safety of the childdeleted text end :

(1) throwing, kicking, burning, biting, or cutting a child;

(2) striking a child with a closed fist;

(3) shaking a child under age three;

(4) striking or other actions which result in any nonaccidental injury to a child under 18 months of age;

(5) unreasonable interference with a child's breathing;

(6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;

(7) striking a child under age one on the face or head;

new text begin (8) striking a child who is at least age one but under age four on the face or head, which results in an injury; new text end

deleted text begin (8)deleted text end new text begin (9)new text end purposely giving a child poison, alcohol, or dangerous, harmful, or controlled substances which were not prescribed for the child by a practitioner, in order to control or punish the child; or other substances that substantially affect the child's behavior, motor coordination, or judgment or that results in sickness or internal injury, or subjects the child to medical procedures that would be unnecessary if the child were not exposed to the substances;

deleted text begin (9)deleted text end new text begin (10)new text end unreasonable physical confinement or restraint not permitted under section 609.379, including but not limited to tying, caging, or chaining; or

deleted text begin (10)deleted text end new text begin (11)new text end in a school facility or school zone, an act by a person responsible for the child's care that is a violation under section 121A.58.

(h) "Report" means any deleted text begin reportdeleted text end new text begin communicationnew text end received by the local welfare agency, police department, county sheriff, or agency responsible for deleted text begin assessing or investigating maltreatmentdeleted text end new text begin child protectionnew text end pursuant to this sectionnew text begin that describes neglect or physical or sexual abuse of a child and contains sufficient content to identify the child and any person believed to be responsible for the neglect or abuse, if knownnew text end .

(i) "Facility" means:

(1) a licensed or unlicensed day care facility, residential facility, agency, hospital, sanitarium, or other facility or institution required to be licensed under sections 144.50 to 144.58, 241.021, or 245A.01 to 245A.16, or chapter 245D;

(2) a school as defined in sections 120A.05, subdivisions 9, 11, and 13; and 124D.10; or

(3) a nonlicensed personal care provider organization as defined in section 256B.0625, subdivision 19a.

(j) "Operator" means an operator or agency as defined in section 245A.02.

(k) "Commissioner" means the commissioner of human services.

(l) "Practice of social services," for the purposes of subdivision 3, includes but is not limited to employee assistance counseling and the provision of guardian ad litem and parenting time expeditor services.

(m) "Mental injury" means an injury to the psychological capacity or emotional stability of a child as evidenced by an observable or substantial impairment in the child's ability to function within a normal range of performance and behavior with due regard to the child's culture.

(n) "Threatened injury" means a statement, overt act, condition, or status that represents a substantial risk of physical or sexual abuse or mental injury. Threatened injury includes, but is not limited to, exposing a child to a person responsible for the child's care, as defined in paragraph (e), clause (1), who has:

(1) subjected a child to, or failed to protect a child from, an overt act or condition that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a similar law of another jurisdiction;

(2) been found to be palpably unfit under section 260C.301, subdivision 1, paragraph (b), clause (4), or a similar law of another jurisdiction;

(3) committed an act that has resulted in an involuntary termination of parental rights under section 260C.301, or a similar law of another jurisdiction; or

(4) committed an act that has resulted in the involuntary transfer of permanent legal and physical custody of a child to a relative under Minnesota Statutes 2010, section 260C.201, subdivision 11, paragraph (d), clause (1), section 260C.515, subdivision 4, or a similar law of another jurisdiction.

A child is the subject of a report of threatened injury when the responsible social services agency receives birth match data under paragraph (o) from the Department of Human Services.

(o) Upon receiving data under section 144.225, subdivision 2b, contained in a birth record or recognition of parentage identifying a child who is subject to threatened injury under paragraph (n), the Department of Human Services shall send the data to the responsible social services agency. The data is known as "birth match" data. Unless the responsible social services agency has already begun an investigation or assessment of the report due to the birth of the child or execution of the recognition of parentage and the parent's previous history with child protection, the agency shall accept the birth match data as a report under this section. The agency may use either a family assessment or investigation to determine whether the child is safe. All of the provisions of this section apply. If the child is determined to be safe, the agency shall consult with the county attorney to determine the appropriateness of filing a petition alleging the child is in need of protection or services under section 260C.007, subdivision 6, clause (16), in order to deliver needed services. If the child is determined not to be safe, the agency and the county attorney shall take appropriate action as required under section 260C.503, subdivision 2.

(p) Persons who conduct assessments or investigations under this section shall take into account accepted child-rearing practices of the culture in which a child participates and accepted teacher discipline practices, which are not injurious to the child's health, welfare, and safety.

(q) "Accidental" means a sudden, not reasonably foreseeable, and unexpected occurrence or event which:

(1) is not likely to occur and could not have been prevented by exercise of due care; and

(2) if occurring while a child is receiving services from a facility, happens when the facility and the employee or person providing services in the facility are in compliance with the laws and rules relevant to the occurrence or event.

(r) "Nonmaltreatment mistake" means:

(1) at the time of the incident, the individual was performing duties identified in the center's child care program plan required under Minnesota Rules, part 9503.0045;

(2) the individual has not been determined responsible for a similar incident that resulted in a finding of maltreatment for at least seven years;

(3) the individual has not been determined to have committed a similar nonmaltreatment mistake under this paragraph for at least four years;

(4) any injury to a child resulting from the incident, if treated, is treated only with remedies that are available over the counter, whether ordered by a medical professional or not; and

(5) except for the period when the incident occurred, the facility and the individual providing services were both in compliance with all licensing requirements relevant to the incident.

This definition only applies to child care centers licensed under Minnesota Rules, chapter 9503. If clauses (1) to (5) apply, rather than making a determination of substantiated maltreatment by the individual, the commissioner of human services shall determine that a nonmaltreatment mistake was made by the individual.

Sec. 90.

Minnesota Statutes 2014, section 626.556, subdivision 3, is amended to read:

Subd. 3.

Persons mandated to reportnew text begin ; persons voluntarily reportingnew text end .

(a) A person who knows or has reason to believe a child is being neglected or physically or sexually abused, as defined in subdivision 2, or has been neglected or physically or sexually abused within the preceding three years, shall immediately report the information to the local welfare agency, agency responsible for assessing or investigating the report, police department, deleted text begin or thedeleted text end county sheriffnew text begin , tribal social services agency, or tribal police departmentnew text end if the person is:

(1) a professional or professional's delegate who is engaged in the practice of the healing arts, social services, hospital administration, psychological or psychiatric treatment, child care, education, correctional supervision, probation and correctional services, or law enforcement; or

(2) employed as a member of the clergy and received the information while engaged in ministerial duties, provided that a member of the clergy is not required by this subdivision to report information that is otherwise privileged under section 595.02, subdivision 1, paragraph (c).

deleted text begin The police department or the county sheriff, upon receiving a report, shall immediately notify the local welfare agency or agency responsible for assessing or investigating the report, orally and in writing. The local welfare agency, or agency responsible for assessing or investigating the report, upon receiving a report, shall immediately notify the local police department or the county sheriff orally and in writing. The county sheriff and the head of every local welfare agency, agency responsible for assessing or investigating reports, and police department shall each designate a person within their agency, department, or office who is responsible for ensuring that the notification duties of this paragraph and paragraph (b) are carried out. Nothing in this subdivision shall be construed to require more than one report from any institution, facility, school, or agency. deleted text end

(b) Any person may voluntarily report to the local welfare agency, agency responsible for assessing or investigating the report, police department, deleted text begin or thedeleted text end county sheriffnew text begin , tribal social services agency, or tribal police departmentnew text end if the person knows, has reason to believe, or suspects a child is being or has been neglected or subjected to physical or sexual abuse. deleted text begin The police department or the county sheriff, upon receiving a report, shall immediately notify the local welfare agency or agency responsible for assessing or investigating the report, orally and in writing. The local welfare agency or agency responsible for assessing or investigating the report, upon receiving a report, shall immediately notify the local police department or the county sheriff orally and in writing.deleted text end

(c) A person mandated to report physical or sexual child abuse or neglect occurring within a licensed facility shall report the information to the agency responsible for licensing the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or chapter 245D; or a nonlicensed personal care provider organization as defined in section 256B.0625, subdivision 19. A health or corrections agency receiving a report may request the local welfare agency to provide assistance pursuant to subdivisions 10, 10a, and 10b. A board or other entity whose licensees perform work within a school facility, upon receiving a complaint of alleged maltreatment, shall provide information about the circumstances of the alleged maltreatment to the commissioner of education. Section 13.03, subdivision 4, applies to data received by the commissioner of education from a licensing entity.

(d) deleted text begin Any person mandated to report shall receive a summary of the disposition of any report made by that reporter, including whether the case has been opened for child protection or other services, or if a referral has been made to a community organization, unless release would be detrimental to the best interests of the child. Any person who is not mandated to report shall, upon request to the local welfare agency, receive a concise summary of the disposition of any report made by that reporter, unless release would be detrimental to the best interests of the child.deleted text end new text begin Notification requirements under subdivision 10 apply to all reports received under this section.new text end

(e) For purposes of this section, "immediately" means as soon as possible but in no event longer than 24 hours.

Sec. 91.

Minnesota Statutes 2014, section 626.556, subdivision 6a, is amended to read:

Subd. 6a.

Failure to notify.

If a local welfare agency receives a report under subdivision 3, paragraph (a) or (b), and fails to notify the local police department or county sheriff as required by subdivision deleted text begin 3, paragraph (a) or (b)deleted text end new text begin 10new text end , the person within the agency who is responsible for ensuring that notification is made shall be subject to disciplinary action in keeping with the agency's existing policy or collective bargaining agreement on discipline of employees. If a local police department or a county sheriff receives a report under subdivision 3, paragraph (a) or (b), and fails to notify the local welfare agency as required by subdivision deleted text begin 3, paragraph (a) or (b)deleted text end new text begin 10new text end , the person within the police department or county sheriff's office who is responsible for ensuring that notification is made shall be subject to disciplinary action in keeping with the agency's existing policy or collective bargaining agreement on discipline of employees.

Sec. 92.

Minnesota Statutes 2014, section 626.556, subdivision 7, as amended by Laws 2015, chapter 4, section 2, is amended to read:

Subd. 7.

Report; information provided to parentnew text begin ; reporternew text end .

(a) An oral report shall be made immediately by telephone or otherwise. An oral report made by a person required under subdivision 3 to report shall be followed within 72 hours, exclusive of weekends and holidays, by a report in writing to the appropriate police department, the county sheriff, the agency responsible for assessing or investigating the report, or the local welfare agency.

new text begin (b) new text end The local welfare agency shall determine if the report is deleted text begin accepted for an assessment or investigationdeleted text end new text begin to be screened in or outnew text end as soon as possible but in no event longer than 24 hours after the report is received.new text begin When determining whether a report will be screened in or out, the agency receiving the report must consider, when relevant, all previous history, including reports that were screened out. The agency may communicate with treating professionals and individuals specified under subdivision 10, paragraph (i), clause (3), item (iii).new text end

deleted text begin (b)deleted text end new text begin (c)new text end Any report shall be of sufficient content to identify the child, any person believed to be responsible for the abuse or neglect of the child if the person is known, the nature and extent of the abuse or neglect and the name and address of the reporter. The local welfare agency or agency responsible for assessing or investigating the report shall accept a report made under subdivision 3 notwithstanding refusal by a reporter to provide the reporter's name or address as long as the report is otherwise sufficient under this paragraph. Written reports received by a police department or the county sheriff shall be forwarded immediately to the local welfare agency or the agency responsible for assessing or investigating the report. The police department or the county sheriff may keep copies of reports received by them. Copies of written reports received by a local welfare department or the agency responsible for assessing or investigating the report shall be forwarded immediately to the local police department or the county sheriff.

deleted text begin (c)deleted text end new text begin (d)new text end When requested, the agency responsible for assessing or investigating a report shall inform the reporter within ten days after the report was made, either orally or in writing, whether the report was accepted or not. If the responsible agency determines the report does not constitute a report under this section, the agency shall advise the reporter the report was screened out. new text begin Any person mandated to report shall receive a summary of the disposition of any report made by that reporter, including whether the case has been opened for child protection or other services, or if a referral has been made to a community organization, unless release would be detrimental to the best interests of the child. Any person who is not mandated to report shall, upon request to the local welfare agency, receive a concise summary of the disposition of any report made by that reporter, unless release would be detrimental to the best interests of the child.new text end

new text begin (e) Reports that are screened out must be maintained in accordance with subdivision 11c, paragraph (a). new text end

new text begin (f) A local welfare agency or agency responsible for investigating or assessing a report may use a screened-out report for making an offer of social services to the subjects of the screened-out report. A local welfare agency or agency responsible for evaluating a report alleging maltreatment of a child shall consider prior reports, including screened-out reports, to determine whether an investigation or family assessment must be conducted. new text end

deleted text begin (d)deleted text end new text begin (g)new text end Notwithstanding paragraph (a), the commissioner of education must inform the parent, guardian, or legal custodian of the child who is the subject of a report of alleged maltreatment in a school facility within ten days of receiving the report, either orally or in writing, whether the commissioner is assessing or investigating the report of alleged maltreatment.

deleted text begin (e)deleted text end new text begin (h)new text end Regardless of whether a report is made under this subdivision, as soon as practicable after a school receives information regarding an incident that may constitute maltreatment of a child in a school facility, the school shall inform the parent, legal guardian, or custodian of the child that an incident has occurred that may constitute maltreatment of the child, when the incident occurred, and the nature of the conduct that may constitute maltreatment.

deleted text begin (f)deleted text end new text begin (i)new text end A written copy of a report maintained by personnel of agencies, other than welfare or law enforcement agencies, which are subject to chapter 13 shall be confidential. An individual subject of the report may obtain access to the original report as provided by subdivision 11.

Sec. 93.

Minnesota Statutes 2014, section 626.556, is amended by adding a subdivision to read:

new text begin Subd. 7a. new text end

new text begin Guidance for screening reports. new text end

new text begin (a) Child protection staff, supervisors, and others involved in child protection screening shall follow the guidance provided in the child maltreatment screening guidelines issued by the commissioner of human services and, when notified by the commissioner, shall immediately implement updated procedures and protocols. new text end

new text begin (b) Any modifications to the screening guidelines must be preapproved by the commissioner of human services and must not be less protective of children than is mandated by statute. The county agency must consult with the county attorney before proposing modifications to the commissioner. The guidelines may provide additional protections for children but must not limit reports that are screened in or provide additional limits on consideration of reports that were screened out in making screening determinations. new text end

Sec. 94.

Minnesota Statutes 2014, section 626.556, subdivision 10, is amended to read:

Subd. 10.

Duties of local welfare agency and local law enforcement agency upon receipt of reportnew text begin ; mandatory notification between police or sheriff and agencynew text end .

(a) new text begin The police department or the county sheriff shall immediately notify the local welfare agency or agency responsible for child protection reports under this section orally and in writing when a report is received. The local welfare agency or agency responsible for child protection reports shall immediately notify the local police department or the county sheriff orally and in writing when a report is received. The county sheriff and the head of every local welfare agency, agency responsible for child protection reports, and police department shall each designate a person within their agency, department, or office who is responsible for ensuring that the notification duties of this paragraph are carried out. When the alleged maltreatment occurred on tribal land, the local welfare agency or agency responsible for child protection reports and the local police department or the county sheriff shall immediately notify the tribe's social services agency and tribal law enforcement orally and in writing when a report is received.new text end

new text begin (b) new text end Upon receipt of a report, the local welfare agency shall determine whether to conduct a family assessment or an investigation as appropriate to prevent or provide a remedy for child maltreatment. The local welfare agency:

(1) shall conduct an investigation on reports involving new text begin sexual abuse ornew text end substantial child endangerment;

(2) shall begin an immediate investigation if, at any time when it is using a family assessment response, it determines that there is reason to believe that new text begin sexual abuse or new text end substantial child endangerment or a serious threat to the child's safety exists;

(3) may conduct a family assessment for reports that do not allege new text begin sexual abuse or new text end substantial child endangerment. In determining that a family assessment is appropriate, the local welfare agency may consider issues of child safety, parental cooperation, and the need for an immediate response; and

(4) may conduct a family assessment on a report that was initially screened and assigned for an investigation. In determining that a complete investigation is not required, the local welfare agency must document the reason for terminating the investigation and notify the local law enforcement agency if the local law enforcement agency is conducting a joint investigation.

If the report alleges neglect, physical abuse, or sexual abuse by a parent, guardian, or individual functioning within the family unit as a person responsible for the child's care, or sexual abuse by a person with a significant relationship to the child when that person resides in the child's household or by a sibling, the local welfare agency shall immediately conduct a family assessment or investigation as identified in clauses (1) to (4). In conducting a family assessment or investigation, the local welfare agency shall gather information on the existence of substance abuse and domestic violence and offer services for purposes of preventing future child maltreatment, safeguarding and enhancing the welfare of the abused or neglected minor, and supporting and preserving family life whenever possible. If the report alleges a violation of a criminal statute involving sexual abuse, physical abuse, or neglect or endangerment, under section 609.378, the local law enforcement agency and local welfare agency shall coordinate the planning and execution of their respective investigation and assessment efforts to avoid a duplication of fact-finding efforts and multiple interviews. Each agency shall prepare a separate report of the results of its investigation new text begin or assessmentnew text end . In cases of alleged child maltreatment resulting in death, the local agency may rely on the fact-finding efforts of a law enforcement investigation to make a determination of whether or not maltreatment occurred. When necessary the local welfare agency shall seek authority to remove the child from the custody of a parent, guardian, or adult with whom the child is living. In performing any of these duties, the local welfare agency shall maintain appropriate records.

If the family assessment or investigation indicates there is a potential for abuse of alcohol or other drugs by the parent, guardian, or person responsible for the child's care, the local welfare agency shall conduct a chemical use assessment pursuant to Minnesota Rules, part 9530.6615.

deleted text begin (b)deleted text end new text begin (c) new text end When a local agency receives a report or otherwise has information indicating that a child who is a client, as defined in section 245.91, has been the subject of physical abuse, sexual abuse, or neglect at an agency, facility, or program as defined in section 245.91, it shall, in addition to its other duties under this section, immediately inform the ombudsman established under sections 245.91 to 245.97. The commissioner of education shall inform the ombudsman established under sections 245.91 to 245.97 of reports regarding a child defined as a client in section 245.91 that maltreatment occurred at a school as defined in sections 120A.05, subdivisions 9, 11, and 13, and 124D.10.

deleted text begin (c)deleted text end new text begin (d) new text end Authority of the local welfare agency responsible for assessing or investigating the child abuse or neglect report, the agency responsible for assessing or investigating the report, and of the local law enforcement agency for investigating the alleged abuse or neglect includes, but is not limited to, authority to interview, without parental consent, the alleged victim and any other minors who currently reside with or who have resided with the alleged offender. The interview may take place at school or at any facility or other place where the alleged victim or other minors might be found or the child may be transported to, and the interview conducted at, a place appropriate for the interview of a child designated by the local welfare agency or law enforcement agency. The interview may take place outside the presence of the alleged offender or parent, legal custodian, guardian, or school official. For family assessments, it is the preferred practice to request a parent or guardian's permission to interview the child prior to conducting the child interview, unless doing so would compromise the safety assessment. Except as provided in this paragraph, the parent, legal custodian, or guardian shall be notified by the responsible local welfare or law enforcement agency no later than the conclusion of the investigation or assessment that this interview has occurred. Notwithstanding rule 32 of the Minnesota Rules of Procedure for Juvenile Courts, the juvenile court may, after hearing on an ex parte motion by the local welfare agency, order that, where reasonable cause exists, the agency withhold notification of this interview from the parent, legal custodian, or guardian. If the interview took place or is to take place on school property, the order shall specify that school officials may not disclose to the parent, legal custodian, or guardian the contents of the notification of intent to interview the child on school property, as provided under this paragraph, and any other related information regarding the interview that may be a part of the child's school record. A copy of the order shall be sent by the local welfare or law enforcement agency to the appropriate school official.

deleted text begin (d)deleted text end new text begin (e)new text end When the local welfare, local law enforcement agency, or the agency responsible for assessing or investigating a report of maltreatment determines that an interview should take place on school property, written notification of intent to interview the child on school property must be received by school officials prior to the interview. The notification shall include the name of the child to be interviewed, the purpose of the interview, and a reference to the statutory authority to conduct an interview on school property. For interviews conducted by the local welfare agency, the notification shall be signed by the chair of the local social services agency or the chair's designee. The notification shall be private data on individuals subject to the provisions of this paragraph. School officials may not disclose to the parent, legal custodian, or guardian the contents of the notification or any other related information regarding the interview until notified in writing by the local welfare or law enforcement agency that the investigation or assessment has been concluded, unless a school employee or agent is alleged to have maltreated the child. Until that time, the local welfare or law enforcement agency or the agency responsible for assessing or investigating a report of maltreatment shall be solely responsible for any disclosures regarding the nature of the assessment or investigation.

Except where the alleged offender is believed to be a school official or employee, the time and place, and manner of the interview on school premises shall be within the discretion of school officials, but the local welfare or law enforcement agency shall have the exclusive authority to determine who may attend the interview. The conditions as to time, place, and manner of the interview set by the school officials shall be reasonable and the interview shall be conducted not more than 24 hours after the receipt of the notification unless another time is considered necessary by agreement between the school officials and the local welfare or law enforcement agency. Where the school fails to comply with the provisions of this paragraph, the juvenile court may order the school to comply. Every effort must be made to reduce the disruption of the educational program of the child, other students, or school staff when an interview is conducted on school premises.

deleted text begin (e)deleted text end new text begin (f)new text end Where the alleged offender or a person responsible for the care of the alleged victim or other minor prevents access to the victim or other minor by the local welfare agency, the juvenile court may order the parents, legal custodian, or guardian to produce the alleged victim or other minor for questioning by the local welfare agency or the local law enforcement agency outside the presence of the alleged offender or any person responsible for the child's care at reasonable places and times as specified by court order.

deleted text begin (f)deleted text end new text begin (g)new text end Before making an order under paragraph deleted text begin (e)deleted text end new text begin (f)new text end , the court shall issue an order to show cause, either upon its own motion or upon a verified petition, specifying the basis for the requested interviews and fixing the time and place of the hearing. The order to show cause shall be served personally and shall be heard in the same manner as provided in other cases in the juvenile court. The court shall consider the need for appointment of a guardian ad litem to protect the best interests of the child. If appointed, the guardian ad litem shall be present at the hearing on the order to show cause.

deleted text begin (g)deleted text end new text begin (h)new text end The commissioner of human services, the ombudsman for mental health and developmental disabilities, the local welfare agencies responsible for investigating reports, the commissioner of education, and the local law enforcement agencies have the right to enter facilities as defined in subdivision 2 and to inspect and copy the facility's records, including medical records, as part of the investigation. Notwithstanding the provisions of chapter 13, they also have the right to inform the facility under investigation that they are conducting an investigation, to disclose to the facility the names of the individuals under investigation for abusing or neglecting a child, and to provide the facility with a copy of the report and the investigative findings.

deleted text begin (h)deleted text end new text begin (i)new text end The local welfare agency responsible for conducting a family assessment or investigation shall collect available and relevant information to determine child safety, risk of subsequent child maltreatment, and family strengths and needs and share not public information with an Indian's tribal social services agency without violating any law of the state that may otherwise impose duties of confidentiality on the local welfare agency in order to implement the tribal state agreement. The local welfare agency or the agency responsible for investigating the report shall collect available and relevant information to ascertain whether maltreatment occurred and whether protective services are needed. Information collected includes, when relevant, information with regard to the person reporting the alleged maltreatment, including the nature of the reporter's relationship to the child and to the alleged offender, and the basis of the reporter's knowledge for the report; the child allegedly being maltreated; the alleged offender; the child's caretaker; and other collateral sources having relevant information related to the alleged maltreatment. The local welfare agency or the agency responsible for investigating the report may make a determination of no maltreatment early in an investigation, and close the case and retain immunity, if the collected information shows no basis for a full investigation.

Information relevant to the assessment or investigation must be asked for, and may include:

(1) the child's sex and agedeleted text begin ,deleted text end new text begin ;new text end prior reports of maltreatment, new text begin including any maltreatment reports that were screened out and not accepted for assessment or investigation; new text end information relating to developmental functioningdeleted text begin ,deleted text end new text begin ;new text end credibility of the child's statementdeleted text begin ,deleted text end new text begin ;new text end and whether the information provided under this clause is consistent with other information collected during the course of the assessment or investigation;

(2) the alleged offender's age, a record check for prior reports of maltreatment, and criminal charges and convictions. The local welfare agency or the agency responsible for assessing or investigating the report must provide the alleged offender with an opportunity to make a statement. The alleged offender may submit supporting documentation relevant to the assessment or investigation;

(3) collateral source information regarding the alleged maltreatment and care of the child. Collateral information includes, when relevant: (i) a medical examination of the child; (ii) prior medical records relating to the alleged maltreatment or the care of the child maintained by any facility, clinic, or health care professional and an interview with the treating professionals; and (iii) interviews with the child's caretakers, including the child's parent, guardian, foster parent, child care provider, teachers, counselors, family members, relatives, and other persons who may have knowledge regarding the alleged maltreatment and the care of the child; and

(4) information on the existence of domestic abuse and violence in the home of the child, and substance abuse.

Nothing in this paragraph precludes the local welfare agency, the local law enforcement agency, or the agency responsible for assessing or investigating the report from collecting other relevant information necessary to conduct the assessment or investigation. Notwithstanding sections 13.384 or 144.291 to 144.298, the local welfare agency has access to medical data and records for purposes of clause (3). Notwithstanding the data's classification in the possession of any other agency, data acquired by the local welfare agency or the agency responsible for assessing or investigating the report during the course of the assessment or investigation are private data on individuals and must be maintained in accordance with subdivision 11. Data of the commissioner of education collected or maintained during and for the purpose of an investigation of alleged maltreatment in a school are governed by this section, notwithstanding the data's classification as educational, licensing, or personnel data under chapter 13.

In conducting an assessment or investigation involving a school facility as defined in subdivision 2, paragraph (i), the commissioner of education shall collect investigative reports and data that are relevant to a report of maltreatment and are from local law enforcement and the school facility.

deleted text begin (i)deleted text end new text begin (j)new text end Upon receipt of a report, the local welfare agency shall conduct a face-to-face contact with the child reported to be maltreated and with the child's primary caregiver sufficient to complete a safety assessment and ensure the immediate safety of the child. The face-to-face contact with the child and primary caregiver shall occur immediately if new text begin sexual abuse ornew text end substantial child endangerment is alleged and within five calendar days for all other reports. If the alleged offender was not already interviewed as the primary caregiver, the local welfare agency shall also conduct a face-to-face interview with the alleged offender in the early stages of the assessment or investigation. At the initial contact, the local child welfare agency or the agency responsible for assessing or investigating the report must inform the alleged offender of the complaints or allegations made against the individual in a manner consistent with laws protecting the rights of the person who made the report. The interview with the alleged offender may be postponed if it would jeopardize an active law enforcement investigation.

deleted text begin (j)deleted text end new text begin (k)new text end When conducting an investigation, the local welfare agency shall use a question and answer interviewing format with questioning as nondirective as possible to elicit spontaneous responses. For investigations only, the following interviewing methods and procedures must be used whenever possible when collecting information:

(1) audio recordings of all interviews with witnesses and collateral sources; and

(2) in cases of alleged sexual abuse, audio-video recordings of each interview with the alleged victim and child witnesses.

deleted text begin (k)deleted text end new text begin (l)new text end In conducting an assessment or investigation involving a school facility as defined in subdivision 2, paragraph (i), the commissioner of education shall collect available and relevant information and use the procedures in paragraphs deleted text begin (i),deleted text end new text begin (j) andnew text end (k), and subdivision 3d, except that the requirement for face-to-face observation of the child and face-to-face interview of the alleged offender is to occur in the initial stages of the assessment or investigation provided that the commissioner may also base the assessment or investigation on investigative reports and data received from the school facility and local law enforcement, to the extent those investigations satisfy the requirements of paragraphs deleted text begin (i) anddeleted text end new text begin (j) andnew text end (k), and subdivision 3d.

Sec. 95.

Minnesota Statutes 2014, section 626.556, subdivision 10e, is amended to read:

Subd. 10e.

Determinations.

(a) The local welfare agency shall conclude the family assessment or the investigation within 45 days of the receipt of a report. The conclusion of the assessment or investigation may be extended to permit the completion of a criminal investigation or the receipt of expert information requested within 45 days of the receipt of the report.

(b) After conducting a family assessment, the local welfare agency shall determine whether services are needed to address the safety of the child and other family members and the risk of subsequent maltreatment.

(c) After conducting an investigation, the local welfare agency shall make two determinations: first, whether maltreatment has occurred; and second, whether child protective services are needed. No determination of maltreatment shall be made when the alleged perpetrator is a child under the age of ten.

(d) If the commissioner of education conducts an assessment or investigation, the commissioner shall determine whether maltreatment occurred and what corrective or protective action was taken by the school facility. If a determination is made that maltreatment has occurred, the commissioner shall report to the employer, the school board, and any appropriate licensing entity the determination that maltreatment occurred and what corrective or protective action was taken by the school facility. In all other cases, the commissioner shall inform the school board or employer that a report was received, the subject of the report, the date of the initial report, the category of maltreatment alleged as defined in paragraph (f), the fact that maltreatment was not determined, and a summary of the specific reasons for the determination.

(e) When maltreatment is determined in an investigation involving a facility, the investigating agency shall also determine whether the facility or individual was responsible, or whether both the facility and the individual were responsible for the maltreatment using the mitigating factors in paragraph (i). Determinations under this subdivision must be made based on a preponderance of the evidence and are private data on individuals or nonpublic data as maintained by the commissioner of education.

(f) For the purposes of this subdivision, "maltreatment" means any of the following acts or omissions:

(1) physical abuse as defined in subdivision 2, paragraph (g);

(2) neglect as defined in subdivision 2, paragraph (f);

(3) sexual abuse as defined in subdivision 2, paragraph (d);

(4) mental injury as defined in subdivision 2, paragraph (m); or

(5) maltreatment of a child in a facility as defined in subdivision 2, paragraph (i).

(g) For the purposes of this subdivision, a determination that child protective services are needed means that the local welfare agency has documented conditions during the assessment or investigation sufficient to cause a child protection worker, as defined in section 626.559, subdivision 1, to conclude that a child is at significant risk of maltreatment if protective intervention is not provided and that the individuals responsible for the child's care have not taken or are not likely to take actions to protect the child from maltreatment or risk of maltreatment.

(h) This subdivision does not mean that maltreatment has occurred solely because the child's parent, guardian, or other person responsible for the child's care in good faith selects and depends upon spiritual means or prayer for treatment or care of disease or remedial care of the child, in lieu of medical care. However, if lack of medical care may result in serious danger to the child's health, the local welfare agency may ensure that necessary medical services are provided to the child.

(i) When determining whether the facility or individual is the responsible party, or whether both the facility and the individual are responsible for determined maltreatment in a facility, the investigating agency shall consider at least the following mitigating factors:

(1) whether the actions of the facility or the individual caregivers were according to, and followed the terms of, an erroneous physician order, prescription, individual care plan, or directive; however, this is not a mitigating factor when the facility or caregiver was responsible for the issuance of the erroneous order, prescription, individual care plan, or directive or knew or should have known of the errors and took no reasonable measures to correct the defect before administering care;

(2) comparative responsibility between the facility, other caregivers, and requirements placed upon an employee, including the facility's compliance with related regulatory standards and the adequacy of facility policies and procedures, facility training, an individual's participation in the training, the caregiver's supervision, and facility staffing levels and the scope of the individual employee's authority and discretion; and

(3) whether the facility or individual followed professional standards in exercising professional judgment.

The evaluation of the facility's responsibility under clause (2) must not be based on the completeness of the risk assessment or risk reduction plan required under section 245A.66, but must be based on the facility's compliance with the regulatory standards for policies and procedures, training, and supervision as cited in Minnesota Statutes and Minnesota Rules.

(j) Notwithstanding paragraph (i), when maltreatment is determined to have been committed by an individual who is also the facility license holder, both the individual and the facility must be determined responsible for the maltreatment, and both the background study disqualification standards under section 245C.15, subdivision 4, and the licensing actions under sections 245A.06 or 245A.07 apply.

deleted text begin (k) Individual counties may implement more detailed definitions or criteria that indicate which allegations to investigate, as long as a county's policies are consistent with the definitions in the statutes and rules and are approved by the county board. Each local welfare agency shall periodically inform mandated reporters under subdivision 3 who work in the county of the definitions of maltreatment in the statutes and rules and any additional definitions or criteria that have been approved by the county board. deleted text end

Sec. 96.

Minnesota Statutes 2014, section 626.556, subdivision 10j, is amended to read:

Subd. 10j.

Release of data to mandated reporters.

new text begin (a)new text end A local social services or child protection agency, or the agency responsible for assessing or investigating the report of maltreatment, deleted text begin maydeleted text end new text begin shall new text end provide relevant private data on individuals obtained under this section to new text begin a new text end mandated deleted text begin reportersdeleted text end new text begin reporter who made the report and new text end who deleted text begin havedeleted text end new text begin has new text end an ongoing responsibility for the health, education, or welfare of a child affected by the data, new text begin unless the agency determines that providing the data would not be new text end in the best interests of the child. new text begin The agency may provide the data to other mandated reporters with ongoing responsibility for the health, education, or welfare of the child. new text end Mandated reporters with ongoing responsibility for the health, education, or welfare of a child affected by the data include the child's teachers or other appropriate school personnel, foster parents, health care providers, respite care workers, therapists, social workers, child care providers, residential care staff, crisis nursery staff, probation officers, and court services personnel. Under this section, a mandated reporter need not have made the report to be considered a person with ongoing responsibility for the health, education, or welfare of a child affected by the data. Data provided under this section must be limited to data pertinent to the individual's responsibility for caring for the child.

new text begin (b) A reporter who receives private data on individuals under this subdivision must treat the data according to that classification, regardless of whether the reporter is an employee of a government entity. The remedies and penalties under sections 13.08 and 13.09 apply if a reporter releases data in violation of this section or other law. new text end

Sec. 97.

Minnesota Statutes 2014, section 626.556, subdivision 10m, is amended to read:

Subd. 10m.

Provision of child protective servicesnew text begin ; consultation with county attorneynew text end .

new text begin (a) new text end The local welfare agency shall create a written plan, in collaboration with the family whenever possible, within 30 days of the determination that child protective services are needed or upon joint agreement of the local welfare agency and the family that family support and preservation services are needed. Child protective services for a family are voluntary unless ordered by the court.

new text begin (b) The local welfare agency shall consult with the county attorney to determine the appropriateness of filing a petition alleging the child is in need of protection or services under section 260C.007, subdivision 6, if: new text end

new text begin (1) the family does not accept or comply with a plan for child protective services; new text end

new text begin (2) voluntary child protective services may not provide sufficient protection for the child; or new text end

new text begin (3) the family is not cooperating with an investigation or assessment. new text end

Sec. 98.

Minnesota Statutes 2014, section 626.556, subdivision 11c, is amended to read:

Subd. 11c.

Welfare, court services agency, and school records maintained.

Notwithstanding sections 138.163 and 138.17, records maintained or records derived from reports of abuse by local welfare agencies, agencies responsible for assessing or investigating the report, court services agencies, or schools under this section shall be destroyed as provided in paragraphs (a) to (d) by the responsible authority.

(a) For new text begin reports alleging child maltreatment that were not accepted for assessment or investigation, new text end family assessment casesnew text begin ,new text end and cases where an investigation results in no determination of maltreatment or the need for child protective services, the deleted text begin assessment or investigationdeleted text end records must be maintained for a period of deleted text begin fourdeleted text end new text begin fivenew text end years after the datenew text begin the report was not accepted for assessment or investigation ornew text end of the final entry in the case record. new text begin Records of reports that were not accepted must contain sufficient information to identify the subjects of the report, the nature of the alleged maltreatment, and the reasons as to why the report was not accepted. new text end Records under this paragraph may not be used for employment, background checks, or purposes other than to assist in future new text begin screening decisions and new text end risk and safety assessments.

(b) All records relating to reports which, upon investigation, indicate either maltreatment or a need for child protective services shall be maintained for ten years after the date of the final entry in the case record.

(c) All records regarding a report of maltreatment, including any notification of intent to interview which was received by a school under subdivision 10, paragraph (d), shall be destroyed by the school when ordered to do so by the agency conducting the assessment or investigation. The agency shall order the destruction of the notification when other records relating to the report under investigation or assessment are destroyed under this subdivision.

(d) Private or confidential data released to a court services agency under subdivision 10h must be destroyed by the court services agency when ordered to do so by the local welfare agency that released the data. The local welfare agency or agency responsible for assessing or investigating the report shall order destruction of the data when other records relating to the assessment or investigation are destroyed under this subdivision.

deleted text begin (e) For reports alleging child maltreatment that were not accepted for assessment or investigation, counties shall maintain sufficient information to identify repeat reports alleging maltreatment of the same child or children for 365 days from the date the report was screened out. The commissioner of human services shall specify to the counties the minimum information needed to accomplish this purpose. Counties shall enter this data into the state social services information system. deleted text end

Sec. 99.

Minnesota Statutes 2014, section 626.556, is amended by adding a subdivision to read:

new text begin Subd. 16. new text end

new text begin Commissioner's duty to provide oversight; quality assurance reviews; annual summary of reviews. new text end

new text begin (a) The commissioner shall develop a plan to perform quality assurance reviews of local welfare agency screening practices and decisions. The commissioner shall provide oversight and guidance to counties to ensure consistent application of screening guidelines, thorough and appropriate screening decisions, and correct documentation and maintenance of reports. Quality assurance reviews must begin no later than September 30, 2015. new text end

new text begin (b) The commissioner shall produce an annual report of the summary results of the reviews. The report must only contain aggregate data and may not include any data that could be used to personally identify any subject whose data is included in the report. The report is public information and must be provided to the chairs and ranking minority members of the legislative committees having jurisdiction over child protection issues. new text end

Sec. 100.

Minnesota Statutes 2014, section 626.559, is amended by adding a subdivision to read:

new text begin Subd. 1b. new text end

new text begin Background studies. new text end

new text begin (a) County employees hired on or after July 1, 2015, who have responsibility for child protection duties or current county employees who are assigned new child protection duties on or after July 1, 2015, are required to undergo a background study. A county may complete these background studies by either: new text end

new text begin (1) use of the Department of Human Services NETStudy 2.0 system according to sections 245C.03 and 245C.10; or new text end

new text begin (2) an alternative process defined by the county. new text end

new text begin (b) County social services agencies and local welfare agencies must initiate background studies before an individual begins a position allowing direct contact with persons served by the agency. new text end

Sec. 101.

Laws 2014, chapter 189, section 5, is amended to read:

Sec. 5.

Minnesota Statutes 2012, section 518C.201, is amended to read:

518C.201 BASES FOR JURISDICTION OVER NONRESIDENT.

(a) In a proceeding to establishdeleted text begin ,deleted text end new text begin ornew text end enforcedeleted text begin , or modifydeleted text end a support order or to determine parentage of a child, a tribunal of this state may exercise personal jurisdiction over a nonresident individual or the individual's guardian or conservator if:

(1) the individual is personally served with a summons or comparable document within this state;

(2) the individual submits to the jurisdiction of this state by consent, by entering a general appearance, or by filing a responsive document having the effect of waiving any contest to personal jurisdiction;

(3) the individual resided with the child in this state;

(4) the individual resided in this state and provided prenatal expenses or support for the child;

(5) the child resides in this state as a result of the acts or directives of the individual;

(6) the individual engaged in sexual intercourse in this state and the child may have been conceived by that act of intercourse;

(7) the individual asserted parentage of a child under sections 257.51 to 257.75; or

(8) there is any other basis consistent with the constitutions of this state and the United States for the exercise of personal jurisdiction.

(b) The bases of personal jurisdiction in paragraph (a) or in any other law of this state may not be used to acquire personal jurisdiction for a tribunal of this state to modify a child support order of another state unless the requirements of section 518C.611 are met, or, in the case of a foreign support order, unless the requirements of section 518C.615 are met.

Sec. 102.

Laws 2014, chapter 189, section 9, is amended to read:

Sec. 9.

Minnesota Statutes 2012, section 518C.205, is amended to read:

518C.205 CONTINUING, EXCLUSIVE JURISDICTION TO MODIFY CHILD SUPPORT ORDER.

(a) A tribunal of this state that has issued a support order consistent with the law of this state has and shall exercise continuing, exclusive jurisdiction to modify its child support order if the order is the controlling order and:

(1) at the time of the filing of a request for modification this state is the residence of the obligor, the individual obligee, or the child for whose benefit the support order is issued; or

(2) even if this state is not the residence of the obligor, the individual obligee, or the child for whose benefit the support order is issued, the parties consent in a record or in open court that the tribunal of this state may continue to exercise jurisdiction to modify its order.

(b) A tribunal of this state that has issued a child support order consistent with the law of this state may not exercise continuing, exclusive jurisdiction to modify the order if:

(1) all of the parties who are individuals file consent in a record with the tribunal of this state that a tribunal of another state that has jurisdiction over at least one of the parties who is an individual or that is located in the state of residence of the child may modify the order and assume continuing, exclusive jurisdiction; or

(2) its order is not the controlling order.

(c) If a tribunal of another state has issued a child support order pursuant to deleted text begin this chapter or a law substantially similar to this chapterdeleted text end new text begin the Uniform Interstate Family Support Act new text end which modifies a child support order of a tribunal of this state, tribunals of this state shall recognize the continuing, exclusive jurisdiction of the tribunal of the other state.

(d) A tribunal of this state that lacks continuing, exclusive jurisdiction to modify a child support order may serve as an initiating tribunal to request a tribunal of another state to modify a support order issued in that state.

(e) A temporary support order issued ex parte or pending resolution of a jurisdictional conflict does not create continuing, exclusive jurisdiction in the issuing tribunal.

Sec. 103.

Laws 2014, chapter 189, section 10, is amended to read:

Sec. 10.

Minnesota Statutes 2012, section 518C.206, is amended to read:

518C.206 deleted text begin ENFORCEMENT AND MODIFICATION OF SUPPORT ORDER BY TRIBUNAL HAVINGdeleted text end CONTINUING JURISDICTIONnew text begin TO ENFORCE CHILD SUPPORT ORDERnew text end .

(a) A tribunal of this state that has issued a child support order consistent with the law of this state may serve as an initiating tribunal to request a tribunal of another state to enforce:

(1) the order if the order is the controlling order and has not been modified by a tribunal of another state that assumed jurisdiction pursuant to deleted text begin this chapter or a law substantially similar to this chapterdeleted text end new text begin the Uniform Interstate Family Support Actnew text end ; or

(2) a money judgment for arrears of support and interest on the order accrued before a determination that an order of a tribunal of another state is the controlling order.

(b) A tribunal of this state having continuingdeleted text begin , exclusivedeleted text end jurisdiction over a support order may act as a responding tribunal to enforce the order.

Sec. 104.

Laws 2014, chapter 189, section 11, is amended to read:

Sec. 11.

Minnesota Statutes 2012, section 518C.207, is amended to read:

518C.207 deleted text begin RECOGNITIONdeleted text end new text begin DETERMINATIONnew text end OF CONTROLLING CHILD SUPPORT ORDER.

(a) If a proceeding is brought under this chapter and only one tribunal has issued a child support order, the order of that tribunal deleted text begin is controllingdeleted text end new text begin controlsnew text end and must be recognized.

(b) If a proceeding is brought under this chapter, and two or more child support orders have been issued by tribunals of this state, another state, or a foreign country with regard to the same obligor and child, a tribunal of this state having personal jurisdiction over both the obligor and the individual obligee shall apply the following rules and by order shall determine which order controls and must be recognized:

(1) If only one of the tribunals would have continuing, exclusive jurisdiction under this chapter, the order of that tribunal deleted text begin is controllingdeleted text end new text begin controlsnew text end .

(2) If more than one of the tribunals would have continuing, exclusive jurisdiction under this chapter:

(i) an order issued by a tribunal in the current home state of the child controls; or

(ii) if an order has not been issued in the current home state of the child, the order most recently issued controls.

(3) If none of the tribunals would have continuing, exclusive jurisdiction under this chapter, the tribunal of this state shall issue a child support order, which controls.

(c) If two or more child support orders have been issued for the same obligor and child, upon request of a party who is an individual or that is a support enforcement agency, a tribunal of this state having personal jurisdiction over both the obligor and the obligee who is an individual shall determine which order controls under paragraph (b). The request may be filed with a registration for enforcement or registration for modification pursuant to sections 518C.601 to 518C.616, or may be filed as a separate proceeding.

(d) A request to determine which is the controlling order must be accompanied by a copy of every child support order in effect and the applicable record of payments. The requesting party shall give notice of the request to each party whose rights may be affected by the determination.

(e) The tribunal that issued the controlling order under paragraph (a), (b), or (c) has continuing jurisdiction to the extent provided in section 518C.205, or 518C.206.

(f) A tribunal of this state which determines by order which is the controlling order under paragraph (b), clause (1) or (2), or paragraph (c), or which issues a new controlling child support order under paragraph (b), clause (3), shall state in that order:

(1) the basis upon which the tribunal made its determination;

(2) the amount of prospective support, if any; and

(3) the total amount of consolidated arrears and accrued interest, if any, under all of the orders after all payments made are credited as provided by section 518C.209.

(g) Within 30 days after issuance of the order determining which is the controlling order, the party obtaining that order shall file a certified copy of it with each tribunal that issued or registered an earlier order of child support. A party or support enforcement agency obtaining the order that fails to file a certified copy is subject to appropriate sanctions by a tribunal in which the issue of failure to file arises. The failure to file does not affect the validity or enforceability of the controlling order.

(h) An order that has been determined to be the controlling order, or a judgment for consolidated arrears of support and interest, if any, made pursuant to this section must be recognized in proceedings under this chapter.

Sec. 105.

Laws 2014, chapter 189, section 16, is amended to read:

Sec. 16.

Minnesota Statutes 2012, section 518C.301, is amended to read:

518C.301 PROCEEDINGS UNDER THIS CHAPTER.

(a) Except as otherwise provided in this chapter, sections 518C.301 to 518C.319 apply to all proceedings under this chapter.

deleted text begin (b) This chapter provides for the following proceedings: deleted text end

deleted text begin (1) establishment of an order for spousal support or child support pursuant to section 518C.401; deleted text end

deleted text begin (2) enforcement of a support order and income-withholding order of another state or a foreign country without registration pursuant to sections 518C.501 and 518C.502; deleted text end

deleted text begin (3) registration of an order for spousal support or child support of another state or a foreign country for enforcement pursuant to sections 518C.601 to 518C.612; deleted text end

deleted text begin (4) modification of an order for child support or spousal support issued by a tribunal of this state pursuant to sections 518C.203 to 518C.206; deleted text end

deleted text begin (5) registration of an order for child support of another state or a foreign country for modification pursuant to sections 518C.601 to 518C.612; deleted text end

deleted text begin (6) determination of parentage of a child pursuant to section 518C.701; and deleted text end

deleted text begin (7) assertion of jurisdiction over nonresidents pursuant to sections 518C.201 and 518C.202. deleted text end

deleted text begin (c)deleted text end new text begin (b)new text end An individual petitioner or a support enforcement agency may commence a proceeding authorized under this chapter by filing a petition in an initiating tribunal for forwarding to a responding tribunal or by filing a petition or a comparable pleading directly in a tribunal of another state or a foreign country which has or can obtain personal jurisdiction over the respondent.

Sec. 106.

Laws 2014, chapter 189, section 17, is amended to read:

Sec. 17.

Minnesota Statutes 2012, section 518C.303, is amended to read:

518C.303 APPLICATION OF LAW OF THIS STATE.

Except as otherwise provided by this chapter, a responding tribunal of this state shall:

(1) apply the procedural and substantive lawdeleted text begin , including the rules on choice of law, deleted text end generally applicable to similar proceedings originating in this state and may exercise all powers and provide all remedies available in those proceedings; and

(2) determine the duty of support and the amount payable in accordance with the law and support guidelines of this state.

Sec. 107.

Laws 2014, chapter 189, section 18, is amended to read:

Sec. 18.

Minnesota Statutes 2012, section 518C.304, is amended to read:

518C.304 DUTIES OF INITIATING TRIBUNAL.

(a) Upon the filing of a petition authorized by this chapter, an initiating tribunal of this state shall forward the petition and its accompanying documents:

(1) to the responding tribunal or appropriate support enforcement agency in the responding state; or

(2) if the identity of the responding tribunal is unknown, to the state information agency of the responding state with a request that they be forwarded to the appropriate tribunal and that receipt be acknowledged.

(b) If requested by the responding tribunal, a tribunal of this state shall issue a certificate or other documents and make findings required by the law of the responding state. If the responding tribunal is in a foreign country, new text begin upon request new text end the tribunal of this state shall specify the amount of support sought, convert that amount into the equivalent amount in the foreign currency under applicable official or market exchange rate as publicly reported, and provide other documents necessary to satisfy the requirements of the responding foreign tribunal.

Sec. 108.

Laws 2014, chapter 189, section 19, is amended to read:

Sec. 19.

Minnesota Statutes 2012, section 518C.305, is amended to read:

518C.305 DUTIES AND POWERS OF RESPONDING TRIBUNAL.

(a) When a responding tribunal of this state receives a petition or comparable pleading from an initiating tribunal or directly pursuant to section 518C.301, paragraph deleted text begin (c) deleted text end new text begin (b)new text end , it shall cause the petition or pleading to be filed and notify the petitioner where and when it was filed.

(b) A responding tribunal of this state, to the extent deleted text begin otherwise authorized bydeleted text end new text begin not prohibited by othernew text end law, may do one or more of the following:

(1) establish or enforce a support order, modify a child support order, determine the controlling child support order, or to determine parentage of a child;

(2) order an obligor to comply with a support order, specifying the amount and the manner of compliance;

(3) order income withholding;

(4) determine the amount of any arrearages, and specify a method of payment;

(5) enforce orders by civil or criminal contempt, or both;

(6) set aside property for satisfaction of the support order;

(7) place liens and order execution on the obligor's property;

(8) order an obligor to keep the tribunal informed of the obligor's current residential address, electronic mail address, telephone number, employer, address of employment, and telephone number at the place of employment;

(9) issue a bench warrant for an obligor who has failed after proper notice to appear at a hearing ordered by the tribunal and enter the bench warrant in any local and state computer systems for criminal warrants;

(10) order the obligor to seek appropriate employment by specified methods;

(11) award reasonable attorney's fees and other fees and costs; and

(12) grant any other available remedy.

(c) A responding tribunal of this state shall include in a support order issued under this chapter, or in the documents accompanying the order, the calculations on which the support order is based.

(d) A responding tribunal of this state may not condition the payment of a support order issued under this chapter upon compliance by a party with provisions for visitation.

(e) If a responding tribunal of this state issues an order under this chapter, the tribunal shall send a copy of the order to the petitioner and the respondent and to the initiating tribunal, if any.

(f) If requested to enforce a support order, arrears, or judgment or modify a support order stated in a foreign currency, a responding tribunal of this state shall convert the amount stated in the foreign currency to the equivalent amount in dollars under the applicable official or market exchange rate as publicly reported.

Sec. 109.

Laws 2014, chapter 189, section 23, is amended to read:

Sec. 23.

Minnesota Statutes 2012, section 518C.310, is amended to read:

518C.310 DUTIES OF STATE INFORMATION AGENCY.

(a) The unit within the Department of Human Services that receives and disseminates incoming interstate actions under title IV-D of the Social Security Act is the State Information Agency under this chapter.

(b) The State Information Agency shall:

(1) compile and maintain a current list, including addresses, of the tribunals in this state which have jurisdiction under this chapter and any support enforcement agencies in this state and transmit a copy to the state information agency of every other state;

(2) maintain a register of new text begin names and addresses of new text end tribunals and support enforcement agencies received from other states;

(3) forward to the appropriate tribunal in the place in this state in which the individual obligee or the obligor resides, or in which the obligor's property is believed to be located, all documents concerning a proceeding under this chapter received from another state or a foreign country; and

(4) obtain information concerning the location of the obligor and the obligor's property within this state not exempt from execution, by such means as postal verification and federal or state locator services, examination of telephone directories, requests for the obligor's address from employers, and examination of governmental records, including, to the extent not prohibited by other law, those relating to real property, vital statistics, law enforcement, taxation, motor vehicles, driver's licenses, and Social Security.

Sec. 110.

Laws 2014, chapter 189, section 24, is amended to read:

Sec. 24.

Minnesota Statutes 2012, section 518C.311, is amended to read:

518C.311 PLEADINGS AND ACCOMPANYING DOCUMENTS.

(a) A petitioner seeking to establish or modify a support order, determine parentage of a child, or register and modify a support order of a tribunal of another state or a foreign country, in a proceeding under this chapter must file a petition. Unless otherwise ordered under section 518C.312, the petition or accompanying documents must provide, so far as known, the name, residential address, and Social Security numbers of the obligor and the obligeenew text begin or parent and alleged parentnew text end , and the name, sex, residential address, Social Security number, and date of birth of each child for whom support is sought or whose deleted text begin parenthooddeleted text end new text begin parentagenew text end is to be determined. new text begin Unless filed at the time of registration, new text end the petition must be accompanied by a deleted text begin certifieddeleted text end copy of any support order deleted text begin in effectdeleted text end new text begin known to have been issued by another tribunalnew text end . The petition may include any other information that may assist in locating or identifying the respondent.

(b) The petition must specify the relief sought. The petition and accompanying documents must conform substantially with the requirements imposed by the forms mandated by federal law for use in cases filed by a support enforcement agency.

Sec. 111.

Laws 2014, chapter 189, section 27, is amended to read:

Sec. 27.

Minnesota Statutes 2012, section 518C.314, is amended to read:

518C.314 LIMITED IMMUNITY OF PETITIONER.

(a) Participation by a petitioner in a proceeding under this chapter before a responding tribunal, whether in person, by private attorney, or through services provided by the support enforcement agency, does not confer personal jurisdiction over the petitioner in another proceeding.

(b) A petitioner is not amenable to service of civil process while physically present in this state to participate in a proceeding under this chapter.

(c) The immunity granted by this section does not extend to civil litigation based on acts unrelated to a proceeding under this chapter committed by a party while new text begin physically new text end present in this state to participate in the proceeding.

Sec. 112.

Laws 2014, chapter 189, section 28, is amended to read:

Sec. 28.

Minnesota Statutes 2012, section 518C.316, is amended to read:

518C.316 SPECIAL RULES OF EVIDENCE AND PROCEDURE.

(a) The physical presence of deleted text begin the petitionerdeleted text end new text begin a nonresident party who is an individual new text end in a deleted text begin respondingdeleted text end tribunal of this state is not required for the establishment, enforcement, or modification of a support order or the rendition of a judgment determining parentage of a child.

(b) deleted text begin A verified petition,deleted text end new text begin Annew text end affidavit, new text begin a new text end document substantially complying with federally mandated forms, deleted text begin anddeleted text end new text begin ornew text end a document incorporated by reference in any of them, not excluded under the hearsay rule if given in person, is admissible in evidence if given under deleted text begin oathdeleted text end new text begin penalty of perjurynew text end by a party or witness residing outside this state.

(c) A copy of the record of child support payments certified as a true copy of the original by the custodian of the record may be forwarded to a responding tribunal. The copy is evidence of facts asserted in it, and is admissible to show whether payments were made.

(d) Copies of bills for testing for parentage of a child, and for prenatal and postnatal health care of the mother and child, furnished to the adverse party at least ten days before trial, are admissible in evidence to prove the amount of the charges billed and that the charges were reasonable, necessary, and customary.

(e) Documentary evidence transmitted from outside this state to a tribunal of this state by telephone, telecopier, or other electronic means that do not provide an original record may not be excluded from evidence on an objection based on the means of transmission.

(f) In a proceeding under this chapter, a tribunal of this state shall permit a party or witness residing outside this state to be deposed or to testify under penalty of perjury by telephone, audiovisual means, or other electronic means at a designated tribunal or other location. A tribunal of this state shall cooperate with other tribunals in designating an appropriate location for the deposition or testimony.

(g) If a party called to testify at a civil hearing refuses to answer on the ground that the testimony may be self-incriminating, the trier of fact may draw an adverse inference from the refusal.

(h) A privilege against disclosure of communications between spouses does not apply in a proceeding under this chapter.

(i) The defense of immunity based on the relationship of husband and wife or parent and child does not apply in a proceeding under this chapter.

(j) A voluntary acknowledgment of paternity, certified as a true copy, is admissible to establish parentage of a child.

Sec. 113.

Laws 2014, chapter 189, section 29, is amended to read:

Sec. 29.

Minnesota Statutes 2012, section 518C.317, is amended to read:

518C.317 COMMUNICATIONS BETWEEN TRIBUNALS.

A tribunal of this state may communicate with a tribunal outside this state in deleted text begin writing, by e-mail, ordeleted text end new text begin a record, ornew text end by telephonenew text begin , electronic mail,new text end or other means, to obtain information concerning the laws of that state, the legal effect of a judgment, decree, or order of that tribunal, and the status of a proceeding. A tribunal of this state may furnish similar information by similar means to a tribunal outside this state.

Sec. 114.

Laws 2014, chapter 189, section 31, is amended to read:

Sec. 31.

Minnesota Statutes 2012, section 518C.319, is amended to read:

518C.319 RECEIPT AND DISBURSEMENT OF PAYMENTS.

(a) A support enforcement agency or tribunal of this state shall disburse promptly any amounts received pursuant to a support order, as directed by the order. The agency or tribunal shall furnish to a requesting party or tribunal of another state or a foreign country a certified statement by the custodian of the record of the amounts and dates of all payments received.

(b) If neither the obligor, deleted text begin notdeleted text end new text begin nornew text end the obligee who is an individual, nor the child resides in this state, upon request from the support enforcement agency of this state or another state, the support enforcement agency of this state or a tribunal of this state shall:

(1) direct that the support payment be made to the support enforcement agency in the state in which the obligee is receiving services; and

(2) issue and send to the obligor's employer a conforming income-withholding order or an administrative notice of change of payee, reflecting the redirected payments.

(c) The support enforcement agency of this state receiving redirected payments from another state pursuant to a law similar to paragraph (b) shall furnish to a requesting party or tribunal of the other state a certified statement by the custodian of the record of the amount and dates of all payments received.

Sec. 115.

Laws 2014, chapter 189, section 43, is amended to read:

Sec. 43.

Minnesota Statutes 2012, section 518C.604, is amended to read:

518C.604 CHOICE OF LAW.

(a) Except as otherwise provided in paragraph (d), the law of the issuing state or foreign country governs:

(1) the nature, extent, amount, and duration of current payments under a registered support order;

(2) the computation and payment of arrearages and accrual of interest on the arrearages under the support order; and

(3) the existence and satisfaction of other obligations under the support order.

(b) In a proceeding for arrearagesnew text begin under a registered support ordernew text end , the statute of limitation under the laws of this state or of the issuing state or foreign country, whichever is longer, applies.

(c) A responding tribunal of this state shall apply the procedures and remedies of this state to enforce current support and collect arrears and interest due on a support order of another state or a foreign country registered in this state.

(d) After a tribunal of this state or another state determines which is the controlling order and issues an order consolidating arrears, if any, a tribunal of this state shall prospectively apply the law of the state or foreign country issuing the controlling order, including its law on interest on arrears, on current and future support, and on consolidated arrears.

Sec. 116.

Laws 2014, chapter 189, section 50, is amended to read:

Sec. 50.

Minnesota Statutes 2012, section 518C.611, is amended to read:

518C.611 MODIFICATION OF CHILD SUPPORT ORDER OF ANOTHER STATE.

(a) If section 518C.613 does not apply, upon petition a tribunal of this state may modify a child support order issued in another state that is registered in this state if, after notice and hearing, it finds that:

(1) the following requirements are met:

(i) neither the child, nor the obligee who is an individual, nor the obligor resides in the issuing state;

(ii) a petitioner who is a nonresident of this state seeks modification; and

(iii) the respondent is subject to the personal jurisdiction of the tribunal of this state; or

(2) this state is the residence of the child, or a party who is an individual is subject to the personal jurisdiction of the tribunal of this state and all of the parties who are individuals have filed deleted text begin writtendeleted text end consents in a record in the issuing tribunal for a tribunal of this state to modify the support order and assume continuing, exclusive jurisdiction deleted text begin over the orderdeleted text end .

(b) Modification of a registered child support order is subject to the same requirements, procedures, and defenses that apply to the modification of an order issued by a tribunal of this state and the order may be enforced and satisfied in the same manner.

(c) A tribunal of this state may not modify any aspect of a child support order that may not be modified under the law of the issuing state, including the duration of the obligation of support. If two or more tribunals have issued child support orders for the same obligor and child, the order that controls and must be recognized under section 518C.207 establishes the aspects of the support order which are nonmodifiable.

(d) In a proceeding to modify a child support order, the law of the state that is determined to have issued the initial controlling order governs the duration of the obligation of support. The obligor's fulfillment of the duty of support established by that order precludes imposition of a further obligation of support by a tribunal of this state.

(e) On issuance of an order new text begin by a tribunal of this state new text end modifying a child support order issued in another state, a tribunal of this state becomes the tribunal having continuing, exclusive jurisdiction.

(f) Notwithstanding paragraphs (a) to deleted text begin (d)deleted text end new text begin (e)new text end and section 518C.201, paragraph (b), a tribunal of this state retains jurisdiction to modify an order issued by a tribunal of this state if:

(1) one party resides in another state; and

(2) the other party resides outside the United States.

Sec. 117.

Laws 2014, chapter 189, section 51, is amended to read:

Sec. 51.

Minnesota Statutes 2012, section 518C.612, is amended to read:

518C.612 RECOGNITION OF ORDER MODIFIED IN ANOTHER STATE.

If a child support order issued by a tribunal of this state is modified by a tribunal of another state which assumed jurisdiction deleted text begin according to this chapter or a law substantially similar to this chapterdeleted text end new text begin pursuant to the Uniform Interstate Family Support Act,new text end a tribunal of this state:

(1) may enforce its order that was modified only as to arrears and interest accruing before the modification;

(2) may provide appropriate relief for violations of its order which occurred before the effective date of the modification; and

(3) shall recognize the modifying order of the other state, upon registration, for the purpose of enforcement.

Sec. 118.

Laws 2014, chapter 189, section 52, is amended to read:

Sec. 52.

Minnesota Statutes 2012, section 518C.613, is amended to read:

518C.613 JURISDICTION TO MODIFY SUPPORT ORDER OF ANOTHER STATE WHEN INDIVIDUAL PARTIES RESIDE IN THIS STATE.

(a) If all of the parties who are individuals reside in this state and the child does not reside in the issuing state, a tribunal of this state has jurisdiction to enforce and to modify the issuing state's child support order in a proceeding to register that order.

(b) A tribunal of this state exercising jurisdiction as provided in this section shall apply sections 518C.101 to deleted text begin 518C.209deleted text end new text begin 518C.211 new text end and 518C.601 to 518C.616 to the enforcement or modification proceeding. Sections 518C.301 to 518C.508 and 518C.701 to 518C.802 do not apply and the tribunal shall apply the procedural and substantive law of this state.

Sec. 119.

Laws 2014, chapter 189, section 73, is amended to read:

Sec. 73.

EFFECTIVE DATE.

This act deleted text begin becomesdeleted text end new text begin isnew text end effective deleted text begin on the date that the United States deposits the instrument of ratification for the Hague Convention on the International Recovery of Child Support and Other Forms of Family Maintenance with the Hague Conference on Private International Lawdeleted text end new text begin July 1, 2015new text end .

new text begin EFFECTIVE DATE. new text end

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

Sec. 120.

new text begin GROUP RESIDENTIAL HOUSING REPORT ON PROGRAM IMPROVEMENTS. new text end

new text begin (a) The commissioner shall, in coordination with stakeholders and advocates, build on the group residential housing (GRH) reforms made in the 2015 legislative session related to program integrity and uniformity, by restructuring the payment rates, exploring assessment tools, and proposing any other necessary modifications that will result in a more cost-effective program, and report to the members of the legislative committees having jurisdiction over GRH issues by December 15, 2016. new text end

new text begin (b) The working group, consisting of the commissioner, stakeholders, and advocates, shall examine the feasibility and fiscal implications of restructuring service rates by eliminating the supplemental service rates, and developing a plan to fund only those services, based on individual need, that are not covered by medical assistance, other insurance, or other programs. In addition, the working group shall analyze the payment structure, and explore different options, including tiered rates for services, and provide the plan and analysis under this paragraph in the report under paragraph (a). new text end

new text begin (c) To determine individual need, the working group shall explore assessment tools, and determine the appropriate assessment tool for the different populations served by the GRH program, which include homeless individuals, individuals with mental illness, and individuals who are chemically dependent. The working group shall coordinate efforts with agency staff who have expertise related to these populations, and use relevant information and data that is available, to determine the most appropriate and effective assessment tool or tools, and provide the analysis and an assessment recommendation in the report under paragraph (a). new text end

Sec. 121.

new text begin CHILD SUPPORT WORK GROUP. new text end

new text begin (a) A child support work group is established to review the parenting expense adjustment in Minnesota Statutes, section 518A.36, and to identify and recommend changes to the parenting expense adjustment. new text end

new text begin (b) Members of the work group shall include: new text end

new text begin (1) two members of the house of representatives, one appointed by the speaker of the house and one appointed by the minority leader; new text end

new text begin (2) two members of the senate, one appointed by the majority leader and one appointed by the minority leader; new text end

new text begin (3) the commissioner of human services or a designee; new text end

new text begin (4) one staff member from the Child Support Division of the Department of Human Services, appointed by the commissioner; new text end

new text begin (5) one representative of the Minnesota State Bar Association, Family Law section, appointed by the section; new text end

new text begin (6) one representative of the Minnesota County Attorneys Association, appointed by the association; new text end

new text begin (7) one representative of the Minnesota Legal Services Coalition, appointed by the coalition; new text end

new text begin (8) one representative of the Minnesota Family Support and Recovery Council, appointed by the council; and new text end

new text begin (9) two representatives from parent advocacy groups, one representing custodial parents and one representing noncustodial parents, appointed by the commissioner of human services. new text end

new text begin The commissioner, or the commissioner's designee, shall appoint the work group chair. new text end

new text begin (c) The work group shall be authorized to retain the services of an economist to help create an equitable parenting expense adjustment formula. The work group may hire an economist by use of a sole-source contract. new text end

new text begin (d) The work group shall issue a report to the chairs and ranking minority members of the legislative committees with jurisdiction over civil law, judiciary, and health and human services by January 15, 2016. The report must include recommendations for changes to the computation of child support and recommendations on the composition of a permanent child support task force. new text end

new text begin (e) Terms, compensation, and removal of members and the filling of vacancies are governed by Minnesota Statutes, section 15.059. new text end

new text begin (f) The work group expires January 16, 2016. new text end

Sec. 122.

new text begin INSTRUCTIONS TO THE COMMISSIONER; CHILD MALTREATMENT SCREENING GUIDELINES. new text end

new text begin (a) No later than October 1, 2015, the commissioner of human services shall update the child maltreatment screening guidelines to require agencies to consider prior reports that were not screened in when determining whether a new report will or will not be screened in. The updated guidelines must emphasize that intervention and prevention efforts are to focus on child safety and the ongoing risk of child abuse or neglect, and that the health and safety of children are of paramount concern. The commissioner shall work with a diverse group of community representatives who are experts on limiting cultural and ethnic bias when developing the updated guidelines. The guidelines must be developed with special sensitivity to reducing system bias with regard to screening and assessment tools. new text end

new text begin (b) No later than November 1, 2015, the commissioner shall publish and distribute the updated guidelines and ensure that all agency staff have received training on the updated guidelines. new text end

new text begin (c) Agency staff must implement the guidelines by January 1, 2016. new text end

Sec. 123.

new text begin COMMISSIONER'S DUTY TO PROVIDE TRAINING TO CHILD PROTECTION SUPERVISORS. new text end

new text begin The commissioner shall establish requirements for competency-based initial training, support, and continuing education for child protection supervisors. This includes developing a set of competencies specific to child protection supervisor knowledge, skills, and attitudes based on the Minnesota Child Welfare Practice Model. Competency-based training of supervisors must advance continuous emphasis and improvement in skills that promote the use of the client's culture as a resource and the ability to integrate the client's traditions, customs, values, and faith into service delivery. new text end

Sec. 124.

new text begin CHILD PROTECTION UPDATED FORMULA. new text end

new text begin The commissioner of human services shall evaluate the formulas in Minnesota Statutes, section 256M.41, and recommend an updated equitable distribution formula beginning in fiscal year 2018, for funding child protection staffing and expanded services to counties and tribes, taking into consideration any relief to counties and tribes for child welfare and foster care costs, additional tribes delivering social services, and any other relevant information that should be considered in developing a new distribution formula. The commissioner shall report to the legislative committees having jurisdiction over child protection issues by December 15, 2016. new text end

Sec. 125.

new text begin LEGISLATIVE TASK FORCE; CHILD PROTECTION. new text end

new text begin (a) A legislative task force is created to: new text end

new text begin (1) review the efforts being made to implement the recommendations of the Governor's Task Force on the Protection of Children, including a review of the roles and functions of the Office of Ombudsperson for Families; new text end

new text begin (2) expand the efforts into related areas of the child welfare system; new text end

new text begin (3) work with the commissioner of human services and community partners to establish and evaluate child protection grants to address disparities in child welfare pursuant to Minnesota Statutes, section 256E.28; and new text end

new text begin (4) identify additional areas within the child welfare system that need to be addressed by the legislature. new text end

new text begin (b) Members of the legislative task force shall include: new text end

new text begin (1) the four legislators who served as members of the Governor's Task Force on the Protection of Children; new text end

new text begin (2) two members from the house of representatives appointed by the speaker, one from the majority party and one from the minority party; and new text end

new text begin (3) two members from the senate appointed by the majority leader, one from the majority party and one from the minority party. new text end

new text begin The speaker and the majority leader shall each appoint a chair and vice-chair from the membership of the task force. The gavel shall rotate after each meeting, and the house of representatives shall assume the leadership of the task force first. new text end

new text begin (c) The task force may provide oversight and monitoring of: new text end

new text begin (1) the efforts by the Department of Human Services, counties, and tribes to implement laws related to child protection; new text end

new text begin (2) efforts by the Department of Human Services, counties, and tribes to implement the recommendations of the Governor's Task Force on the Protection of Children; new text end

new text begin (3) efforts by agencies, including but not limited to the Minnesota Department of Education, the Minnesota Housing Finance Agency, the Minnesota Department of Corrections, and the Minnesota Department of Public Safety, to work with the Department of Human Services to assure safety and well-being for children at risk of harm or children in the child welfare system; and new text end

new text begin (4) efforts by the Department of Human Services, other agencies, counties, and tribes to implement best practices to ensure every child is protected from maltreatment and neglect and to ensure every child has the opportunity for healthy development. new text end

new text begin (d) The task force, in cooperation with the commissioner of human services, shall issue a report to the legislature and governor February 1, 2016. The report must contain information on the progress toward implementation of changes to the child protection system, recommendations for additional legislative changes and procedures affecting child protection and child welfare, and funding needs to implement recommended changes. new text end

new text begin (e) The task force shall convene upon the effective date of this section and shall continue until the last day of the 2016 legislative session. 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. 126.

new text begin REVISOR'S INSTRUCTION. new text end

new text begin The revisor of statutes shall alphabetize the definitions in Minnesota Statutes, section 626.556, subdivision 2, and correct related cross-references. new text end

ARTICLE 2

CHEMICAL AND MENTAL HEALTH SERVICES

Section 1.

Minnesota Statutes 2014, section 13.46, subdivision 2, is amended to read:

Subd. 2.

General.

(a) Data on individuals collected, maintained, used, or disseminated by the welfare system are private data on individuals, and shall not be disclosed except:

(1) according to section 13.05;

(2) according to court order;

(3) according to a statute specifically authorizing access to the private data;

(4) to an agent of the welfare system and an investigator acting on behalf of a county, the state, or the federal government, including a law enforcement person or attorney in the investigation or prosecution of a criminal, civil, or administrative proceeding relating to the administration of a program;

(5) to personnel of the welfare system who require the data to verify an individual's identity; determine eligibility, amount of assistance, and the need to provide services to an individual or family across programs; new text begin coordinate services for an individual or family; new text end evaluate the effectiveness of programs; assess parental contribution amounts; and investigate suspected fraud;

(6) to administer federal funds or programs;

(7) between personnel of the welfare system working in the same program;

(8) to the Department of Revenue to assess parental contribution amounts for purposes of section 252.27, subdivision 2a, administer and evaluate tax refund or tax credit programs and to identify individuals who may benefit from these programs. The following information may be disclosed under this paragraph: an individual's and their dependent's names, dates of birth, Social Security numbers, income, addresses, and other data as required, upon request by the Department of Revenue. Disclosures by the commissioner of revenue to the commissioner of human services for the purposes described in this clause are governed by section 270B.14, subdivision 1. Tax refund or tax credit programs include, but are not limited to, the dependent care credit under section 290.067, the Minnesota working family credit under section 290.0671, the property tax refund and rental credit under section 290A.04, and the Minnesota education credit under section 290.0674;

(9) between the Department of Human Services, the Department of Employment and Economic Development, and when applicable, the Department of Education, for the following purposes:

(i) to monitor the eligibility of the data subject for unemployment benefits, for any employment or training program administered, supervised, or certified by that agency;

(ii) to administer any rehabilitation program or child care assistance program, whether alone or in conjunction with the welfare system;

(iii) to monitor and evaluate the Minnesota family investment program or the child care assistance program by exchanging data on recipients and former recipients of food support, cash assistance under chapter 256, 256D, 256J, or 256K, child care assistance under chapter 119B, or medical programs under chapter 256B, 256D, or 256L; and

(iv) to analyze public assistance employment services and program utilization, cost, effectiveness, and outcomes as implemented under the authority established in Title II, Sections 201-204 of the Ticket to Work and Work Incentives Improvement Act of 1999. Health records governed by sections 144.291 to 144.298 and "protected health information" as defined in Code of Federal Regulations, title 45, section 160.103, and governed by Code of Federal Regulations, title 45, parts 160-164, including health care claims utilization information, must not be exchanged under this clause;

(10) to appropriate parties in connection with an emergency if knowledge of the information is necessary to protect the health or safety of the individual or other individuals or persons;

(11) data maintained by residential programs as defined in section 245A.02 may be disclosed to the protection and advocacy system established in this state according to Part C of Public Law 98-527 to protect the legal and human rights of persons with developmental disabilities or other related conditions who live in residential facilities for these persons if the protection and advocacy system receives a complaint by or on behalf of that person and the person does not have a legal guardian or the state or a designee of the state is the legal guardian of the person;

(12) to the county medical examiner or the county coroner for identifying or locating relatives or friends of a deceased person;

(13) data on a child support obligor who makes payments to the public agency may be disclosed to the Minnesota Office of Higher Education to the extent necessary to determine eligibility under section 136A.121, subdivision 2, clause (5);

(14) participant Social Security numbers and names collected by the telephone assistance program may be disclosed to the Department of Revenue to conduct an electronic data match with the property tax refund database to determine eligibility under section 237.70, subdivision 4a;

(15) the current address of a Minnesota family investment program participant may be disclosed to law enforcement officers who provide the name of the participant and notify the agency that:

(i) the participant:

(A) is a fugitive felon fleeing to avoid prosecution, or custody or confinement after conviction, for a crime or attempt to commit a crime that is a felony under the laws of the jurisdiction from which the individual is fleeing; or

(B) is violating a condition of probation or parole imposed under state or federal law;

(ii) the location or apprehension of the felon is within the law enforcement officer's official duties; and

(iii) the request is made in writing and in the proper exercise of those duties;

(16) the current address of a recipient of general assistance or general assistance medical care may be disclosed to probation officers and corrections agents who are supervising the recipient and to law enforcement officers who are investigating the recipient in connection with a felony level offense;

(17) information obtained from food support applicant or recipient households may be disclosed to local, state, or federal law enforcement officials, upon their written request, for the purpose of investigating an alleged violation of the Food Stamp Act, according to Code of Federal Regulations, title 7, section 272.1(c);

(18) the address, Social Security number, and, if available, photograph of any member of a household receiving food support shall be made available, on request, to a local, state, or federal law enforcement officer if the officer furnishes the agency with the name of the member and notifies the agency that:

(i) the member:

(A) is fleeing to avoid prosecution, or custody or confinement after conviction, for a crime or attempt to commit a crime that is a felony in the jurisdiction the member is fleeing;

(B) is violating a condition of probation or parole imposed under state or federal law; or

(C) has information that is necessary for the officer to conduct an official duty related to conduct described in subitem (A) or (B);

(ii) locating or apprehending the member is within the officer's official duties; and

(iii) the request is made in writing and in the proper exercise of the officer's official duty;

(19) the current address of a recipient of Minnesota family investment program, general assistance, general assistance medical care, or food support may be disclosed to law enforcement officers who, in writing, provide the name of the recipient and notify the agency that the recipient is a person required to register under section 243.166, but is not residing at the address at which the recipient is registered under section 243.166;

(20) certain information regarding child support obligors who are in arrears may be made public according to section 518A.74;

(21) data on child support payments made by a child support obligor and data on the distribution of those payments excluding identifying information on obligees may be disclosed to all obligees to whom the obligor owes support, and data on the enforcement actions undertaken by the public authority, the status of those actions, and data on the income of the obligor or obligee may be disclosed to the other party;

(22) data in the work reporting system may be disclosed under section 256.998, subdivision 7;

(23) to the Department of Education for the purpose of matching Department of Education student data with public assistance data to determine students eligible for free and reduced-price meals, meal supplements, and free milk according to United States Code, title 42, sections 1758, 1761, 1766, 1766a, 1772, and 1773; to allocate federal and state funds that are distributed based on income of the student's family; and to verify receipt of energy assistance for the telephone assistance plan;

(24) the current address and telephone number of program recipients and emergency contacts may be released to the commissioner of health or a community health board as defined in section 145A.02, subdivision 5, when the commissioner or community health board has reason to believe that a program recipient is a disease case, carrier, suspect case, or at risk of illness, and the data are necessary to locate the person;

(25) to other state agencies, statewide systems, and political subdivisions of this state, including the attorney general, and agencies of other states, interstate information networks, federal agencies, and other entities as required by federal regulation or law for the administration of the child support enforcement program;

(26) to personnel of public assistance programs as defined in section 256.741, for access to the child support system database for the purpose of administration, including monitoring and evaluation of those public assistance programs;

(27) to monitor and evaluate the Minnesota family investment program by exchanging data between the Departments of Human Services and Education, on recipients and former recipients of food support, cash assistance under chapter 256, 256D, 256J, or 256K, child care assistance under chapter 119B, or medical programs under chapter 256B, 256D, or 256L;

(28) to evaluate child support program performance and to identify and prevent fraud in the child support program by exchanging data between the Department of Human Services, Department of Revenue under section 270B.14, subdivision 1, paragraphs (a) and (b), without regard to the limitation of use in paragraph (c), Department of Health, Department of Employment and Economic Development, and other state agencies as is reasonably necessary to perform these functions;

(29) counties operating child care assistance programs under chapter 119B may disseminate data on program participants, applicants, and providers to the commissioner of education; deleted text begin ordeleted text end

(30) child support data on the child, the parents, and relatives of the child may be disclosed to agencies administering programs under titles IV-B and IV-E of the Social Security Act, as authorized by federal lawdeleted text begin .deleted text end new text begin ; ornew text end

new text begin (31) to a health care provider governed by sections 144.291 to 144.298, to the extent necessary to coordinate services. new text end

(b) Information on persons who have been treated for drug or alcohol abuse may only be disclosed according to the requirements of Code of Federal Regulations, title 42, sections 2.1 to 2.67.

(c) Data provided to law enforcement agencies under paragraph (a), clause (15), (16), (17), or (18), or paragraph (b), are investigative data and are confidential or protected nonpublic while the investigation is active. The data are private after the investigation becomes inactive under section 13.82, subdivision 5, paragraph (a) or (b).

(d) Mental health data shall be treated as provided in subdivisions 7, 8, and 9, but are not subject to the access provisions of subdivision 10, paragraph (b).

For the purposes of this subdivision, a request will be deemed to be made in writing if made through a computer interface system.

Sec. 2.

Minnesota Statutes 2014, section 13.46, subdivision 7, is amended to read:

Subd. 7.

Mental health data.

(a) Mental health data are private data on individuals and shall not be disclosed, except:

(1) pursuant to section 13.05, as determined by the responsible authority for the community mental health center, mental health division, or provider;

(2) pursuant to court order;

(3) pursuant to a statute specifically authorizing access to or disclosure of mental health data or as otherwise provided by this subdivision; deleted text begin ordeleted text end

(4) new text begin to personnel of the welfare system working in the same program or providing services to the same individual or family to the extent necessary to coordinate services, provided that a health record may be disclosed only as provided under section 144.293; new text end

new text begin (5) to a health care provider governed by sections 144.291 to 144.298, to the extent necessary to coordinate services; or new text end

new text begin (6) new text end with the consent of the client or patient.

(b) An agency of the welfare system may not require an individual to consent to the release of mental health data as a condition for receiving services or for reimbursing a community mental health center, mental health division of a county, or provider under contract to deliver mental health services.

(c) Notwithstanding section 245.69, subdivision 2, paragraph (f), or any other law to the contrary, the responsible authority for a community mental health center, mental health division of a county, or a mental health provider must disclose mental health data to a law enforcement agency if the law enforcement agency provides the name of a client or patient and communicates that the:

(1) client or patient is currently involved in an emergency interaction with the law enforcement agency; and

(2) data is necessary to protect the health or safety of the client or patient or of another person.

The scope of disclosure under this paragraph is limited to the minimum necessary for law enforcement to respond to the emergency. Disclosure under this paragraph may include, but is not limited to, the name and telephone number of the psychiatrist, psychologist, therapist, mental health professional, practitioner, or case manager of the client or patient. A law enforcement agency that obtains mental health data under this paragraph shall maintain a record of the requestor, the provider of the information, and the client or patient name. Mental health data obtained by a law enforcement agency under this paragraph are private data on individuals and must not be used by the law enforcement agency for any other purpose. A law enforcement agency that obtains mental health data under this paragraph shall inform the subject of the data that mental health data was obtained.

(d) In the event of a request under paragraph (a), clause (4), a community mental health center, county mental health division, or provider must release mental health data to Criminal Mental Health Court personnel in advance of receiving a copy of a consent if the Criminal Mental Health Court personnel communicate that the:

(1) client or patient is a defendant in a criminal case pending in the district court;

(2) data being requested is limited to information that is necessary to assess whether the defendant is eligible for participation in the Criminal Mental Health Court; and

(3) client or patient has consented to the release of the mental health data and a copy of the consent will be provided to the community mental health center, county mental health division, or provider within 72 hours of the release of the data.

For purposes of this paragraph, "Criminal Mental Health Court" refers to a specialty criminal calendar of the Hennepin County District Court for defendants with mental illness and brain injury where a primary goal of the calendar is to assess the treatment needs of the defendants and to incorporate those treatment needs into voluntary case disposition plans. The data released pursuant to this paragraph may be used for the sole purpose of determining whether the person is eligible for participation in mental health court. This paragraph does not in any way limit or otherwise extend the rights of the court to obtain the release of mental health data pursuant to court order or any other means allowed by law.

Sec. 3.

Minnesota Statutes 2014, section 62Q.55, subdivision 3, is amended to read:

Subd. 3.

Emergency services.

As used in this section, "emergency services" means, with respect to an emergency medical condition:

(1) a medical screening examination, as required under section 1867 of the Social Security Act, that is within the capability of the emergency department of a hospital, including ancillary services routinely available to the emergency department to evaluate such emergency medical condition; deleted text begin anddeleted text end

(2) within the capabilities of the staff and facilities available at the hospital, such further medical examination and treatment as are required under section 1867 of the Social Security Act to stabilize the patientnew text begin ; andnew text end

new text begin (3) emergency services as defined in sections 245.462, subdivision 11, and 245.4871, subdivision 14new text end .

Sec. 4.

Minnesota Statutes 2014, section 144.293, subdivision 6, is amended to read:

Subd. 6.

Consent does not expire.

Notwithstanding subdivision 4, if a patient explicitly gives informed consent to the release of health records for the purposes and restrictions in deleted text begin clausesdeleted text end new text begin clausenew text end (1) deleted text begin anddeleted text end new text begin ,new text end (2),new text begin or (3),new text end the consent does not expire after one year for:

(1) the release of health records to a provider who is being advised or consulted with in connection with the releasing provider's current treatment of the patient;

(2) the release of health records to an accident and health insurer, health service plan corporation, health maintenance organization, or third-party administrator for purposes of payment of claims, fraud investigation, or quality of care review and studies, provided that:

(i) the use or release of the records complies with sections 72A.49 to 72A.505;

(ii) further use or release of the records in individually identifiable form to a person other than the patient without the patient's consent is prohibited; and

(iii) the recipient establishes adequate safeguards to protect the records from unauthorized disclosure, including a procedure for removal or destruction of information that identifies the patientnew text begin ; ornew text end

new text begin (3) the release of health records to a program in the welfare system, as defined in section 13.46, to the extent necessary to coordinate services for the patientnew text end .

Sec. 5.

Minnesota Statutes 2014, section 144.551, subdivision 1, is amended to read:

Subdivision 1.

Restricted construction or modification.

(a) The following construction or modification may not be commenced:

(1) any erection, building, alteration, reconstruction, modernization, improvement, extension, lease, or other acquisition by or on behalf of a hospital that increases the bed capacity of a hospital, relocates hospital beds from one physical facility, complex, or site to another, or otherwise results in an increase or redistribution of hospital beds within the state; and

(2) the establishment of a new hospital.

(b) This section does not apply to:

(1) construction or relocation within a county by a hospital, clinic, or other health care facility that is a national referral center engaged in substantial programs of patient care, medical research, and medical education meeting state and national needs that receives more than 40 percent of its patients from outside the state of Minnesota;

(2) a project for construction or modification for which a health care facility held an approved certificate of need on May 1, 1984, regardless of the date of expiration of the certificate;

(3) a project for which a certificate of need was denied before July 1, 1990, if a timely appeal results in an order reversing the denial;

(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200, section 2;

(5) a project involving consolidation of pediatric specialty hospital services within the Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number of pediatric specialty hospital beds among the hospitals being consolidated;

(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to an existing licensed hospital that will allow for the reconstruction of a new philanthropic, pediatric-orthopedic hospital on an existing site and that will not result in a net increase in the number of hospital beds. Upon completion of the reconstruction, the licenses of both hospitals must be reinstated at the capacity that existed on each site before the relocation;

(7) the relocation or redistribution of hospital beds within a hospital building or identifiable complex of buildings provided the relocation or redistribution does not result in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from one physical site or complex to another; or (iii) redistribution of hospital beds within the state or a region of the state;

(8) relocation or redistribution of hospital beds within a hospital corporate system that involves the transfer of beds from a closed facility site or complex to an existing site or complex provided that: (i) no more than 50 percent of the capacity of the closed facility is transferred; (ii) the capacity of the site or complex to which the beds are transferred does not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal health systems agency boundary in place on July 1, 1983; and (iv) the relocation or redistribution does not involve the construction of a new hospital building;

(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice County that primarily serves adolescents and that receives more than 70 percent of its patients from outside the state of Minnesota;

(10) a project to replace a hospital or hospitals with a combined licensed capacity of 130 beds or less if: (i) the new hospital site is located within five miles of the current site; and (ii) the total licensed capacity of the replacement hospital, either at the time of construction of the initial building or as the result of future expansion, will not exceed 70 licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;

(11) the relocation of licensed hospital beds from an existing state facility operated by the commissioner of human services to a new or existing facility, building, or complex operated by the commissioner of human services; from one regional treatment center site to another; or from one building or site to a new or existing building or site on the same campus;

(12) the construction or relocation of hospital beds operated by a hospital having a statutory obligation to provide hospital and medical services for the indigent that does not result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27 beds, of which 12 serve mental health needs, may be transferred from Hennepin County Medical Center to Regions Hospital under this clause;

(13) a construction project involving the addition of up to 31 new beds in an existing nonfederal hospital in Beltrami County;

(14) a construction project involving the addition of up to eight new beds in an existing nonfederal hospital in Otter Tail County with 100 licensed acute care beds;

(15) a construction project involving the addition of 20 new hospital beds used for rehabilitation services in an existing hospital in Carver County serving the southwest suburban metropolitan area. Beds constructed under this clause shall not be eligible for reimbursement under medical assistance, general assistance medical care, or MinnesotaCare;

(16) a project for the construction or relocation of up to 20 hospital beds for the operation of up to two psychiatric facilities or units for children provided that the operation of the facilities or units have received the approval of the commissioner of human services;

(17) a project involving the addition of 14 new hospital beds to be used for rehabilitation services in an existing hospital in Itasca County;

(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin County that closed 20 rehabilitation beds in 2002, provided that the beds are used only for rehabilitation in the hospital's current rehabilitation building. If the beds are used for another purpose or moved to another location, the hospital's licensed capacity is reduced by 20 beds;

(19) a critical access hospital established under section 144.1483, clause (9), and section 1820 of the federal Social Security Act, United States Code, title 42, section 1395i-4, that delicensed beds since enactment of the Balanced Budget Act of 1997, Public Law 105-33, to the extent that the critical access hospital does not seek to exceed the maximum number of beds permitted such hospital under federal law;

(20) notwithstanding section 144.552, a project for the construction of a new hospital in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:

(i) the project, including each hospital or health system that will own or control the entity that will hold the new hospital license, is approved by a resolution of the Maple Grove City Council as of March 1, 2006;

(ii) the entity that will hold the new hospital license will be owned or controlled by one or more not-for-profit hospitals or health systems that have previously submitted a plan or plans for a project in Maple Grove as required under section 144.552, and the plan or plans have been found to be in the public interest by the commissioner of health as of April 1, 2005;

(iii) the new hospital's initial inpatient services must include, but are not limited to, medical and surgical services, obstetrical and gynecological services, intensive care services, orthopedic services, pediatric services, noninvasive cardiac diagnostics, behavioral health services, and emergency room services;

(iv) the new hospital:

(A) will have the ability to provide and staff sufficient new beds to meet the growing needs of the Maple Grove service area and the surrounding communities currently being served by the hospital or health system that will own or control the entity that will hold the new hospital license;

(B) will provide uncompensated care;

(C) will provide mental health services, including inpatient beds;

(D) will be a site for workforce development for a broad spectrum of health-care-related occupations and have a commitment to providing clinical training programs for physicians and other health care providers;

(E) will demonstrate a commitment to quality care and patient safety;

(F) will have an electronic medical records system, including physician order entry;

(G) will provide a broad range of senior services;

(H) will provide emergency medical services that will coordinate care with regional providers of trauma services and licensed emergency ambulance services in order to enhance the continuity of care for emergency medical patients; and

(I) will be completed by December 31, 2009, unless delayed by circumstances beyond the control of the entity holding the new hospital license; and

(v) as of 30 days following submission of a written plan, the commissioner of health has not determined that the hospitals or health systems that will own or control the entity that will hold the new hospital license are unable to meet the criteria of this clause;

(21) a project approved under section 144.553;

(22) a project for the construction of a hospital with up to 25 beds in Cass County within a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's license holder is approved by the Cass County Board;

(23) a project for an acute care hospital in Fergus Falls that will increase the bed capacity from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 and closing a separately licensed 13-bed skilled nursing facility;

(24) notwithstanding section 144.552, a project for the construction and expansion of a specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for patients who are under 21 years of age on the date of admission. The commissioner conducted a public interest review of the mental health needs of Minnesota and the Twin Cities metropolitan area in 2008. No further public interest review shall be conducted for the construction or expansion project under this clause; deleted text begin ordeleted text end

(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if the commissioner finds the project is in the public interest after the public interest review conducted under section 144.552 is completenew text begin ; ornew text end

new text begin (26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the city of Maple Grove, exclusively for patients who are under 21 years of age on the date of admission, if the commissioner finds the project is in the public interest after the public interest review conducted under section 144.552 is complete; new text end

new text begin (ii) this project shall serve patients in the continuing care benefit program under section 256.9693. The project may also serve patients not in the continuing care benefit program; and new text end

new text begin (iii) if the project ceases to participate in the continuing care benefit program, the commissioner must complete a subsequent public interest review under section 144.552. If the project is found not to be in the public interest, the license must be terminated six months from the date of that finding. If the commissioner of human services terminates the contract without cause or reduces per diem payment rates for patients under the continuing care benefit program below the rates in effect for services provided on December 31, 2015, the project may cease to participate in the continuing care benefit program and continue to operate without a subsequent public interest reviewnew text end .

Sec. 6.

Minnesota Statutes 2014, section 145.56, subdivision 2, is amended to read:

Subd. 2.

Community-based programs.

To the extent funds are appropriated for the purposes of this subdivision, the commissioner shall establish a grant program to fund:

(1) community-based programs to provide education, outreach, and advocacy services to populations who may be at risk for suicide;

(2) community-based programs that educate community helpers and gatekeepers, such as family members, spiritual leaders, coaches, and business owners, employers, and coworkers on how to prevent suicide by encouraging help-seeking behaviors;

(3) community-based programs that educate populations at risk for suicide and community helpers and gatekeepers that must include information on the symptoms of depression and other psychiatric illnesses, the warning signs of suicide, skills for preventing suicides, and making or seeking effective referrals to intervention and community resources; deleted text begin anddeleted text end

(4) community-based programs to provide evidence-based suicide prevention and intervention education to school staff, parents, and students in grades kindergarten through 12, and for students attending Minnesota colleges and universitiesnew text begin ;new text end

new text begin (5) community-based programs to provide evidence-based suicide prevention and intervention to public school nurses, teachers, administrators, coaches, school social workers, peace officers, firefighters, emergency medical technicians, advanced emergency medical technicians, paramedics, primary care providers, and others; and new text end

new text begin (6) community-based, evidence-based postvention training to mental health professionals and practitioners in order to provide technical assistance to communities after a suicide and to prevent suicide clusters and contagionnew text end .

Sec. 7.

Minnesota Statutes 2014, section 145.56, subdivision 4, is amended to read:

Subd. 4.

Collection and reporting suicide data.

new text begin (a) new text end The commissioner shall coordinate with federal, regional, local, and other state agencies to collect, analyze, and annually issue a public report on Minnesota-specific data on suicide and suicidal behaviors.

new text begin (b) The commissioner, in consultation with stakeholders, shall submit a detailed plan identifying proposed methods to improve the timeliness, usefulness, and quality of suicide-related data so that the data can help identify the scope of the suicide problem, identify high-risk groups, set priority prevention activities, and monitor the effects of suicide prevention programs. The report shall include how to improve external cause of injury coding, progress on implementing the Minnesota Violent Death Reporting System, how to obtain and release data in a timely manner, and how to support the use of psychological autopsies. new text end

new text begin (c) The written report must be provided to the chairs and ranking minority members of the house of representatives and senate finance and policy divisions and committees with jurisdiction over health and human services by February 1, 2016. new text end

Sec. 8.

Minnesota Statutes 2014, section 245.4661, subdivision 5, is amended to read:

Subd. 5.

Planning for pilot projects.

(a) Each local plan for a pilot project, with the exception of the placement of a Minnesota specialty treatment facility as defined in paragraph (c), 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.

(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.

(c) For purposes of this section, "Minnesota specialty treatment facility" is defined as an intensive deleted text begin rehabilitative mental healthdeleted text end new text begin residential treatment new text end service under section 256B.0622, subdivision 2, paragraph (b).

Sec. 9.

Minnesota Statutes 2014, 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) community support services funds administered under Minnesota Rules, parts 9535.1700 to 9535.1760;

(2) other mental health special project funds;

(3) 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;new text begin andnew text end

(4) regional treatment center resources consistent with section 246.0136, subdivision 1deleted text begin ; anddeleted text end new text begin .new text end

deleted text begin (5) 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. deleted 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. 10.

Minnesota Statutes 2014, section 245.4661, is amended by adding a subdivision to read:

new text begin Subd. 9. new text end

new text begin Services and programs. new text end

new text begin (a) The following three distinct grant programs are funded under this section: new text end

new text begin (1) mental health crisis services; new text end

new text begin (2) housing with supports for adults with serious mental illness; and new text end

new text begin (3) projects for assistance in transitioning from homelessness (PATH program). new text end

new text begin (b) In addition, the following are eligible for grant funds: new text end

new text begin (1) community education and prevention; new text end

new text begin (2) client outreach; new text end

new text begin (3) early identification and intervention; new text end

new text begin (4) adult outpatient diagnostic assessment and psychological testing; new text end

new text begin (5) peer support services; new text end

new text begin (6) community support program services (CSP); new text end

new text begin (7) adult residential crisis stabilization; new text end

new text begin (8) supported employment; new text end

new text begin (9) assertive community treatment (ACT); new text end

new text begin (10) housing subsidies; new text end

new text begin (11) basic living, social skills, and community intervention; new text end

new text begin (12) emergency response services; new text end

new text begin (13) adult outpatient psychotherapy; new text end

new text begin (14) adult outpatient medication management; new text end

new text begin (15) adult mobile crisis services; new text end

new text begin (16) adult day treatment; new text end

new text begin (17) partial hospitalization; new text end

new text begin (18) adult residential treatment; new text end

new text begin (19) adult mental health targeted case management; new text end

new text begin (20) intensive community residential services (IRCS); and new text end

new text begin (21) transportation. new text end

Sec. 11.

Minnesota Statutes 2014, section 245.4661, is amended by adding a subdivision to read:

new text begin Subd. 10. new text end

new text begin Commissioner duty to report on use of grant funds biennially. new text end

new text begin By November 1, 2016, and biennially thereafter, the commissioner of human services shall provide sufficient information to the members of the legislative committees having jurisdiction over mental health funding and policy issues to evaluate the use of funds appropriated under this section of law. The commissioner shall provide, at a minimum, the following information: new text end

new text begin (1) the amount of funding to mental health initiatives, what programs and services were funded in the previous two years, gaps in services that each initiative brought to the attention of the commissioner, and outcome data for the programs and services that were funded; and new text end

new text begin (2) the amount of funding for other targeted services and the location of services. new text end

Sec. 12.

Minnesota Statutes 2014, section 245.467, subdivision 6, is amended to read:

Subd. 6.

Restricted access to data.

The county board shall establish procedures to ensure that the names and addresses of persons receiving mental health services are disclosed only to:

(1) county employees who are specifically responsible for determining county of financial responsibility or making payments to providers; deleted text begin anddeleted text end

(2) staff who provide treatment services or case management and their clinical supervisorsdeleted text begin .deleted text end new text begin ; andnew text end

new text begin (3) personnel of the welfare system or health care providers who have access to the data under section 13.46, subdivision 7. new text end

Release of mental health data on individuals submitted under subdivisions 4 and 5, to persons other than those specified in this subdivision, or use of this data for purposes other than those stated in subdivisions 4 and 5, results in civil or criminal liability under the standards in section 13.08 or 13.09.

Sec. 13.

Minnesota Statutes 2014, section 245.4876, subdivision 7, is amended to read:

Subd. 7.

Restricted access to data.

The county board shall establish procedures to ensure that the names and addresses of children receiving mental health services and their families are disclosed only to:

(1) county employees who are specifically responsible for determining county of financial responsibility or making payments to providers; deleted text begin anddeleted text end

(2) staff who provide treatment services or case management and their clinical supervisorsdeleted text begin .deleted text end new text begin ; andnew text end

new text begin (3) personnel of the welfare system or health care providers who have access to the data under section 13.46, subdivision 7. new text end

Release of mental health data on individuals submitted under subdivisions 5 and 6, to persons other than those specified in this subdivision, or use of this data for purposes other than those stated in subdivisions 5 and 6, results in civil or criminal liability under section 13.08 or 13.09.

Sec. 14.

Minnesota Statutes 2014, section 245.4889, subdivision 1, is amended to read:

Subdivision 1.

Establishment and authority.

(a) The commissioner is authorized to make grants from available appropriations to assist:

(1) counties;

(2) Indian tribes;

(3) children's collaboratives under section 124D.23 or 245.493; or

(4) mental health service providers

deleted text begin for providing services to children with emotional disturbances as defined in section 245.4871, subdivision 15, and their families. The commissioner may also authorize grants to young adults meeting the criteria for transition services in section 245.4875, subdivision 8, and their familiesdeleted text end .

(b) new text begin The following services are eligible for grants under this section:new text end

new text begin (1) services to children with emotional disturbances as defined in section 245.4871, subdivision 15, and their families; new text end

new text begin (2) transition services under section 245.4875, subdivision 8, for young adults under age 21 and their families; new text end

new text begin (3) respite care services for children with severe emotional disturbances who are at risk of out-of-home placement; new text end

new text begin (4) children's mental health crisis services; new text end

new text begin (5) mental health services for people from cultural and ethnic minorities; new text end

new text begin (6) children's mental health screening and follow-up diagnostic assessment and treatment; new text end

new text begin (7) services to promote and develop the capacity of providers to use evidence-based practices in providing children's mental health services; new text end

new text begin (8) school-linked mental health services; new text end

new text begin (9) building evidence-based mental health intervention capacity for children birth to age five; new text end

new text begin (10) suicide prevention and counseling services that use text messaging statewide; new text end

new text begin (11) mental health first aid training; new text end

new text begin (12) training for parents, collaborative partners, and mental health providers on the impact of adverse childhood experiences and trauma and development of an interactive Web site to share information and strategies to promote resilience and prevent trauma; new text end

new text begin (13) transition age services to develop or expand mental health treatment and supports for adolescents and young adults 26 years of age or younger; new text end

new text begin (14) early childhood mental health consultation; new text end

new text begin (15) evidence-based interventions for youth at risk of developing or experiencing a first episode of psychosis, and a public awareness campaign on the signs and symptoms of psychosis; and new text end

new text begin (16) psychiatric consultation for primary care practitioners. new text end

new text begin (c) new text end Services under paragraph deleted text begin (a)deleted text end new text begin (b) new text end must be designed to help each child to function and remain with the child's family in the community and delivered consistent with the child's treatment plan. Transition services to eligible young adults under paragraph deleted text begin (a)deleted text end new text begin (b) new text end must be designed to foster independent living in the community.

Sec. 15.

Minnesota Statutes 2014, section 245.4889, is amended by adding a subdivision to read:

new text begin Subd. 3. new text end

new text begin Commissioner duty to report on use of grant funds biennially. new text end

new text begin By November 1, 2016, and biennially thereafter, the commissioner of human services shall provide sufficient information to the members of the legislative committees having jurisdiction over mental health funding and policy issues to evaluate the use of funds appropriated under this section. The commissioner shall provide, at a minimum, the following information: new text end

new text begin (1) the amount of funding for children's mental health grants, what programs and services were funded in the previous two years, and outcome data for the programs and services that were funded; and new text end

new text begin (2) the amount of funding for other targeted services and the location of services. new text end

Sec. 16.

new text begin [245.735] EXCELLENCE IN MENTAL HEALTH DEMONSTRATION PROJECT. new text end

new text begin Subdivision 1. new text end

new text begin Excellence in Mental Health demonstration project. new text end

new text begin The commissioner shall develop and execute projects to reform the mental health system by participating in the Excellence in Mental Health demonstration project. new text end

new text begin Subd. 2. new text end

new text begin Federal proposal. new text end

new text begin The commissioner shall develop and submit to the United States Department of Health and Human Services a proposal for the Excellence in Mental Health demonstration project. The proposal shall include any necessary state plan amendments, waivers, requests for new funding, realignment of existing funding, and other authority necessary to implement the projects specified in subdivision 3. new text end

new text begin Subd. 3. new text end

new text begin Reform projects. new text end

new text begin (a) The commissioner shall establish standards for state certification of clinics as certified community behavioral health clinics, in accordance with the criteria published on or before September 1, 2015, by the United States Department of Health and Human Services. Certification standards established by the commissioner shall require that: new text end

new text begin (1) clinic staff have backgrounds in diverse disciplines, include licensed mental health professionals, and are culturally and linguistically trained to serve the needs of the clinic's patient population; new text end

new text begin (2) clinic services are available and accessible and that crisis management services are available 24 hours per day; new text end

new text begin (3) fees for clinic services are established using a sliding fee scale and services to patients are not denied or limited due to a patient's inability to pay for services; new text end

new text begin (4) clinics provide coordination of care across settings and providers to ensure seamless transitions for patients across the full spectrum of health services, including acute, chronic, and behavioral needs. Care coordination may be accomplished through partnerships or formal contracts with federally qualified health centers, inpatient psychiatric facilities, substance use and detoxification facilities, community-based mental health providers, and other community services, supports, and providers including schools, child welfare agencies, juvenile and criminal justice agencies, Indian Health Services clinics, tribally licensed health care and mental health facilities, urban Indian health clinics, Department of Veterans Affairs medical centers, outpatient clinics, drop-in centers, acute care hospitals, and hospital outpatient clinics; new text end

new text begin (5) services provided by clinics include crisis mental health services, emergency crisis intervention services, and stabilization services; screening, assessment, and diagnosis services, including risk assessments and level of care determinations; patient-centered treatment planning; outpatient mental health and substance use services; targeted case management; psychiatric rehabilitation services; peer support and counselor services and family support services; and intensive community-based mental health services, including mental health services for members of the armed forces and veterans; and new text end

new text begin (6) clinics comply with quality assurance reporting requirements and other reporting requirements, including any required reporting of encounter data, clinical outcomes data, and quality data. new text end

new text begin (b) The commissioner shall establish standards and methodologies for a prospective payment system for medical assistance payments for mental health services delivered by certified community behavioral health clinics, in accordance with guidance issued on or before September 1, 2015, by the Centers for Medicare and Medicaid Services. During the operation of the demonstration project, payments shall comply with federal requirements for a 90 percent enhanced federal medical assistance percentage. new text end

new text begin Subd. 4. new text end

new text begin Public participation. new text end

new text begin In developing the projects under subdivision 3, the commissioner shall consult with mental health providers, advocacy organizations, licensed mental health professionals, and Minnesota public health care program enrollees who receive mental health services and their families. new text end

new text begin Subd. 5. new text end

new text begin Information systems support. new text end

new text begin The commissioner and the state chief information officer shall provide information systems support to the projects as necessary to comply with federal requirements. new text end

Sec. 17.

Minnesota Statutes 2014, section 246.18, subdivision 8, is amended to read:

Subd. 8.

State-operated services account.

(a) 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.

(b) Funds deposited in the state-operated services account are deleted text begin available deleted text end new text begin appropriated new text end to the commissioner of human services for the purposes of:

(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 begin andnew text end

(2) deleted text begin grants to providers participating in mental health specialty treatment services under section 245.4661; anddeleted text end

deleted text begin (3)deleted text end to fund the operation of the intensive residential treatment service program in Willmar.

Sec. 18.

Minnesota Statutes 2014, section 253B.18, subdivision 4c, is amended to read:

Subd. 4c.

Special review board.

(a) The commissioner shall establish one or more panels of a special review board. The board shall consist of three members experienced in the field of mental illness. One member of each special review board panel shall be a psychiatrist or a doctoral level psychologist with forensic experience and one member shall be an attorney. No member shall be affiliated with the Department of Human Services. The special review board shall meet at least every six months and at the call of the commissioner. It shall hear and consider all petitions for a reduction in custody or to appeal a revocation of provisional discharge. A "reduction in custody" means transfer from a secure treatment facility, discharge, and provisional discharge. Patients may be transferred by the commissioner between secure treatment facilities without a special review board hearing.

Members of the special review board shall receive compensation and reimbursement for expenses as established by the commissioner.

(b) new text begin The special review board must review each denied petition under subdivision 5 for barriers and obstacles preventing the patient from progressing in treatment. Based on the cases before the board in the previous year, the special review board shall provide to the commissioner an annual summation of the barriers to treatment progress, and recommendations to achieve the common goal of making progress in treatment.new text end

new text begin (c) new text end A petition filed by a person committed as mentally ill and dangerous to the public under this section must be heard as provided in subdivision 5 and, as applicable, subdivision 13. A petition filed by a person committed as a sexual psychopathic personality or as a sexually dangerous person under chapter 253D, or committed as both mentally ill and dangerous to the public under this section and as a sexual psychopathic personality or as a sexually dangerous person must be heard as provided in section 253D.27.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2016. new text end

Sec. 19.

Minnesota Statutes 2014, section 253B.18, subdivision 5, is amended to read:

Subd. 5.

Petition; notice of hearing; attendance; order.

(a) A petition for a reduction in custody or revocation of provisional discharge shall be filed with the commissioner and may be filed by the patient or by the head of the treatment facility. A patient may not petition the special review board for six months following commitment under subdivision 3 or following the final disposition of any previous petition and subsequent appeal by the patient. new text begin The head of the treatment facility must schedule a hearing before the special review board for any patient who has not appeared before the special review board in the previous three years, and schedule a hearing at least every three years thereafter. new text end The medical director may petition at any time.

(b) Fourteen days prior to the hearing, the committing court, the county attorney of the county of commitment, the designated agency, interested person, the petitioner, and the petitioner's counsel shall be given written notice by the commissioner of the time and place of the hearing before the special review board. Only those entitled to statutory notice of the hearing or those administratively required to attend may be present at the hearing. The patient may designate interested persons to receive notice by providing the names and addresses to the commissioner at least 21 days before the hearing. The board shall provide the commissioner with written findings of fact and recommendations within 21 days of the hearing. The commissioner shall issue an order no later than 14 days after receiving the recommendation of the special review board. A copy of the order shall be mailed to every person entitled to statutory notice of the hearing within five days after it is signed. No order by the commissioner shall be effective sooner than 30 days after the order is signed, unless the county attorney, the patient, and the commissioner agree that it may become effective sooner.

(c) The special review board shall hold a hearing on each petition prior to making its recommendation to the commissioner. The special review board proceedings are not contested cases as defined in chapter 14. Any person or agency receiving notice that submits documentary evidence to the special review board prior to the hearing shall also provide copies to the patient, the patient's counsel, the county attorney of the county of commitment, the case manager, and the commissioner.

(d) Prior to the final decision by the commissioner, the special review board may be reconvened to consider events or circumstances that occurred subsequent to the hearing.

(e) In making their recommendations and order, the special review board and commissioner must consider any statements received from victims under subdivision 5a.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2016, with hearings starting no later than February 1, 2016. new text end

Sec. 20.

Minnesota Statutes 2014, section 254B.05, subdivision 5, as amended by Laws 2015, chapter 21, article 1, section 52, is amended to read:

Subd. 5.

Rate requirements.

(a) The commissioner shall establish rates for chemical dependency services and service enhancements funded under this chapter.

(b) Eligible chemical dependency treatment services include:

(1) outpatient treatment services that are licensed according to Minnesota Rules, parts 9530.6405 to 9530.6480, or applicable tribal license;

(2) medication-assisted therapy services that are licensed according to Minnesota Rules, parts 9530.6405 to 9530.6480 and 9530.6500, or applicable tribal license;

(3) medication-assisted therapy plus enhanced treatment services that meet the requirements of clause (2) and provide nine hours of clinical services each week;

(4) high, medium, and low intensity residential treatment services that are licensed according to Minnesota Rules, parts 9530.6405 to 9530.6480 and 9530.6505, or applicable tribal license which provide, respectively, 30, 15, and five hours of clinical services each week;

(5) hospital-based treatment services that are licensed according to Minnesota Rules, parts 9530.6405 to 9530.6480, or applicable tribal license and licensed as a hospital under sections 144.50 to 144.56;

(6) adolescent treatment programs that are licensed as outpatient treatment programs according to Minnesota Rules, parts 9530.6405 to 9530.6485, or as residential treatment programs according to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or applicable tribal license; deleted text begin anddeleted text end

(7) new text begin high-intensity residential treatment services that are licensed according to Minnesota Rules, parts 9530.6405 to 9530.6480 and 9530.6505, or applicable tribal license, which provide 30 hours of clinical services each week provided by a state-operated vendor or to clients who have been civilly committed to the commissioner, present the most complex and difficult care needs, and are a potential threat to the community; andnew text end

new text begin (8) new text end room and board facilities that meet the requirements of subdivision 1a.

(c) The commissioner shall establish higher rates for programs that meet the requirements of paragraph (b) and the following additional requirements:

(1) programs that serve parents with their children if the program:

(i) provides on-site child care during hours of treatment activity that meets the requirements in Minnesota Rules, part 9530.6490, or section 245A.03, subdivision 2; or

(ii) arranges for off-site child care during hours of treatment activity at a facility that is licensed under chapter 245A as:

(A) a child care center under Minnesota Rules, chapter 9503; or

(B) a family child care home under Minnesota Rules, chapter 9502;

(2) culturally specific programs as defined in section 254B.01, subdivision 4a, if the program meets the requirements in Minnesota Rules, part 9530.6605, subpart 13;

(3) programs that offer medical services delivered by appropriately credentialed health care staff in an amount equal to two hours per client per week if the medical needs of the client and the nature and provision of any medical services provided are documented in the client file; and

(4) programs that offer services to individuals with co-occurring mental health and chemical dependency problems if:

(i) the program meets the co-occurring requirements in Minnesota Rules, part 9530.6495;

(ii) 25 percent of the counseling staff are licensed mental health professionals, as defined in section 245.462, subdivision 18, clauses (1) to (6), or are students or licensing candidates under the supervision of a licensed alcohol and drug counselor supervisor and licensed mental health professional, except that no more than 50 percent of the mental health staff may be students or licensing candidates with time documented to be directly related to provisions of co-occurring services;

(iii) clients scoring positive on a standardized mental health screen receive a mental health diagnostic assessment within ten days of admission;

(iv) the program has standards for multidisciplinary case review that include a monthly review for each client that, at a minimum, includes a licensed mental health professional and licensed alcohol and drug counselor, and their involvement in the review is documented;

(v) family education is offered that addresses mental health and substance abuse disorders and the interaction between the two; and

(vi) co-occurring counseling staff will receive eight hours of co-occurring disorder training annually.

(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program that provides arrangements for off-site child care must maintain current documentation at the chemical dependency facility of the child care provider's current licensure to provide child care services. Programs that provide child care according to paragraph (c), clause (1), must be deemed in compliance with the licensing requirements in Minnesota Rules, part 9530.6490.

(e) Adolescent residential programs that meet the requirements of Minnesota Rules, parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements in paragraph (c), clause (4), items (i) to (iv).

Sec. 21.

Minnesota Statutes 2014, section 254B.12, subdivision 2, is amended to read:

Subd. 2.

Payment methodology for highly specialized vendors.

deleted text begin (a) deleted text end Notwithstanding subdivision 1, the commissioner shall seek federal authority to develop separate payment methodologies for chemical dependency treatment services provided under the consolidated chemical dependency treatment fund: (1) by a state-operated vendor; or (2) for persons who have been civilly committed to the commissioner, present the most complex and difficult care needs, and are a potential threat to the community. A payment methodology under this subdivision is effective for services provided on or after October 1, 2015, or on or after the receipt of federal approval, whichever is later.

deleted text begin (b) Before implementing an approved payment methodology under paragraph (a), the commissioner must also receive any necessary legislative approval of required changes to state law or funding. deleted text end

Sec. 22.

Minnesota Statutes 2014, section 256B.0615, subdivision 3, is amended to read:

Subd. 3.

Eligibility.

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

Sec. 23.

Minnesota Statutes 2014, section 256B.0622, subdivision 1, is amended to read:

Subdivision 1.

Scope.

Subject to federal approval, medical assistance covers medically necessary, deleted text begin intensive nonresidentialdeleted text end new text begin assertive community treatmentnew text end and new text begin intensive new text end residential deleted text begin rehabilitative mental healthdeleted text end new text begin treatmentnew text end services as defined in subdivision 2, for recipients as defined in subdivision 3, when the services are provided by an entity meeting the standards in this section.

Sec. 24.

Minnesota Statutes 2014, section 256B.0622, subdivision 2, is amended to read:

Subd. 2.

Definitions.

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

(a) deleted text begin "Intensive nonresidential rehabilitative mental health services" means adult rehabilitative mental health services as defined in section 256B.0623, subdivision 2, paragraph (a), except that these services are provided by a multidisciplinary staff using a total team approach consistent with assertive community treatment, the Fairweather Lodge treatment model, as defined by the standards established by the National Coalition for Community Living, and other evidence-based practices, and directed to recipients with a serious mental illness who require intensive services.deleted text end new text begin "Assertive community treatment" means intensive nonresidential rehabilitative mental health services provided according to the evidence-based practice of assertive community treatment. Core elements of this service include, but are not limited to:new text end

new text begin (1) a multidisciplinary staff who utilize a total team approach and who serve as a fixed point of responsibility for all service delivery; new text end

new text begin (2) providing services 24 hours per day and 7 days per week; new text end

new text begin (3) providing the majority of services in a community setting; new text end

new text begin (4) offering a low ratio of recipients to staff; and new text end

new text begin (5) providing service that is not time-limited. new text end

(b) "Intensive residential deleted text begin rehabilitative mental healthdeleted text end new text begin treatmentnew text end services" means short-term, time-limited services provided in a residential setting to recipients who are in need of more restrictive settings and are at risk of significant functional deterioration if they do not receive these services. Services are designed to develop and enhance psychiatric stability, personal and emotional adjustment, self-sufficiency, and skills to live in a more independent setting. Services must be directed toward a targeted discharge date with specified client outcomes deleted text begin and must be consistent with the Fairweather Lodge treatment model as defined in paragraph (a), and other evidence-based practicesdeleted text end .

(c) "Evidence-based practices" are nationally recognized mental health services that are proven by substantial research to be effective in helping individuals with serious mental illness obtain specific treatment goals.

(d) "Overnight staff" means a member of the intensive residential rehabilitative mental health treatment team who is responsible during hours when recipients are typically asleep.

(e) "Treatment team" means all staff who provide services under this section to recipients. At a minimum, this includes the clinical supervisor, mental health professionals as defined in section 245.462, subdivision 18, clauses (1) to (6); mental health practitioners as defined in section 245.462, subdivision 17; mental health rehabilitation workers under section 256B.0623, subdivision 5, clause (3); and certified peer specialists under section 256B.0615.

Sec. 25.

Minnesota Statutes 2014, section 256B.0622, subdivision 3, is amended to read:

Subd. 3.

Eligibility.

An eligible recipient is an individual who:

(1) is age 18 or older;

(2) is eligible for medical assistance;

(3) is diagnosed with a mental illness;

(4) because of a mental illness, has substantial disability and functional impairment in three or more of the areas listed in section 245.462, subdivision 11a, so that self-sufficiency is markedly reduced;

(5) has one or more of the following: a history of deleted text begin two or moredeleted text end new text begin recurring or prolonged new text end inpatient hospitalizations in the past year, significant independent living instability, homelessness, or very frequent use of mental health and related services yielding poor outcomes; and

(6) in the written opinion of a licensed mental health professional, has the need for mental health services that cannot be met with other available community-based services, or is likely to experience a mental health crisis or require a more restrictive setting if intensive rehabilitative mental health services are not provided.

Sec. 26.

Minnesota Statutes 2014, section 256B.0622, subdivision 4, is amended to read:

Subd. 4.

Provider certification and contract requirements.

(a) The deleted text begin intensive nonresidential rehabilitative mental health servicesdeleted text end new text begin assertive community treatment new text end provider must:

(1) have a contract with the host county to provide intensive adult rehabilitative mental health services; and

(2) be certified by the commissioner as being in compliance with this section and section 256B.0623.

(b) The intensive residential deleted text begin rehabilitative mental healthdeleted text end new text begin treatmentnew text end services provider must:

(1) be licensed under Minnesota Rules, parts 9520.0500 to 9520.0670;

(2) not exceed 16 beds per site;

(3) comply with the additional standards in this section; and

(4) have a contract with the host county to provide these services.

(c) The commissioner shall develop procedures for counties and providers to submit contracts and other documentation as needed to allow the commissioner to determine whether the standards in this section are met.

Sec. 27.

Minnesota Statutes 2014, section 256B.0622, subdivision 5, is amended to read:

Subd. 5.

Standards applicable to both deleted text begin nonresidentialdeleted text end new text begin assertive community treatmentnew text end and residential providers.

(a) Services must be provided by qualified staff as defined in section 256B.0623, subdivision 5, who are trained and supervised according to section 256B.0623, subdivision 6, except that mental health rehabilitation workers acting as overnight staff are not required to comply with section 256B.0623, subdivision 5, clause deleted text begin (3)deleted text end new text begin (4), item new text end (iv).

(b) The clinical supervisor must be an active member of the treatment team. The treatment team must meet with the clinical supervisor at least weekly to discuss recipients' progress and make rapid adjustments to meet recipients' needs. The team meeting shall include recipient-specific case reviews and general treatment discussions among team members. Recipient-specific case reviews and planning must be documented in the individual recipient's treatment record.

(c) Treatment staff must have prompt access in person or by telephone to a mental health practitioner or mental health professional. The provider must have the capacity to promptly and appropriately respond to emergent needs and make any necessary staffing adjustments to assure the health and safety of recipients.

(d) The initial functional assessment must be completed within ten days of intake and updated at least every deleted text begin three monthsdeleted text end new text begin 30 days for intensive residential treatment services and every six months for assertive community treatment,new text end or prior to discharge from the service, whichever comes first.

(e) The initial individual treatment plan must be completed within ten days of intake deleted text begin anddeleted text end new text begin for assertive community treatment and within 24 hours of admission for intensive residential treatment services. Within ten days of admission, the initial treatment plan must be refined and further developed for intensive residential treatment services, except for providers certified according to Minnesota Rules, parts 9533.0010 to 9533.0180. The individual treatment plan must be new text end reviewednew text begin with the recipientnew text end and updated at least monthly deleted text begin with the recipientdeleted text end new text begin for intensive residential treatment services and at least every six months for assertive community treatmentnew text end .

Sec. 28.

Minnesota Statutes 2014, section 256B.0622, subdivision 7, is amended to read:

Subd. 7.

Additional standards for deleted text begin nonresidential servicesdeleted text end new text begin assertive community treatmentnew text end .

The standards in this subdivision apply to deleted text begin intensive nonresidential rehabilitative mental healthdeleted text end new text begin assertive community treatmentnew text end services.

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

(2) The clinical supervisor must function as a practicing clinician at least on a part-time basis.

(3) The staffing ratio must not exceed ten recipients to one full-time equivalent treatment team position.

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

(5) The treatment team must actively and assertively engage and reach out to the recipient's family members and significant others, after obtaining the recipient's permission.

(6) The treatment team must establish ongoing communication and collaboration between the team, family, and significant others and educate the family and significant others about mental illness, symptom management, and the family's role in treatment.

(7) The treatment team must provide interventions to promote positive interpersonal relationships.

Sec. 29.

Minnesota Statutes 2014, section 256B.0622, subdivision 8, is amended to read:

Subd. 8.

Medical assistance payment for intensive rehabilitative mental health services.

(a) Payment for new text begin intensive new text end residential deleted text begin and nonresidentialdeleted text end new text begin treatmentnew text end services new text begin and assertive community treatment new text end in this section shall be based on one daily rate per provider inclusive of the following services received by an eligible recipient in a given calendar day: all rehabilitative services under this section, staff travel time to provide rehabilitative services under this section, and nonresidential crisis stabilization services under section 256B.0624.

(b) Except as indicated in paragraph (c), payment will not be made to more than one entity for each recipient for services provided under this section on a given day. If services under this section are provided by a team that includes staff from more than one entity, the team must determine how to distribute the payment among the members.

(c) The commissioner shall determine one rate for each provider that will bill medical assistance for residential services under this section and one rate for each deleted text begin nonresidentialdeleted text end new text begin assertive community treatmentnew text end provider. If a single entity provides both services, one rate is established for the entity's residential services and another rate for the entity's nonresidential services under this section. A provider is not eligible for payment under this section without authorization from the commissioner. The commissioner shall develop rates using the following criteria:

deleted text begin (1) the cost for similar services in the local trade area; deleted text end

deleted text begin (2)deleted text end new text begin (1)new text end the provider's cost for services shall include direct services costs, other program costs, and other costs determined as follows:

(i) the direct services costs must be determined using actual costs of salaries, benefits, payroll taxes, and training of direct service staff and service-related transportation;

(ii) other program costs not included in item (i) must be determined as a specified percentage of the direct services costs as determined by item (i). The percentage used shall be determined by the commissioner based upon the average of percentages that represent the relationship of other program costs to direct services costs among the entities that provide similar services;

(iii) deleted text begin in situations where a provider of intensive residential services can demonstrate actual program-related physical plant costs in excess of the group residential housing reimbursement, the commissioner may include these costs in the program rate, so long as the additional reimbursement does not subsidize the room and board expenses of the programdeleted text end new text begin physical plant costs calculated based on the percentage of space within the program that is entirely devoted to treatment and programming. This does not include administrative or residential spacenew text end ;

(iv) deleted text begin intensive nonresidential servicesdeleted text end new text begin assertive community treatmentnew text end physical plant costs must be reimbursed as part of the costs described in item (ii); and

(v) new text begin subject to federal approval, new text end up to an additional five percent of the total rate deleted text begin must deleted text end new text begin maynew text end be added to the program rate as a quality incentive based upon the entity meeting performance criteria specified by the commissioner;

deleted text begin (3)deleted text end new text begin (2)new text end actual cost is defined as costs which are allowable, allocable, and reasonable, and consistent with federal reimbursement requirements under Code of Federal Regulations, title 48, chapter 1, part 31, relating to for-profit entities, and Office of Management and Budget Circular Number A-122, relating to nonprofit entities;

deleted text begin (4)deleted text end new text begin (3)new text end the number of service units;

deleted text begin (5)deleted text end new text begin (4)new text end the degree to which recipients will receive services other than services under this section;new text begin andnew text end

deleted text begin (6)deleted text end new text begin (5)new text end the costs of other services that will be separately reimburseddeleted text begin ; anddeleted text end new text begin .new text end

deleted text begin (7) input from the local planning process authorized by the adult mental health initiative under section 245.4661, regarding recipients' service needs. deleted text end

(d) The rate for intensive deleted text begin rehabilitative mental healthdeleted text end new text begin residential treatmentnew text end services new text begin and assertive community treatmentnew text end must exclude room and board, as defined in section 256I.03, subdivision 6, and services not covered under this section, such as partial hospitalization, home care, and inpatient services.

new text begin (e) new text end Physician services that are not separately billed may be included in the rate to the extent that a psychiatristnew text begin , or other health care professional providing physician services within their scope of practice, new text end is a member of the treatment team.new text begin Physician services, whether billed separately or included in the rate, may be delivered by telemedicine. For purposes of this paragraph, "telemedicine" has the meaning given to "mental health telemedicine" in section 256B.0625, subdivision 46, when telemedicine is used to provide intensive residential treatment services.new text end

deleted text begin (e)deleted text end new text begin (f)new text end When services under this section are provided by an deleted text begin intensive nonresidential servicedeleted text end new text begin assertive community treatment new text end provider, case management functions must be an integral part of the team.

deleted text begin (f)deleted text end new text begin (g)new text end The rate for a provider must not exceed the rate charged by that provider for the same service to other payors.

deleted text begin (g)deleted text end new text begin (h)new text end The rates for existing programs must be established prospectively based upon the expenditures and utilization over a prior 12-month period using the criteria established in paragraph (c).new text begin The rates for new programs must be established based upon estimated expenditures and estimated utilization using the criteria established in paragraph (c).new text end

deleted text begin (h)deleted text end new text begin (i)new text end Entities who discontinue providing services must be subject to a settle-up process whereby actual costs and reimbursement for the previous 12 months are compared. In the event that the entity was paid more than the entity's actual costs plus any applicable performance-related funding due the provider, the excess payment must be reimbursed to the department. If a provider's revenue is less than actual allowed costs due to lower utilization than projected, the commissioner may reimburse the provider to recover its actual allowable costs. The resulting adjustments by the commissioner must be proportional to the percent of total units of service reimbursed by the commissioner new text begin and must reflect a difference of greater than five percentnew text end .

deleted text begin (i)deleted text end new text begin (j)new text end A provider may request of the commissioner a review of any rate-setting decision made under this subdivision.

Sec. 30.

Minnesota Statutes 2014, section 256B.0622, subdivision 9, is amended to read:

Subd. 9.

Provider enrollment; rate setting for county-operated entities.

Counties that employ their own staff to provide services under this section shall apply directly to the commissioner for enrollment and rate setting. In this case, a county contract is not required deleted text begin and the commissioner shall perform the program review and rate setting duties which would otherwise be required of counties under this sectiondeleted text end .

Sec. 31.

Minnesota Statutes 2014, section 256B.0622, subdivision 10, is amended to read:

Subd. 10.

Provider enrollment; rate setting for specialized program.

A new text begin county contract is not required for a new text end provider proposing to serve a subpopulation of eligible recipients deleted text begin may bypass the county approval procedures in this section and receive approval for provider enrollment and rate setting directly from the commissionerdeleted text end under the following circumstances:

(1) the provider demonstrates that the subpopulation to be served requires a specialized program which is not available from county-approved entities; and

(2) the subpopulation to be served is of such a low incidence that it is not feasible to develop a program serving a single county or regional group of counties.

deleted text begin For providers meeting the criteria in clauses (1) and (2), the commissioner shall perform the program review and rate setting duties which would otherwise be required of counties under this section. deleted text end

Sec. 32.

Minnesota Statutes 2014, section 256B.0622, is amended by adding a subdivision to read:

new text begin Subd. 11. new text end

new text begin Sustainability grants. new text end

new text begin The commissioner may disburse grant funds directly to intensive residential treatment services providers and assertive community treatment providers to maintain access to these services. new text end

Sec. 33.

Minnesota Statutes 2014, section 256B.0624, subdivision 7, is amended to read:

Subd. 7.

Crisis stabilization services.

(a) Crisis stabilization services must be provided by qualified staff of a crisis stabilization services provider entity and must meet the following standards:

(1) a crisis stabilization treatment plan must be developed which meets the criteria in subdivision 11;

(2) staff must be qualified as defined in subdivision 8; and

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

(b) If crisis stabilization services are provided in a supervised, licensed residential setting, the recipient must be contacted face-to-face daily by a qualified mental health practitioner or mental health professional. The program must have 24-hour-a-day residential staffing which may include staff who do not meet the qualifications in subdivision 8. The residential staff must have 24-hour-a-day immediate direct or telephone access to a qualified mental health professional or practitioner.

(c) If crisis stabilization services are provided in a supervised, licensed residential setting that serves no more than four adult residents, and deleted text begin no more than two are recipients of crisis stabilization servicesdeleted text end new text begin one or more individuals are present at the setting to receive residential crisis stabilization servicesnew text end , the residential staff must include, for at least eight hours per day, at least one individual who meets the qualifications in subdivision 8new text begin , paragraph (a), clause (1) or (2)new text end .

(d) If crisis stabilization services are provided in a supervised, licensed residential setting that serves more than four adult residents, and one or more are recipients of crisis stabilization services, the residential staff must include, for 24 hours a day, at least one individual who meets the qualifications in subdivision 8. During the first 48 hours that a recipient is in the residential program, the residential program must have at least two staff working 24 hours a day. Staffing levels may be adjusted thereafter according to the needs of the recipient as specified in the crisis stabilization treatment plan.

Sec. 34.

Minnesota Statutes 2014, section 256B.0625, is amended by adding a subdivision to read:

new text begin Subd. 45a. new text end

new text begin Psychiatric residential treatment facility services for persons under 21 years of age. new text end

new text begin (a) Medical assistance covers psychiatric residential treatment facility services for persons under 21 years of age. Individuals who reach age 21 at the time they are receiving services are eligible to continue receiving services until they no longer require services or until they reach age 22, whichever occurs first. new text end

new text begin (b) For purposes of this subdivision, "psychiatric residential treatment facility" means a facility other than a hospital that provides psychiatric services, as described in Code of Federal Regulations, title 42, sections 441.151 to 441.182, to individuals under age 21 in an inpatient setting. new text end

new text begin (c) The commissioner shall develop admissions and discharge procedures and establish rates consistent with guidelines from the federal Centers for Medicare and Medicaid Services. new text end

new text begin (d) The commissioner shall enroll up to 150 certified psychiatric residential treatment facility services beds at up to six sites. The commissioner shall select psychiatric residential treatment facility services providers through a request for proposals process. Providers of state-operated services may respond to the request for proposals. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2017, 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. 35.

Minnesota Statutes 2014, section 256B.0625, subdivision 48, is amended to read:

Subd. 48.

Psychiatric consultation to primary care practitioners.

Medical assistance covers consultation provided by a psychiatrist, a psychologist, deleted text begin ordeleted text end an advanced practice registered nurse certified in psychiatric mental healthnew text begin , a licensed independent clinical social worker, as defined in section 245.462, subdivision 18, clause (2), or a licensed marriage and family therapist, as defined in section 245.462, subdivision 18, clause (5),new 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. 36.

new text begin [256B.7631] CHEMICAL DEPENDENCY PROVIDER RATE INCREASE. new text end

new text begin For the chemical dependency services listed in section 254B.05, subdivision 5, and provided on or after July 1, 2015, payment rates shall be increased by two percent over the rates in effect on January 1, 2014, for vendors who meet the requirements of section 254B.05. new text end

Sec. 37.

new text begin CLUBHOUSE PROGRAM SERVICES. new text end

new text begin The commissioner of human services, in consultation with stakeholders, shall develop service standards and a payment methodology for Clubhouse program services to be covered under medical assistance when provided by a Clubhouse International accredited provider or a provider meeting equivalent standards. The commissioner shall seek federal approval for the service standards and payment methodology. Upon federal approval, the commissioner must seek and obtain legislative approval of the services standards and funding methodology allowing medical assistance coverage of the service. new text end

Sec. 38.

new text begin EXCELLENCE IN MENTAL HEALTH DEMONSTRATION PROJECT. new text end

new text begin By January 15, 2016, the commissioner of human services shall report to the legislative committees in the house of representatives and senate with jurisdiction over human services issues on the progress of the Excellence in Mental Health demonstration project under Minnesota Statutes, section 245.735. The commissioner shall include in the report any recommendations for legislative changes needed to implement the reform projects specified in Minnesota Statutes, section 245.735, subdivision 3. new text end

Sec. 39.

new text begin RATE-SETTING METHODOLOGY FOR COMMUNITY-BASED MENTAL HEALTH SERVICES. new text end

new text begin The commissioner of human services shall conduct a comprehensive analysis of the current rate-setting methodology for all community-based mental health services for children and adults. The report shall include an assessment of alternative payment structures, consistent with the intent and direction of the federal Centers for Medicare and Medicaid Services, that could provide adequate reimbursement to sustain community-based mental health services regardless of geographic location. The report shall also include recommendations for establishing pay-for-performance measures for providers delivering services consistent with evidence-based practices. In developing the report, the commissioner shall consult with stakeholders and with outside experts in Medicaid financing. The commissioner shall provide a report on the analysis to the chairs of the legislative committees with jurisdiction over health and human services finance by January 1, 2017. new text end

Sec. 40.

new text begin REPORT ON HUMAN SERVICES DATA SHARING TO COORDINATE SERVICES AND CARE OF A PATIENT. new text end

new text begin The commissioner of human services, in coordination with Hennepin County, shall report to the legislative committees with jurisdiction over health care financing on the fiscal impact, including the estimated savings, resulting from the modifications to the Data Practices Act in the 2015 legislative session, permitting the sharing of public welfare data and allowing the exchange of health records between providers to the extent necessary to coordinate services and care for clients enrolled in public health care programs. Counties shall provide information on the fiscal impact, including the estimated savings, resulting from the modifications to the Data Practices Act in the 2015 legislative session, the number of clients receiving care coordination, and improved outcomes achieved due to data sharing, to the commissioner of human services to include in the report. The commissioner may establish the form in which the information must be provided. The report is due January 1, 2017. new text end

Sec. 41.

new text begin COMPREHENSIVE MENTAL HEALTH PROGRAM IN BELTRAMI COUNTY. new text end

new text begin (a) The commissioner of human services shall award a grant to Beltrami County to fund the planning and development of a comprehensive mental health program contingent upon Beltrami County providing to the commissioner of human services a formal commitment and plan to fund, operate, and sustain the program and services after the onetime state grant is expended. The county must provide evidence of the funding stream or mechanism, and a sufficient local funding commitment, that will ensure that the onetime state investment in the program will result in a sustainable program without future state grants. The funding stream may include state funding for programs and services for which the individuals served under this section may be eligible. The grant under this section cannot be used for any purpose that could be funded with state bond proceeds. This is a onetime appropriation. new text end

new text begin (b) The planning and development of the program by the county must include an integrated care model for the provision of mental health and substance use disorder treatment for the individuals served under paragraph (c), in collaboration with existing services. The model may include mobile crisis services, crisis residential services, outpatient services, and community-based services. The model must be patient-centered, culturally competent, and based on evidence-based practices. new text end

new text begin (c) The comprehensive mental health program will serve individuals who are: new text end

new text begin (1) under arrest or subject to arrest who are experiencing a mental health crisis; new text end

new text begin (2) under a transport hold under Minnesota Statutes, section 253B.05, subdivision 2; or new text end

new text begin (3) in immediate need of mental health crisis services. new text end

new text begin (d) The commissioner of human services may encourage the commissioners of the Minnesota Housing Finance Agency, corrections, and health to provide technical assistance and support in the planning and development of the mental health program under paragraph (a). The commissioners of the Minnesota Housing Finance Agency and human services may explore a plan to develop short-term and long-term housing for individuals served by the program, and the possibility of using existing appropriations available in the housing finance budget for low-income housing or homelessness. new text end

new text begin (e) The commissioner of human services, in consultation with Beltrami County, shall report to the senate and house of representatives committees having jurisdiction over mental health issues the status of the planning and development of the mental health program, and the plan to financially support the program and services after the state grant is expended, by November 1, 2017. new text end

Sec. 42.

new text begin MENTAL HEALTH CRISIS SERVICES. new text end

new text begin The commissioner of human services shall increase access to mental health crisis services for children and adults. In order to increase access, the commissioner must: new text end

new text begin (1) develop a central phone number where calls can be routed to the appropriate crisis services; new text end

new text begin (2) provide telephone consultation 24 hours a day to mobile crisis teams who are serving people with traumatic brain injury or intellectual disabilities who are experiencing a mental health crisis; new text end

new text begin (3) expand crisis services across the state, including rural areas of the state and examining access per population; new text end

new text begin (4) establish and implement state standards for crisis services; and new text end

new text begin (5) provide grants to adult mental health initiatives, counties, tribes, or community mental health providers to establish new mental health crisis residential service capacity. new text end

new text begin Priority will be given to regions that do not have a mental health crisis residential services program, do not have an inpatient psychiatric unit within the region, do not have an inpatient psychiatric unit within 90 miles, or have a demonstrated need based on the number of crisis residential or intensive residential treatment beds available to meet the needs of the residents in the region. At least 50 percent of the funds must be distributed to programs in rural Minnesota. Grant funds may be used for start-up costs, including but not limited to renovations, furnishings, and staff training. Grant applications shall provide details on how the intended service will address identified needs and shall demonstrate collaboration with crisis teams, other mental health providers, hospitals, and police. new text end

Sec. 43.

new text begin INSTRUCTIONS TO THE COMMISSIONER. new text end

new text begin The commissioner of human services shall, in consultation with stakeholders, develop recommendations on funding for children's mental health crisis residential services that will allow for timely access without requiring county authorization or child welfare placement. new text end

ARTICLE 3

WITHDRAWAL MANAGEMENT PROGRAMS

Section 1.

new text begin [245F.01] PURPOSE. new text end

new text begin It is hereby declared to be the public policy of this state that the public interest is best served by providing efficient and effective withdrawal management services to persons in need of appropriate detoxification, assessment, intervention, and referral services. The services shall vary to address the unique medical needs of each patient and shall be responsive to the language and cultural needs of each patient. Services shall not be denied on the basis of a patient's inability to pay. new text end

Sec. 2.

new text begin [245F.02] DEFINITIONS. new text end

new text begin Subdivision 1. new text end

new text begin Scope. new text end

new text begin The terms used in this chapter have the meanings given them in this section. new text end

new text begin Subd. 2. new text end

new text begin Administration of medications. new text end

new text begin "Administration of medications" means performing a task to provide medications to a patient, and includes the following tasks performed in the following order: new text end

new text begin (1) checking the patient's medication record; new text end

new text begin (2) preparing the medication for administration; new text end

new text begin (3) administering the medication to the patient; new text end

new text begin (4) documenting administration of the medication or the reason for not administering the medication as prescribed; and new text end

new text begin (5) reporting information to a licensed practitioner or a registered nurse regarding problems with the administration of the medication or the patient's refusal to take the medication. new text end

new text begin Subd. 3. new text end

new text begin Alcohol and drug counselor. new text end

new text begin "Alcohol and drug counselor" means an individual qualified under Minnesota Rules, part 9530.6450, subpart 5. new text end

new text begin Subd. 4. new text end

new text begin Applicant. new text end

new text begin "Applicant" means an individual, partnership, voluntary association, corporation, or other public or private organization that submits an application for licensure under this chapter. new text end

new text begin Subd. 5. new text end

new text begin Care coordination. new text end

new text begin "Care coordination" means activities intended to bring together health services, patient needs, and streams of information to facilitate the aims of care. Care coordination includes an ongoing needs assessment, life skills advocacy, treatment follow-up, disease management, education, and other services as needed. new text end

new text begin Subd. 6. new text end

new text begin Chemical. new text end

new text begin "Chemical" means alcohol, solvents, controlled substances as defined in section 152.01, subdivision 4, and other mood-altering substances. new text end

new text begin Subd. 7. new text end

new text begin Clinically managed program. new text end

new text begin "Clinically managed program" means a residential setting with staff comprised of a medical director and a licensed practical nurse. A licensed practical nurse must be on site 24 hours a day, seven days a week. A qualified medical professional must be available by telephone or in person for consultation 24 hours a day. Patients admitted to this level of service receive medical observation, evaluation, and stabilization services during the detoxification process; access to medications administered by trained, licensed staff to manage withdrawal; and a comprehensive assessment pursuant to Minnesota Rules, part 9530.6422. new text end

new text begin Subd. 8. new text end

new text begin Commissioner. new text end

new text begin "Commissioner" means the commissioner of human services or the commissioner's designated representative. new text end

new text begin Subd. 9. new text end

new text begin Department. new text end

new text begin "Department" means the Department of Human Services. new text end

new text begin Subd. 10. new text end

new text begin Direct patient contact. new text end

new text begin "Direct patient contact" has the meaning given for "direct contact" in section 245C.02, subdivision 11. new text end

new text begin Subd. 11. new text end

new text begin Discharge plan. new text end

new text begin "Discharge plan" means a written plan that states with specificity the services the program has arranged for the patient to transition back into the community. new text end

new text begin Subd. 12. new text end

new text begin Licensed practitioner. new text end

new text begin "Licensed practitioner" means a practitioner as defined in section 151.01, subdivision 23, who is authorized to prescribe. new text end

new text begin Subd. 13. new text end

new text begin Medical director. new text end

new text begin "Medical director" means an individual licensed in Minnesota as a doctor of osteopathy or physician, or an individual licensed in Minnesota as an advanced practice registered nurse by the Board of Nursing and certified to practice as a clinical nurse specialist or nurse practitioner by a national nurse organization acceptable to the board. The medical director must be employed by or under contract with the license holder to direct and supervise health care for patients of a program licensed under this chapter. new text end

new text begin Subd. 14. new text end

new text begin Medically monitored program. new text end

new text begin "Medically monitored program" means a residential setting with staff that includes a registered nurse and a medical director. A registered nurse must be on site 24 hours a day. A medical director must be on site seven days a week, and patients must have the ability to be seen by a medical director within 24 hours. Patients admitted to this level of service receive medical observation, evaluation, and stabilization services during the detoxification process; medications administered by trained, licensed staff to manage withdrawal; and a comprehensive assessment pursuant to Minnesota Rules, part 9530.6422. new text end

new text begin Subd. 15. new text end

new text begin Nurse. new text end

new text begin "Nurse" means a person licensed and currently registered to practice practical or professional nursing as defined in section 148.171, subdivisions 14 and 15. new text end

new text begin Subd. 16. new text end

new text begin Patient. new text end

new text begin "Patient" means an individual who presents or is presented for admission to a withdrawal management program that meets the criteria in section 245F.05. new text end

new text begin Subd. 17. new text end

new text begin Peer recovery support services. new text end

new text begin "Peer recovery support services" means mentoring and education, advocacy, and nonclinical recovery support provided by a recovery peer. new text end

new text begin Subd. 18. new text end

new text begin Program director. new text end

new text begin "Program director" means the individual who is designated by the license holder to be responsible for all operations of a withdrawal management program and who meets the qualifications specified in section 245F.15, subdivision 3. new text end

new text begin Subd. 19. new text end

new text begin Protective procedure. new text end

new text begin "Protective procedure" means an action taken by a staff member of a withdrawal management program to protect a patient from imminent danger of harming self or others. Protective procedures include the following actions: new text end

new text begin (1) seclusion, which means the temporary placement of a patient, without the patient's consent, in an environment to prevent social contact; and new text end

new text begin (2) physical restraint, which means the restraint of a patient by use of physical holds intended to limit movement of the body. new text end

new text begin Subd. 20. new text end

new text begin Qualified medical professional. new text end

new text begin "Qualified medical professional" means an individual licensed in Minnesota as a doctor of osteopathy or physician, or an individual licensed in Minnesota as an advanced practice registered nurse by the Board of Nursing and certified to practice as a clinical nurse specialist or nurse practitioner by a national nurse organization acceptable to the board. new text end

new text begin Subd. 21. new text end

new text begin Recovery peer. new text end

new text begin "Recovery peer" means a person who has progressed in the person's own recovery from substance use disorder and is willing to serve as a peer to assist others in their recovery. new text end

new text begin Subd. 22. new text end

new text begin Responsible staff person. new text end

new text begin "Responsible staff person" means the program director, the medical director, or a staff person with current licensure as a nurse in Minnesota. The responsible staff person must be on the premises and is authorized to make immediate decisions concerning patient care and safety. new text end

new text begin Subd. 23. new text end

new text begin Substance. new text end

new text begin "Substance" means "chemical" as defined in subdivision 6. new text end

new text begin Subd. 24. new text end

new text begin Substance use disorder. new text end

new text begin "Substance use disorder" means a pattern of substance use as defined in the current edition of the Diagnostic and Statistical Manual of Mental Disorders. new text end

new text begin Subd. 25. new text end

new text begin Technician. new text end

new text begin "Technician" means a person who meets the qualifications in section 245F.15, subdivision 6. new text end

new text begin Subd. 26. new text end

new text begin Withdrawal management program. new text end

new text begin "Withdrawal management program" means a licensed program that provides short-term medical services on a 24-hour basis for the purpose of stabilizing intoxicated patients, managing their withdrawal, and facilitating access to substance use disorder treatment as indicated by a comprehensive assessment. new text end

Sec. 3.

new text begin [245F.03] APPLICATION. new text end

new text begin (a) This chapter establishes minimum standards for withdrawal management programs licensed by the commissioner that serve one or more unrelated persons. new text end

new text begin (b) This chapter does not apply to a withdrawal management program licensed as a hospital under sections 144.50 to 144.581. A withdrawal management program located in a hospital licensed under sections 144.50 to 144.581 that chooses to be licensed under this chapter is deemed to be in compliance with section 245F.13. new text end

Sec. 4.

new text begin [245F.04] PROGRAM LICENSURE. new text end

new text begin Subdivision 1. new text end

new text begin General application and license requirements. new text end

new text begin An applicant for licensure as a clinically managed withdrawal management program or medically monitored withdrawal management program must meet the following requirements, except where otherwise noted. All programs must comply with federal requirements and the general requirements in chapters 245A and 245C and sections 626.556, 626.557, and 626.5572. A withdrawal management program must be located in a hospital licensed under sections 144.50 to 144.581, or must be a supervised living facility with a class B license from the Department of Health under Minnesota Rules, parts 4665.0100 to 4665.9900. new text end

new text begin Subd. 2. new text end

new text begin Contents of application. new text end

new text begin Prior to the issuance of a license, an applicant must submit, on forms provided by the commissioner, documentation demonstrating the following: new text end

new text begin (1) compliance with this section; new text end

new text begin (2) compliance with applicable building, fire, and safety codes; health rules; zoning ordinances; and other applicable rules and regulations or documentation that a waiver has been granted. The granting of a waiver does not constitute modification of any requirement of this section; new text end

new text begin (3) completion of an assessment of need for a new or expanded program as required by Minnesota Rules, part 9530.6800; and new text end

new text begin (4) insurance coverage, including bonding, sufficient to cover all patient funds, property, and interests. new text end

new text begin Subd. 3. new text end

new text begin Changes in license terms. new text end

new text begin (a) A license holder must notify the commissioner before one of the following occurs and the commissioner must determine the need for a new license: new text end

new text begin (1) a change in the Department of Health's licensure of the program; new text end

new text begin (2) a change in the medical services provided by the program that affects the program's capacity to provide services required by the program's license designation as a clinically managed program or medically monitored program; new text end

new text begin (3) a change in program capacity; or new text end

new text begin (4) a change in location. new text end

new text begin (b) A license holder must notify the commissioner and apply for a new license when a change in program ownership occurs. new text end

new text begin Subd. 4. new text end

new text begin Variances. new text end

new text begin The commissioner may grant variances to the requirements of this chapter under section 245A.04, subdivision 9. new text end

Sec. 5.

new text begin [245F.05] ADMISSION AND DISCHARGE POLICIES. new text end

new text begin Subdivision 1. new text end

new text begin Admission policy. new text end

new text begin A license holder must have a written admission policy containing specific admission criteria. The policy must describe the admission process and the point at which an individual who is eligible under subdivision 2 is admitted to the program. A license holder must not admit individuals who do not meet the admission criteria. The admission policy must be approved and signed by the medical director of the facility and must designate which staff members are authorized to admit and discharge patients. The admission policy must be posted in the area of the facility where patients are admitted and given to all interested individuals upon request. new text end

new text begin Subd. 2. new text end

new text begin Admission criteria. new text end

new text begin For an individual to be admitted to a withdrawal management program, the program must make a determination that the program services are appropriate to the needs of the individual. A program may only admit individuals who meet the admission criteria and who, at the time of admission: new text end

new text begin (1) are impaired as the result of intoxication; new text end

new text begin (2) are experiencing physical, mental, or emotional problems due to intoxication or withdrawal from alcohol or other drugs; new text end

new text begin (3) are being held under apprehend and hold orders under section 253B.07, subdivision 2b; new text end

new text begin (4) have been committed under chapter 253B, and need temporary placement; new text end

new text begin (5) are held under emergency holds or peace and health officer holds under section 253B.05, subdivision 1 or 2; or new text end

new text begin (6) need to stay temporarily in a protective environment because of a crisis related to substance use disorder. Individuals satisfying this clause may be admitted only at the request of the county of fiscal responsibility, as determined according to section 256G.02, subdivision 4. Individuals admitted according to this clause must not be restricted to the facility. new text end

new text begin Subd. 3. new text end

new text begin Individuals denied admission by program. new text end

new text begin (a) A license holder must have a written policy and procedure for addressing the needs of individuals who are denied admission to the program. These individuals include: new text end

new text begin (1) individuals whose pregnancy, in combination with their presenting problem, requires services not provided by the program; and new text end

new text begin (2) individuals who are in imminent danger of harming self or others if their behavior is beyond the behavior management capabilities of the program and staff. new text end

new text begin (b) Programs must document denied admissions, including the date and time of the admission request, reason for the denial of admission, and where the individual was referred. If the individual did not receive a referral, the program must document why a referral was not made. This information must be documented on a form approved by the commissioner and made available to the commissioner upon request. new text end

new text begin Subd. 4. new text end

new text begin License holder responsibilities; denying admission or terminating services. new text end

new text begin (a) If a license holder denies an individual admission to the program or terminates services to a patient and the denial or termination poses an immediate threat to the patient's or individual's health or requires immediate medical intervention, the license holder must refer the patient or individual to a medical facility capable of admitting the patient or individual. new text end

new text begin (b) A license holder must report to a law enforcement agency with proper jurisdiction all denials of admission and terminations of services that involve the commission of a crime against a staff member of the license holder or on the license holder's property, as provided in Code of Federal Regulations, title 42, section 2.12(c)(5), and title 45, parts 160 to 164. new text end

new text begin Subd. 5. new text end

new text begin Discharge and transfer policies. new text end

new text begin A license holder must have a written policy and procedure, approved and signed by the medical director, that specifies conditions under which patients may be discharged or transferred. The policy must include the following: new text end

new text begin (1) guidelines for determining when a patient is medically stable and whether a patient is able to be discharged or transferred to a lower level of care; new text end

new text begin (2) guidelines for determining when a patient needs a transfer to a higher level of care. Clinically managed program guidelines must include guidelines for transfer to a medically monitored program, hospital, or other acute care facility. Medically monitored program guidelines must include guidelines for transfer to a hospital or other acute care facility; new text end

new text begin (3) procedures staff must follow when discharging a patient under each of the following circumstances: new text end

new text begin (i) the patient is involved in the commission of a crime against program staff or against a license holder's property. The procedures for a patient discharged under this item must specify how reports must be made to law enforcement agencies with proper jurisdiction as allowed under Code of Federal Regulations, title 42, section 2.12(c)(5), and title 45, parts 160 to 164; new text end

new text begin (ii) the patient is in imminent danger of harming self or others and is beyond the license holder's capacity to ensure safety; new text end

new text begin (iii) the patient was admitted under chapter 253B; or new text end

new text begin (iv) the patient is leaving against staff or medical advice; and new text end

new text begin (4) a requirement that staff must document where the patient was referred after discharge or transfer, and if a referral was not made, the reason the patient was not provided a referral. new text end

Sec. 6.

new text begin [245F.06] SCREENING AND COMPREHENSIVE ASSESSMENT. new text end

new text begin Subdivision 1. new text end

new text begin Screening for substance use disorder. new text end

new text begin A nurse or an alcohol and drug counselor must screen each patient upon admission to determine whether a comprehensive assessment is indicated. The license holder must screen patients at each admission, except that if the patient has already been determined to suffer from a substance use disorder, subdivision 2 applies. new text end

new text begin Subd. 2. new text end

new text begin Comprehensive assessment. new text end

new text begin (a) Prior to a medically stable discharge, but not later than 72 hours following admission, a license holder must provide a comprehensive assessment according to section 245.4863, paragraph (a), and Minnesota Rules, part 9530.6422, for each patient who has a positive screening for a substance use disorder. If a patient's medical condition prevents a comprehensive assessment from being completed within 72 hours, the license holder must document why the assessment was not completed. The comprehensive assessment must include documentation of the appropriateness of an involuntary referral through the civil commitment process. new text end

new text begin (b) If available to the program, a patient's previous comprehensive assessment may be used in the patient record. If a previously completed comprehensive assessment is used, its contents must be reviewed to ensure the assessment is accurate and current and complies with the requirements of this chapter. The review must be completed by a staff person qualified according to Minnesota Rules, part 9530.6450, subpart 5. The license holder must document that the review was completed and that the previously completed assessment is accurate and current, or the license holder must complete an updated or new assessment. new text end

Sec. 7.

new text begin [245F.07] STABILIZATION PLANNING. new text end

new text begin Subdivision 1. new text end

new text begin Stabilization plan. new text end

new text begin Within 12 hours of admission, a license holder must develop an individualized stabilization plan for each patient accepted for stabilization services. The plan must be based on the patient's initial health assessment and continually updated based on new information gathered about the patient's condition from the comprehensive assessment, medical evaluation and consultation, and ongoing monitoring and observations of the patient. The patient must have an opportunity to have direct involvement in the development of the plan. The stabilization plan must: new text end

new text begin (1) identify medical needs and goals to be achieved while the patient is receiving services; new text end

new text begin (2) specify stabilization services to address the identified medical needs and goals, including amount and frequency of services; new text end

new text begin (3) specify the participation of others in the stabilization planning process and specific services where appropriate; and new text end

new text begin (4) document the patient's participation in developing the content of the stabilization plan and any updates. new text end

new text begin Subd. 2. new text end

new text begin Progress notes. new text end

new text begin Progress notes must be entered in the patient's file at least daily and immediately following any significant event, including any change that impacts the medical, behavioral, or legal status of the patient. Progress notes must: new text end

new text begin (1) include documentation of the patient's involvement in the stabilization services, including the type and amount of each stabilization service; new text end

new text begin (2) include the monitoring and observations of the patient's medical needs; new text end

new text begin (3) include documentation of referrals made to other services or agencies; new text end

new text begin (4) specify the participation of others; and new text end

new text begin (5) be legible, signed, and dated by the staff person completing the documentation. new text end

new text begin Subd. 3. new text end

new text begin Discharge plan. new text end

new text begin Before a patient leaves the facility, the license holder must conduct discharge planning for the patient, document discharge planning in the patient's record, and provide the patient with a copy of the discharge plan. The discharge plan must include: new text end

new text begin (1) referrals made to other services or agencies at the time of transition; new text end

new text begin (2) the patient's plan for follow-up, aftercare, or other poststabilization services; new text end

new text begin (3) documentation of the patient's participation in the development of the transition plan; new text end

new text begin (4) any service that will continue after discharge under the direction of the license holder; and new text end

new text begin (5) a stabilization summary and final evaluation of the patient's progress toward treatment objectives. new text end

Sec. 8.

new text begin [245F.08] STABILIZATION SERVICES. new text end

new text begin Subdivision 1. new text end

new text begin General. new text end

new text begin The license holder must encourage patients to remain in care for an appropriate duration as determined by the patient's stabilization plan, and must encourage all patients to enter programs for ongoing recovery as clinically indicated. In addition, the license holder must offer services that are patient-centered, trauma-informed, and culturally appropriate. Culturally appropriate services must include translation services and dietary services that meet a patient's dietary needs. All services provided to the patient must be documented in the patient's medical record. The following services must be offered unless clinically inappropriate and the justifying clinical rationale is documented: new text end

new text begin (1) individual or group motivational counseling sessions; new text end

new text begin (2) individual advocacy and case management services; new text end

new text begin (3) medical services as required in section 245F.12; new text end

new text begin (4) care coordination provided according to subdivision 2; new text end

new text begin (5) peer recovery support services provided according to subdivision 3; new text end

new text begin (6) patient education provided according to subdivision 4; and new text end

new text begin (7) referrals to mutual aid, self-help, and support groups. new text end

new text begin Subd. 2. new text end

new text begin Care coordination. new text end

new text begin Care coordination services must be initiated for each patient upon admission. The license holder must identify the staff person responsible for the provision of each service. Care coordination services must include: new text end

new text begin (1) coordination with significant others to assist in the stabilization planning process whenever possible; new text end

new text begin (2) coordination with and follow-up to appropriate medical services as identified by the nurse or licensed practitioner; new text end

new text begin (3) referral to substance use disorder services as indicated by the comprehensive assessment; new text end

new text begin (4) referral to mental health services as identified in the comprehensive assessment; new text end

new text begin (5) referrals to economic assistance, social services, and prenatal care in accordance with the patient's needs; new text end

new text begin (6) review and approval of the transition plan prior to discharge, except in an emergency, by a staff member able to provide direct patient contact; new text end

new text begin (7) documentation of the provision of care coordination services in the patient's file; and new text end

new text begin (8) addressing cultural and socioeconomic factors affecting the patient's access to services. new text end

new text begin Subd. 3. new text end

new text begin Peer recovery support services. new text end

new text begin (a) Peers in recovery serve as mentors or recovery-support partners for individuals in recovery, and may provide encouragement, self-disclosure of recovery experiences, transportation to appointments, assistance with finding resources that will help locate housing, job search resources, and assistance finding and participating in support groups. new text end

new text begin (b) Peer recovery support services are provided by a recovery peer and must be supervised by the responsible staff person. new text end

new text begin Subd. 4. new text end

new text begin Patient education. new text end

new text begin A license holder must provide education to each patient on the following: new text end

new text begin (1) substance use disorder, including the effects of alcohol and other drugs, specific information about the effects of substance use on unborn children, and the signs and symptoms of fetal alcohol spectrum disorders; new text end

new text begin (2) tuberculosis and reporting known cases of tuberculosis disease to health care authorities according to section 144.4804; new text end

new text begin (3) Hepatitis C treatment and prevention; new text end

new text begin (4) HIV as required in section 245A.19, paragraphs (b) and (c); new text end

new text begin (5) nicotine cessation options, if applicable; new text end

new text begin (6) opioid tolerance and overdose risks, if applicable; and new text end

new text begin (7) long-term withdrawal issues related to use of barbiturates and benzodiazepines, if applicable. new text end

new text begin Subd. 5. new text end

new text begin Mutual aid, self-help, and support groups. new text end

new text begin The license holder must refer patients to mutual aid, self-help, and support groups when clinically indicated and to the extent available in the community. new text end

Sec. 9.

new text begin [245F.09] PROTECTIVE PROCEDURES. new text end

new text begin Subdivision 1. new text end

new text begin Use of protective procedures. new text end

new text begin (a) Programs must incorporate person-centered planning and trauma-informed care into its protective procedure policies. Protective procedures may be used only in cases where a less restrictive alternative will not protect the patient or others from harm and when the patient is in imminent danger of harming self or others. When a program uses a protective procedure, the program must continuously observe the patient until the patient may safely be left for 15-minute intervals. Use of the procedure must end when the patient is no longer in imminent danger of harming self or others. new text end

new text begin (b) Protective procedures may not be used: new text end

new text begin (1) for disciplinary purposes; new text end

new text begin (2) to enforce program rules; new text end

new text begin (3) for the convenience of staff; new text end

new text begin (4) as a part of any patient's health monitoring plan; or new text end

new text begin (5) for any reason except in response to specific, current behaviors which create an imminent danger of harm to the patient or others. new text end

new text begin Subd. 2. new text end

new text begin Protective procedures plan. new text end

new text begin A license holder must have a written policy and procedure that establishes the protective procedures that program staff must follow when a patient is in imminent danger of harming self or others. The policy must be appropriate to the type of facility and the level of staff training. The protective procedures policy must include: new text end

new text begin (1) an approval signed and dated by the program director and medical director prior to implementation. Any changes to the policy must also be approved, signed, and dated by the current program director and the medical director prior to implementation; new text end

new text begin (2) which protective procedures the license holder will use to prevent patients from imminent danger of harming self or others; new text end

new text begin (3) the emergency conditions under which the protective procedures are permitted to be used, if any; new text end

new text begin (4) the patient's health conditions that limit the specific procedures that may be used and alternative means of ensuring safety; new text end

new text begin (5) emergency resources the program staff must contact when a patient's behavior cannot be controlled by the procedures established in the policy; new text end

new text begin (6) the training that staff must have before using any protective procedure; new text end

new text begin (7) documentation of approved therapeutic holds; new text end

new text begin (8) the use of law enforcement personnel as described in subdivision 4; new text end

new text begin (9) standards governing emergency use of seclusion. Seclusion must be used only when less restrictive measures are ineffective or not feasible. The standards in items (i) to (vii) must be met when seclusion is used with a patient: new text end

new text begin (i) seclusion must be employed solely for the purpose of preventing a patient from imminent danger of harming self or others; new text end

new text begin (ii) seclusion rooms must be equipped in a manner that prevents patients from self-harm using projections, windows, electrical fixtures, or hard objects, and must allow the patient to be readily observed without being interrupted; new text end

new text begin (iii) seclusion must be authorized by the program director, a licensed physician, or a registered nurse. If one of these individuals is not present in the facility, the program director or a licensed physician or registered nurse must be contacted and authorization must be obtained within 30 minutes of initiating seclusion, according to written policies; new text end

new text begin (iv) patients must not be placed in seclusion for more than 12 hours at any one time; new text end

new text begin (v) once the condition of a patient in seclusion has been determined to be safe enough to end continuous observation, a patient in seclusion must be observed at a minimum of every 15 minutes for the duration of seclusion and must always be within hearing range of program staff; new text end

new text begin (vi) a process for program staff to use to remove a patient to other resources available to the facility if seclusion does not sufficiently assure patient safety; and new text end

new text begin (vii) a seclusion area may be used for other purposes, such as intensive observation, if the room meets normal standards of care for the purpose and if the room is not locked; and new text end

new text begin (10) physical holds may only be used when less restrictive measures are not feasible. The standards in items (i) to (iv) must be met when physical holds are used with a patient: new text end

new text begin (i) physical holds must be employed solely for preventing a patient from imminent danger of harming self or others; new text end

new text begin (ii) physical holds must be authorized by the program director, a licensed physician, or a registered nurse. If one of these individuals is not present in the facility, the program director or a licensed physician or a registered nurse must be contacted and authorization must be obtained within 30 minutes of initiating a physical hold, according to written policies; new text end

new text begin (iii) the patient's health concerns must be considered in deciding whether to use physical holds and which holds are appropriate for the patient; and new text end

new text begin (iv) only approved holds may be utilized. Prone holds are not allowed and must not be authorized. new text end

new text begin Subd. 3. new text end

new text begin Records. new text end

new text begin Each use of a protective procedure must be documented in the patient record. The patient record must include: new text end

new text begin (1) a description of specific patient behavior precipitating a decision to use a protective procedure, including date, time, and program staff present; new text end

new text begin (2) the specific means used to limit the patient's behavior; new text end

new text begin (3) the time the protective procedure began, the time the protective procedure ended, and the time of each staff observation of the patient during the procedure; new text end

new text begin (4) the names of the program staff authorizing the use of the protective procedure, the time of the authorization, and the program staff directly involved in the protective procedure and the observation process; new text end

new text begin (5) a brief description of the purpose for using the protective procedure, including less restrictive interventions used prior to the decision to use the protective procedure and a description of the behavioral results obtained through the use of the procedure. If a less restrictive intervention was not used, the reasons for not using a less restrictive intervention must be documented; new text end

new text begin (6) documentation by the responsible staff person on duty of reassessment of the patient at least every 15 minutes to determine if seclusion or the physical hold can be terminated; new text end

new text begin (7) a description of the physical holds used in escorting a patient; and new text end

new text begin (8) any injury to the patient that occurred during the use of a protective procedure. new text end

new text begin Subd. 4. new text end

new text begin Use of law enforcement. new text end

new text begin The program must maintain a central log documenting each incident involving use of law enforcement, including: new text end

new text begin (1) the date and time law enforcement arrived at and left the program; new text end

new text begin (2) the reason for the use of law enforcement; new text end

new text begin (3) if law enforcement used force or a protective procedure and which protective procedure was used; and new text end

new text begin (4) whether any injuries occurred. new text end

new text begin Subd. 5. new text end

new text begin Administrative review. new text end

new text begin (a) The license holder must keep a record of all patient incidents and protective procedures used. An administrative review of each use of protective procedures must be completed within 72 hours by someone other than the person who used the protective procedure. The record of the administrative review of the use of protective procedures must state whether: new text end

new text begin (1) the required documentation was recorded for each use of a protective procedure; new text end

new text begin (2) the protective procedure was used according to the policy and procedures; new text end

new text begin (3) the staff who implemented the protective procedure was properly trained; and new text end

new text begin (4) the behavior met the standards for imminent danger of harming self or others. new text end

new text begin (b) The license holder must conduct and document a quarterly review of the use of protective procedures with the goal of reducing the use of protective procedures. The review must include: new text end

new text begin (1) any patterns or problems indicated by similarities in the time of day, day of the week, duration of the use of a protective procedure, individuals involved, or other factors associated with the use of protective procedures; new text end

new text begin (2) any injuries resulting from the use of protective procedures; new text end

new text begin (3) whether law enforcement was involved in the use of a protective procedure; new text end

new text begin (4) actions needed to correct deficiencies in the program's implementation of protective procedures; new text end

new text begin (5) an assessment of opportunities missed to avoid the use of protective procedures; and new text end

new text begin (6) proposed actions to be taken to minimize the use of protective procedures. new text end

Sec. 10.

new text begin [245F.10] PATIENT RIGHTS AND GRIEVANCE PROCEDURES. new text end

new text begin Subdivision 1. new text end

new text begin Patient rights. new text end

new text begin Patients have the rights in sections 144.651, 148F.165, and 253B.03, as applicable. The license holder must give each patient, upon admission, a written statement of patient rights. Program staff must review the statement with the patient. new text end

new text begin Subd. 2. new text end

new text begin Grievance procedure. new text end

new text begin Upon admission, the license holder must explain the grievance procedure to the patient or patient's representative and give the patient a written copy of the procedure. The grievance procedure must be posted in a place visible to the patient and must be made available to current and former patients upon request. A license holder's written grievance procedure must include: new text end

new text begin (1) staff assistance in developing and processing the grievance; new text end

new text begin (2) an initial response to the patient who filed the grievance within 24 hours of the program's receipt of the grievance, and timelines for additional steps to be taken to resolve the grievance, including access to the person with the highest level of authority in the program if the grievance cannot be resolved by other staff members; and new text end

new text begin (3) the current addresses and telephone numbers of the Department of Human Services Licensing Division, Department of Health Office of Health Facilities Complaints, Board of Behavioral Health and Therapy, Board of Medical Practice, Board of Nursing, and Office of the Ombudsman for Mental Health and Developmental Disabilities. new text end

Sec. 11.

new text begin [245F.11] PATIENT PROPERTY MANAGEMENT. new text end

new text begin A license holder must meet the requirements for handling patient funds and property in section 245A.04, subdivision 13, except: new text end

new text begin (1) a license holder must establish policies regarding the use of personal property to assure that program activities and the rights of other patients are not infringed, and may take temporary custody of personal property if these policies are violated; new text end

new text begin (2) a license holder must retain the patient's property for a minimum of seven days after discharge if the patient does not reclaim the property after discharge; and new text end

new text begin (3) the license holder must return to the patient all of the patient's property held in trust at discharge, regardless of discharge status, except that: new text end

new text begin (i) drugs, drug paraphernalia, and drug containers that are subject to forfeiture under section 609.5316 must be given over to the custody of a local law enforcement agency or, if giving the property over to the custody of a local law enforcement agency would violate Code of Federal Regulations, title 42, sections 2.1 to 2.67, and title 45, parts 160 to 164, destroyed by a staff person designated by the program director; and new text end

new text begin (ii) weapons, explosives, and other property that may cause serious harm to self or others must be transferred to a local law enforcement agency. The patient must be notified of the transfer and the right to reclaim the property if the patient has a legal right to possess the item. new text end

Sec. 12.

new text begin [245F.12] MEDICAL SERVICES. new text end

new text begin Subdivision 1. new text end

new text begin Services provided at all programs. new text end

new text begin Withdrawal management programs must have: new text end

new text begin (1) a standardized data collection tool for collecting health-related information about each patient. The data collection tool must be developed in collaboration with a registered nurse and approved and signed by the medical director; and new text end

new text begin (2) written procedures for a nurse to assess and monitor patient health within the nurse's scope of practice. The procedures must: new text end

new text begin (i) be approved by the medical director; new text end

new text begin (ii) include a follow-up screening conducted between four and 12 hours after service initiation to collect information relating to acute intoxication, other health complaints, and behavioral risk factors that the patient may not have communicated at service initiation; new text end

new text begin (iii) specify the physical signs and symptoms that, when present, require consultation with a registered nurse or a physician and that require transfer to an acute care facility or a higher level of care than that provided by the program; new text end

new text begin (iv) specify those staff members responsible for monitoring patient health and provide for hourly observation and for more frequent observation if the initial health assessment or follow-up screening indicates a need for intensive physical or behavioral health monitoring; and new text end

new text begin (v) specify the actions to be taken to address specific complicating conditions, including pregnancy or the presence of physical signs or symptoms of any other medical condition. new text end

new text begin Subd. 2. new text end

new text begin Services provided at clinically managed programs. new text end

new text begin In addition to the services listed in subdivision 1, clinically managed programs must: new text end

new text begin (1) have a licensed practical nurse on site 24 hours a day and a medical director; new text end

new text begin (2) provide an initial health assessment conducted by a nurse upon admission; new text end

new text begin (3) provide daily on-site medical evaluation by a nurse; new text end

new text begin (4) have a registered nurse available by telephone or in person for consultation 24 hours a day; new text end

new text begin (5) have a qualified medical professional available by telephone or in person for consultation 24 hours a day; and new text end

new text begin (6) have appropriately licensed staff available to administer medications according to prescriber-approved orders. new text end

new text begin Subd. 3. new text end

new text begin Services provided at medically monitored programs. new text end

new text begin In addition to the services listed in subdivision 1, medically monitored programs must have a registered nurse on site 24 hours a day and a medical director. Medically monitored programs must provide intensive inpatient withdrawal management services which must include: new text end

new text begin (1) an initial health assessment conducted by a registered nurse upon admission; new text end

new text begin (2) the availability of a medical evaluation and consultation with a registered nurse 24 hours a day; new text end

new text begin (3) the availability of a qualified medical professional by telephone or in person for consultation 24 hours a day; new text end

new text begin (4) the ability to be seen within 24 hours or sooner by a qualified medical professional if the initial health assessment indicates the need to be seen; new text end

new text begin (5) the availability of on-site monitoring of patient care seven days a week by a qualified medical professional; and new text end

new text begin (6) appropriately licensed staff available to administer medications according to prescriber-approved orders. new text end

Sec. 13.

new text begin [245F.13] MEDICATIONS. new text end

new text begin Subdivision 1. new text end

new text begin Administration of medications. new text end

new text begin A license holder must employ or contract with a registered nurse to develop the policies and procedures for medication administration. A registered nurse must provide supervision as defined in section 148.171, subdivision 23, for the administration of medications. For clinically managed programs, the registered nurse supervision must include on-site supervision at least monthly or more often as warranted by the health needs of the patient. The medication administration policies and procedures must include: new text end

new text begin (1) a provision that patients may carry emergency medication such as nitroglycerin as instructed by their prescriber; new text end

new text begin (2) requirements for recording the patient's use of medication, including staff signatures with date and time; new text end

new text begin (3) guidelines regarding when to inform a licensed practitioner or a registered nurse of problems with medication administration, including failure to administer, patient refusal of a medication, adverse reactions, or errors; and new text end

new text begin (4) procedures for acceptance, documentation, and implementation of prescriptions, whether written, oral, telephonic, or electronic. new text end

new text begin Subd. 2. new text end

new text begin Control of drugs. new text end

new text begin A license holder must have in place and implement written policies and procedures relating to control of drugs. The policies and procedures must be developed by a registered nurse and must contain the following provisions: new text end

new text begin (1) a requirement that all drugs must be stored in a locked compartment. Schedule II drugs, as defined in section 152.02, subdivision 3, must be stored in a separately locked compartment that is permanently affixed to the physical plant or a medication cart; new text end

new text begin (2) a system for accounting for all scheduled drugs each shift; new text end

new text begin (3) a procedure for recording a patient's use of medication, including staff signatures with time and date; new text end

new text begin (4) a procedure for destruction of discontinued, outdated, or deteriorated medications; new text end

new text begin (5) a statement that only authorized personnel are permitted to have access to the keys to the locked drug compartments; and new text end

new text begin (6) a statement that no legend drug supply for one patient may be given to another patient. new text end

Sec. 14.

new text begin [245F.14] STAFFING REQUIREMENTS AND DUTIES. new text end

new text begin Subdivision 1. new text end

new text begin Program director. new text end

new text begin A license holder must employ or contract with a person, on a full-time basis, to serve as program director. The program director must be responsible for all aspects of the facility and the services delivered to the license holder's patients. An individual may serve as program director for more than one program owned by the same license holder. new text end

new text begin Subd. 2. new text end

new text begin Responsible staff person. new text end

new text begin During all hours of operation, a license holder must designate a staff member as the responsible staff person to be present and awake in the facility and be responsible for the program. The responsible staff person must have decision-making authority over the day-to-day operation of the program as well as the authority to direct the activity of or terminate the shift of any staff member who has direct patient contact. new text end

new text begin Subd. 3. new text end

new text begin Technician required. new text end

new text begin A license holder must have one technician awake and on duty at all times for every ten patients in the program. A license holder may assign technicians according to the need for care of the patients, except that the same technician must not be responsible for more than 15 patients at one time. For purposes of establishing this ratio, all staff whose qualifications meet or exceed those for technicians under section 245F.15, subdivision 6, and who are performing the duties of a technician may be counted as technicians. The same individual may not be counted as both a technician and an alcohol and drug counselor. new text end

new text begin Subd. 4. new text end

new text begin Registered nurse required. new text end

new text begin A license holder must employ or contract with a registered nurse, who must be available 24 hours a day by telephone or in person for consultation. The registered nurse is responsible for: new text end

new text begin (1) establishing and implementing procedures for the provision of nursing care and delegated medical care, including: new text end

new text begin (i) a health monitoring plan; new text end

new text begin (ii) a medication control plan; new text end

new text begin (iii) training and competency evaluations for staff performing delegated medical and nursing functions; new text end

new text begin (iv) handling serious illness, accident, or injury to patients; new text end

new text begin (v) an infection control program; and new text end

new text begin (vi) a first aid kit; new text end

new text begin (2) delegating nursing functions to other staff consistent with their education, competence, and legal authorization; new text end

new text begin (3) assigning, supervising, and evaluating the performance of nursing tasks; and new text end

new text begin (4) implementing condition-specific protocols in compliance with section 151.37, subdivision 2. new text end

new text begin Subd. 5. new text end

new text begin Medical director required. new text end

new text begin A license holder must have a medical director available for medical supervision. The medical director is responsible for ensuring the accurate and safe provision of all health-related services and procedures. A license holder must obtain and document the medical director's annual approval of the following procedures before the procedures may be used: new text end

new text begin (1) admission, discharge, and transfer criteria and procedures; new text end

new text begin (2) a health services plan; new text end

new text begin (3) physical indicators for a referral to a physician, registered nurse, or hospital, and procedures for referral; new text end

new text begin (4) procedures to follow in case of accident, injury, or death of a patient; new text end

new text begin (5) formulation of condition-specific protocols regarding the medications that require a withdrawal regimen that will be administered to patients; new text end

new text begin (6) an infection control program; new text end

new text begin (7) protective procedures; and new text end

new text begin (8) a medication control plan. new text end

new text begin Subd. 6. new text end

new text begin Alcohol and drug counselor. new text end

new text begin A withdrawal management program must provide one full-time equivalent alcohol and drug counselor for every 16 patients served by the program. new text end

new text begin Subd. 7. new text end

new text begin Ensuring staff-to-patient ratio. new text end

new text begin The responsible staff person under subdivision 2 must ensure that the program does not exceed the staff-to-patient ratios in subdivisions 3 and 6 and must inform admitting staff of the current staffed capacity of the program for that shift. A license holder must have a written policy for documenting staff-to-patient ratios for each shift and actions to take when staffed capacity is reached. new text end

Sec. 15.

new text begin [245F.15] STAFF QUALIFICATIONS. new text end

new text begin Subdivision 1. new text end

new text begin Qualifications for all staff who have direct patient contact. new text end

new text begin (a) All staff who have direct patient contact must be at least 18 years of age and must, at the time of hiring, document that they meet the requirements in paragraph (b), (c), or (d). new text end

new text begin (b) Program directors, supervisors, nurses, and alcohol and drug counselors must be free of substance use problems for at least two years immediately preceding their hiring and must sign a statement attesting to that fact. new text end

new text begin (c) Recovery peers must be free of substance use problems for at least one year immediately preceding their hiring and must sign a statement attesting to that fact. new text end

new text begin (d) Technicians and other support staff must be free of substance use problems for at least six months immediately preceding their hiring and must sign a statement attesting to that fact. new text end

new text begin Subd. 2. new text end

new text begin Continuing employment; no substance use problems. new text end

new text begin License holders must require staff to be free from substance use problems as a condition of continuing employment. Staff are not required to sign statements attesting to their freedom from substance use problems after the initial statement required by subdivision 1. Staff with substance use problems must be immediately removed from any responsibilities that include direct patient contact. new text end

new text begin Subd. 3. new text end

new text begin Program director qualifications. new text end

new text begin A program director must: new text end

new text begin (1) have at least one year of work experience in direct service to individuals with substance use disorders or one year of work experience in the management or administration of direct service to individuals with substance use disorders; new text end

new text begin (2) have a baccalaureate degree or three years of work experience in administration or personnel supervision in human services; and new text end

new text begin (3) know and understand the requirements of this chapter and chapters 245A and 245C, and sections 253B.04, 253B.05, 626.556, 626.557, and 626.5572. new text end

new text begin Subd. 4. new text end

new text begin Alcohol and drug counselor qualifications. new text end

new text begin An alcohol and drug counselor must meet the requirements in Minnesota Rules, part 9530.6450, subpart 5. new text end

new text begin Subd. 5. new text end

new text begin Responsible staff person qualifications. new text end

new text begin Each responsible staff person must know and understand the requirements of this chapter and sections 245A.65, 253B.04, 253B.05, 626.556, 626.557, and 626.5572. In a clinically managed program, the responsible staff person must be a licensed practical nurse employed by or under contract with the license holder. In a medically monitored program, the responsible staff person must be a registered nurse, program director, or physician. new text end

new text begin Subd. 6. new text end

new text begin Technician qualifications. new text end

new text begin A technician employed by a program must demonstrate competency, prior to direct patient contact, in the following areas: new text end

new text begin (1) knowledge of the client bill of rights in section 148F.165, and staff responsibilities in sections 144.651 and 253B.03; new text end

new text begin (2) knowledge of and the ability to perform basic health screening procedures with intoxicated patients that consist of: new text end

new text begin (i) blood pressure, pulse, temperature, and respiration readings; new text end

new text begin (ii) interviewing to obtain relevant medical history and current health complaints; and new text end

new text begin (iii) visual observation of a patient's health status, including monitoring a patient's behavior as it relates to health status; new text end

new text begin (3) a current first aid certificate from the American Red Cross or an equivalent organization; a current cardiopulmonary resuscitation certificate from the American Red Cross, the American Heart Association, a community organization, or an equivalent organization; and knowledge of first aid for seizures, trauma, and loss of consciousness; and new text end

new text begin (4) knowledge of and ability to perform basic activities of daily living and personal hygiene. new text end

new text begin Subd. 7. new text end

new text begin Recovery peer qualifications. new text end

new text begin Recovery peers must: new text end

new text begin (1) be at least 21 years of age and have a high school diploma or its equivalent; new text end

new text begin (2) have a minimum of one year in recovery from substance use disorder; new text end

new text begin (3) have completed a curriculum designated by the commissioner that teaches specific skills and training in the domains of ethics and boundaries, advocacy, mentoring and education, and recovery and wellness support; and new text end

new text begin (4) receive supervision in areas specific to the domains of their role by qualified supervisory staff. new text end

new text begin Subd. 8. new text end

new text begin Personal relationships. new text end

new text begin A license holder must have a written policy addressing personal relationships between patients and staff who have direct patient contact. The policy must: new text end

new text begin (1) prohibit direct patient contact between a patient and a staff member if the staff member has had a personal relationship with the patient within two years prior to the patient's admission to the program; new text end

new text begin (2) prohibit access to a patient's clinical records by a staff member who has had a personal relationship with the patient within two years prior to the patient's admission, unless the patient consents in writing; and new text end

new text begin (3) prohibit a clinical relationship between a staff member and a patient if the staff member has had a personal relationship with the patient within two years prior to the patient's admission. If a personal relationship exists, the staff member must report the relationship to the staff member's supervisor and recuse the staff member from a clinical relationship with that patient. new text end

Sec. 16.

new text begin [245F.16] PERSONNEL POLICIES AND PROCEDURES. new text end

new text begin Subdivision 1. new text end

new text begin Policy requirements. new text end

new text begin A license holder must have written personnel policies and must make them available to staff members at all times. The personnel policies must: new text end

new text begin (1) ensure that a staff member's retention, promotion, job assignment, or pay are not affected by a good faith communication between the staff member and the Department of Human Services, Department of Health, Ombudsman for Mental Health and Developmental Disabilities, law enforcement, or local agencies that investigate complaints regarding patient rights, health, or safety; new text end

new text begin (2) include a job description for each position that specifies job responsibilities, degree of authority to execute job responsibilities, standards of job performance related to specified job responsibilities, and qualifications; new text end

new text begin (3) provide for written job performance evaluations for staff members of the license holder at least annually; new text end

new text begin (4) describe behavior that constitutes grounds for disciplinary action, suspension, or dismissal, including policies that address substance use problems and meet the requirements of section 245F.15, subdivisions 1 and 2. The policies and procedures must list behaviors or incidents that are considered substance use problems. The list must include: new text end

new text begin (i) receiving treatment for substance use disorder within the period specified for the position in the staff qualification requirements; new text end

new text begin (ii) substance use that has a negative impact on the staff member's job performance; new text end

new text begin (iii) substance use that affects the credibility of treatment services with patients, referral sources, or other members of the community; and new text end

new text begin (iv) symptoms of intoxication or withdrawal on the job; new text end

new text begin (5) include policies prohibiting personal involvement with patients and policies prohibiting patient maltreatment as specified under chapter 604 and sections 245A.65, 626.556, 626.557, and 626.5572; new text end

new text begin (6) include a chart or description of organizational structure indicating the lines of authority and responsibilities; new text end

new text begin (7) include a written plan for new staff member orientation that, at a minimum, includes training related to the specific job functions for which the staff member was hired, program policies and procedures, patient needs, and the areas identified in subdivision 2, paragraphs (b) to (e); and new text end

new text begin (8) include a policy on the confidentiality of patient information. new text end

new text begin Subd. 2. new text end

new text begin Staff development. new text end

new text begin (a) A license holder must ensure that each staff member receives orientation training before providing direct patient care and at least 30 hours of continuing education every two years. A written record must be kept to demonstrate completion of training requirements. new text end

new text begin (b) Within 72 hours of beginning employment, all staff having direct patient contact must be provided orientation on the following: new text end

new text begin (1) specific license holder and staff responsibilities for patient confidentiality; new text end

new text begin (2) standards governing the use of protective procedures; new text end

new text begin (3) patient ethical boundaries and patient rights, including the rights of patients admitted under chapter 253B; new text end

new text begin (4) infection control procedures; new text end

new text begin (5) mandatory reporting under sections 245A.65, 626.556, and 626.557, including specific training covering the facility's policies concerning obtaining patient releases of information; new text end

new text begin (6) HIV minimum standards as required in section 245A.19; new text end

new text begin (7) motivational counseling techniques and identifying stages of change; and new text end

new text begin (8) eight hours of training on the program's protective procedures policy required in section 245F.09, including: new text end

new text begin (i) approved therapeutic holds; new text end

new text begin (ii) protective procedures used to prevent patients from imminent danger of harming self or others; new text end

new text begin (iii) the emergency conditions under which the protective procedures may be used, if any; new text end

new text begin (iv) documentation standards for using protective procedures; new text end

new text begin (v) how to monitor and respond to patient distress; and new text end

new text begin (vi) person-centered planning and trauma-informed care. new text end

new text begin (c) All staff having direct patient contact must be provided annual training on the following: new text end

new text begin (1) infection control procedures; new text end

new text begin (2) mandatory reporting under sections 245A.65, 626.556, and 626.557, including specific training covering the facility's policies concerning obtaining patient releases of information; new text end

new text begin (3) HIV minimum standards as required in section 245A.19; and new text end

new text begin (4) motivational counseling techniques and identifying stages of change. new text end

new text begin (d) All staff having direct patient contact must be provided training every two years on the following: new text end

new text begin (1) specific license holder and staff responsibilities for patient confidentiality; new text end

new text begin (2) standards governing use of protective procedures, including: new text end

new text begin (i) approved therapeutic holds; new text end

new text begin (ii) protective procedures used to prevent patients from imminent danger of harming self or others; new text end

new text begin (iii) the emergency conditions under which the protective procedures may be used, if any; new text end

new text begin (iv) documentation standards for using protective procedures; new text end

new text begin (v) how to monitor and respond to patient distress; and new text end

new text begin (vi) person-centered planning and trauma-informed care; and new text end

new text begin (3) patient ethical boundaries and patient rights, including the rights of patients admitted under chapter 253B. new text end

new text begin (e) Continuing education that is completed in areas outside of the required topics must provide information to the staff person that is useful to the performance of the individual staff person's duties. new text end

Sec. 17.

new text begin [245F.17] PERSONNEL FILES. new text end

new text begin A license holder must maintain a separate personnel file for each staff member. At a minimum, the file must contain: new text end

new text begin (1) a completed application for employment signed by the staff member that contains the staff member's qualifications for employment and documentation related to the applicant's background study data, as defined in chapter 245C; new text end

new text begin (2) documentation of the staff member's current professional license or registration, if relevant; new text end

new text begin (3) documentation of orientation and subsequent training; new text end

new text begin (4) documentation of a statement of freedom from substance use problems; and new text end

new text begin (5) an annual job performance evaluation. new text end

Sec. 18.

new text begin [245F.18] POLICY AND PROCEDURES MANUAL. new text end

new text begin A license holder must develop a written policy and procedures manual that is alphabetically indexed and has a table of contents, so that staff have immediate access to all policies and procedures, and that consumers of the services, and other authorized parties have access to all policies and procedures. The manual must contain the following materials: new text end

new text begin (1) a description of patient education services as required in section 245F.06; new text end

new text begin (2) personnel policies that comply with section 245F.16; new text end

new text begin (3) admission information and referral and discharge policies that comply with section 245F.05; new text end

new text begin (4) a health monitoring plan that complies with section 245F.12; new text end

new text begin (5) a protective procedures policy that complies with section 245F.09, if the program elects to use protective procedures; new text end

new text begin (6) policies and procedures for assuring appropriate patient-to-staff ratios that comply with section 245F.14; new text end

new text begin (7) policies and procedures for assessing and documenting the susceptibility for risk of abuse to the patient as the basis for the individual abuse prevention plan required by section 245A.65; new text end

new text begin (8) procedures for mandatory reporting as required by sections 245A.65, 626.556, and 626.557; new text end

new text begin (9) a medication control plan that complies with section 245F.13; and new text end

new text begin (10) policies and procedures regarding HIV that meet the minimum standards under section 245A.19. new text end

Sec. 19.

new text begin [245F.19] PATIENT RECORDS. new text end

new text begin Subdivision 1. new text end

new text begin Patient records required. new text end

new text begin A license holder must maintain a file of current patient records on the program premises where the treatment is provided. Each entry in each patient record must be signed and dated by the staff member making the entry. Patient records must be protected against loss, tampering, or unauthorized disclosure in compliance with chapter 13 and section 254A.09; Code of Federal Regulations, title 42, sections 2.1 to 2.67; and title 45, parts 160 to 164. new text end

new text begin Subd. 2. new text end

new text begin Records retention. new text end

new text begin A license holder must retain and store records as required by section 245A.041, subdivisions 3 and 4. new text end

new text begin Subd. 3. new text end

new text begin Contents of records. new text end

new text begin Patient records must include the following: new text end

new text begin (1) documentation of the patient's presenting problem, any substance use screening, the most recent assessment, and any updates; new text end

new text begin (2) a stabilization plan and progress notes as required by section 245F.07, subdivisions 1 and 2; new text end

new text begin (3) a discharge summary as required by section 245F.07, subdivision 3; new text end

new text begin (4) an individual abuse prevention plan that complies with section 245A.65, and related rules; new text end

new text begin (5) documentation of referrals made; and new text end

new text begin (6) documentation of the monitoring and observations of the patient's medical needs. new text end

Sec. 20.

new text begin [245F.20] DATA COLLECTION REQUIRED. new text end

new text begin The license holder must participate in the drug and alcohol abuse normative evaluation system (DAANES) by submitting, in a format provided by the commissioner, information concerning each patient admitted to the program. Staff submitting data must be trained by the license holder with the DAANES Web manual. new text end

Sec. 21.

new text begin [245F.21] PAYMENT METHODOLOGY. new text end

new text begin The commissioner shall develop a payment methodology for services provided under this chapter or by an Indian Health Services facility or a facility owned and operated by a tribe or tribal organization operating under Public Law 93-638 as a 638 facility. The commissioner shall seek federal approval for the methodology. Upon federal approval, the commissioner must seek and obtain legislative approval of the funding methodology to support the service. new text end

ARTICLE 4

DIRECT CARE AND TREATMENT

Section 1.

Minnesota Statutes 2014, section 43A.241, is amended to read:

43A.241 INSURANCE CONTRIBUTIONS; FORMER deleted text begin CORRECTIONS deleted text end EMPLOYEES.

(a) This section applies to a person who:

(1) was employed by the commissioner of the Department of Corrections deleted text begin at a state institution under control of the commissioner, and in that employment was a member of the general plan of the Minnesota State Retirement System;deleted text end new text begin or by the Department of Human Services;new text end

(2) new text begin was covered by the correctional employee retirement plan under section 352.91 or the general state employees retirement plan of the Minnesota State Retirement System as defined in section 352.021;new text end

new text begin (3) while employed under clause (1), new text end was assaulted bynew text begin : new text end

deleted text begin an inmate at a state institution under control of the commissioner of the Department of Corrections deleted text end new text begin (i) a person under correctional supervision for a criminal offense; or new text end

new text begin (ii) a client or patient at the Minnesota sex offender program, or at a state-operated forensic services program as defined in section 352.91, subdivision 3j, under the control of the commissioner of the Department of Human Servicesnew text end ; and

deleted text begin (3)deleted text end new text begin (4) as a direct result of the assault under clause (3), new text end was determined to be totally and permanently new text begin physically new text end disabled under laws governing the Minnesota State Retirement System.

(b) For a person to whom this section applies, the commissioner of the Department of Corrections new text begin or the commissioner of the Department of Human Services new text end must continue to make the employer contribution for deleted text begin hospital,deleted text end medicaldeleted text begin ,deleted text end and dental benefits under the State Employee Group Insurance Program after the person terminates state service. If the person had dependent coverage at the time of terminating state service, employer contributions for dependent coverage also must continue under this section. The employer contributions must be in the amount of the employer contribution for active state employees at the time each payment is made. The employer contributions must continue until the person reaches age 65, provided the person makes the required employee contributions, in the amount required of an active state employee, at the time and in the manner specified by the commissioner.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment and applies to a person assaulted by an inmate, client, or patient on or after that date. new text end

Sec. 2.

Minnesota Statutes 2014, section 246.54, subdivision 1, is amended to read:

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 deleted text begin to 60deleted text end new text begin and over if the stay is determined to be clinically appropriate for the clientnew text end ; and

(3) deleted text begin 75 percent for any days over 60deleted text end new text begin 100 percent for each day during the stay, including the day of admission, when the facility determines that it is clinically appropriate for the client to be dischargednew text end .

deleted text begin (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. deleted text end

deleted text begin (c)deleted text end new text begin (b)new text end If payments received by the state under sections 246.50 to 246.53 exceed 80 percent of the cost of care for days new text begin over new text end 31 deleted text begin to 60, or 25 percent for days over 60deleted text end new text begin for clients who meet the criteria in paragraph (a), clause (2)new text end , 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.

ARTICLE 5

SIMPLIFICATION OF PUBLIC ASSISTANCE PROGRAMS

Section 1.

Minnesota Statutes 2014, section 119B.011, subdivision 15, is amended to read:

Subd. 15.

Income.

"Income" means earned deleted text begin or unearneddeleted text end income deleted text begin received by all family members, includingdeleted text end new text begin as defined under section 256P.01, subdivision 3, unearned income as defined under section 256P.01, subdivision 8, and new text end public assistance cash benefits deleted text begin anddeleted text end new text begin , including the Minnesota family investment program, diversionary work program, work benefit, Minnesota supplemental aid, general assistance, refugee cash assistance, new text end at-home infant child care subsidy payments, deleted text begin unless specifically excludeddeleted text end and child support and maintenance distributed to the family under section 256.741, subdivision 15. The following are deleted text begin excludeddeleted text end new text begin deductednew text end from income: funds used to pay for health insurance premiums for family members, deleted text begin Supplemental Security Income, scholarships, work-study income, and grants that cover costs or reimbursement for tuition, fees, books, and educational supplies; student loans for tuition, fees, books, supplies, and living expenses; state and federal earned income tax credits; assistance specifically excluded as income by law; in-kind income such as food support, energy assistance, foster care assistance, medical assistance, child care assistance, and housing subsidies; earned income of full-time or part-time students up to the age of 19, who have not earned a high school diploma or GED high school equivalency diploma including earnings from summer employment; grant awards under the family subsidy program; nonrecurring lump-sum income only to the extent that it is earmarked and used for the purpose for which it is paid; and any income assigned to the public authority according to section 256.741deleted text end new text begin and child or spousal support paid to or on behalf of a person or persons who live outside of the household. Income sources not included in this subdivision and section 256P.06, subdivision 3, are not countednew text end .

Sec. 2.

Minnesota Statutes 2014, 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. 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. 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.new text begin Changes must be reported as required by section 256P.07. A change in income occurs on the day the participant received the first payment reflecting the change in income.new text end

(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.

Sec. 3.

Minnesota Statutes 2014, section 119B.035, subdivision 4, is amended to read:

Subd. 4.

Assistance.

(a) A family is limited to a lifetime total of 12 months of assistance under subdivision 2. The maximum rate of assistance is equal to 68 percent of the rate established under section 119B.13 for care of infants in licensed family child care in the applicant's county of residence.

(b) A participating family must report income and other family changes as specified in new text begin sections 256P.06 and 256P.07, and new text end the county's plan under section 119B.08, subdivision 3.

(c) Persons who are admitted to the at-home infant child care program retain their position in any basic sliding fee program. Persons leaving the at-home infant child care program reenter the basic sliding fee program at the position they would have occupied.

(d) Assistance under this section does not establish an employer-employee relationship between any member of the assisted family and the county or state.

Sec. 4.

Minnesota Statutes 2014, section 119B.09, subdivision 4, is amended to read:

Subd. 4.

Eligibility; annual income; calculation.

Annual income of the applicant family is the current monthly income of the family multiplied by 12 or the income for the 12-month period immediately preceding the date of application, or income calculated by the method which provides the most accurate assessment of income available to the family. Self-employment income must be calculated based on gross receipts less operating expenses. Income must be recalculated when the family's income changes, but no less often than every six months. 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, income must be recalculated when the family's income changes, but otherwise shall be deferred beyond six months, but not to exceed 12 months, to the end of the student's school year.new text begin Included lump sums counted as income under section 256P.06, subdivision 3, must be annualized over 12 months.new text end Income must be verified with documentary evidence. If the applicant does not have sufficient evidence of income, verification must be obtained from the source of the income.

Sec. 5.

Minnesota Statutes 2014, section 256D.01, subdivision 1a, is amended to read:

Subd. 1a.

Standards.

(a) A principal objective in providing general assistance is to provide for single adults, childless couples, or children as defined in section 256D.02, subdivision 6, ineligible for federal programs who are unable to provide for themselves. The minimum standard of assistance determines the total amount of the general assistance grant without separate standards for shelter, utilities, or other needs.

(b) The commissioner shall set the standard of assistance for an assistance unit consisting of an adult recipient who is childless and unmarried or living apart from children and spouse and who does not live with a parent or parents or a legal custodian. When the other standards specified in this subdivision increase, this standard must also be increased by the same percentage.

(c) For an assistance unit consisting of a single adult who lives with a parent or parents, the general assistance standard of assistance is the amount that the aid to families with dependent children standard of assistance, in effect on July 16, 1996, would increase if the recipient were added as an additional minor child to an assistance unit consisting of the recipient's parent and all of that parent's family members, except that the standard may not exceed the standard for a general assistance recipient living alone. Benefits received by a responsible relative of the assistance unit under the Supplemental Security Income program, a workers' compensation program, the Minnesota supplemental aid program, or any other program based on the responsible relative's disability, and any benefits received by a responsible relative of the assistance unit under the Social Security retirement program, may not be counted in the determination of eligibility or benefit level for the assistance unit. Except as provided below, the assistance unit is ineligible for general assistance if the available resources or the countable income of the assistance unit and the parent or parents with whom the assistance unit lives are such that a family consisting of the assistance unit's parent or parents, the parent or parents' other family members and the assistance unit as the only or additional minor child would be financially ineligible for general assistance. For the purposes of calculating the countable income of the assistance unit's parent or parents, the calculation methodsdeleted text begin , income deductions, exclusions, and disregards used when calculating the countable income for a single adult or childless coupledeleted text end must deleted text begin be useddeleted text end new text begin follow the provisions under section 256P.06new text end .

(d) For an assistance unit consisting of a childless couple, the standards of assistance are the same as the first and second adult standards of the aid to families with dependent children program in effect on July 16, 1996. If one member of the couple is not included in the general assistance grant, the standard of assistance for the other is the second adult standard of the aid to families with dependent children program as of July 16, 1996.

Sec. 6.

Minnesota Statutes 2014, section 256D.02, is amended by adding a subdivision to read:

new text begin Subd. 1a. new text end

new text begin Assistance unit. new text end

new text begin "Assistance unit" means an individual who is, or an eligible married couple who live together who are, applying for or receiving benefits under this chapter. new text end

Sec. 7.

Minnesota Statutes 2014, section 256D.02, is amended by adding a subdivision to read:

new text begin Subd. 1b. new text end

new text begin Cash assistance benefit. new text end

new text begin "Cash assistance benefit" means any payment received as a disability benefit, including veterans or workers' compensation; old age, survivors, and disability insurance; railroad retirement benefits; unemployment benefits; and benefits under any federally aided categorical assistance program, Supplemental Security Income, or other assistance program. new text end

Sec. 8.

Minnesota Statutes 2014, section 256D.02, subdivision 8, is amended to read:

Subd. 8.

Income.

"Income" means deleted text begin any form of income, including remuneration for services performed as an employee and earned income from rental income and self-employment earnings as described under section 256P.05deleted text end new text begin earned income as defined under section 256P.01, subdivision 3, and unearned income as defined under section 256P.01, subdivision 8new text end .

deleted text begin Income includes any payments received as an annuity, retirement, or disability benefit, including veteran's or workers' compensation; old age, survivors, and disability insurance; railroad retirement benefits; unemployment benefits; and benefits under any federally aided categorical assistance program, supplementary security income, or other assistance program; rents, dividends, interest and royalties; and support and maintenance payments. Such payments may not be considered as available to meet the needs of any person other than the person for whose benefit they are received, unless that person is a family member or a spouse and the income is not excluded under section 256D.01, subdivision 1a. Goods and services provided in lieu of cash payment shall be excluded from the definition of income, except that payments made for room, board, tuition or fees by a parent, on behalf of a child enrolled as a full-time student in a postsecondary institution, and payments made on behalf of an applicant or participant which the applicant or participant could legally demand to receive personally in cash, must be included as income. Benefits of an applicant or participant, such as those administered by the Social Security Administration, that are paid to a representative payee, and are spent on behalf of the applicant or participant, are considered available income of the applicant or participant. deleted text end

Sec. 9.

Minnesota Statutes 2014, section 256D.06, subdivision 1, is amended to read:

Subdivision 1.

Eligibility; amount of assistance.

General assistance shall be granted in an amount that when added to the deleted text begin nonexemptdeleted text end new text begin countable new text end income new text begin as determined to be new text end actually available to the assistance unitnew text begin under section 256P.06new text end , the total amount equals the applicable standard of assistance for general assistance. In determining eligibility for and the amount of assistance for an individual or married couple, the agency shall apply the earned income disregard as determined in section 256P.03.

Sec. 10.

Minnesota Statutes 2014, section 256D.405, subdivision 3, is amended to read:

Subd. 3.

Reports.

Participants must report changes in circumstances new text begin according to section 256P.07 new text end that affect eligibility or assistance payment amounts within ten days of the change. Participants who do not receive SSI because of excess income must complete a monthly report form if they have earned income, if they have income deemed to them from a financially responsible relative with whom the participant resides, or if they have income deemed to them by a sponsor. If the report form is not received before the end of the month in which it is due, the county agency must terminate assistance. The termination shall be effective on the first day of the month following the month in which the report was due. If a complete report is received within the month the assistance was terminated, the assistance unit is considered to have continued its application for assistance, effective the first day of the month the assistance was terminated.

Sec. 11.

Minnesota Statutes 2014, section 256I.03, is amended by adding a subdivision to read:

new text begin Subd. 1b. new text end

new text begin Assistance unit. new text end

new text begin "Assistance unit" means an individual who is applying for or receiving benefits under this chapter. new text end

Sec. 12.

Minnesota Statutes 2014, section 256I.03, subdivision 7, is amended to read:

Subd. 7.

Countable income.

"Countable income" means all income received by an applicant or recipient new text begin as described under section 256P.06, new text end less any applicable exclusions or disregards. For a recipient of any cash benefit from the SSI program, countable income means the SSI benefit limit in effect at the time the person is in a GRH, less the medical assistance personal needs allowance. If the SSI limit has been reduced for a person due to events occurring prior to the persons entering the GRH setting, countable income means actual income less any applicable exclusions and disregards.

Sec. 13.

Minnesota Statutes 2014, section 256I.04, subdivision 1, is amended to read:

Subdivision 1.

Individual eligibility requirements.

An individual is eligible for and entitled to a group residential housing payment to be made on the individual's behalf if the agency has approved the individual's residence in a group residential housing setting and the individual meets the requirements in paragraph (a) or (b).

(a) The individual is aged, blind, or is over 18 years of age and disabled as determined under the criteria used by the title II program of the Social Security Act, and meets the resource restrictions and standards of section 256P.02, and the individual's countable income after deducting the (1) exclusions and disregards of the SSI program, (2) the medical assistance personal needs allowance under section 256B.35, and (3) an amount equal to the income actually made available to a community spouse by an elderly waiver participant under the provisions of sections 256B.0575, paragraph (a), clause (4), and 256B.058, subdivision 2, is less than the monthly rate specified in the agency's agreement with the provider of group residential housing in which the individual resides.

(b) The individual meets a category of eligibility under section 256D.05, subdivision 1, paragraph (a), and the individual's resources are less than the standards specified by section 256P.02, and the individual's countable income as determined under deleted text begin sections 256D.01 to 256D.21deleted text end new text begin section 256P.06new text end , less the medical assistance personal needs allowance under section 256B.35 is less than the monthly rate specified in the agency's agreement with the provider of group residential housing in which the individual resides.

Sec. 14.

Minnesota Statutes 2014, section 256I.06, subdivision 6, is amended to read:

Subd. 6.

Reports.

Recipients must report changes in circumstances new text begin according to section 256P.07 new text end that affect eligibility or group residential housing payment amounts within ten days of the change. Recipients with countable earned income must complete a monthly household report form. If the report form is not received before the end of the month in which it is due, the county agency must terminate eligibility for group residential housing payments. The termination shall be effective on the first day of the month following the month in which the report was due. If a complete report is received within the month eligibility was terminated, the individual is considered to have continued an application for group residential housing payment effective the first day of the month the eligibility was terminated.

Sec. 15.

Minnesota Statutes 2014, section 256J.08, subdivision 26, is amended to read:

Subd. 26.

Earned income.

"Earned income" deleted text begin means cash or in-kind income earned through the receipt of wages, salary, commissions, profit from employment activities, net profit from self-employment activities, payments made by an employer for regularly accrued vacation or sick leave, and any other profit from activity earned through effort or labor. The income must be in return for, or as a result of, legal activitydeleted text end new text begin has the meaning given in section 256P.01, subdivision 3new text end .

Sec. 16.

Minnesota Statutes 2014, section 256J.08, subdivision 86, is amended to read:

Subd. 86.

Unearned income.

"Unearned income" deleted text begin means income received by a person that does not meet the definition of earned income. Unearned income includes income from a contract for deed, interest, dividends, unemployment benefits, disability insurance payments, veterans benefits, pension payments, return on capital investment, insurance payments or settlements, severance payments, child support and maintenance payments, and payments for illness or disability whether the premium payments are made in whole or in part by an employer or participantdeleted text end new text begin has the meaning given in section 256P.01, subdivision 8new text end .

Sec. 17.

Minnesota Statutes 2014, section 256J.30, subdivision 1, is amended to read:

Subdivision 1.

Applicant reporting requirements.

An applicant must provide information on an application form and supplemental forms about the applicant's circumstances deleted text begin which affect MFIP eligibility or the assistance payment. An applicant must report changes identified in subdivision 9 while the application is pending. When an applicant does not accurately report information on an application, both an overpayment and a referral for a fraud investigation may result. When an applicant does not provide information or documentation, the receipt of the assistance payment may be delayed or the application may be denied depending on the type of information required and its effect on eligibilitydeleted text end new text begin according to section 256P.07new text end .

Sec. 18.

Minnesota Statutes 2014, section 256J.30, subdivision 9, is amended to read:

Subd. 9.

Changes that must be reported.

A caregiver must report deleted text begin the changes or anticipated changes specified in clauses (1) to (15) within ten days of the date they occur, at the time of the periodic recertification of eligibility under section 256P.04, subdivisions 8 and 9, or within eight calendar days of a reporting period as in subdivision 5, whichever occurs first. A caregiver must report other changes at the time of the periodic recertification of eligibility under section 256P.04, subdivisions 8 and 9, or at the end of a reporting period under subdivision 5, as applicable. A caregiver must make these reports in writing to the agency. When an agency could have reduced or terminated assistance for one or more payment months if a delay in reporting a change specified under clauses (1) to (14) had not occurred, the agency must determine whether a timely notice under section 256J.31, subdivision 4, could have been issued on the day that the change occurred. When a timely notice could have been issued, each month's overpayment subsequent to that notice must be considered a client error overpayment under section 256J.38. Calculation of overpayments for late reporting under clause (15) is specified in section 256J.09, subdivision 9. Changes in circumstances which must be reported within ten days must also be reported on the MFIP household report form for the reporting period in which those changes occurred. Within ten days, a caregiver must report:deleted text end new text begin changes as specified under section 256P.07.new text end

deleted text begin (1) a change in initial employment; deleted text end

deleted text begin (2) a change in initial receipt of unearned income; deleted text end

deleted text begin (3) a recurring change in unearned income; deleted text end

deleted text begin (4) a nonrecurring change of unearned income that exceeds $30; deleted text end

deleted text begin (5) the receipt of a lump sum; deleted text end

deleted text begin (6) an increase in assets that may cause the assistance unit to exceed asset limits; deleted text end

deleted text begin (7) a change in the physical or mental status of an incapacitated member of the assistance unit if the physical or mental status is the basis for reducing the hourly participation requirements under section 256J.55, subdivision 1, or the type of activities included in an employment plan under section 256J.521, subdivision 2; deleted text end

deleted text begin (8) a change in employment status; deleted text end

deleted text begin (9) the marriage or divorce of an assistance unit member; deleted text end

deleted text begin (10) the death of a parent, minor child, or financially responsible person; deleted text end

deleted text begin (11) a change in address or living quarters of the assistance unit; deleted text end

deleted text begin (12) the sale, purchase, or other transfer of property; deleted text end

deleted text begin (13) a change in school attendance of a caregiver under age 20 or an employed child; deleted text end

deleted text begin (14) filing a lawsuit, a workers' compensation claim, or a monetary claim against a third party; and deleted text end

deleted text begin (15) a change in household composition, including births, returns to and departures from the home of assistance unit members and financially responsible persons, or a change in the custody of a minor child. deleted text end

Sec. 19.

Minnesota Statutes 2014, section 256J.35, is amended to read:

256J.35 AMOUNT OF ASSISTANCE PAYMENT.

Except as provided in paragraphs (a) to (d), 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.

(a) Beginning July 1, 2015, MFIP assistance units are eligible for an MFIP housing assistance grant of $110 per month, unless:

(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

(2) the assistance unit is a child-only case under section 256J.88.

(b) 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.

(c) MFIP overpayments to an assistance unit must be recouped according to section deleted text begin 256J.38, subdivision 4deleted text end new text begin 256P.08, subdivision 6new text end .

(d) An initial assistance payment must not be made to an applicant who is not eligible on the date payment is made.

Sec. 20.

Minnesota Statutes 2014, section 256J.40, is amended to read:

256J.40 FAIR HEARINGS.

Caregivers receiving a notice of intent to sanction or a notice of adverse action that includes a sanction, reduction in benefits, suspension of benefits, denial of benefits, or termination of benefits may request a fair hearing. A request for a fair hearing must be submitted in writing to the county agency or to the commissioner and must be mailed within 30 days after a participant or former participant receives written notice of the agency's action or within 90 days when a participant or former participant shows good cause for not submitting the request within 30 days. A former participant who receives a notice of adverse action due to an overpayment may appeal the adverse action according to the requirements in this section. Issues that may be appealed are:

(1) the amount of the assistance payment;

(2) a suspension, reduction, denial, or termination of assistance;

(3) the basis for an overpayment, the calculated amount of an overpayment, and the level of recoupment;

(4) the eligibility for an assistance payment; and

(5) the use of protective or vendor payments under section 256J.39, subdivision 2, clauses (1) to (3).

Except for benefits issued under section 256J.95, a county agency must not reduce, suspend, or terminate payment when an aggrieved participant requests a fair hearing prior to the effective date of the adverse action or within ten days of the mailing of the notice of adverse action, whichever is later, unless the participant requests in writing not to receive continued assistance pending a hearing decision. An appeal request cannot extend benefits for the diversionary work program under section 256J.95 beyond the four-month time limit. Assistance issued pending a fair hearing is subject to recovery under section deleted text begin 256J.38deleted text end new text begin 256P.08new text end when as a result of the fair hearing decision the participant is determined ineligible for assistance or the amount of the assistance received. A county agency may increase or reduce an assistance payment while an appeal is pending when the circumstances of the participant change and are not related to the issue on appeal. The commissioner's order is binding on a county agency. No additional notice is required to enforce the commissioner's order.

A county agency shall reimburse appellants for reasonable and necessary expenses of attendance at the hearing, such as child care and transportation costs and for the transportation expenses of the appellant's witnesses and representatives to and from the hearing. Reasonable and necessary expenses do not include legal fees. Fair hearings must be conducted at a reasonable time and date by an impartial human services judge employed by the department. The hearing may be conducted by telephone or at a site that is readily accessible to persons with disabilities.

The appellant may introduce new or additional evidence relevant to the issues on appeal. Recommendations of the human services judge and decisions of the commissioner must be based on evidence in the hearing record and are not limited to a review of the county agency action.

Sec. 21.

Minnesota Statutes 2014, section 256J.95, subdivision 19, is amended to read:

Subd. 19.

DWP overpayments and underpayments.

DWP benefits are subject to overpayments and underpayments. Anytime an overpayment or an underpayment is determined for DWP, the correction shall be calculated using prospective budgeting. Corrections shall be determined based on the policy in section 256J.34, subdivision 1, paragraphs (a), (b), and (c). ATM errors must be recovered as specified in section deleted text begin 256J.38, subdivision 5deleted text end new text begin 256P.08, subdivision 7new text end . Cross program recoupment of overpayments cannot be assigned to or from DWP.

Sec. 22.

Minnesota Statutes 2014, section 256P.001, is amended to read:

256P.001 APPLICABILITY.

General assistance and Minnesota supplemental aid under chapter 256Dnew text begin , child care assistance programs under chapter 119B, new text end and programs governed by chapter 256I or 256J are subject to the requirements of this chapter, unless otherwise specified or exempted.

Sec. 23.

Minnesota Statutes 2014, section 256P.01, is amended by adding a subdivision to read:

new text begin Subd. 2a. new text end

new text begin Assistance unit. new text end

new text begin "Assistance unit" is defined by program area under sections 119B.011, subdivision 13; 256D.02, subdivision 1a; 256D.35, subdivision 3a; 256I.03, subdivision 1b; and 256J.08, subdivision 7. new text end

Sec. 24.

Minnesota Statutes 2014, section 256P.01, subdivision 3, is amended to read:

Subd. 3.

Earned income.

"Earned income" means cash or in-kind income earned through the receipt of wages, salary, commissions, new text begin bonuses, tips, gratuities, new text end profit from employment activities, net profit from self-employment activities, payments made by an employer for regularly accrued vacation or sick leave, deleted text begin and anydeleted text end new text begin severance pay based on accrued leave time, payments from training programs at a rate at or greater than the state's minimum wage, royalties, honoraria, or new text end other profit from activity deleted text begin earned through effortdeleted text end new text begin that results from the client's work, service, effort, new text end or labor. The income must be in return for, or as a result of, legal activity.

Sec. 25.

Minnesota Statutes 2014, section 256P.01, is amended by adding a subdivision to read:

new text begin Subd. 8. new text end

new text begin Unearned income. new text end

new text begin "Unearned income" has the meaning given in section 256P.06, subdivision 3, clause (2). new text end

Sec. 26.

Minnesota Statutes 2014, section 256P.02, is amended by adding a subdivision to read:

new text begin Subd. 1a. new text end

new text begin Exemption. new text end

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

Sec. 27.

Minnesota Statutes 2014, section 256P.03, subdivision 1, is amended to read:

Subdivision 1.

Exempted programs.

Participants who qualify for new text begin child care assistance programs under chapter 119B, new text end Minnesota supplemental aid under chapter 256Dnew text begin ,new text end and deleted text begin fordeleted text end group residential housing under chapter 256I on the basis of eligibility for Supplemental Security Income are exempt from this section.

Sec. 28.

Minnesota Statutes 2014, section 256P.04, subdivision 1, is amended to read:

Subdivision 1.

Exemption.

Participants who receive Minnesota supplemental aid and who maintain Supplemental Security Income eligibility under chapters 256D and 256I are exempt from the reporting requirements of this section, except that the policies and procedures for transfers of assets are those used by the medical assistance program under section 256B.0595.new text begin Participants who receive child care assistance under chapter 119B are exempt from the requirements of this section.new text end

Sec. 29.

Minnesota Statutes 2014, section 256P.04, subdivision 4, is amended to read:

Subd. 4.

Factors to be verified.

(a) The agency shall verify the following at application:

(1) identity of adults;

(2) age, if necessary to determine eligibility;

(3) immigration status;

(4) income;

(5) spousal support and child support payments made to persons outside the household;

(6) vehicles;

(7) checking and savings accounts;

(8) inconsistent information, if related to eligibility;

(9) residence; deleted text begin anddeleted text end

(10) Social Security numberdeleted text begin .deleted text end new text begin ; andnew text end

new text begin (11) use of nonrecurring income under section 256P.06, subdivision 3, clause (2), item (ix), for the intended purpose for which it was given and received. new text end

(b) Applicants who are qualified noncitizens and victims of domestic violence as defined under section 256J.08, subdivision 73, clause (7), are not required to verify the information in paragraph (a), clause (10). When a Social Security number is not provided to the agency for verification, this requirement is satisfied when each member of the assistance unit cooperates with the procedures for verification of Social Security numbers, issuance of duplicate cards, and issuance of new numbers which have been established jointly between the Social Security Administration and the commissioner.

Sec. 30.

Minnesota Statutes 2014, section 256P.05, subdivision 1, is amended to read:

Subdivision 1.

Exempted programs.

Participants who qualify fornew text begin child care assistance programs under chapter 119B, new text end Minnesota supplemental aid under chapter 256Dnew text begin ,new text end and deleted text begin fordeleted text end group residential housing under chapter 256I on the basis of eligibility for Supplemental Security Income are exempt from this section.

Sec. 31.

new text begin [256P.06] INCOME CALCULATIONS. new text end

new text begin Subdivision 1. new text end

new text begin Reporting of income. new text end

new text begin To determine eligibility, the county agency must evaluate income received by members of the assistance unit, or by other persons whose income is considered available to the assistance unit, and only count income that is available to the assistance unit. Income is available if the individual has legal access to the income. new text end

new text begin Subd. 2. new text end

new text begin Exempted individuals. new text end

new text begin The following members of an assistance unit under chapters 119B and 256J are exempt from having their earned income count towards the income of an assistance unit: new text end

new text begin (1) children under six years old; new text end

new text begin (2) caregivers under 20 years of age enrolled at least half-time in school; and new text end

new text begin (3) minors enrolled in school full time. new text end

new text begin Subd. 3. new text end

new text begin Income inclusions. new text end

new text begin The following must be included in determining the income of an assistance unit: new text end

new text begin (1) earned income; and new text end

new text begin (2) unearned income, which includes: new text end

new text begin (i) interest and dividends from investments and savings; new text end

new text begin (ii) capital gains as defined by the Internal Revenue Service from any sale of real property; new text end

new text begin (iii) proceeds from rent and contract for deed payments in excess of the principal and interest portion owed on property; new text end

new text begin (iv) income from trusts, excluding special needs and supplemental needs trusts; new text end

new text begin (v) interest income from loans made by the participant or household; new text end

new text begin (vi) cash prizes and winnings; new text end

new text begin (vii) unemployment insurance income; new text end

new text begin (viii) retirement, survivors, and disability insurance payments; new text end

new text begin (ix) nonrecurring income over $60 per quarter unless earmarked and used for the purpose for which it is intended. Income and use of this income is subject to verification requirements under section 256P.04; new text end

new text begin (x) retirement benefits; new text end

new text begin (xi) cash assistance benefits, as defined by each program in chapters 119B, 256D, 256I, and 256J; new text end

new text begin (xii) tribal per capita payments unless excluded by federal and state law; new text end

new text begin (xiii) income and payments from service and rehabilitation programs that meet or exceed the state's minimum wage rate; new text end

new text begin (xiv) income from members of the United States armed forces unless excluded from income taxes according to federal or state law; new text end

new text begin (xv) all child support payments for programs under chapters 119B, 256D, and 256I; new text end

new text begin (xvi) the amount of current child support received that exceeds $100 for assistance units with one child and $200 for assistance units with two or more children for programs under chapter 256J; and new text end

new text begin (xvii) spousal support. new text end

Sec. 32.

new text begin [256P.07] REPORTING OF INCOME AND CHANGES. new text end

new text begin Subdivision 1. new text end

new text begin Exempted programs. new text end

new text begin Participants who qualify for Minnesota supplemental aid under chapter 256D and for group residential housing under chapter 256I on the basis of eligibility for Supplemental Security Income are exempt from this section. new text end

new text begin Subd. 2. new text end

new text begin Reporting requirements. new text end

new text begin An applicant or participant must provide information on an application and any subsequent reporting forms about the assistance unit's circumstances that affect eligibility or benefits. An applicant or assistance unit must report changes identified in subdivision 3. When information is not accurately reported, both an overpayment and a referral for a fraud investigation may result. When information or documentation is not provided, the receipt of any benefit may be delayed or denied, depending on the type of information required and its effect on eligibility. new text end

new text begin Subd. 3. new text end

new text begin Changes that must be reported. new text end

new text begin An assistance unit must report the changes or anticipated changes specified in clauses (1) to (12) within ten days of the date they occur, at the time of recertification of eligibility under section 256P.04, subdivisions 8 and 9, or within eight calendar days of a reporting period, whichever occurs first. An assistance unit must report other changes at the time of recertification of eligibility under section 256P.04, subdivisions 8 and 9, or at the end of a reporting period, as applicable. When an agency could have reduced or terminated assistance for one or more payment months if a delay in reporting a change specified under clauses (1) to (12) had not occurred, the agency must determine whether a timely notice could have been issued on the day that the change occurred. When a timely notice could have been issued, each month's overpayment subsequent to that notice must be considered a client error overpayment under section 119B.11, subdivision 2a, or 256P.08. Changes in circumstances that must be reported within ten days must also be reported for the reporting period in which those changes occurred. Within ten days, an assistance unit must report: new text end

new text begin (1) a change in earned income of $100 per month or greater; new text end

new text begin (2) a change in unearned income of $50 per month or greater; new text end

new text begin (3) a change in employment status and hours; new text end

new text begin (4) a change in address or residence; new text end

new text begin (5) a change in household composition with the exception of programs under chapter 256I; new text end

new text begin (6) a receipt of a lump-sum payment; new text end

new text begin (7) an increase in assets if over $9,000 with the exception of programs under chapter 119B; new text end

new text begin (8) a change in citizenship or immigration status; new text end

new text begin (9) a change in family status with the exception of programs under chapter 256I; new text end

new text begin (10) a change in disability status of a unit member, with the exception of programs under chapter 119B; new text end

new text begin (11) a new rent subsidy or a change in rent subsidy; and new text end

new text begin (12) a sale, purchase, or transfer of real property. new text end

new text begin Subd. 4. new text end

new text begin MFIP-specific reporting. new text end

new text begin In addition to subdivision 3, an assistance unit under chapter 256J, within ten days of the change, must report: new text end

new text begin (1) a pregnancy not resulting in birth when there are no other minor children; and new text end

new text begin (2) a change in school attendance of a parent under 20 years of age or of an employed child. new text end

new text begin Subd. 5. new text end

new text begin DWP-specific reporting. new text end

new text begin In addition to subdivisions 3 and 4, an assistance unit participating in the diversionary work program under section 256J.95 must report on an application: new text end

new text begin (1) shelter expenses; and new text end

new text begin (2) utility expenses. new text end

new text begin Subd. 6. new text end

new text begin Child care assistance programs-specific reporting. new text end

new text begin In addition to subdivision 3, an assistance unit under chapter 119B, within ten days of the change, must report: new text end

new text begin (1) a change in a parentally responsible individual's visitation schedule or custody arrangement for any child receiving child care assistance program benefits; and new text end

new text begin (2) a change in authorized activity status. new text end

new text begin Subd. 7. new text end

new text begin Minnesota supplemental aid-specific reporting. new text end

new text begin In addition to subdivision 3, an assistance unit participating in the Minnesota supplemental aid program under section 256D.44, subdivision 5, paragraph (f), within ten days of the change, must report shelter expenses. new text end

Sec. 33.

new text begin [256P.08] CORRECTION OF OVERPAYMENTS AND UNDERPAYMENTS. new text end

new text begin Subdivision 1. new text end

new text begin Exempted programs. new text end

new text begin Participants who qualify for child care assistance programs under chapter 119B or group residential housing under chapter 256I are exempt from this section. new text end

new text begin Subd. 2. new text end

new text begin Scope of overpayment. new text end

new text begin (a) When a participant or former participant receives an overpayment due to client or ATM error, or due to assistance received while an appeal is pending and the participant or former participant is determined ineligible for assistance or for less assistance than was received, except as provided for interim assistance in section 256D.06, subdivision 5, the county agency must recoup or recover the overpayment using the following methods: new text end

new text begin (1) reconstruct each affected budget month and corresponding payment month; new text end

new text begin (2) use the policies and procedures that were in effect for the payment month; and new text end

new text begin (3) do not allow employment disregards in the calculation of the overpayment when the unit has not reported within two calendar months following the end of the month in which the income was received. new text end

new text begin (b) Establishment of an overpayment is limited to six years prior to the month of discovery due to client error or an intentional program violation determined under section 256.046. new text end

new text begin (c) A participant or former participant is not responsible for overpayments due to agency error, unless the amount of the overpayment is large enough that a reasonable person would know it is an error. new text end

new text begin Subd. 3. new text end

new text begin Notice of overpayment. new text end

new text begin When a county agency discovers that a participant or former participant has received an overpayment for one or more months, the county agency must notify the participant or former participant of the overpayment in writing. A notice of overpayment must specify the reason for the overpayment, the authority for citing the overpayment, the time period in which the overpayment occurred, the amount of the overpayment, and the participant's or former participant's right to appeal. No limit applies to the period in which the county agency is required to recoup or recover an overpayment according to subdivisions 4, 5, and 6. new text end

new text begin Subd. 4. new text end

new text begin Recovering general assistance and Minnesota supplemental aid overpayments. new text end

new text begin (a) If an amount of assistance is paid to an assistance unit in excess of the payment due, it shall be recoverable by the agency. The agency shall give written notice to the participant of its intention to recover the overpayment. new text end

new text begin (b) If the individual is no longer receiving assistance, the agency may request voluntary repayment or pursue civil recovery. new text end

new text begin (c) If the individual is receiving assistance, except as provided for interim assistance in section 256D.06, subdivision 5, when an overpayment occurs the agency shall recover the overpayment by withholding an amount equal to: new text end

new text begin (1) three percent of the assistance unit's standard of need for all Minnesota supplemental aid assistance units, and nonfraud cases for general assistance; and new text end

new text begin (2) ten percent where fraud has occurred in general assistance cases; or new text end

new text begin (3) the amount of the monthly general assistance or Minnesota supplemental aid payment, whichever is less. new text end

new text begin (d) In cases when there is both an overpayment and underpayment, the county agency shall offset one against the other in correcting the payment. new text end

new text begin (e) Overpayments may also be voluntarily repaid, in part or in full, by the individual, in addition to the assistance reductions provided in this subdivision, to include further voluntary reductions in the grant level agreed to in writing by the individual, until the total amount of the overpayment is repaid. new text end

new text begin (f) The county agency shall make reasonable efforts to recover overpayments to individuals no longer on assistance. The agency need not attempt to recover overpayments of less than $35 paid to an individual no longer on assistance if the individual does not receive assistance again within three years, unless the individual has been convicted of violating section 256.98. new text end

new text begin (g) Establishment of an overpayment is limited to 12 months prior to the month of discovery due to agency error and six years prior to the month of discovery due to client error or an intentional program violation determined under section 256.046. new text end

new text begin (h) Residents of licensed residential facilities shall not have overpayments recovered from their personal needs allowance. new text end

new text begin (i) Overpayments by another maintenance benefit program shall not be recovered from the general assistance or Minnesota supplemental aid grant. new text end

new text begin Subd. 5. new text end

new text begin Recovering MFIP overpayments. new text end

new text begin A county agency must initiate efforts to recover overpayments paid to a former participant or caregiver. Caregivers, both parental and nonparental, and minor caregivers of an assistance unit at the time an overpayment occurs, whether receiving assistance or not, are jointly and individually liable for repayment of the overpayment. The county agency must request repayment from the former participants and caregivers. When an agreement for repayment is not completed within six months of the date of discovery or when there is a default on an agreement for repayment after six months, the county agency must initiate recovery consistent with chapter 270A or section 541.05. When a person has been disqualified or convicted of fraud under section 256.98, recovery must be sought regardless of the amount of overpayment. When an overpayment is less than $35, and is not the result of a fraud conviction under section 256.98, the county agency must not seek recovery under this subdivision. The county agency must retain information about all overpayments regardless of the amount. When an adult, adult caregiver, or minor caregiver reapplies for assistance, the overpayment must be recouped under subdivision 6. new text end

new text begin Subd. 6. new text end

new text begin Recouping overpayments from MFIP participants. new text end

new text begin A participant may voluntarily repay, in part or in full, an overpayment even if assistance is reduced under this subdivision, until the total amount of the overpayment is repaid. When an overpayment occurs due to fraud, the county agency must recover from the overpaid assistance unit, including child-only cases, ten percent of the applicable standard or the amount of the monthly assistance payment, whichever is less. When a nonfraud overpayment occurs, the county agency must recover from the overpaid assistance unit, including child-only cases, three percent of the MFIP standard of need or the amount of the monthly assistance payment, whichever is less. new text end

new text begin Subd. 7. new text end

new text begin Recovering automatic teller machine errors. new text end

new text begin For recipients receiving benefits by electronic benefit transfer, if the overpayment is a result of an ATM dispensing funds in error to the recipient, the agency may recover the ATM error by immediately withdrawing funds from the recipient's electronic benefit transfer account, up to the amount of the error. new text end

new text begin Subd. 8. new text end

new text begin Scope of underpayments. new text end

new text begin A county agency must issue a corrective payment for underpayments made to a participant or to a person who would be a participant if an agency or client error causing the underpayment had not occurred. Corrective payments are limited to 12 months prior to the month of discovery. The county agency must issue the corrective payment according to subdivision 10. new text end

new text begin Subd. 9. new text end

new text begin Identifying the underpayment. new text end

new text begin An underpayment may be identified by a county agency, participant, former participant, or person who would be a participant except for agency or client error. new text end

new text begin Subd. 10. new text end

new text begin Issuing corrective payments. new text end

new text begin A county agency must correct an underpayment within seven calendar days after the underpayment has been identified, by adding the corrective payment amount to the monthly assistance payment of the participant, issuing a separate payment to a participant or former participant, or reducing an existing overpayment balance. When an underpayment occurs in a payment month and is not identified until the next payment month or later, the county agency must first subtract the underpayment from any overpayment balance before issuing the corrective payment. The county agency must not apply an underpayment in a current payment month against an overpayment balance. When an underpayment in the current payment month is identified, the corrective payment must be issued within seven calendar days after the underpayment is identified. Corrective payments must be excluded when determining the applicant's or participant's income and resources for the month of payment. The county agency must correct underpayments using the following methods: new text end

new text begin (1) reconstruct each affected budget month and corresponding payment month; and new text end

new text begin (2) use the policies and procedures that were in effect for the payment month. new text end

new text begin Subd. 11. new text end

new text begin Appeals. new text end

new text begin A participant may appeal an underpayment, an overpayment, and a reduction in an assistance payment made to recoup the overpayment under subdivisions 4 and 6. The participant's appeal of each issue must be timely under section 256.045. When an appeal based on the notice issued under subdivision 3 is not timely, the fact or the amount of that overpayment must not be considered as a part of a later appeal, including an appeal of a reduction in an assistance payment to recoup that overpayment. new text end

Sec. 34.

new text begin REPEALER. new text end

new text begin (a) new text end new text begin Minnesota Statutes 2014, sections 256D.0513; 256D.06, subdivision 8; 256D.09, subdivision 6; 256D.49; and 256J.38, new text end new text begin are repealed. new text end

new text begin (b) new text end new text begin Minnesota Rules, part 3400.0170, subparts 5, 6, 12, and 13, new text end new text begin are repealed. new text end

Sec. 35.

new text begin EFFECTIVE DATE. new text end

new text begin This article is effective August 1, 2016. new text end

ARTICLE 6

NURSING FACILITY PAYMENT REFORM AND WORKFORCE DEVELOPMENT

Section 1.

new text begin [144.1503] HOME AND COMMUNITY-BASED SERVICES EMPLOYEE SCHOLARSHIP PROGRAM. new text end

new text begin Subdivision 1. new text end

new text begin Creation. new text end

new text begin The home and community-based services employee scholarship grant program is established for the purpose of assisting qualified provider applicants to fund employee scholarships for education in nursing and other health care fields. new text end

new text begin Subd. 2. new text end

new text begin Provision of grants. new text end

new text begin The commissioner shall make grants available to qualified providers of older adult services. Grants must be used by home and community-based service providers to recruit and train staff through the establishment of an employee scholarship fund. new text end

new text begin Subd. 3. new text end

new text begin Eligibility. new text end

new text begin (a) Eligible providers must primarily provide services to individuals who are 65 years of age and older in home and community-based settings, including housing with services establishments as defined in section 144D.01, subdivision 4; adult day care as defined in section 245A.02, subdivision 2a; and home care services as defined in section 144A.43, subdivision 3. new text end

new text begin (b) Qualifying providers must establish a home and community-based services employee scholarship program, as specified in subdivision 4. Providers that receive funding under this section must use the funds to award scholarships to employees who work an average of at least 16 hours per week for the provider. new text end

new text begin Subd. 4. new text end

new text begin Home and community-based services employee scholarship program. new text end

new text begin Each qualifying provider under this section must propose a home and community-based services employee scholarship program. Providers must establish criteria by which funds are to be distributed among employees. At a minimum, the scholarship program must cover employee costs related to a course of study that is expected to lead to career advancement with the provider or in the field of long-term care, including home care, care of persons with disabilities, or nursing. new text end

new text begin Subd. 5. new text end

new text begin Participating providers. new text end

new text begin The commissioner shall publish a request for proposals in the State Register, specifying provider eligibility requirements, criteria for a qualifying employee scholarship program, provider selection criteria, documentation required for program participation, maximum award amount, and methods of evaluation. The commissioner must publish additional requests for proposals each year in which funding is available for this purpose. new text end

new text begin Subd. 6. new text end

new text begin Application requirements. new text end

new text begin Eligible providers seeking a grant shall submit an application to the commissioner. Applications must contain a complete description of the employee scholarship program being proposed by the applicant, including the need for the organization to enhance the education of its workforce, the process for determining which employees will be eligible for scholarships, any other sources of funding for scholarships, the expected degrees or credentials eligible for scholarships, the amount of funding sought for the scholarship program, a proposed budget detailing how funds will be spent, and plans for retaining eligible employees after completion of their scholarship. new text end

new text begin Subd. 7. new text end

new text begin Selection process. new text end

new text begin The commissioner shall determine a maximum award for grants and make grant selections based on the information provided in the grant application, including the demonstrated need for an applicant provider to enhance the education of its workforce, the proposed employee scholarship selection process, the applicant's proposed budget, and other criteria as determined by the commissioner. Notwithstanding any law or rule to the contrary, funds awarded to grantees in a grant agreement do not lapse until the grant agreement expires. new text end

new text begin Subd. 8. new text end

new text begin Reporting requirements. new text end

new text begin Participating providers shall submit an invoice for reimbursement and a report to the commissioner on a schedule determined by the commissioner and on a form supplied by the commissioner. The report shall include the amount spent on scholarships; the number of employees who received scholarships; and, for each scholarship recipient, the name of the recipient, the current position of the recipient, the amount awarded, the educational institution attended, the nature of the educational program, and the expected or actual program completion date. During the grant period, the commissioner may require and collect from grant recipients other information necessary to evaluate the program. new text end

Sec. 2.

Minnesota Statutes 2014, section 144A.071, subdivision 4a, is amended to read:

Subd. 4a.

Exceptions for replacement beds.

It is in the best interest of the state to ensure that nursing homes and boarding care homes continue to meet the physical plant licensing and certification requirements by permitting certain construction projects. Facilities should be maintained in condition to satisfy the physical and emotional needs of residents while allowing the state to maintain control over nursing home expenditure growth.

The commissioner of health in coordination with the commissioner of human services, may approve the renovation, replacement, upgrading, or relocation of a nursing home or boarding care home, under the following conditions:

(a) to license or certify beds in a new facility constructed to replace a facility or to make repairs in an existing facility that was destroyed or damaged after June 30, 1987, by fire, lightning, or other hazard provided:

(i) destruction was not caused by the intentional act of or at the direction of a controlling person of the facility;

(ii) at the time the facility was destroyed or damaged the controlling persons of the facility maintained insurance coverage for the type of hazard that occurred in an amount that a reasonable person would conclude was adequate;

(iii) the net proceeds from an insurance settlement for the damages caused by the hazard are applied to the cost of the new facility or repairs;

(iv) the number of licensed and certified beds in the new facility does not exceed the number of licensed and certified beds in the destroyed facility; and

(v) the commissioner determines that the replacement beds are needed to prevent an inadequate supply of beds.

Project construction costs incurred for repairs authorized under this clause shall not be considered in the dollar threshold amount defined in subdivision 2;

(b) to license or certify beds that are moved from one location to another within a nursing home facility, provided the total costs of remodeling performed in conjunction with the relocation of beds does not exceed $1,000,000;

(c) to license or certify beds in a project recommended for approval under section 144A.073;

(d) to license or certify beds that are moved from an existing state nursing home to a different state facility, provided there is no net increase in the number of state nursing home beds;

(e) to certify and license as nursing home beds boarding care beds in a certified boarding care facility if the beds meet the standards for nursing home licensure, or in a facility that was granted an exception to the moratorium under section 144A.073, and if the cost of any remodeling of the facility does not exceed $1,000,000. If boarding care beds are licensed as nursing home beds, the number of boarding care beds in the facility must not increase beyond the number remaining at the time of the upgrade in licensure. The provisions contained in section 144A.073 regarding the upgrading of the facilities do not apply to facilities that satisfy these requirements;

(f) to license and certify up to 40 beds transferred from an existing facility owned and operated by the Amherst H. Wilder Foundation in the city of St. Paul to a new unit at the same location as the existing facility that will serve persons with Alzheimer's disease and other related disorders. The transfer of beds may occur gradually or in stages, provided the total number of beds transferred does not exceed 40. At the time of licensure and certification of a bed or beds in the new unit, the commissioner of health shall delicense and decertify the same number of beds in the existing facility. As a condition of receiving a license or certification under this clause, the facility must make a written commitment to the commissioner of human services that it will not seek to receive an increase in its property-related payment rate as a result of the transfers allowed under this paragraph;

(g) to license and certify nursing home beds to replace currently licensed and certified boarding care beds which may be located either in a remodeled or renovated boarding care or nursing home facility or in a remodeled, renovated, newly constructed, or replacement nursing home facility within the identifiable complex of health care facilities in which the currently licensed boarding care beds are presently located, provided that the number of boarding care beds in the facility or complex are decreased by the number to be licensed as nursing home beds and further provided that, if the total costs of new construction, replacement, remodeling, or renovation exceed ten percent of the appraised value of the facility or $200,000, whichever is less, the facility makes a written commitment to the commissioner of human services that it will not seek to receive an increase in its property-related payment rate by reason of the new construction, replacement, remodeling, or renovation. The provisions contained in section 144A.073 regarding the upgrading of facilities do not apply to facilities that satisfy these requirements;

(h) to license as a nursing home and certify as a nursing facility a facility that is licensed as a boarding care facility but not certified under the medical assistance program, but only if the commissioner of human services certifies to the commissioner of health that licensing the facility as a nursing home and certifying the facility as a nursing facility will result in a net annual savings to the state general fund of $200,000 or more;

(i) to certify, after September 30, 1992, and prior to July 1, 1993, existing nursing home beds in a facility that was licensed and in operation prior to January 1, 1992;

(j) to license and certify new nursing home beds to replace beds in a facility acquired by the Minneapolis Community Development Agency as part of redevelopment activities in a city of the first class, provided the new facility is located within three miles of the site of the old facility. Operating and property costs for the new facility must be determined and allowed under section 256B.431 or 256B.434;

(k) to license and certify up to 20 new nursing home beds in a community-operated hospital and attached convalescent and nursing care facility with 40 beds on April 21, 1991, that suspended operation of the hospital in April 1986. The commissioner of human services shall provide the facility with the same per diem property-related payment rate for each additional licensed and certified bed as it will receive for its existing 40 beds;

(l) to license or certify beds in renovation, replacement, or upgrading projects as defined in section 144A.073, subdivision 1, so long as the cumulative total costs of the facility's remodeling projects do not exceed $1,000,000;

(m) to license and certify beds that are moved from one location to another for the purposes of converting up to five four-bed wards to single or double occupancy rooms in a nursing home that, as of January 1, 1993, was county-owned and had a licensed capacity of 115 beds;

(n) to allow a facility that on April 16, 1993, was a 106-bed licensed and certified nursing facility located in Minneapolis to layaway all of its licensed and certified nursing home beds. These beds may be relicensed and recertified in a newly constructed teaching nursing home facility affiliated with a teaching hospital upon approval by the legislature. The proposal must be developed in consultation with the interagency committee on long-term care planning. The beds on layaway status shall have the same status as voluntarily delicensed and decertified beds, except that beds on layaway status remain subject to the surcharge in section 256.9657. This layaway provision expires July 1, 1998;

(o) to allow a project which will be completed in conjunction with an approved moratorium exception project for a nursing home in southern Cass County and which is directly related to that portion of the facility that must be repaired, renovated, or replaced, to correct an emergency plumbing problem for which a state correction order has been issued and which must be corrected by August 31, 1993;

(p) to allow a facility that on April 16, 1993, was a 368-bed licensed and certified nursing facility located in Minneapolis to layaway, upon 30 days prior written notice to the commissioner, up to 30 of the facility's licensed and certified beds by converting three-bed wards to single or double occupancy. Beds on layaway status shall have the same status as voluntarily delicensed and decertified beds except that beds on layaway status remain subject to the surcharge in section 256.9657, remain subject to the license application and renewal fees under section 144A.07 and shall be subject to a $100 per bed reactivation fee. In addition, at any time within three years of the effective date of the layaway, the beds on layaway status may be:

(1) relicensed and recertified upon relocation and reactivation of some or all of the beds to an existing licensed and certified facility or facilities located in Pine River, Brainerd, or International Falls; provided that the total project construction costs related to the relocation of beds from layaway status for any facility receiving relocated beds may not exceed the dollar threshold provided in subdivision 2 unless the construction project has been approved through the moratorium exception process under section 144A.073;

(2) relicensed and recertified, upon reactivation of some or all of the beds within the facility which placed the beds in layaway status, if the commissioner has determined a need for the reactivation of the beds on layaway status.

The property-related payment rate of a facility placing beds on layaway status must be adjusted by the incremental change in its rental per diem after recalculating the rental per diem as provided in section 256B.431, subdivision 3a, paragraph (c). The property-related payment rate for a facility relicensing and recertifying beds from layaway status must be adjusted by the incremental change in its rental per diem after recalculating its rental per diem using the number of beds after the relicensing to establish the facility's capacity day divisor, which shall be effective the first day of the month following the month in which the relicensing and recertification became effective. Any beds remaining on layaway status more than three years after the date the layaway status became effective must be removed from layaway status and immediately delicensed and decertified;

(q) to license and certify beds in a renovation and remodeling project to convert 12 four-bed wards into 24 two-bed rooms, expand space, and add improvements in a nursing home that, as of January 1, 1994, met the following conditions: the nursing home was located in Ramsey County; had a licensed capacity of 154 beds; and had been ranked among the top 15 applicants by the 1993 moratorium exceptions advisory review panel. The total project construction cost estimate for this project must not exceed the cost estimate submitted in connection with the 1993 moratorium exception process;

(r) to license and certify up to 117 beds that are relocated from a licensed and certified 138-bed nursing facility located in St. Paul to a hospital with 130 licensed hospital beds located in South St. Paul, provided that the nursing facility and hospital are owned by the same or a related organization and that prior to the date the relocation is completed the hospital ceases operation of its inpatient hospital services at that hospital. After relocation, the nursing facility's status shall be the same as it was prior to relocation. The nursing facility's property-related payment rate resulting from the project authorized in this paragraph shall become effective no earlier than April 1, 1996. For purposes of calculating the incremental change in the facility's rental per diem resulting from this project, the allowable appraised value of the nursing facility portion of the existing health care facility physical plant prior to the renovation and relocation may not exceed $2,490,000;

(s) to license and certify two beds in a facility to replace beds that were voluntarily delicensed and decertified on June 28, 1991;

(t) to allow 16 licensed and certified beds located on July 1, 1994, in a 142-bed nursing home and 21-bed boarding care home facility in Minneapolis, notwithstanding the licensure and certification after July 1, 1995, of the Minneapolis facility as a 147-bed nursing home facility after completion of a construction project approved in 1993 under section 144A.073, to be laid away upon 30 days' prior written notice to the commissioner. Beds on layaway status shall have the same status as voluntarily delicensed or decertified beds except that they shall remain subject to the surcharge in section 256.9657. The 16 beds on layaway status may be relicensed as nursing home beds and recertified at any time within five years of the effective date of the layaway upon relocation of some or all of the beds to a licensed and certified facility located in Watertown, provided that the total project construction costs related to the relocation of beds from layaway status for the Watertown facility may not exceed the dollar threshold provided in subdivision 2 unless the construction project has been approved through the moratorium exception process under section 144A.073.

The property-related payment rate of the facility placing beds on layaway status must be adjusted by the incremental change in its rental per diem after recalculating the rental per diem as provided in section 256B.431, subdivision 3a, paragraph (c). The property-related payment rate for the facility relicensing and recertifying beds from layaway status must be adjusted by the incremental change in its rental per diem after recalculating its rental per diem using the number of beds after the relicensing to establish the facility's capacity day divisor, which shall be effective the first day of the month following the month in which the relicensing and recertification became effective. Any beds remaining on layaway status more than five years after the date the layaway status became effective must be removed from layaway status and immediately delicensed and decertified;

(u) to license and certify beds that are moved within an existing area of a facility or to a newly constructed addition which is built for the purpose of eliminating three- and four-bed rooms and adding space for dining, lounge areas, bathing rooms, and ancillary service areas in a nursing home that, as of January 1, 1995, was located in Fridley and had a licensed capacity of 129 beds;

(v) to relocate 36 beds in Crow Wing County and four beds from Hennepin County to a 160-bed facility in Crow Wing County, provided all the affected beds are under common ownership;

(w) to license and certify a total replacement project of up to 49 beds located in Norman County that are relocated from a nursing home destroyed by flood and whose residents were relocated to other nursing homes. The operating cost payment rates for the new nursing facility shall be determined based on the interim and settle-up payment provisions of Minnesota Rules, part 9549.0057, and the reimbursement provisions of section 256B.431. Property-related reimbursement rates shall be determined under section 256B.431, taking into account any federal or state flood-related loans or grants provided to the facility;

(x) to license and certify deleted text begin a totaldeleted text end new text begin to the licensee of a nursing home in Polk County that was destroyed by flood in 1997new text end replacement deleted text begin projectdeleted text end new text begin projects with a totalnew text end of up to 129 bedsnew text begin , with at least 25 beds to benew text end located in Polk County deleted text begin that are relocated from a nursing home destroyed by flood and whose residents were relocated to other nursing homes.deleted text end new text begin and up to 104 beds distributed among up to three other counties. These beds may only be distributed to counties with fewer than the median number of age intensity adjusted beds per thousand, as most recently published by the commissioner of human services. If the licensee chooses to distribute beds outside of Polk County under this paragraph, prior to distributing the beds, the commissioner of health must approve the location in which the licensee plans to distribute the beds. The commissioner of health shall consult with the commissioner of human services prior to approving the location of the proposed beds. The licensee may combine these beds with beds relocated from other nursing facilities as provided in section 144A.073, subdivision 3c.new text end The operating deleted text begin costdeleted text end payment rates for the new nursing deleted text begin facilitydeleted text end new text begin facilitiesnew text end shall be determined based on the interim and settle-up payment provisions ofnew text begin section 256B.431, 256B.434, or 256B.441 ornew text end Minnesota Rules, deleted text begin part 9549.0057, and the reimbursement provisions of section 256B.431, except that subdivision 26, paragraphs (a) and (b), shall not apply until the second rate year after the settle-up cost report is filed. Property-related reimbursement rates shall be determined under section 256B.431, taking into account any federal or state flood-related loans or grants provided to the facility;deleted text end new text begin parts 9549.0010 to 9549.0080. Property-related reimbursement rates shall be determined under section 256B.431, 256B.434, or 256B.441. If the replacement beds permitted under this paragraph are combined with beds from other nursing facilities, the rates shall be calculated as the weighted average of rates determined as provided in this paragraph and section 256B.441, subdivision 60;new text end

(y) to license and certify beds in a renovation and remodeling project to convert 13 three-bed wards into 13 two-bed rooms and 13 single-bed rooms, expand space, and add improvements in a nursing home that, as of January 1, 1994, met the following conditions: the nursing home was located in Ramsey County, was not owned by a hospital corporation, had a licensed capacity of 64 beds, and had been ranked among the top 15 applicants by the 1993 moratorium exceptions advisory review panel. The total project construction cost estimate for this project must not exceed the cost estimate submitted in connection with the 1993 moratorium exception process;

(z) to license and certify up to 150 nursing home beds to replace an existing 285 bed nursing facility located in St. Paul. The replacement project shall include both the renovation of existing buildings and the construction of new facilities at the existing site. The reduction in the licensed capacity of the existing facility shall occur during the construction project as beds are taken out of service due to the construction process. Prior to the start of the construction process, the facility shall provide written information to the commissioner of health describing the process for bed reduction, plans for the relocation of residents, and the estimated construction schedule. The relocation of residents shall be in accordance with the provisions of law and rule;

(aa) to allow the commissioner of human services to license an additional 36 beds to provide residential services for the physically disabled under Minnesota Rules, parts 9570.2000 to 9570.3400, in a 198-bed nursing home located in Red Wing, provided that the total number of licensed and certified beds at the facility does not increase;

(bb) to license and certify a new facility in St. Louis County with 44 beds constructed to replace an existing facility in St. Louis County with 31 beds, which has resident rooms on two separate floors and an antiquated elevator that creates safety concerns for residents and prevents nonambulatory residents from residing on the second floor. The project shall include the elimination of three- and four-bed rooms;

(cc) to license and certify four beds in a 16-bed certified boarding care home in Minneapolis to replace beds that were voluntarily delicensed and decertified on or before March 31, 1992. The licensure and certification is conditional upon the facility periodically assessing and adjusting its resident mix and other factors which may contribute to a potential institution for mental disease declaration. The commissioner of human services shall retain the authority to audit the facility at any time and shall require the facility to comply with any requirements necessary to prevent an institution for mental disease declaration, including delicensure and decertification of beds, if necessary;

(dd) to license and certify 72 beds in an existing facility in Mille Lacs County with 80 beds as part of a renovation project. The renovation must include construction of an addition to accommodate ten residents with beginning and midstage dementia in a self-contained living unit; creation of three resident households where dining, activities, and support spaces are located near resident living quarters; designation of four beds for rehabilitation in a self-contained area; designation of 30 private rooms; and other improvements;

(ee) to license and certify beds in a facility that has undergone replacement or remodeling as part of a planned closure under section 256B.437;

(ff) to license and certify a total replacement project of up to 124 beds located in Wilkin County that are in need of relocation from a nursing home significantly damaged by flood. The operating cost payment rates for the new nursing facility shall be determined based on the interim and settle-up payment provisions of Minnesota Rules, part 9549.0057, and the reimbursement provisions of section 256B.431. Property-related reimbursement rates shall be determined under section 256B.431, taking into account any federal or state flood-related loans or grants provided to the facility;

(gg) to allow the commissioner of human services to license an additional nine beds to provide residential services for the physically disabled under Minnesota Rules, parts 9570.2000 to 9570.3400, in a 240-bed nursing home located in Duluth, provided that the total number of licensed and certified beds at the facility does not increase;

(hh) to license and certify up to 120 new nursing facility beds to replace beds in a facility in Anoka County, which was licensed for 98 beds as of July 1, 2000, provided the new facility is located within four miles of the existing facility and is in Anoka County. Operating and property rates shall be determined and allowed under section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or 256B.441; or

(ii) to transfer up to 98 beds of a 129-licensed bed facility located in Anoka County that, as of March 25, 2001, is in the active process of closing, to a 122-licensed bed nonprofit nursing facility located in the city of Columbia Heights or its affiliate. The transfer is effective when the receiving facility notifies the commissioner in writing of the number of beds accepted. The commissioner shall place all transferred beds on layaway status held in the name of the receiving facility. The layaway adjustment provisions of section 256B.431, subdivision 30, do not apply to this layaway. The receiving facility may only remove the beds from layaway for recertification and relicensure at the receiving facility's current site, or at a newly constructed facility located in Anoka County. The receiving facility must receive statutory authorization before removing these beds from layaway status, or may remove these beds from layaway status if removal from layaway status is part of a moratorium exception project approved by the commissioner under section 144A.073.

Sec. 3.

Minnesota Statutes 2014, 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 4e, 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, deleted text begin paragraphdeleted text end new text begin paragraphsnew text end (a)new text begin and (e)new text end . 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. 4.

Minnesota Statutes 2014, section 256B.0915, subdivision 3a, is amended to read:

Subd. 3a.

Elderly waiver cost limits.

(a) deleted text begin The monthly limit for the cost of waivered services to an individual elderly waiver client except for individuals described in paragraphs (b) and (d) shall be the weighted average monthly nursing facility rate of the case mix resident class to which the elderly waiver client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in which the resident assessment system as described in section 256B.438 for nursing home rate determination is implemented.deleted text end Effective on the first day of the state fiscal year in which the resident assessment system as described in section 256B.438 for nursing home rate determination is implemented and the first day of each subsequent state fiscal year, the monthly limit for the cost of waivered services to an individual elderly waiver client shall be the deleted text begin ratedeleted text end new text begin monthly limitnew text end of the case mix resident class to which the waiver client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the previous state fiscal year, adjusted by any legislatively adopted home and community-based services percentage rate adjustment.

(b) The monthly limit for the cost of waivered servicesnew text begin under paragraph (a)new text end to an individual elderly waiver client assigned to a case mix classification A deleted text begin under paragraph (a)deleted text end with:

(1) no dependencies in activities of daily living; or

(2) up to two dependencies in bathing, dressing, grooming, walking, and eating when the dependency score in eating is three or greater as determined by an assessment performed under section 256B.0911 shall be $1,750 per month effective on July 1, 2011, for all new participants enrolled in the program on or after July 1, 2011. This monthly limit shall be applied to all other participants who meet this criteria at reassessment. This monthly limit shall be increased annually as described in deleted text begin paragraphdeleted text end new text begin paragraphsnew text end (a)new text begin and (e)new text end .

(c) If extended medical supplies and equipment or environmental modifications are or will be purchased for an elderly waiver client, the costs may be prorated for up to 12 consecutive months beginning with the month of purchase. If the monthly cost of a recipient's waivered services exceeds the monthly limit established in paragraph (a) deleted text begin ordeleted text end new text begin , new text end (b),new text begin (d), or (e),new text end the annual cost of all waivered services shall be determined. In this event, the annual cost of all waivered services shall not exceed 12 times the monthly limit of waivered services as described in paragraph (a) deleted text begin ordeleted text end new text begin , new text end (b)new text begin , (d), or (e)new text end .

(d) Effective July 1, 2013, the monthly cost limit of waiver services, including any necessary home care services described in section 256B.0651, subdivision 2, for individuals who meet the criteria as ventilator-dependent given in section 256B.0651, subdivision 1, paragraph (g), shall be the average of the monthly medical assistance amount established for home care services as described in section 256B.0652, subdivision 7, and the annual average contracted amount established by the commissioner for nursing facility services for ventilator-dependent individuals. This monthly limit shall be increased annually as described in deleted text begin paragraphdeleted text end new text begin paragraphsnew text end (a)new text begin and (e)new text end .

new text begin (e) Effective July 1, 2016, and each July 1 thereafter, the monthly cost limits for elderly waiver services in effect on the previous June 30 shall be increased by the difference between any legislatively adopted home and community-based provider rate increases effective on July 1 or since the previous July 1 and the average statewide percentage increase in nursing facility operating payment rates under sections 256B.431, 256B.434, and 256B.441, effective the previous January 1. This paragraph shall only apply if the average statewide percentage increase in nursing facility operating payment rates is greater than any legislatively adopted home and community-based provider rate increases effective on July 1, or occurring since the previous July 1. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 5.

Minnesota Statutes 2014, section 256B.0915, subdivision 3e, is amended to read:

Subd. 3e.

Customized living service rate.

(a) Payment for customized living services shall be a monthly rate authorized by the lead agency within the parameters established by the commissioner. The payment agreement must delineate the amount of each component service included in the recipient's customized living service plan. The lead agency, with input from the provider of customized living services, shall ensure that there is a documented need within the parameters established by the commissioner for all component customized living services authorized.

(b) The payment rate must be based on the amount of component services to be provided utilizing component rates established by the commissioner. Counties and tribes shall use tools issued by the commissioner to develop and document customized living service plans and rates.

(c) Component service rates must not exceed payment rates for comparable elderly waiver or medical assistance services and must reflect economies of scale. Customized living services must not include rent or raw food costs.

(d) With the exception of individuals described in subdivision 3a, paragraph (b), the individualized monthly authorized payment for the customized living service plan shall not exceed 50 percent of the greater of either the statewide or any of the geographic groups' weighted average monthly nursing facility rate of the case mix resident class to which the elderly waiver eligible client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described in subdivision 1d, paragraph (a)deleted text begin , until the July 1 of the state fiscal year in which the resident assessment system as described in section 256B.438 for nursing home rate determination is implementeddeleted text end . Effective on July 1 of the state fiscal year in which the resident assessment system as described in section 256B.438 for nursing home rate determination is implemented and July 1 of each subsequent state fiscal year, the individualized monthly authorized payment for the services described in this clause shall not exceed the limit which was in effect on June 30 of the previous state fiscal year updated annually based on legislatively adopted changes to all service rate maximums for home and community-based service providers.

(e) Effective July 1, 2011, the individualized monthly payment for the customized living service plan for individuals described in subdivision 3a, paragraph (b), must be the monthly authorized payment limit for customized living for individuals classified as case mix A, reduced by 25 percent. This rate limit must be applied to all new participants enrolled in the program on or after July 1, 2011, who meet the criteria described in subdivision 3a, paragraph (b). This monthly limit also applies to all other participants who meet the criteria described in subdivision 3a, paragraph (b), at reassessment.

(f) Customized living services are delivered by a provider licensed by the Department of Health as a class A or class F home care provider and provided in a building that is registered as a housing with services establishment under chapter 144D. Licensed home care providers are subject to section 256B.0651, subdivision 14.

(g) A provider may not bill or otherwise charge an elderly waiver participant or their family for additional units of any allowable component service beyond those available under the service rate limits described in paragraph (d), nor for additional units of any allowable component service beyond those approved in the service plan by the lead agency.

new text begin (h) Effective July 1, 2016, and each July 1 thereafter, individualized service rate limits for customized living services under this subdivision shall be increased by the difference between any legislatively adopted home and community-based provider rate increases effective on July 1 or since the previous July 1 and the average statewide percentage increase in nursing facility operating payment rates under sections 256B.431, 256B.434, and 256B.441, effective the previous January 1. This paragraph shall only apply if the average statewide percentage increase in nursing facility operating payment rates is greater than any legislatively adopted home and community-based provider rate increases effective on July 1, or occurring since the previous July 1. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 6.

Minnesota Statutes 2014, section 256B.0915, subdivision 3h, is amended to read:

Subd. 3h.

Service rate limits; 24-hour customized living services.

(a) The payment rate for 24-hour customized living services is a monthly rate authorized by the lead agency within the parameters established by the commissioner of human services. The payment agreement must delineate the amount of each component service included in each recipient's customized living service plan. The lead agency, with input from the provider of customized living services, shall ensure that there is a documented need within the parameters established by the commissioner for all component customized living services authorized. The lead agency shall not authorize 24-hour customized living services unless there is a documented need for 24-hour supervision.

(b) For purposes of this section, "24-hour supervision" means that the recipient requires assistance due to needs related to one or more of the following:

(1) intermittent assistance with toileting, positioning, or transferring;

(2) cognitive or behavioral issues;

(3) a medical condition that requires clinical monitoring; or

(4) for all new participants enrolled in the program on or after July 1, 2011, and all other participants at their first reassessment after July 1, 2011, dependency in at least three of the following activities of daily living as determined by assessment under section 256B.0911: bathing; dressing; grooming; walking; or eating when the dependency score in eating is three or greater; and needs medication management and at least 50 hours of service per month. The lead agency shall ensure that the frequency and mode of supervision of the recipient and the qualifications of staff providing supervision are described and meet the needs of the recipient.

(c) The payment rate for 24-hour customized living services must be based on the amount of component services to be provided utilizing component rates established by the commissioner. Counties and tribes will use tools issued by the commissioner to develop and document customized living plans and authorize rates.

(d) Component service rates must not exceed payment rates for comparable elderly waiver or medical assistance services and must reflect economies of scale.

(e) The individually authorized 24-hour customized living payments, in combination with the payment for other elderly waiver services, including case management, must not exceed the recipient's community budget cap specified in subdivision 3a. Customized living services must not include rent or raw food costs.

(f) The individually authorized 24-hour customized living payment rates shall not exceed the 95 percentile of statewide monthly authorizations for 24-hour customized living services in effect and in the Medicaid management information systems on March 31, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050 to 9549.0059, to which elderly waiver service clients are assigned. When there are fewer than 50 authorizations in effect in the case mix resident class, the commissioner shall multiply the calculated service payment rate maximum for the A classification by the standard weight for that classification under Minnesota Rules, parts 9549.0050 to 9549.0059, to determine the applicable payment rate maximum. Service payment rate maximums shall be updated annually based on legislatively adopted changes to all service rates for home and community-based service providers.

(g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner may establish alternative payment rate systems for 24-hour customized living services in housing with services establishments which are freestanding buildings with a capacity of 16 or fewer, by applying a single hourly rate for covered component services provided in either:

(1) licensed corporate adult foster homes; or

(2) specialized dementia care units which meet the requirements of section 144D.065 and in which:

(i) each resident is offered the option of having their own apartment; or

(ii) the units are licensed as board and lodge establishments with maximum capacity of eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205, subparts 1, 2, 3, and 4, item A.

(h) Twenty-four-hour customized living services are delivered by a provider licensed by the Department of Health as a class A or class F home care provider and provided in a building that is registered as a housing with services establishment under chapter 144D. Licensed home care providers are subject to section 256B.0651, subdivision 14.

(i) A provider may not bill or otherwise charge an elderly waiver participant or their family for additional units of any allowable component service beyond those available under the service rate limits described in paragraph (e), nor for additional units of any allowable component service beyond those approved in the service plan by the lead agency.

new text begin (j) Effective July 1, 2016, and each July 1 thereafter, individualized service rate limits for 24-hour customized living services under this subdivision shall be increased by the difference between any legislatively adopted home and community-based provider rate increases effective on July 1 or since the previous July 1 and the average statewide percentage increase in nursing facility operating payment rates under sections 256B.431, 256B.434, and 256B.441, effective the previous January 1. This paragraph shall only apply if the average statewide percentage increase in nursing facility operating payment rates is greater than any legislatively adopted home and community-based provider rate increases effective on July 1, or occurring since the previous July 1. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 7.

Minnesota Statutes 2014, section 256B.431, subdivision 2b, is amended to read:

Subd. 2b.

Operating costs after July 1, 1985.

(a) For rate years beginning on or after July 1, 1985, the commissioner shall establish procedures for determining per diem reimbursement for operating costs.

(b) The commissioner shall contract with an econometric firm with recognized expertise in and access to national economic change indices that can be applied to the appropriate cost categories when determining the operating cost payment rate.

(c) The commissioner shall analyze and evaluate each nursing facility's cost report of allowable operating costs incurred by the nursing facility during the reporting year immediately preceding the rate year for which the payment rate becomes effective.

(d) The commissioner shall establish limits on actual allowable historical operating cost per diems based on cost reports of allowable operating costs for the reporting year that begins October 1, 1983, taking into consideration relevant factors including resident needs, geographic location, and size of the nursing facility. In developing the geographic groups for purposes of reimbursement under this section, the commissioner shall ensure that nursing facilities in any county contiguous to the Minneapolis-St. Paul seven-county metropolitan area are included in the same geographic group. The limits established by the commissioner shall not be less, in the aggregate, than the 60th percentile of total actual allowable historical operating cost per diems for each group of nursing facilities established under subdivision 1 based on cost reports of allowable operating costs in the previous reporting year. For rate years beginning on or after July 1, 1989, facilities located in geographic group I as described in Minnesota Rules, part 9549.0052, on January 1, 1989, may choose to have the commissioner apply either the care related limits or the other operating cost limits calculated for facilities located in geographic group II, or both, if either of the limits calculated for the group II facilities is higher. The efficiency incentive for geographic group I nursing facilities must be calculated based on geographic group I limits. The phase-in must be established utilizing the chosen limits. For purposes of these exceptions to the geographic grouping requirements, the definitions in Minnesota Rules, parts 9549.0050 to 9549.0059 (Emergency), and 9549.0010 to 9549.0080, apply. The limits established under this paragraph remain in effect until the commissioner establishes a new base period. Until the new base period is established, the commissioner shall adjust the limits annually using the appropriate economic change indices established in paragraph (e). In determining allowable historical operating cost per diems for purposes of setting limits and nursing facility payment rates, the commissioner shall divide the allowable historical operating costs by the actual number of resident days, except that where a nursing facility is occupied at less than 90 percent of licensed capacity days, the commissioner may establish procedures to adjust the computation of the per diem to an imputed occupancy level at or below 90 percent. The commissioner shall establish efficiency incentives as appropriate. The commissioner may establish efficiency incentives for different operating cost categories. The commissioner shall consider establishing efficiency incentives in care related cost categories. The commissioner may combine one or more operating cost categories and may use different methods for calculating payment rates for each operating cost category or combination of operating cost categories. For the rate year beginning on July 1, 1985, the commissioner shall:

(1) allow nursing facilities that have an average length of stay of 180 days or less in their skilled nursing level of care, 125 percent of the care related limit and 105 percent of the other operating cost limit established by rule; and

(2) exempt nursing facilities licensed on July 1, 1983, by the commissioner to provide residential services for the physically disabled under Minnesota Rules, parts 9570.2000 to 9570.3600, from the care related limits and allow 105 percent of the other operating cost limit established by rule.

For the purpose of calculating the other operating cost efficiency incentive for nursing facilities referred to in clause (1) or (2), the commissioner shall use the other operating cost limit established by rule before application of the 105 percent.

(e) The commissioner shall establish a composite index or indices by determining the appropriate economic change indicators to be applied to specific operating cost categories or combination of operating cost categories.

(f) Each nursing facility shall receive an operating cost payment rate equal to the sum of the nursing facility's operating cost payment rates for each operating cost category. The operating cost payment rate for an operating cost category shall be the lesser of the nursing facility's historical operating cost in the category increased by the appropriate index established in paragraph (e) for the operating cost category plus an efficiency incentive established pursuant to paragraph (d) or the limit for the operating cost category increased by the same index. If a nursing facility's actual historic operating costs are greater than the prospective payment rate for that rate year, there shall be no retroactive cost settle up. In establishing payment rates for one or more operating cost categories, the commissioner may establish separate rates for different classes of residents based on their relative care needs.

(g) The commissioner shall include the reported actual real estate tax liability or payments in lieu of real estate tax of each nursing facility as an operating cost of that nursing facility. Allowable costs under this subdivision for payments made by a nonprofit nursing facility that are in lieu of real estate taxes shall not exceed the amount which the nursing facility would have paid to a city or township and county for fire, police, sanitation services, and road maintenance costs had real estate taxes been levied on that property for those purposes. For rate years beginning on or after July 1, 1987, the reported actual real estate tax liability or payments in lieu of real estate tax of nursing facilities shall be adjusted to include an amount equal to one-half of the dollar change in real estate taxes from the prior year. The commissioner shall include a reported actual special assessment, and reported actual license fees required by the Minnesota Department of Health, for each nursing facility as an operating cost of that nursing facility. For rate years beginning on or after July 1, 1989, the commissioner shall include a nursing facility's reported Public Employee Retirement Act contribution for the reporting year as apportioned to the care-related operating cost categories and other operating cost categories multiplied by the appropriate composite index or indices established pursuant to paragraph (e) as costs under this paragraph. Total adjusted real estate tax liability, payments in lieu of real estate tax, actual special assessments paid, the indexed Public Employee Retirement Act contribution, and license fees paid as required by the Minnesota Department of Health, for each nursing facility (1) shall be divided by actual resident days in order to compute the operating cost payment rate for this operating cost category, (2) shall not be used to compute the care-related operating cost limits or other operating cost limits established by the commissioner, and (3) shall not be increased by the composite index or indices established pursuant to paragraph (e), unless otherwise indicated in this paragraph.

deleted text begin (h) For rate years beginning on or after July 1, 1987, the commissioner shall adjust the rates of a nursing facility that meets the criteria for the special dietary needs of its residents and the requirements in section 31.651. The adjustment for raw food cost shall be the difference between the nursing facility's allowable historical raw food cost per diem and 115 percent of the median historical allowable raw food cost per diem of the corresponding geographic group. deleted text end

deleted text begin The rate adjustment shall be reduced by the applicable phase-in percentage as provided under subdivision 2h. deleted text end

Sec. 8.

Minnesota Statutes 2014, section 256B.431, subdivision 36, is amended to read:

Subd. 36.

Employee scholarship costs and training in English as a second language.

(a) For the period between July 1, 2001, and June 30, 2003, the commissioner shall provide to each nursing facility reimbursed under this section, section 256B.434, or any other section, a scholarship per diem of 25 cents to the total operating payment ratenew text begin . For the 27-month period beginning October 1, 2015, through December 31, 2017, the commissioner shall allow a scholarship per diem of up to 25 cents for each nursing facility with no scholarship per diem that is requesting a scholarship per diem to be added to the external fixed payment ratenew text end to be used:

(1) for employee scholarships that satisfy the following requirements:

(i) scholarships are available to all employees who work an average of at least deleted text begin 20 deleted text end new text begin tennew text end hours per week at the facility except the administrator, deleted text begin department supervisors, and registered nursesdeleted text end new text begin and to reimburse student loan expenses for newly hired and recently graduated registered nurses and licensed practical nurses, and training expenses for nursing assistants as defined in section 144A.611, subdivision 2, who are newly hired and have graduated within the last 12 monthsnew text end ; and

(ii) the course of study is expected to lead to career advancement with the facility or in long-term care, including medical care interpreter services and social work; and

(2) to provide job-related training in English as a second language.

(b) deleted text begin A facility receivingdeleted text end new text begin All facilities may annually requestnew text end a rate adjustment under this subdivision deleted text begin may submitdeleted text end new text begin by submitting informationnew text end to the commissioner on a schedule deleted text begin determined by the commissionerdeleted text end and deleted text begin ondeleted text end new text begin innew text end a form supplied by the commissioner deleted text begin a calculation of the scholarship per diem, including: the amount received from this rate adjustment; the amount used for training in English as a second language; the number of persons receiving the training; the name of the person or entity providing the training; and for each scholarship recipient, the name of the recipient, the amount awarded, the educational institution attended, the nature of the educational program, the program completion date, and a determination of the per diem amount of these costs based on actual resident daysdeleted text end .new text begin The commissioner shall allow a scholarship payment rate equal to the reported and allowable costs divided by resident days.new text end

(c) deleted text begin On July 1, 2003, the commissioner shall remove the 25 cent scholarship per diem from the total operating payment rate of each facility.deleted text end

deleted text begin (d) For rate years beginning after June 30, 2003, the commissioner shall provide to each facility the scholarship per diem determined in paragraph (b).deleted text end In calculating the per diem under paragraph (b), the commissioner shall allow deleted text begin onlydeleted text end costs related to tuition deleted text begin anddeleted text end new text begin , new text end direct educational expensesnew text begin , and reasonable costs as defined by the commissioner for child care costs and transportation expenses related to direct educational expensesnew text end .

new text begin (d) The rate increase under this subdivision is an optional rate add-on that the facility must request from the commissioner in a manner prescribed by the commissioner. The rate increase must be used for scholarships as specified in this subdivision. new text end

new text begin (e) For instances in which a rate adjustment will be 15 cents or greater, nursing facilities that close beds during a rate year may request to have their scholarship adjustment under paragraph (b) recalculated by the commissioner for the remainder of the rate year to reflect the reduction in resident days compared to the cost report year. new text end

Sec. 9.

Minnesota Statutes 2014, section 256B.434, subdivision 4, is amended to read:

Subd. 4.

Alternate rates for nursing facilities.

deleted text begin (a) For nursing facilities which have their payment rates determined under this section rather than section 256B.431, the commissioner shall establish a rate under this subdivision. The nursing facility must enter into a written contract with the commissioner. deleted text end

deleted text begin (b) A nursing facility's case mix payment rate for the first rate year of a facility's contract under this section is the payment rate the facility would have received under section 256B.431. deleted text end

deleted text begin (c)deleted text end A nursing facility's case mix payment rates for the second and subsequent years of a facility's contract under this section are the previous rate year's contract payment rates plus an inflation adjustment and, for facilities reimbursed under this section or section 256B.431, an adjustment to include the cost of any increase in Health Department licensing fees for the facility taking effect on or after July 1, 2001. The index for the inflation adjustment must be based on the change in the Consumer Price Index-All Items (United States City average) (CPI-U) forecasted by the commissioner of management and budget's national economic consultant, as forecasted in the fourth quarter of the calendar year preceding the rate year. The inflation adjustment must be based on the 12-month period from the midpoint of the previous rate year to the midpoint of the rate year for which the rate is being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007, July 1, 2008, October 1, 2009, and October 1, 2010, this paragraph shall apply only to the property-related payment rate. For the rate years beginning on October 1, 2011, October 1, 2012, October 1, 2013, October 1, 2014, October 1, 2015, deleted text begin and Octoberdeleted text end new text begin Januarynew text end 1, 2016, new text begin and January 1, 2017, new text end the rate adjustment under this paragraph shall be suspended. Beginning in 2005, adjustment to the property payment rate under this section and section 256B.431 shall be effective on October 1. In determining the amount of the property-related payment rate adjustment under this paragraph, the commissioner shall determine the proportion of the facility's rates that are property-related based on the facility's most recent cost report.

deleted text begin (d) The commissioner shall develop additional incentive-based payments of up to five percent above a facility's operating payment rate for achieving outcomes specified in a contract. The commissioner may solicit contract amendments and implement those which, on a competitive basis, best meet the state's policy objectives. The commissioner shall limit the amount of any incentive payment and the number of contract amendments under this paragraph to operate the incentive payments within funds appropriated for this purpose. The contract amendments may specify various levels of payment for various levels of performance. Incentive payments to facilities under this paragraph may be in the form of time-limited rate adjustments or onetime supplemental payments. In establishing the specified outcomes and related criteria, the commissioner shall consider the following state policy objectives: deleted text end

deleted text begin (1) successful diversion or discharge of residents to the residents' prior home or other community-based alternatives; deleted text end

deleted text begin (2) adoption of new technology to improve quality or efficiency; deleted text end

deleted text begin (3) improved quality as measured in the Nursing Home Report Card; deleted text end

deleted text begin (4) reduced acute care costs; and deleted text end

deleted text begin (5) any additional outcomes proposed by a nursing facility that the commissioner finds desirable. deleted text end

deleted text begin (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that take action to come into compliance with existing or pending requirements of the life safety code provisions or federal regulations governing sprinkler systems must receive reimbursement for the costs associated with compliance if all of the following conditions are met: deleted text end

deleted text begin (1) the expenses associated with compliance occurred on or after January 1, 2005, and before December 31, 2008; deleted text end

deleted text begin (2) the costs were not otherwise reimbursed under subdivision 4f or section 144A.071 or 144A.073; and deleted text end

deleted text begin (3) the total allowable costs reported under this paragraph are less than the minimum threshold established under section 256B.431, subdivision 15, paragraph (e), and subdivision 16. deleted text end

deleted text begin The commissioner shall use money appropriated for this purpose to provide to qualifying nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30, 2008. Nursing facilities that have spent money or anticipate the need to spend money to satisfy the most recent life safety code requirements by (1) installing a sprinkler system or (2) replacing all or portions of an existing sprinkler system may submit to the commissioner by June 30, 2007, on a form provided by the commissioner the actual costs of a completed project or the estimated costs, based on a project bid, of a planned project. The commissioner shall calculate a rate adjustment equal to the allowable costs of the project divided by the resident days reported for the report year ending September 30, 2006. If the costs from all projects exceed the appropriation for this purpose, the commissioner shall allocate the money appropriated on a pro rata basis to the qualifying facilities by reducing the rate adjustment determined for each facility by an equal percentage. Facilities that used estimated costs when requesting the rate adjustment shall report to the commissioner by January 31, 2009, on the use of this money on a form provided by the commissioner. If the nursing facility fails to provide the report, the commissioner shall recoup the money paid to the facility for this purpose. If the facility reports expenditures allowable under this subdivision that are less than the amount received in the facility's annualized rate adjustment, the commissioner shall recoup the difference. deleted text end

Sec. 10.

Minnesota Statutes 2014, section 256B.434, is amended by adding a subdivision to read:

new text begin Subd. 4i. new text end

new text begin Construction project rate adjustments for certain nursing facilities. new text end

new text begin (a) This subdivision applies to nursing facilities with at least 120 active beds as of January 1, 2015, that have projects approved in 2015 under the nursing facility moratorium exception process in section 144A.073. When each facility's moratorium exception construction project is completed, the facility must receive the rate adjustment allowed under subdivision 4f. In addition to that rate adjustment, facilities with at least 120 active beds, but not more than 149 active beds, as of January 1, 2015, must have their construction project rate adjustment increased by an additional $4; and facilities with at least 150 active beds, but not more than 160 active beds, as of January 1, 2015, must have their construction project rate adjustment increased by an additional $12.50. new text end

new text begin (b) Notwithstanding any other law to the contrary, money available under section 144A.073, subdivision 11, after the completion of the moratorium exception approval process in 2015 under section 144A.073, subdivision 3, shall be used to reduce the fiscal impact to the medical assistance budget for the increases allowed in this subdivision. new text end

Sec. 11.

Minnesota Statutes 2014, section 256B.441, subdivision 1, is amended to read:

Subdivision 1.

deleted text begin Rebasingdeleted text end new text begin Calculationnew text end of nursing facility operating payment rates.

(a) The commissioner shall deleted text begin rebase nursing facility operating payment rates to align payments to facilities with the cost of providing care. The rebaseddeleted text end new text begin calculatenew text end operating payment rates deleted text begin shall be calculateddeleted text end using the statistical and cost report filed by each nursing facility for the report period ending deleted text begin one yeardeleted text end new text begin 15 monthsnew text end prior to the rate year.

(b) The deleted text begin newdeleted text end operating payment rates based on this section shall take effect deleted text begin beginning deleted text end with the rate year beginning deleted text begin October 1, 2008, and shall be phased in over eight rate years through October 1, 2015. For each year of the phase-in, the operating payment rates shall be calculated using the statistical and cost report filed by each nursing facility for the report period ending one year prior to the rate yeardeleted text end new text begin January 1, 2016new text end .

deleted text begin (c) Operating payment rates shall be rebased on October 1, 2016, and every two years after that date. deleted text end

deleted text begin (d)deleted text end new text begin (c)new text end Each cost reporting year shall begin on October 1 and end on the following September 30. deleted text begin Beginning in 2014,deleted text end A statistical and cost report shall be filed by each nursing facility by February 1new text begin in a form and manner specified by the commissionernew text end . Notice of rates shall be distributed by deleted text begin Augustdeleted text end new text begin Novembernew text end 15 and the rates shall go into effect on deleted text begin Octoberdeleted text end new text begin Januarynew text end 1 for one year.

deleted text begin (e) Effective October 1, 2014, property rates shall be rebased in accordance with section 256B.431 and Minnesota Rules, chapter 9549. The commissioner shall determine what the property payment rate for a nursing facility would be had the facility not had its property rate determined under section 256B.434. The commissioner shall allow nursing facilities to provide information affecting this rate determination that would have been filed annually under Minnesota Rules, chapter 9549, and nursing facilities shall report information necessary to determine allowable debt. The commissioner shall use this information to determine the property payment rate. deleted text end

Sec. 12.

Minnesota Statutes 2014, section 256B.441, subdivision 5, is amended to read:

Subd. 5.

Administrative costs.

"Administrative costs" means the direct costs for administering the overall activities of the nursing home. These costs include salaries and wages of the administrator, assistant administrator, business office employees, security guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases related to business office functions, licenses, and permits except as provided in the external fixed costs category, employee recognition, travel including meals and lodging, all training except as specified in subdivision 11, voice and data communication or transmission, office supplies,new text begin property andnew text end liability insurance and other forms of insurance not designated to other areas, personnel recruitment, legal services, accounting services, management or business consultants, data processing, information technology, Web site, central or home office costs, business meetings and seminars, postage, fees for professional organizations, subscriptions, security services, advertising, board of director's fees, working capital interest expense, and bad debts and bad debt collection fees.

Sec. 13.

Minnesota Statutes 2014, section 256B.441, subdivision 6, is amended to read:

Subd. 6.

Allowed costs.

new text begin (a) new text end "Allowed costs" means the amounts reported by the facility which are necessary for the operation of the facility and the care of residents and which are reviewed by the department for accuracy; reasonableness, in accordance with the requirements set forth in title XVIII of the federal Social Security Act and the interpretations in the provider reimbursement manual; and compliance with this section and generally accepted accounting principles. All references to costs in this section shall be assumed to refer to allowed costs.

new text begin (b) For facilities where employees are represented by collective bargaining agents, costs related to the salaries and wages, payroll taxes, and employer's share of fringe benefit costs, except employer health insurance costs, for facility employees who are members of the bargaining unit are allowed costs only if: new text end

new text begin (1) these costs are incurred pursuant to a collective bargaining agreement. The commissioner shall allow until March 1 following the date on which the cost report was required to be submitted for a collective bargaining agent to notify the commissioner if a collective bargaining agreement, effective on the last day of the cost reporting year, was not in effect; or new text end

new text begin (2) the collective bargaining agent notifies the commissioner by October 1 following the date on which the cost report was required to be submitted that these costs are incurred pursuant to an agreement or understanding between the facility and the collective bargaining agent. new text end

new text begin (c) In any year when a portion of a facility's reported costs are not allowed costs under paragraph (b), when calculating the operating payment rate for the facility, the commissioner shall use the facility's allowed costs from the facility's second most recent cost report in place of the nonallowed costs. For the purpose of setting the price for other operating costs under subdivision 51, the price shall be reduced by the difference between the nonallowed costs and the allowed costs from the facility's second most recent cost report. new text end

Sec. 14.

Minnesota Statutes 2014, section 256B.441, is amended by adding a subdivision to read:

new text begin Subd. 11a. new text end

new text begin Employer health insurance costs. new text end

new text begin "Employer health insurance costs" means premium expenses for group coverage and reinsurance, actual expenses incurred for self-insured plans, and employer contributions to employee health reimbursement and health savings accounts. Premium and expense costs and contributions are allowable for employees who meet the definition of full-time employees and their spouse and dependents under the federal Affordable Care Act, Public Law 111-148, and part-time employees. new text end

Sec. 15.

Minnesota Statutes 2014, 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; deleted text begin until September 30, 2013, long-term care consultation fees under section 256B.0911, subdivision 6;deleted text end family advisory council fee under section 144A.33; scholarships under section 256B.431, subdivision 36; planned closure rate adjustments under section 256B.437; deleted text begin ordeleted text end single bed room incentives under section 256B.431, subdivision 42; property taxes deleted text begin and property insurancedeleted text end new text begin , assessments, and payments in lieu of taxes; employer health insurance costs; quality improvement incentive payment rate adjustments under subdivision 46c; performance-based incentive payments under subdivision 46d; special dietary needs under subdivision 51bnew text end ; and PERA.

Sec. 16.

Minnesota Statutes 2014, section 256B.441, subdivision 14, is amended to read:

Subd. 14.

Facility average case mix index.

"Facility average case mix index" or "CMI" means a numerical deleted text begin valuedeleted text end score that describes the relative resource use for all residents within the groups under the resource utilization group deleted text begin (RUG-III)deleted text end new text begin (RUG) new text end classification system prescribed by the commissioner based on an assessment of each resident. The facility average CMI shall be computed as the standardized days divided by total days for all residents in the facility. The RUG's weights used deleted text begin in this section shall be as follows for each RUG's class: SE3 1.605; SE2 1.247; SE1 1.081; RAD 1.509; RAC 1.259; RAB 1.109; RAA 0.957; SSC 1.453; SSB 1.224; SSA 1.047; CC2 1.292; CC1 1.200; CB2 1.086; CB1 1.017; CA2 0.908; CA1 0.834; IB2 0.877; IB1 0.817; IA2 0.720; IA1 0.676; BB2 0.956; BB1 0.885; BA2 0.716; BA1 0.673; PE2 1.199; PE1 1.104; PD2 1.023; PD1 0.948; PC2 0.926; PC1 0.860; PB2 0.786; PB1 0.734; PA2 0.691; PA1 0.651; BC1 0.651; and DDF 1.000deleted text end new text begin shall be based on the system prescribed in section 256B.438new text end .

Sec. 17.

Minnesota Statutes 2014, section 256B.441, subdivision 17, is amended to read:

Subd. 17.

Fringe benefit costs.

"Fringe benefit costs" means the costs for group life, deleted text begin health,deleted text end dental, workers' compensation, and other employee insurances and pension, new text begin except for the Public Employees Retirement Association and employer health insurance costs; new text end profit sharingdeleted text begin ,deleted text end new text begin ;new text end and retirement plans for which the employer pays all or a portion of the costs.

Sec. 18.

Minnesota Statutes 2014, section 256B.441, subdivision 30, is amended to read:

Subd. 30.

deleted text begin Peer groupsdeleted text end new text begin Median total care-related cost per diem and other operating per diem determinednew text end .

deleted text begin Facilities shall be classified into three groups by county. The groups shall consist of: deleted text end

deleted text begin (1) group one: facilities in Anoka, Benton, Carlton, Carver, Chisago, Dakota, Dodge, Goodhue, Hennepin, Isanti, Mille Lacs, Morrison, Olmsted, Ramsey, Rice, Scott, Sherburne, St. Louis, Stearns, Steele, Wabasha, Washington, Winona, or Wright County; deleted text end

deleted text begin (2) group two: facilities in Aitkin, Beltrami, Blue Earth, Brown, Cass, Clay, Cook, Crow Wing, Faribault, Fillmore, Freeborn, Houston, Hubbard, Itasca, Kanabec, Koochiching, Lake, Lake of the Woods, Le Sueur, Martin, McLeod, Meeker, Mower, Nicollet, Norman, Pine, Roseau, Sibley, Todd, Wadena, Waseca, Watonwan, or Wilkin County; and deleted text end

deleted text begin (3) group three: facilities in all other countiesdeleted text end new text begin (a) The commissioner shall determine the median total care-related per diem to be used in subdivision 50 and the median other operating per diem to be used in subdivision 51 using the cost reports from nursing facilities in Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and Washington Countiesnew text end .

new text begin (b) The median total care-related per diem shall be equal to the median direct care cost for a RUG's weight of 1.00 for facilities located in the counties listed in paragraph (a). new text end

new text begin (c) The median other operating per diem shall be equal to the median other operating per diem for facilities located in the counties listed in paragraph (a). The other operating per diem shall be the sum of each facility's administrative costs, dietary costs, housekeeping costs, laundry costs, and maintenance and plant operations costs divided by each facility's resident days. new text end

Sec. 19.

Minnesota Statutes 2014, section 256B.441, subdivision 31, is amended to read:

Subd. 31.

Prior system operating cost payment rate.

"Prior system operating cost payment rate" means the operating cost payment rate in effect on deleted text begin September 30, 2008 deleted text end new text begin December 31, 2015new text end , under Minnesota Rules and Minnesota Statutes, deleted text begin not including planned closure rate adjustments under section 256B.437 or single bed room incentives under section 256B.431, subdivision 42deleted text end new text begin inclusive of health insurance plus property insurance costs from external fixed, but not including rate increases allowed under subdivision 55anew text end .

Sec. 20.

Minnesota Statutes 2014, section 256B.441, subdivision 33, is amended to read:

Subd. 33.

Rate year.

"Rate year" means the 12-month period beginning on deleted text begin October deleted text end new text begin Januarynew text end 1 deleted text begin following the second most recent reporting yeardeleted text end .

Sec. 21.

Minnesota Statutes 2014, section 256B.441, subdivision 35, is amended to read:

Subd. 35.

Reporting period.

"Reporting period" means the one-year period beginning on October 1 and ending on the following September 30 during which incurred costs are accumulated and then reported on the statistical and cost report.new text begin If a facility is reporting for an interim or settle-up period, the reporting period beginning date may be a date other than October 1. An interim or settle-up report must cover at least five months, but no more than 17 months, and must always end on September 30.new text end

Sec. 22.

Minnesota Statutes 2014, section 256B.441, subdivision 40, is amended to read:

Subd. 40.

Standardized days.

"Standardized days" means the sum of resident days by case mix category multiplied by the RUG index for each category.new text begin When a facility has resident days at a penalty classification, these days shall be reported as resident days at the RUG class established immediately after the penalty period, if available, and otherwise, at the RUG class in effect before the penalty began.new text end

Sec. 23.

Minnesota Statutes 2014, section 256B.441, subdivision 44, is amended to read:

Subd. 44.

Calculation of a quality score.

(a) The commissioner shall determine a quality score for each nursing facility using quality measures established in section 256B.439, according to methods determined by the commissioner in consultation with stakeholders and expertsnew text begin , and using the most recently available data as provided in the Minnesota Nursing Home Report Cardnew text end . These methods shall be exempt from the rulemaking requirements under chapter 14.

(b) For each quality measure, a score shall be determined with deleted text begin a maximumdeleted text end new text begin the new text end number of points deleted text begin available and number of pointsdeleted text end assigned as determined by the commissioner using the methodology established according to this subdivision. deleted text begin The scores determined for all quality measures shall be totaled.deleted text end The determination of the quality measures to be used and the methods of calculating scores may be revised annually by the commissioner.

(c) deleted text begin For the initial rate year under the new payment system, the quality measures shall include:deleted text end

deleted text begin (1) staff turnover; deleted text end

deleted text begin (2) staff retention; deleted text end

deleted text begin (3) use of pool staff; deleted text end

deleted text begin (4) quality indicators from the minimum data set; and deleted text end

deleted text begin (5) survey deficiencies. deleted text end

deleted text begin (d)deleted text end Beginning deleted text begin July 1, 2013deleted text end new text begin January 1, 2016new text end , the quality score shall deleted text begin be a value between zero and 100, using data as provided in the Minnesota nursing home report card, withdeleted text end new text begin include up to new text end 50 deleted text begin percent derived fromdeleted text end new text begin points related to new text end the Minnesota quality indicators score, new text begin up to new text end 40 deleted text begin percent derived fromdeleted text end new text begin points related to new text end the resident quality of life score, andnew text begin up to new text end ten deleted text begin percent derived fromdeleted text end new text begin points related to new text end the state inspection results score.

deleted text begin (e)deleted text end new text begin (d) new text end The commissioner, in cooperation with the commissioner of health, may adjust the formula in paragraph deleted text begin (d)deleted text end new text begin (c)new text end , or the methodology for computing the total quality score, effective July 1 of any year beginning in deleted text begin 2014deleted text end new text begin 2017new text end , with five months advance public notice. In changing the formula, the commissioner shall consider quality measure priorities registered by report card users, advice of stakeholders, and available research.

Sec. 24.

Minnesota Statutes 2014, section 256B.441, subdivision 46c, is amended to read:

Subd. 46c.

Quality improvement incentive system beginning October 1, 2015.

The commissioner shall develop a quality improvement incentive program in consultation with stakeholders. The annual funding pool available for quality improvement incentive payments shall be equal to 0.8 percent of all operating payments, not including any rate components resulting from equitable cost-sharing for publicly owned nursing facility program participation under subdivision 55a, critical access nursing facility program participation under subdivision 63, or performance-based incentive payment program participation under section 256B.434, subdivision 4, paragraph (d). new text begin For the period from October 1, 2015, to December 31, 2016, rate adjustments provided under this subdivision shall be effective for 15 months. new text end Beginning deleted text begin October 1, 2015deleted text end new text begin January 1, 2017new text end , annual rate adjustments provided under this subdivision shall be effective for one year, starting deleted text begin Octoberdeleted text end new text begin January new text end 1 and ending the following deleted text begin September 30deleted text end new text begin December 31. The increase in this subdivision shall be included in the external fixed payment rate under subdivisions 13 and 53new text end .

Sec. 25.

Minnesota Statutes 2014, section 256B.441, is amended by adding a subdivision to read:

new text begin Subd. 46d. new text end

new text begin Performance-based incentive payments. new text end

new text begin The commissioner shall develop additional incentive-based payments of up to five percent above a facility's operating payment rate for achieving outcomes specified in a contract. The commissioner may solicit proposals and select those which, on a competitive basis, best meet the state's policy objectives. The commissioner shall limit the amount of any incentive payment and the number of contract amendments under this subdivision to operate the incentive payments within funds appropriated for this purpose. The commissioner shall approve proposals through a memorandum of understanding which shall specify various levels of payment for various levels of performance. Incentive payments to facilities under this subdivision shall be in the form of time-limited rate adjustments which shall be included in the external fixed payment rate under subdivisions 13 and 53. In establishing the specified outcomes and related criteria, the commissioner shall consider the following state policy objectives: new text end

new text begin (1) successful diversion or discharge of residents to the residents' prior home or other community-based alternatives; new text end

new text begin (2) adoption of new technology to improve quality or efficiency; new text end

new text begin (3) improved quality as measured in the Minnesota Nursing Home Report Card; new text end

new text begin (4) reduced acute care costs; and new text end

new text begin (5) any additional outcomes proposed by a nursing facility that the commissioner finds desirable. new text end

Sec. 26.

Minnesota Statutes 2014, section 256B.441, subdivision 48, is amended to read:

Subd. 48.

Calculation of deleted text begin operatingdeleted text end new text begin care-relatednew text end per diems.

The direct care per diem for each facility shall be the facility's direct care costs divided by its standardized days. The other care-related per diem shall be the sum of the facility's activities costs, other direct care costs, raw food costs, therapy costs, and social services costs, divided by the facility's resident days. deleted text begin The other operating per diem shall be the sum of the facility's administrative costs, dietary costs, housekeeping costs, laundry costs, and maintenance and plant operations costs divided by the facility's resident days.deleted text end

Sec. 27.

Minnesota Statutes 2014, section 256B.441, subdivision 50, is amended to read:

Subd. 50.

Determination of total care-related limit.

(a) The deleted text begin limit on thedeleted text end new text begin median new text end total care-related per diem shall be determined deleted text begin for each peer group and facility type group combination. A facility's total care-related per diems shall be limited to 120 percent of the median for the facility's peer and facility type group. The facility-specific direct care costs used in making this comparison and in the calculation of the median shall be based on a RUG's weight of 1.00. A facility that is above that limit shall have its total care-related per diem reduced to the limit. If a reduction of the total care-related per diem is necessary because of this limit, the reduction shall be made proportionally to both the direct care per diem and the other care-related per diemdeleted text end new text begin according to subdivision 30new text end .

(b) deleted text begin Beginning with rates determined for October 1, 2016, thedeleted text end new text begin A facility'snew text end total care-related limit shall be a variable amount based on each facility's quality score, as determined under subdivision 44, in accordance with clauses (1) to deleted text begin (4)deleted text end new text begin (3)new text end :

(1) deleted text begin for each facility, the commissioner shall determine the quality score, subtract 40, divide by 40, and convert to a percentagedeleted text end new text begin the quality score shall be multiplied by 0.5625new text end ;

(2) deleted text begin if the value determined in clause (1) is less than zero, the total care-related limit shall be 105 percent of the median for the facility's peer and facility type groupdeleted text end new text begin add 89.375 to the amount determined in clause (1), and divide the total by 100new text end ;new text begin andnew text end

(3) deleted text begin if the value determined in clause (1) is greater than 100 percent, the total care-related limit shall be 125 percent of the median for the facility's peer and facility type group; anddeleted text end new text begin multiply the amount determined in clause (2) by the median total care-related per diem determined in subdivision 30, paragraph (b).new text end

deleted text begin (4) if the value determined in clause (1) is greater than zero and less than 100 percent, the total care-related limit shall be 105 percent of the median for the facility's peer and facility type group plus one-fifth of the percentage determined in clause (1). deleted text end

new text begin (c) A RUG's weight of 1.00 shall be used in the calculation of the median total care-related per diem, and in comparisons of facility-specific direct care costs to the median. new text end

new text begin (d) A facility that is above its total care-related limit as determined according to paragraph (b) shall have its total care-related per diem reduced to its limit. If a reduction of the total care-related per diem is necessary due to this limit, the reduction shall be made proportionally to both the direct care per diem and the other care-related per diem. new text end

Sec. 28.

Minnesota Statutes 2014, section 256B.441, subdivision 51, is amended to read:

Subd. 51.

Determination of other operating deleted text begin limitdeleted text end new text begin pricenew text end .

deleted text begin The limit on thedeleted text end new text begin A price fornew text end other operating deleted text begin per diemdeleted text end new text begin costsnew text end shall be determined deleted text begin for each peer groupdeleted text end . deleted text begin A facility's other operating per diem shall be limited todeleted text end new text begin The price shall be calculated asnew text end 105 percent of the median deleted text begin for its peer groupdeleted text end new text begin other operating per diem described in subdivision 30, paragraph (c)new text end . deleted text begin A facility that is above that limit shall have its other operating per diem reduced to the limit.deleted text end

Sec. 29.

Minnesota Statutes 2014, section 256B.441, subdivision 51a, is amended to read:

Subd. 51a.

Exception deleted text begin allowing contractingdeleted text end for specialized carenew text begin facilitiesnew text end .

(a) For rate years beginning on or after deleted text begin Octoberdeleted text end new text begin Januarynew text end 1, 2016, deleted text begin the commissioner may negotiate increases to the care-related limit for nursing facilities that provide specialized care, at a cost to the general fund not to exceed $600,000 per year. The commissioner shall publish a request for proposals annually, and may negotiate increases to the limits that shall apply for either one or two years before the increase shall be subject to a new proposal and negotiation.deleted text end the care-related limit deleted text begin maydeleted text end new text begin for specialized care facilities shall new text end be increased by deleted text begin up todeleted text end 50 percent.

(b) deleted text begin In selecting facilities with which to negotiate, the commissioner shall consider: deleted text end new text begin "Specialized care facilities" are defined as a facility having a program licensed under chapter 245A and Minnesota Rules, chapter 9570, or a facility with 96 beds on January 1, 2015, located in Robbinsdale that specializes in the treatment of Huntington's Disease.new text end

deleted text begin (1) the diagnoses or other circumstances of residents in the specialized program that require care that costs substantially more than the RUG's rates associated with those residents; deleted text end

deleted text begin (2) the nature of the specialized program or programs offered to meet the needs of these individuals; and deleted text end

deleted text begin (3) outcomes achieved by the specialized program. deleted text end

Sec. 30.

Minnesota Statutes 2014, section 256B.441, is amended by adding a subdivision to read:

new text begin Subd. 51b. new text end

new text begin Special dietary needs. new text end

new text begin The commissioner shall adjust the rates of a nursing facility that meets the criteria for the special dietary needs of its residents and the requirements in section 31.651 or 31.658. The adjustment for raw food cost shall be the difference between the nursing facility's most recently reported allowable raw food cost per diem and 115 percent of the median allowable raw food cost per diem. For rate years beginning on or after January 1, 2016, this amount shall be removed from allowable raw food per diem costs under operating costs and included in the external fixed per diem rate under subdivisions 13 and 53. new text end

Sec. 31.

Minnesota Statutes 2014, 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) new text begin The portion related to development and education of resident and family advisory councils under section 144A.33 shall be $5 divided by 365.new text end

new text begin (d) new text end The portion related to scholarships shall be determined under section 256B.431, subdivision 36.

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

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

deleted text begin (f)deleted text end new text begin (e)new text end 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. deleted text begin 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.deleted text end

new text begin (f) The single bed room incentives shall be as determined under section 256B.431, subdivision 42. new text end

(g) The portions related to deleted text begin property insurance,deleted text end 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) new text begin The portion related to employer health insurance costs shall be the allowable costs divided by resident days.new text end

new text begin (i) new text end The portion related to the Public Employees Retirement Association shall be actual costs divided by resident days.

deleted text begin (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. deleted text end

new text begin (j) The portion related to quality improvement incentive payment rate adjustments shall be as determined under subdivision 46c. new text end

new text begin (k) The portion related to performance-based incentive payments shall be as determined under subdivision 46d. new text end

new text begin (l) The portion related to special dietary needs shall be the per diem amount determined under subdivision 51b. new text end

deleted text begin (j)deleted text end new text begin (m)new text end The payment rate for external fixed costs shall be the sum of the amounts in paragraphs (a) to deleted text begin (i)deleted text end new text begin (l)new text end .

Sec. 32.

Minnesota Statutes 2014, section 256B.441, subdivision 54, is amended to read:

Subd. 54.

Determination of total payment rates.

deleted text begin In rate years when rates are rebased,deleted text end new text begin The total care-related per diem, other operating price, and external fixed per diem for each facility shall be converted to payment rates.new text end The total payment rate for a RUG's weight of 1.00 shall be the sum of the total care-related payment rate, other operating payment rate, deleted text begin efficiency incentive,deleted text end external fixed cost rate, and the property rate determined under section 256B.434. To determine a total payment rate for each RUG's level, the total care-related payment rate shall be divided into the direct care payment rate and the other care-related payment rate, and the direct care payment rate multiplied by the RUG's weight for each RUG's level deleted text begin using the weights in subdivision 14deleted text end .

Sec. 33.

Minnesota Statutes 2014, section 256B.441, subdivision 55a, is amended to read:

Subd. 55a.

Alternative to phase-in for publicly owned nursing facilities.

(a) For operating payment rates implemented between October 1, 2011, and the day before deleted text begin the phase-in under subdivision 55 is completedeleted text end new text begin operating payment rates are determined under this sectionnew text end , the commissioner shall allow nursing facilities whose physical plant is owned or whose license is held by a city, county, or hospital district to apply for a higher payment rate under this section if the local governmental entity agrees to pay a specified portion of the nonfederal share of medical assistance costs. Nursing facilities that apply shall be eligible to select an operating payment rate, with a weight of 1.00, up to the rate calculated in subdivision 54, without application of the phase-in under subdivision 55. The rates for the other RUGs shall be computed as provided under subdivision 54.

(b) For operating payment rates implemented beginning the day when the deleted text begin phase-in under subdivision 55 is completedeleted text end new text begin operating payment rates are determined under this sectionnew text end , the commissioner shall allow nursing facilities whose physical plant is owned or whose license is held by a city, county, or hospital district to apply for a higher payment rate under this section if the local governmental entity agrees to pay a specified portion of the nonfederal share of medical assistance costs. Nursing facilities that apply are eligible to select an operating payment rate with a weight of 1.00, up to an amount determined by the commissioner to be allowable under the Medicare upper payment limit test. The rates for the other RUGs shall be computed under subdivision 54. The rate increase allowed in this paragraph shall take effect only upon federal approval.

(c) Rates determined under this subdivision shall take effect deleted text begin beginning October 1, 2011, based on cost reports for the reporting year ending September 30, 2010, and in future rate years, rates determined for nursing facilities participating under this subdivision shall take effect on October 1 of each yeardeleted text end new text begin in accordance with the rate year in subdivision 33new text end , based on the most recent available cost report.

(d) Eligible nursing facilities that wish to participate under this subdivision shall make an application to the commissioner by August 31, 2011, or by deleted text begin Junedeleted text end new text begin Septembernew text end 30 of any subsequent year.

(e) For each participating nursing facility, the public entity that owns the physical plant or is the license holder of the nursing facility shall pay to the state the entire nonfederal share of medical assistance payments received as a result of the difference between the nursing facility's payment rate under paragraph (a) or (b), and the rates that the nursing facility would otherwise be paid without application of this subdivision under subdivision 54 deleted text begin or 55deleted text end as determined by the commissioner.

(f) The commissioner may, at any time, reduce the payments under this subdivision based on the commissioner's determination that the payments shall cause nursing facility rates to exceed the state's Medicare upper payment limit or any other federal limitation. If the commissioner determines a reduction is necessary, the commissioner shall reduce all payment rates for participating nursing facilities by a percentage applied to the amount of increase they would otherwise receive under this subdivision and shall notify participating facilities of the reductions. If payments to a nursing facility are reduced, payments under section 256B.19, subdivision 1e, shall be reduced accordingly.

Sec. 34.

Minnesota Statutes 2014, section 256B.441, subdivision 56, is amended to read:

Subd. 56.

Hold harmless.

new text begin (a) new text end For the rate years beginning deleted text begin October 1, 2008, to Octoberdeleted text end new text begin on or after Januarynew text end 1, 2016, no nursing facility shall receive deleted text begin an operatingdeleted text end new text begin anew text end cost payment ratenew text begin , including the property insurance portion of operating costs plus the health insurance component of external fixed,new text end less than its deleted text begin operatingdeleted text end new text begin prior systemnew text end cost payment rate deleted text begin under section 256B.434. For rate years beginning between October 1, 2009, and October 1, 2015, no nursing facility shall receive an operating payment rate less than its operating payment rate in effect on September 30, 2009deleted text end new text begin , which included operating costs inclusive of health insurance costs plus the property insurance component of external fixednew text end . The comparison of operating payment rates under this section shall be made for a RUG's rate with a weight of 1.00.

new text begin (b) For rate years beginning on or after January 1, 2016, no facility shall be subject to a care-related payment rate limit reduction greater than five percent of the median determined in subdivision 30. new text end

Sec. 35.

Minnesota Statutes 2014, section 256B.441, subdivision 63, is amended to read:

Subd. 63.

Critical access nursing facilities.

(a) The commissioner, in consultation with the commissioner of health, may designate certain nursing facilities as critical access nursing facilities. The designation shall be granted on a competitive basis, within the limits of funds appropriated for this purpose.

(b) The commissioner shall request proposals from nursing facilities every two years. Proposals must be submitted in the form and according to the timelines established by the commissioner. In selecting applicants to designate, the commissioner, in consultation with the commissioner of health, and with input from stakeholders, shall develop criteria designed to preserve access to nursing facility services in isolated areas, rebalance long-term care, and improve quality. Beginning in fiscal year 2015, to the extent practicable, the commissioner shall ensure an even distribution of designations across the state.

(c) The commissioner shall allow the benefits in clauses (1) to (5) for nursing facilities designated as critical access nursing facilities:

(1) partial rebasing, with the commissioner allowing a designated facility operating payment rates being the sum of up to 60 percent of the operating payment rate determined in accordance with subdivision 54 and at least 40 percent, with the sum of the two portions being equal to 100 percent, of the operating payment rate that would have been allowed had the facility not been designated. The commissioner may adjust these percentages by up to 20 percent and may approve a request for less than the amount allowed;

(2) enhanced payments for leave days. Notwithstanding section 256B.431, subdivision 2r, upon designation as a critical access nursing facility, the commissioner shall limit payment for leave days to 60 percent of that nursing facility's total payment rate for the involved resident, and shall allow this payment only when the occupancy of the nursing facility, inclusive of bed hold days, is equal to or greater than 90 percent;

(3) two designated critical access nursing facilities, with up to 100 beds in active service, may jointly apply to the commissioner of health for a waiver of Minnesota Rules, part 4658.0500, subpart 2, in order to jointly employ a director of nursing. The commissioner of health will consider each waiver request independently based on the criteria under Minnesota Rules, part 4658.0040;

(4) the minimum threshold under section 256B.431, subdivision 15, paragraph (e), shall be 40 percent of the amount that would otherwise apply; and

(5) deleted text begin notwithstanding subdivision 58, beginning October 1, 2014,deleted text end the quality-based rate limits under subdivision 50 shall apply to designated critical access nursing facilities.

(d) Designation of a critical access nursing facility shall be for a period of two years, after which the benefits allowed under paragraph (c) shall be removed. Designated facilities may apply for continued designation.

new text begin (e) This subdivision is suspended and no state or federal funding shall be appropriated or allocated for the purposes of this subdivision from January 1, 2016, to December 31, 2017. new text end

Sec. 36.

Minnesota Statutes 2014, section 256B.441, is amended by adding a subdivision to read:

new text begin Subd. 65. new text end

new text begin Nursing facility in Golden Valley. new text end

new text begin Effective for the rate year beginning January 1, 2016, and all subsequent rate years, the operating payment rate for a facility located in the city of Golden Valley at 3915 Golden Valley Road with 44 licensed rehabilitation beds as of January 7, 2015, must be calculated without the application of subdivisions 50 and 51. new text end

Sec. 37.

Minnesota Statutes 2014, section 256B.441, is amended by adding a subdivision to read:

new text begin Subd. 66. new text end

new text begin Nursing facilities in border cities. new text end

new text begin Effective for the rate year beginning January 1, 2016, and annually thereafter, operating payment rates of a nonprofit nursing facility that exists on January 1, 2015, is located anywhere within the boundaries of the city of Breckenridge, and is reimbursed under this section, section 256B.431, or section 256B.434, shall be adjusted to be equal to the median RUG's rates, including comparable rate components as determined by the commissioner, for the equivalent RUG's weight of the nonprofit nursing facility or facilities located in an adjacent city in another state and in cities contiguous to the adjacent city. The Minnesota facility's operating payment rate with a weight of 1.0 shall be computed by dividing the adjacent city's nursing facilities median operating payment rate with a weight of 1.02 by 1.02. If the adjustments under this subdivision result in a rate that exceeds the limits in subdivisions 50 and 51 in a given rate year, the facility's rate shall not be subject to those limits for that rate year. This subdivision shall apply only if it results in a higher operating payment rate than would otherwise be determined under this section, section 256B.431, or section 256B.434. new text end

Sec. 38.

Minnesota Statutes 2014, section 256B.441, is amended by adding a subdivision to read:

new text begin Subd. 67. new text end

new text begin Nursing facility; contract with insurance provider. new text end

new text begin Within the projected cost of nursing facility payment reform under this section, for a facility that did not provide employee health insurance coverage as of May 1, 2015, if the facility has a signed contract with a health insurance provider to begin providing employee health insurance coverage by January 1, 2016, the facility shall be paid for the employer health insurance costs portion of external fixed costs under subdivisions 13 and 53 beginning January 1, 2016. new text end

Sec. 39.

Minnesota Statutes 2014, section 256B.50, subdivision 1, is amended to read:

Subdivision 1.

Scope.

A provider may appeal from a determination of a payment rate established pursuant to this chapternew text begin or allowed costs under section 256B.441new text end and reimbursement rules of the commissioner if the appeal, if successful, would result in a change to the provider's payment rate or to the calculation of maximum charges to therapy vendors as provided by section 256B.433, subdivision 3. Appeals must be filed in accordance with procedures in this section. This section does not apply to a request from a resident or long-term care facility for reconsideration of the classification of a resident under section 144.0722.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2015, and applies to appeals filed on or after that date. new text end

Sec. 40.

Minnesota Statutes 2014, section 256I.05, subdivision 2, is amended to read:

Subd. 2.

Monthly rates; exemptions.

This subdivision applies to a residence that on August 1, 1984, was licensed by the commissioner of health only as a boarding care home, certified by the commissioner of health as an intermediate care facility, and licensed by the commissioner of human services under Minnesota Rules, parts 9520.0500 to 9520.0690. Notwithstanding the provisions of subdivision 1c, the rate paid to a facility reimbursed under this subdivision shall be determined under section 256B.431, deleted text begin or under sectiondeleted text end 256B.434new text begin , or 256B.441,new text end if the facility is accepted by the commissioner for participation in the alternative payment demonstration project. The rate paid to this facility shall also include adjustments to the group residential housing rate according to subdivision 1, and any adjustments applicable to supplemental service rates statewide.

Sec. 41.

new text begin DIRECTION TO COMMISSIONER; NURSING FACILITY PAYMENT REFORM REPORT. new text end

new text begin By January 1, 2017, the commissioner of human services shall evaluate and report to the house of representatives and senate committees and divisions with jurisdiction over nursing facility payment rates on: new text end

new text begin (1) the impact of using cost report data to set rates without accounting for cost report to rate year inflation; new text end

new text begin (2) the impact of the quality adjusted care limits; new text end

new text begin (3) the ability of nursing facilities to attract and retain employees, including how rate increases are being passed through to employees, under the new payment system; new text end

new text begin (4) the efficacy of the critical access nursing facility program under Minnesota Statutes, section 256B.441, subdivision 63, given the new nursing facility payment system; new text end

new text begin (5) creating a process for the commissioner to designate certain facilities as specialized care facilities for difficult-to-serve populations; and new text end

new text begin (6) limiting the hold harmless in Minnesota Statutes, section 256B.441, subdivision 56. new text end

Sec. 42.

new text begin PROPERTY RATE SETTING. new text end

new text begin The commissioner shall conduct a study, in consultation with stakeholders and experts, of property rate setting, based on a rental value or other approach for Minnesota nursing facilities, and shall report the findings to the house of representatives and senate committees and divisions with jurisdiction over nursing facility payment rates by March 1, 2016, for a system implementation date of January 1, 2017. The commissioner shall: new text end

new text begin (1) contract with at least two firms to conduct appraisals of all nursing facilities in the medical assistance program. Each firm shall conduct appraisals of approximately equal portions of all nursing facilities assigned to them at random. The appraisals shall determine the value of the land, building, and equipment of each nursing facility, taking into account the quality of construction and current condition of the building; new text end

new text begin (2) use the information from the appraisals to complete the design of a rental value or other system and calculate a replacement value and an effective age for each nursing facility. Nursing facilities may request an appraisal by a second firm which shall be assigned randomly by the commissioner. The commissioner shall use the findings of the second appraisal. If the second firm increases the appraisal value by more than five percent, the state shall pay for the second appraisal. Otherwise, the nursing facility shall pay the cost of the appraisal. Results of appraisals are not otherwise subject to appeal under section 256B.50; and new text end

new text begin (3) include in the report required under this section the following items: new text end

new text begin (i) a description of the proposed rental value or other system; new text end

new text begin (ii) options for adjusting the system parameters that vary the cost of implementing the new property rate system and an analysis of individual nursing facilities under the current property payment rate and the rates under various approaches to calculating rates under the rental value or other system; new text end

new text begin (iii) recommended steps for transition to the rental value or other system; new text end

new text begin (iv) an analysis of the expected long-term incentives of the rental value or other system for nursing facilities to maintain and replace buildings, including how the current exceptions to the moratorium process under Minnesota Statutes, section 144A.073, may be adapted; and new text end

new text begin (v) bill language for implementation of the rental value or other system. new text end

Sec. 43.

new text begin REVISOR'S INSTRUCTION. new text end

new text begin The revisor of statutes, in consultation with the House Research Department, Office of Senate Counsel, Research, and Fiscal Analysis, Department of Human Services, and stakeholders, shall prepare legislation for the 2016 legislative session to recodify laws governing nursing home payments and rates in Minnesota Statutes, chapter 256B, and in Minnesota Rules, chapter 9549. 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. 44.

new text begin REPEALER. new text end

new text begin Minnesota Statutes 2014, sections 256B.434, subdivision 19b; and 256B.441, subdivisions 14a, 19, 50a, 52, 55, 58, and 62, new text end new text begin are repealed. new text end

ARTICLE 7

CONTINUING CARE

Section 1.

Minnesota Statutes 2014, section 13.461, is amended by adding a subdivision to read:

new text begin Subd. 32. new text end

new text begin ABLE accounts and designated beneficiaries. new text end

new text begin Data on ABLE accounts and designated beneficiaries of ABLE accounts are classified under section 256Q.05, subdivision 7. new text end

Sec. 2.

Minnesota Statutes 2014, section 144.057, subdivision 1, is amended to read:

Subdivision 1.

Background studies required.

The commissioner of health shall contract with the commissioner of human services to conduct background studies of:

(1) individuals providing services which have direct contact, as defined under section 245C.02, subdivision 11, with patients and residents in hospitals, boarding care homes, outpatient surgical centers licensed under sections 144.50 to 144.58; nursing homes and home care agencies licensed under chapter 144A; residential care homes licensed under chapter 144B, and board and lodging establishments that are registered to provide supportive or health supervision services under section 157.17;

(2) individuals specified in section 245C.03, subdivision 1, who perform direct contact services in a nursing home or a home care agency licensed under chapter 144A or a boarding care home licensed under sections 144.50 to 144.58deleted text begin , anddeleted text end new text begin .new text end If the individual under study resides outside Minnesota, the study must deleted text begin be at least as comprehensive as that of a Minnesota resident and include a search of information from the criminal justice data communications network in the state where the subject of the study residesdeleted text end new text begin include a check for substantiated findings of maltreatment of adults and children in the individual's state of residence when the information is made available by that state, and must include a check of the National Crime Information Center databasenew text end ;

(3) beginning July 1, 1999, all other employees in nursing homes licensed under chapter 144A, and boarding care homes licensed under sections 144.50 to 144.58. A disqualification of an individual in this section shall disqualify the individual from positions allowing direct contact or access to patients or residents receiving services. "Access" means physical access to a client or the client's personal property without continuous, direct supervision as defined in section 245C.02, subdivision 8, when the employee's employment responsibilities do not include providing direct contact services;

(4) individuals employed by a supplemental nursing services agency, as defined under section 144A.70, who are providing services in health care facilities; and

(5) controlling persons of a supplemental nursing services agency, as defined under section 144A.70.

If a facility or program is licensed by the Department of Human Services and subject to the background study provisions of chapter 245C and is also licensed by the Department of Health, the Department of Human Services is solely responsible for the background studies of individuals in the jointly licensed programs.

Sec. 3.

Minnesota Statutes 2014, section 245A.06, is amended by adding a subdivision to read:

new text begin Subd. 1a. new text end

new text begin Correction orders and conditional licenses for programs licensed as home and community-based services. new text end

new text begin (a) For programs licensed under both this chapter and chapter 245D, if the license holder operates more than one service site under a single license governed by chapter 245D, the order issued under this section shall be specific to the service site or sites at which the violations of applicable law or rules occurred. The order shall not apply to other service sites governed by chapter 245D and operated by the same license holder unless the commissioner has included in the order the articulable basis for applying the order to another service site. new text end

new text begin (b) If the commissioner has issued more than one license to the license holder under this chapter, the conditions imposed under this section shall be specific to the license for the program at which the violations of applicable law or rules occurred and shall not apply to other licenses held by the same license holder if those programs are being operated in substantial compliance with applicable law and rules. new text end

Sec. 4.

new text begin [245A.081] SETTLEMENT AGREEMENT. new text end

new text begin (a) A license holder who has made a timely appeal pursuant to section 245A.06, subdivision 4, or 245A.07, subdivision 3, or the commissioner may initiate a discussion about a possible settlement agreement related to the licensing sanction. For the purposes of this section, the following conditions apply to a settlement agreement reached by the parties: new text end

new text begin (1) if the parties enter into a settlement agreement, the effect of the agreement shall be that the appeal is withdrawn and the agreement shall constitute the full agreement between the commissioner and the party who filed the appeal; and new text end

new text begin (2) the settlement agreement must identify the agreed upon actions the license holder has taken and will take in order to achieve and maintain compliance with the licensing requirements that the commissioner determined the license holder had violated. new text end

new text begin (b) Neither the license holder nor the commissioner is required to initiate a settlement discussion under this section. new text end

new text begin (c) If a settlement discussion is initiated by the license holder, the commissioner shall respond to the license holder within 14 calendar days of receipt of the license holder's submission. new text end

new text begin (d) If the commissioner agrees to engage in settlement discussions, the commissioner may decide at any time not to continue settlement discussions with a license holder. new text end

Sec. 5.

Minnesota Statutes 2014, section 245A.155, subdivision 1, is amended to read:

Subdivision 1.

Licensed foster care and respite care.

This section applies to foster care agencies and licensed foster care providers who place, supervise, or care for individuals who rely on medical monitoring equipment to sustain life or monitor a medical conditionnew text begin that could become life-threatening without proper use of the medical equipment new text end in respite care or foster care.

Sec. 6.

Minnesota Statutes 2014, section 245A.155, subdivision 2, is amended to read:

Subd. 2.

Foster care agency requirements.

In order for an agency to place an individual who relies on medical equipment to sustain life or monitor a medical condition new text begin that could become life-threatening without proper use of the medical equipmentnew text end with a foster care provider, the agency must ensure that the foster care provider has received the training to operate such equipment as observed and confirmed by a qualified source, and that the provider:

(1) is currently caring for an individual who is using the same equipment in the foster home; or

(2) has written documentation that the foster care provider has cared for an individual who relied on such equipment within the past six months; or

(3) has successfully completed training with the individual being placed with the provider.

Sec. 7.

Minnesota Statutes 2014, section 245A.65, subdivision 2, is amended to read:

Subd. 2.

Abuse prevention plans.

All license holders shall establish and enforce ongoing written program abuse prevention plans and individual abuse prevention plans as required under section 626.557, subdivision 14.

(a) The scope of the program abuse prevention plan is limited to the population, physical plant, and environment within the control of the license holder and the location where licensed services are provided. In addition to the requirements in section 626.557, subdivision 14, the program abuse prevention plan shall meet the requirements in clauses (1) to (5).

(1) The assessment of the population shall include an evaluation of the following factors: age, gender, mental functioning, physical and emotional health or behavior of the client; the need for specialized programs of care for clients; the need for training of staff to meet identified individual needs; and the knowledge a license holder may have regarding previous abuse that is relevant to minimizing risk of abuse for clients.

(2) The assessment of the physical plant where the licensed services are provided shall include an evaluation of the following factors: the condition and design of the building as it relates to the safety of the clients; and the existence of areas in the building which are difficult to supervise.

(3) The assessment of the environment for each facility and for each site when living arrangements are provided by the agency shall include an evaluation of the following factors: the location of the program in a particular neighborhood or community; the type of grounds and terrain surrounding the building; the type of internal programming; and the program's staffing patterns.

(4) The license holder shall provide an orientation to the program abuse prevention plan for clients receiving services. If applicable, the client's legal representative must be notified of the orientation. The license holder shall provide this orientation for each new person within 24 hours of admission, or for persons who would benefit more from a later orientation, the orientation may take place within 72 hours.

(5) The license holder's governing bodynew text begin or the governing body's delegated representativenew text end shall review the plan at least annually using the assessment factors in the plan and any substantiated maltreatment findings that occurred since the last review. The governing bodynew text begin or the governing body's delegated representativenew text end shall revise the plan, if necessary, to reflect the review results.

(6) A copy of the program abuse prevention plan shall be posted in a prominent location in the program and be available upon request to mandated reporters, persons receiving services, and legal representatives.

(b) In addition to the requirements in section 626.557, subdivision 14, the individual abuse prevention plan shall meet the requirements in clauses (1) and (2).

(1) The plan shall include a statement of measures that will be taken to minimize the risk of abuse to the vulnerable adult when the individual assessment required in section 626.557, subdivision 14, paragraph (b), indicates the need for measures in addition to the specific measures identified in the program abuse prevention plan. The measures shall include the specific actions the program will take to minimize the risk of abuse within the scope of the licensed services, and will identify referrals made when the vulnerable adult is susceptible to abuse outside the scope or control of the licensed services. When the assessment indicates that the vulnerable adult does not need specific risk reduction measures in addition to those identified in the program abuse prevention plan, the individual abuse prevention plan shall document this determination.

(2) An individual abuse prevention plan shall be developed for each new person as part of the initial individual program plan or service plan required under the applicable licensing rule. The review and evaluation of the individual abuse prevention plan shall be done as part of the review of the program plan or service plan. The person receiving services shall participate in the development of the individual abuse prevention plan to the full extent of the person's abilities. If applicable, the person's legal representative shall be given the opportunity to participate with or for the person in the development of the plan. The interdisciplinary team shall document the review of all abuse prevention plans at least annually, using the individual assessment and any reports of abuse relating to the person. The plan shall be revised to reflect the results of this review.

Sec. 8.

Minnesota Statutes 2014, 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 Apprehension, including information regarding a background study subject's registration in Minnesota as a predatory offender under section 243.166;

(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 5new text begin , or as required under section 144.057, subdivision 1, clause (2)new text end ; and

(6) for a background study related to a child foster care application for licensure, a transfer of permanent legal and physical custody of a child under sections 260C.503 to 260C.515, 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.

(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.

(d) When the commissioner has reasonable cause to believe that the identity of a background study subject is uncertain, the commissioner may require the subject to provide a set of classifiable fingerprints for purposes of completing a fingerprint-based record check with the Bureau of Criminal Apprehension. Fingerprints collected under this paragraph shall not be saved by the commissioner after they have been used to verify the identity of the background study subject against the particular criminal record in question.

new text begin (e) The commissioner may inform the entity that initiated a background study under NETStudy 2.0 of the status of processing of the subject's fingerprints. new text end

Sec. 9.

Minnesota Statutes 2014, section 245C.12, is amended to read:

245C.12 BACKGROUND STUDY; TRIBAL ORGANIZATIONS.

(a) For the purposes of background studies completed by tribal organizations performing licensing activities otherwise required of the commissioner under this chapter, after obtaining consent from the background study subject, tribal licensing agencies shall have access to criminal history data in the same manner as county licensing agencies and private licensing agencies under this chapter.

(b) Tribal organizations may contract with the commissioner to obtain background study data on individuals under tribal jurisdiction related to adoptions according to section 245C.34. Tribal organizations may also contract with the commissioner to obtain background study data on individuals under tribal jurisdiction related to child foster care according to section 245C.34.

new text begin (c) For the purposes of background studies completed to comply with a tribal organization's licensing requirements for individuals affiliated with a tribally licensed nursing facility, the commissioner shall obtain criminal history data from the National Criminal Records Repository in accordance with section 245C.32. new text end

Sec. 10.

Minnesota Statutes 2014, section 245D.02, is amended by adding a subdivision to read:

new text begin Subd. 37. new text end

new text begin Working day. new text end

new text begin "Working day" means Monday, Tuesday, Wednesday, Thursday, or Friday, excluding any legal holiday. new text end

Sec. 11.

Minnesota Statutes 2014, section 245D.05, subdivision 1, is amended to read:

Subdivision 1.

Health needs.

(a) The license holder is responsible for meeting health service needs assigned in the coordinated service and support plan or the coordinated service and support plan addendum, consistent with the person's health needs. new text begin Unless directed otherwise in the coordinated service and support plan or the coordinated service and support plan addendum,new text end the license holder is responsible for promptly notifying the person's legal representative, if any, and the case manager of changes in a person's physical and mental health needs affecting health service needs assigned to the license holder in the coordinated service and support plan or the coordinated service and support plan addendum, when discovered by the license holder, unless the license holder has reason to know the change has already been reported. The license holder must document when the notice is provided.

(b) If responsibility for meeting the person's health service needs has been assigned to the license holder in the coordinated service and support plan or the coordinated service and support plan addendum, the license holder must maintain documentation on how the person's health needs will be met, including a description of the procedures the license holder will follow in order to:

(1) provide medication setup, assistance, or administration according to this chapter. Unlicensed staff responsible for medication setup or medication administration under this section must complete training according to section 245D.09, subdivision 4a, paragraph (d);

(2) monitor health conditions according to written instructions from a licensed health professional;

(3) assist with or coordinate medical, dental, and other health service appointments; or

(4) use medical equipment, devices, or adaptive aides or technology safely and correctly according to written instructions from a licensed health professional.

Sec. 12.

Minnesota Statutes 2014, section 245D.05, subdivision 2, is amended to read:

Subd. 2.

Medication administration.

(a) For purposes of this subdivision, "medication administration" means:

(1) checking the person's medication record;

(2) preparing the medication as necessary;

(3) administering the medication or treatment to the person;

(4) documenting the administration of the medication or treatment or the reason for not administering the medication or treatment; and

(5) reporting to the prescriber or a nurse any concerns about the medication or treatment, including side effects, effectiveness, or a pattern of the person refusing to take the medication or treatment as prescribed. Adverse reactions must be immediately reported to the prescriber or a nurse.

(b)(1) If responsibility for medication administration is assigned to the license holder in the coordinated service and support plan or the coordinated service and support plan addendum, the license holder must implement medication administration procedures to ensure a person takes medications and treatments as prescribed. The license holder must ensure that the requirements in clauses (2) and (3) have been met before administering medication or treatment.

(2) The license holder must obtain written authorization from the person or the person's legal representative to administer medication or treatment deleted text begin and must obtain reauthorization annually as neededdeleted text end . This authorization shall remain in effect unless it is withdrawn in writing and may be withdrawn at any time. If the person or the person's legal representative refuses to authorize the license holder to administer medication, the medication must not be administered. The refusal to authorize medication administration must be reported to the prescriber as expediently as possible.

(3) For a license holder providing intensive support services, the medication or treatment must be administered according to the license holder's medication administration policy and procedures as required under section 245D.11, subdivision 2, clause (3).

(c) The license holder must ensure the following information is documented in the person's medication administration record:

(1) the information on the current prescription label or the prescriber's current written or electronically recorded order or prescription that includes the person's name, description of the medication or treatment to be provided, and the frequency and other information needed to safely and correctly administer the medication or treatment to ensure effectiveness;

(2) information on any risks or other side effects that are reasonable to expect, and any contraindications to its use. This information must be readily available to all staff administering the medication;

(3) the possible consequences if the medication or treatment is not taken or administered as directed;

(4) instruction on when and to whom to report the following:

(i) if a dose of medication is not administered or treatment is not performed as prescribed, whether by error by the staff or the person or by refusal by the person; and

(ii) the occurrence of possible adverse reactions to the medication or treatment;

(5) notation of any occurrence of a dose of medication not being administered or treatment not performed as prescribed, whether by error by the staff or the person or by refusal by the person, or of adverse reactions, and when and to whom the report was made; and

(6) notation of when a medication or treatment is started, administered, changed, or discontinued.

Sec. 13.

Minnesota Statutes 2014, section 245D.06, subdivision 1, is amended to read:

Subdivision 1.

Incident response and reporting.

(a) The license holder must respond to incidents under section 245D.02, subdivision 11, that occur while providing services to protect the health and safety of and minimize risk of harm to the person.

(b) The license holder must maintain information about and report incidents to the person's legal representative or designated emergency contact and case manager within 24 hours of an incident occurring while services are being provided, within 24 hours of discovery or receipt of information that an incident occurred, unless the license holder has reason to know that the incident has already been reported, or as otherwise directed in a person's coordinated service and support plan or coordinated service and support plan addendum. An incident of suspected or alleged maltreatment must be reported as required under paragraph (d), and an incident of serious injury or death must be reported as required under paragraph (e).

(c) When the incident involves more than one person, the license holder must not disclose personally identifiable information about any other person when making the report to each person and case manager unless the license holder has the consent of the person.

(d) Within 24 hours of reporting maltreatment as required under section 626.556 or 626.557, the license holder must inform the case manager of the report unless there is reason to believe that the case manager is involved in the suspected maltreatment. The license holder must disclose the nature of the activity or occurrence reported and the agency that received the report.

(e) The license holder must report the death or serious injury of the person as required in paragraph (b) and to the Department of Human Services Licensing Division, and the Office of Ombudsman for Mental Health and Developmental Disabilities as required under section 245.94, subdivision 2a, within 24 hours of the deathnew text begin or serious injurynew text end , or receipt of information that the deathnew text begin or serious injurynew text end occurred, unless the license holder has reason to know that the deathnew text begin or serious injurynew text end has already been reported.

(f) When a death or serious injury occurs in a facility certified as an intermediate care facility for persons with developmental disabilities, the death or serious injury must be reported to the Department of Health, Office of Health Facility Complaints, and the Office of Ombudsman for Mental Health and Developmental Disabilities, as required under sections 245.91 and 245.94, subdivision 2a, unless the license holder has reason to know that the deathnew text begin or serious injurynew text end has already been reported.

(g) The license holder must conduct an internal review of incident reports of deaths and serious injuries that occurred while services were being provided and that were not reported by the program as alleged or suspected maltreatment, for identification of incident patterns, and implementation of corrective action as necessary to reduce occurrences. The review must include an evaluation of whether related policies and procedures were followed, whether the policies and procedures were adequate, whether there is a need for additional staff training, whether the reported event is similar to past events with the persons or the services involved, and whether there is a need for corrective action by the license holder to protect the health and safety of persons receiving services. Based on the results of this review, the license holder must develop, document, and implement a corrective action plan designed to correct current lapses and prevent future lapses in performance by staff or the license holder, if any.

(h) The license holder must verbally report the emergency use of manual restraint of a person as required in paragraph (b) within 24 hours of the occurrence. The license holder must ensure the written report and internal review of all incident reports of the emergency use of manual restraints are completed according to the requirements in section 245D.061 or successor provisions.

Sec. 14.

Minnesota Statutes 2014, section 245D.06, subdivision 2, is amended to read:

Subd. 2.

Environment and safety.

The license holder must:

(1) ensure the following when the license holder is the owner, lessor, or tenant of the service site:

(i) the service site is a safe and hazard-free environment;

(ii) that toxic substances or dangerous items are inaccessible to persons served by the program only to protect the safety of a person receiving services when a known safety threat exists and not as a substitute for staff supervision or interactions with a person who is receiving services. If toxic substances or dangerous items are made inaccessible, the license holder must document an assessment of the physical plant, its environment, and its population identifying the risk factors which require toxic substances or dangerous items to be inaccessible and a statement of specific measures to be taken to minimize the safety risk to persons receiving services and to restore accessibility to all persons receiving services at the service site;

(iii) doors are locked from the inside to prevent a person from exiting only when necessary to protect the safety of a person receiving services and not as a substitute for staff supervision or interactions with the person. If doors are locked from the inside, the license holder must document an assessment of the physical plant, the environment and the population served, identifying the risk factors which require the use of locked doors, and a statement of specific measures to be taken to minimize the safety risk to persons receiving services at the service site; and

(iv) a staff person is available at the service site who is trained in basic first aid and, when required in a person's coordinated service and support plan or coordinated service and support plan addendum, cardiopulmonary resuscitation (CPR) whenever persons are present and staff are required to be at the site to provide direct support service. The CPR training must include deleted text begin in-persondeleted text end instruction, hands-on practice, and an observed skills assessment under the direct supervision of a CPR instructor;

(2) maintain equipment, vehicles, supplies, and materials owned or leased by the license holder in good condition when used to provide services;

(3) follow procedures to ensure safe transportation, handling, and transfers of the person and any equipment used by the person, when the license holder is responsible for transportation of a person or a person's equipment;

(4) be prepared for emergencies and follow emergency response procedures to ensure the person's safety in an emergency; and

(5) follow universal precautions and sanitary practices, including hand washing, for infection prevention and control, and to prevent communicable diseases.

Sec. 15.

Minnesota Statutes 2014, section 245D.06, subdivision 7, is amended to read:

Subd. 7.

Permitted actions and procedures.

(a) Use of the instructional techniques and intervention procedures as identified in paragraphs (b) and (c) is permitted when used on an intermittent or continuous basis. When used on a continuous basis, it must be addressed in a person's coordinated service and support plan addendum as identified in sections 245D.07 and 245D.071. For purposes of this chapter, the requirements of this subdivision supersede the requirements identified in Minnesota Rules, part 9525.2720.

(b) Physical contact or instructional techniques must use the least restrictive alternative possible to meet the needs of the person and may be used:

(1) to calm or comfort a person by holding that person with no resistance from that person;

(2) to protect a person known to be at risk of injury due to frequent falls as a result of a medical condition;

(3) to facilitate the person's completion of a task or response when the person does not resist or the person's resistance is minimal in intensity and duration;

(4) to block or redirect a person's limbs or body without holding the person or limiting the person's movement to interrupt the person's behavior that may result in injury to self or others with less than 60 seconds of physical contact by staff; or

(5) to redirect a person's behavior when the behavior does not pose a serious threat to the person or others and the behavior is effectively redirected with less than 60 seconds of physical contact by staff.

(c) Restraint may be used as an intervention procedure to:

(1) allow a licensed health care professional to safely conduct a medical examination or to provide medical treatment ordered by a licensed health care professional deleted text begin to a person necessary to promote healing or recovery from an acute, meaning short-term, medical conditiondeleted text end ;

(2) assist in the safe evacuation or redirection of a person in the event of an emergency and the person is at imminent risk of harm; or

(3) position a person with physical disabilities in a manner specified in the person's coordinated service and support plan addendum.

Any use of manual restraint as allowed in this paragraph must comply with the restrictions identified in subdivision 6, paragraph (b).

(d) Use of adaptive aids or equipment, orthotic devices, or other medical equipment ordered by a licensed health professional to treat a diagnosed medical condition do not in and of themselves constitute the use of mechanical restraint.

Sec. 16.

Minnesota Statutes 2014, section 245D.07, subdivision 2, is amended to read:

Subd. 2.

Service planning requirements for basic support services.

(a) License holders providing basic support services must meet the requirements of this subdivision.

(b) Within 15new text begin calendarnew text end days of service initiation the license holder must complete a preliminary coordinated service and support plan addendum based on the coordinated service and support plan.

(c) Within 60new text begin calendarnew text end days of service initiation the license holder must review and revise as needed the preliminary coordinated service and support plan addendum to document the services that will be provided including how, when, and by whom services will be provided, and the person responsible for overseeing the delivery and coordination of services.

(d) The license holder must participate in service planning and support team meetings for the person following stated timelines established in the person's coordinated service and support plan or as requested by the person or the person's legal representative, the support team or the expanded support team.

Sec. 17.

Minnesota Statutes 2014, section 245D.071, subdivision 5, is amended to read:

Subd. 5.

Service plan review and evaluation.

(a) The license holder must give the person or the person's legal representative and case manager an opportunity to participate in the ongoing review and development of the service plan and the methods used to support the person and accomplish outcomes identified in subdivisions 3 and 4. The license holder, in coordination with the person's support team or expanded support team, must meet with the person, the person's legal representative, and the case manager, and participate in service plan review meetings following stated timelines established in the person's coordinated service and support plan or coordinated service and support plan addendum or within 30 days of a written request by the person, the person's legal representative, or the case manager, at a minimum of once per year. The purpose of the service plan review is to determine whether changes are needed to the service plan based on the assessment information, the license holder's evaluation of progress towards accomplishing outcomes, or other information provided by the support team or expanded support team.

(b) The license holder must summarize the person's status and progress toward achieving the identified outcomes and make recommendations and identify the rationale for changing, continuing, or discontinuing implementation of supports and methods identified in subdivision 4 in a deleted text begin writtendeleted text end report deleted text begin sent to the person or the person's legal representative and case manager five working days prior to the review meeting, unless the person, the person's legal representative, or the case manager requests to receive the report deleted text end new text begin availablenew text end at the time of thenew text begin progress reviewnew text end meeting.new text begin The report must be sent at least five working days prior to the progress review meeting if requested by the team in the coordinated service and support plan or coordinated service and support plan addendum.new text end

(c) new text begin The license holder must send the coordinated service and support plan addendum to the person, the person's legal representative, and the case manager by mail within ten working days of the progress review meeting.new text end Within ten working days of the deleted text begin progress review meetingdeleted text end new text begin mailing of the coordinated service and support plan addendumnew text end , the license holder must obtain dated signatures from the person or the person's legal representative and the case manager to document approval of any changes to the coordinated service and support plan addendum.

new text begin (d) If, within ten working days of submitting changes to the coordinated service and support plan and coordinated service and support plan addendum, the person or the person's legal representative or case manager has not signed and returned to the license holder the coordinated service and support plan or coordinated service and support plan addendum or has not proposed written modifications to the license holder's submission, the submission is deemed approved and the coordinated service and support plan addendum becomes effective and remains in effect until the legal representative or case manager submits a written request to revise the coordinated service and support plan addendum. new text end

Sec. 18.

Minnesota Statutes 2014, section 245D.09, subdivision 3, is amended to read:

Subd. 3.

Staff qualifications.

(a) The license holder must ensure that staff providing direct support, or staff who have responsibilities related to supervising or managing the provision of direct support service, are competent as demonstrated through skills and knowledge training, experience, and education relevant to the primary disability of the person and to meet the person's needs and additional requirements as written in the coordinated service and support plan or coordinated service and support plan addendum, or when otherwise required by the case manager or the federal waiver plan. The license holder must verify and maintain evidence of staff competency, including documentation of:

(1) education and experience qualifications relevant to the job responsibilities assigned to the staff and to the primary disability of persons served by the program, including a valid degree and transcript, or a current license, registration, or certification, when a degree or licensure, registration, or certification is required by this chapter or in the coordinated service and support plan or coordinated service and support plan addendum;

(2) demonstrated competency in the orientation and training areas required under this chapter, and when applicable, completion of continuing education required to maintain professional licensure, registration, or certification requirements. Competency in these areas is determined by the license holder through knowledge testing or observed skill assessment conducted by the trainer or instructornew text begin or by an individual who has been previously deemed competent by the trainer or instructor in the area being assessednew text end ; and

(3) except for a license holder who is the sole direct support staff, periodic performance evaluations completed by the license holder of the direct support staff person's ability to perform the job functions based on direct observation.

(b) Staff under 18 years of age may not perform overnight duties or administer medication.

Sec. 19.

Minnesota Statutes 2014, section 245D.09, subdivision 5, is amended to read:

Subd. 5.

Annual training.

A license holder must provide annual training to direct support staff on the topics identified in subdivision 4, clauses (3) to (10). new text begin If the direct support staff has a first aid certification, annual training under subdivision 4, clause (9), is not required as long as the certification remains current. new text end A license holder must provide a minimum of 24 hours of annual training to direct service staff providing intensive services and having fewer than five years of documented experience and 12 hours of annual training to direct service staff providing intensive services and having five or more years of documented experience in topics described in subdivisions 4 and 4a, paragraphs (a) to (f). Training on relevant topics received from sources other than the license holder may count toward training requirements. A license holder must provide a minimum of 12 hours of annual training to direct service staff providing basic services and having fewer than five years of documented experience and six hours of annual training to direct service staff providing basic services and having five or more years of documented experience.

Sec. 20.

Minnesota Statutes 2014, section 245D.22, subdivision 4, is amended to read:

Subd. 4.

First aid must be available on site.

(a) A staff person trained in first aid must be available on site and, when required in a person's coordinated service and support plan or coordinated service and support plan addendum, be able to provide cardiopulmonary resuscitation, whenever persons are present and staff are required to be at the site to provide direct service. The CPR training must include deleted text begin in-persondeleted text end instruction, hands-on practice, and an observed skills assessment under the direct supervision of a CPR instructor.

(b) A facility must have first aid kits readily available for use by, and that meet the needs of, persons receiving services and staff. At a minimum, the first aid kit must be equipped with accessible first aid supplies including bandages, sterile compresses, scissors, an ice bag or cold pack, an oral or surface thermometer, mild liquid soap, adhesive tape, and first aid manual.

Sec. 21.

Minnesota Statutes 2014, section 245D.31, subdivision 3, is amended to read:

Subd. 3.

Staff ratio requirement for each person receiving services.

The case manager, in consultation with the interdisciplinary team, must determine at least once each year which of the ratios in subdivisions 4, 5, and 6 is appropriate for each person receiving services on the basis of the characteristics described in subdivisions 4, 5, and 6. The ratio assigned each person and the documentation of how the ratio was arrived at must be kept in each person's individual service plan. Documentation must include an assessment of the person with respect to the characteristics in subdivisions 4, 5, and 6 deleted text begin recorded on a standard assessment form required by the commissionerdeleted text end .

Sec. 22.

Minnesota Statutes 2014, section 245D.31, subdivision 4, is amended to read:

Subd. 4.

Person requiring staff ratio of one to four.

A person must be assigned a staff ratio requirement of one to four if:

(1) on a daily basis the person requires total care and monitoring or constant hand-over-hand physical guidance to successfully complete at least three of the following activities: toileting, communicating basic needs, eating,new text begin ornew text end ambulating; deleted text begin or is not capable of taking appropriate action for self-preservation under emergency conditions;deleted text end or

(2) the person engages in conduct that poses an imminent risk of physical harm to self or others at a documented level of frequency, intensity, or duration requiring frequent daily ongoing intervention and monitoring as established in the person's coordinated service and support plan or coordinated service and support plan addendum.

Sec. 23.

Minnesota Statutes 2014, section 245D.31, subdivision 5, is amended to read:

Subd. 5.

Person requiring staff ratio of one to eight.

A person must be assigned a staff ratio requirement of one to eight if:

(1) the person does not meet the requirements in subdivision 4; and

(2) on a daily basis the person requires verbal prompts or spot checks and minimal or no physical assistance to successfully complete at least deleted text begin fourdeleted text end new text begin threenew text end of the following activities: toileting, communicating basic needs, eating, new text begin or new text end ambulatingdeleted text begin , or taking appropriate action for self-preservation under emergency conditionsdeleted text end .

Sec. 24.

Minnesota Statutes 2014, 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 chapter 259A 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 275 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:

(1) if the adjusted gross income is equal to or greater than 275 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 2.48deleted text end new text begin 2.23new text end percent of adjusted gross income at 275 percent of federal poverty guidelines and increases to deleted text begin 6.75deleted text end new text begin 6.08new text end percent of adjusted gross income for those with adjusted gross income up to 545 percent of federal poverty guidelines;

(2) 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 deleted text begin 6.75deleted text end new text begin 6.08new text end percent of adjusted gross income;

(3) 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 deleted text begin 6.75deleted text end new text begin 6.08new text end percent of adjusted gross income at 675 percent of federal poverty guidelines and increases to deleted text begin ninedeleted text end new text begin 8.1new text end percent of adjusted gross income for those with adjusted gross income up to 975 percent of federal poverty guidelines; and

(4) if the adjusted gross income is equal to or greater than 975 percent of federal poverty guidelines, the parental contribution shall be deleted text begin 11.25deleted text end new text begin 10.13new text end 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.

Sec. 25.

Minnesota Statutes 2014, section 256.478, is amended to read:

256.478 HOME AND COMMUNITY-BASED SERVICES TRANSITIONS GRANTS.

deleted text begin (a)deleted text end 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.

deleted 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. deleted text end

Sec. 26.

Minnesota Statutes 2014, section 256.975, is amended by adding a subdivision to read:

new text begin Subd. 11. new text end

new text begin Regional and local dementia grants. new text end

new text begin (a) The Minnesota Board on Aging shall award competitive grants to eligible applicants for regional and local projects and initiatives targeted to a designated community, which may consist of a specific geographic area or population, to increase awareness of Alzheimer's disease and other dementias, increase the rate of cognitive testing in the population at risk for dementias, promote the benefits of early diagnosis of dementias, or connect caregivers of persons with dementia to education and resources. new text end

new text begin (b) The project areas for grants include: new text end

new text begin (1) local or community-based initiatives to promote the benefits of physician consultations for all individuals who suspect a memory or cognitive problem; new text end

new text begin (2) local or community-based initiatives to promote the benefits of early diagnosis of Alzheimer's disease and other dementias; and new text end

new text begin (3) local or community-based initiatives to provide informational materials and other resources to caregivers of persons with dementia. new text end

new text begin (c) Eligible applicants for local and regional grants may include, but are not limited to, community health boards, school districts, colleges and universities, community clinics, tribal communities, nonprofit organizations, and other health care organizations. new text end

new text begin (d) Applicants must: new text end

new text begin (1) describe the proposed initiative, including the targeted community and how the initiative meets the requirements of this subdivision; and new text end

new text begin (2) identify the proposed outcomes of the initiative and the evaluation process to be used to measure these outcomes. new text end

new text begin (e) In awarding the regional and local dementia grants, the Minnesota Board on Aging must give priority to applicants who demonstrate that the proposed project: new text end

new text begin (1) is supported by and appropriately targeted to the community the applicant serves; new text end

new text begin (2) is designed to coordinate with other community activities related to other health initiatives, particularly those initiatives targeted at the elderly; new text end

new text begin (3) is conducted by an applicant able to demonstrate expertise in the project areas; new text end

new text begin (4) utilizes and enhances existing activities and resources or involves innovative approaches to achieve success in the project areas; and new text end

new text begin (5) strengthens community relationships and partnerships in order to achieve the project areas. new text end

new text begin (f) The board shall divide the state into specific geographic regions and allocate a percentage of the money available for the local and regional dementia grants to projects or initiatives aimed at each geographic region. new text end

new text begin (g) The board shall award any available grants by January 1, 2016, and each July 1 thereafter. new text end

new text begin (h) Each grant recipient shall report to the board on the progress of the initiative at least once during the grant period, and within two months of the end of the grant period shall submit a final report to the board that includes the outcome results. new text end

new text begin (i) The Minnesota Board on Aging shall: new text end

new text begin (1) develop the criteria and procedures to allocate the grants under this subdivision, evaluate all applicants on a competitive basis and award the grants, and select qualified providers to offer technical assistance to grant applicants and grantees. The selected provider shall provide applicants and grantees assistance with project design, evaluation methods, materials, and training; and new text end

new text begin (2) submit by January 15, 2017, and on each January 15 thereafter, a progress report on the dementia grants programs under this subdivision to the chairs and ranking minority members of the senate and house of representatives committees and divisions with jurisdiction over health finance and policy. The report shall include: new text end

new text begin (i) information on each grant recipient; new text end

new text begin (ii) a summary of all projects or initiatives undertaken with each grant; new text end

new text begin (iii) the measurable outcomes established by each grantee, an explanation of the evaluation process used to determine whether the outcomes were met, and the results of the evaluation; and new text end

new text begin (iv) an accounting of how the grant funds were spent. new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 27.

Minnesota Statutes 2014, section 256B.056, subdivision 5c, is amended to read:

Subd. 5c.

Excess income standard.

(a) The excess income standard for parents and caretaker relatives, pregnant women, infants, and children ages two through 20 is the standard specified in subdivision 4, paragraph (b).

(b) The excess income standard for a person whose eligibility is based on blindness, disability, or age of 65 or more years shall equal deleted text begin 75deleted text end new text begin 80new text end percent of the federal poverty guidelines.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 28.

Minnesota Statutes 2014, section 256B.057, subdivision 9, is amended to read:

Subd. 9.

Employed persons with disabilities.

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

(1) but for excess earnings or assets, meets the definition of disabled under the Supplemental Security Income program;

(2) meets the asset limits in paragraph (d); and

(3) pays a premium and other obligations under paragraph (e).

(b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible for medical assistance under this subdivision, a person must have more than $65 of earned income. Earned income must have Medicare, Social Security, and applicable state and federal taxes withheld. The person must document earned income tax withholding. Any spousal income or assets shall be disregarded for purposes of eligibility and premium determinations.

(c) After the month of enrollment, a person enrolled in medical assistance under this subdivision who:

(1) is temporarily unable to work and without receipt of earned income due to a medical condition, as verified by a physician; or

(2) loses employment for reasons not attributable to the enrollee, and is without receipt of earned income may retain eligibility for up to four consecutive months after the month of job loss. To receive a four-month extension, enrollees must verify the medical condition or provide notification of job loss. All other eligibility requirements must be met and the enrollee must pay all calculated premium costs for continued eligibility.

(d) For purposes of determining eligibility under this subdivision, a person's assets must not exceed $20,000, excluding:

(1) all assets excluded under section 256B.056;

(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, Keogh plans, and pension plans;

(3) medical expense accounts set up through the person's employer; and

(4) spousal assets, including spouse's share of jointly held assets.

(e) All enrollees must pay a premium to be eligible for medical assistance under this subdivision, except as provided under clause (5).

(1) An enrollee must pay the greater of a deleted text begin $65deleted text end new text begin $35new text end premium or the premium calculated based on the person's gross earned and unearned income and the applicable family size using a sliding fee scale established by the commissioner, which begins at one percent of income at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income for those with incomes at or above 300 percent of the federal poverty guidelines.

(2) Annual adjustments in the premium schedule based upon changes in the federal poverty guidelines shall be effective for premiums due in July of each year.

(3) All enrollees who receive unearned income must pay deleted text begin fivedeleted text end new text begin one-half of one new text end percent of unearned income in addition to the premium amount, except as provided under clause (5).

(4) Increases in benefits under title II of the Social Security Act shall not be counted as income for purposes of this subdivision until July 1 of each year.

(5) Effective July 1, 2009, American Indians are exempt from paying premiums 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.

(f) A person's eligibility and premium shall be determined by the local county agency. Premiums must be paid to the commissioner. All premiums are dedicated to the commissioner.

(g) Any required premium shall be determined at application and redetermined at the enrollee's six-month income review or when a change in income or household size is reported. Enrollees must report any change in income or household size within ten days of when the change occurs. A decreased premium resulting from a reported change in income or household size shall be effective the first day of the next available billing month after the change is reported. Except for changes occurring from annual cost-of-living increases, a change resulting in an increased premium shall not affect the premium amount until the next six-month review.

(h) Premium payment is due upon notification from the commissioner of the premium amount required. Premiums may be paid in installments at the discretion of the commissioner.

(i) Nonpayment of the premium shall result in denial or termination of medical assistance unless the person demonstrates good cause for nonpayment. Good cause exists if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to D, are met. Except when an installment agreement is accepted by the commissioner, all persons disenrolled for nonpayment of a premium must pay any past due premiums as well as current premiums due prior to being reenrolled. Nonpayment shall include payment with a returned, refused, or dishonored instrument. The commissioner may require a guaranteed form of payment as the only means to replace a returned, refused, or dishonored instrument.

(j) For enrollees whose income does not exceed 200 percent of the federal poverty guidelines and who are also enrolled in Medicare, the commissioner shall reimburse the enrollee for Medicare part B premiums under section 256B.0625, subdivision 15, paragraph (a).

new text begin EFFECTIVE DATE. new text end

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

Sec. 29.

Minnesota Statutes 2014, section 256B.059, subdivision 5, is amended to read:

Subd. 5.

Asset availability.

(a) At the time of initial determination of eligibility for medical assistance benefits following the first continuous period of institutionalization on or after October 1, 1989, assets considered available to the institutionalized spouse shall be the total value of all assets in which either spouse has an ownership interest, reduced by the following amount for the community spouse:

(1) prior to July 1, 1994, the greater of:

(i) $14,148;

(ii) the lesser of the spousal share or $70,740; or

(iii) the amount required by court order to be paid to the community spouse;

(2) for persons whose date of initial determination of eligibility for medical assistance following their first continuous period of institutionalization occurs on or after July 1, 1994, the greater of:

(i) $20,000;

(ii) the lesser of the spousal share or $70,740; or

(iii) the amount required by court order to be paid to the community spouse.

The value of assets transferred for the sole benefit of the community spouse under section 256B.0595, subdivision 4, in combination with other assets available to the community spouse under this section, cannot exceed the limit for the community spouse asset allowance determined under subdivision 3 or 4. Assets that exceed this allowance shall be considered available to the institutionalized spouse deleted text begin whether or notdeleted text end deleted text begin converted todeleted text end deleted text begin incomedeleted text end . If the community spouse asset allowance has been increased under subdivision 4, then the assets considered available to the institutionalized spouse under this subdivision shall be further reduced by the value of additional amounts allowed under subdivision 4.

(b) An institutionalized spouse may be found eligible for medical assistance even though assets in excess of the allowable amount are found to be available under paragraph (a) if the assets are owned jointly or individually by the community spouse, and the institutionalized spouse cannot use those assets to pay for the cost of care without the consent of the community spouse, and if: (i) the institutionalized spouse assigns to the commissioner the right to support from the community spouse under section 256B.14, subdivision 3; (ii) the institutionalized spouse lacks the ability to execute an assignment due to a physical or mental impairment; or (iii) the denial of eligibility would cause an imminent threat to the institutionalized spouse's health and well-being.

(c) After the month in which the institutionalized spouse is determined eligible for medical assistance, during the continuous period of institutionalization, no assets of the community spouse are considered available to the institutionalized spouse, unless the institutionalized spouse has been found eligible under paragraph (b).

(d) Assets determined to be available to the institutionalized spouse under this section must be used for the health care or personal needs of the institutionalized spouse.

(e) For purposes of this section, assets do not include assets excluded under the Supplemental Security Income program.

Sec. 30.

Minnesota Statutes 2014, section 256B.0916, subdivision 2, is amended to read:

Subd. 2.

Distribution of funds; partnerships.

(a) Beginning with fiscal year 2000, the commissioner shall distribute all funding available for home and community-based waiver services for persons with developmental disabilities to individual counties or to groups of counties that form partnerships to jointly plan, administer, and authorize funding for eligible individuals. The commissioner shall encourage counties to form partnerships that have a sufficient number of recipients and funding to adequately manage the risk and maximize use of available resources.

(b) Counties must submit a request for funds and a plan for administering the program as required by the commissioner. The plan must identify the number of clients to be served, their ages, and their priority listing based on:

(1) requirements in Minnesota Rules, part 9525.1880; and

(2) statewide priorities identified in section 256B.092, subdivision 12.

The plan must also identify changes made to improve services to eligible persons and to improve program management.

(c) In allocating resources to counties, priority must be given to groups of counties that form partnerships to jointly plan, administer, and authorize funding for eligible individuals and to counties determined by the commissioner to have sufficient waiver capacity to maximize resource use.

(d) Within 30 days after receiving the county request for funds and plans, the commissioner shall provide a written response to the plan that includes the level of resources available to serve additional persons.

(e) Counties are eligible to receive medical assistance administrative reimbursement for administrative costs under criteria established by the commissioner.

new text begin (f) The commissioner shall manage waiver allocations in such a manner as to fully use available state and federal waiver appropriations. 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. 31.

Minnesota Statutes 2014, section 256B.0916, subdivision 11, is amended to read:

Subd. 11.

Excess spending.

County and tribal agencies are responsible for spending in excess of the allocation made by the commissioner. In the event a county or tribal agency spends in excess of the allocation made by the commissioner for a given allocation period, they must submit a corrective action plan to the commissionernew text begin for approvalnew text end . The plan must state the actions the agency will take to correct their overspending for the deleted text begin yeardeleted text end new text begin two years new text end following the period when the overspending occurred. deleted text begin Failure to correct overspending shall result in recoupment of spending in excess of the allocationdeleted text end new text begin . The commissioner shall recoup spending in excess of the allocation only in cases where statewide spending exceeds the appropriation designated for the home and community-based services waiversnew text end . Nothing in this subdivision shall be construed as reducing the county's responsibility to offer and make available feasible home and community-based options to eligible waiver recipients within the resources allocated to them for that purpose.

new text begin EFFECTIVE DATE. new text end

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

Sec. 32.

Minnesota Statutes 2014, section 256B.0916, is amended by adding a subdivision to read:

new text begin Subd. 12. new text end

new text begin Use of waiver allocations. new text end

new text begin County and tribal agencies are responsible for spending the annual allocation made by the commissioner. In the event a county or tribal agency spends less than 97 percent of the allocation, while maintaining a list of persons waiting for waiver services, the county or tribal agency must submit a corrective action plan to the commissioner for approval. The commissioner may determine a plan is unnecessary given the size of the allocation and capacity for new enrollment. The plan must state the actions the agency will take to assure reasonable and timely access to home and community-based waiver services for persons waiting for services. If a county or tribe does not submit a plan when required or implement the changes required, the commissioner shall assure access to waiver services within the county's or tribe's available allocation and take other actions needed to assure that all waiver participants in that county or tribe are receiving appropriate waiver services to meet their needs. 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 2014, section 256B.49, subdivision 26, is amended to read:

Subd. 26.

Excess allocations.

new text begin (a) Effective through June 30, 2018, new text end county and tribal agencies will be responsible for authorizations in excess of the new text begin annual new text end allocation made by the commissioner. In the event a county or tribal agency authorizes in excess of the allocation made by the commissioner for a given allocation period, the county or tribal agency must submit a corrective action plan to the commissionernew text begin for approvalnew text end . The plan must state the actions the agency will take to correct their overspending for the deleted text begin yeardeleted text end new text begin two years new text end following the period when the overspending occurred. deleted text begin Failure to correct overauthorizations shall result in recoupment of authorizations in excess of the allocation.deleted text end new text begin The commissioner shall recoup funds spent in excess of the allocation only in cases where statewide spending exceeds the appropriation designated for the home and community-based services waivers. new text end Nothing in this subdivision shall be construed as reducing the county's responsibility to offer and make available feasible home and community-based options to eligible waiver recipients within the resources allocated to them for that purpose.

new text begin (b) Effective July 1, 2018, county and tribal agencies will be responsible for spending in excess of the annual allocation made by the commissioner. In the event a county or tribal agency spends in excess of the allocation made by the commissioner for a given allocation period, the county or tribal agency must submit a corrective action plan to the commissioner for approval. The plan must state the actions the agency will take to correct its overspending for the two years following the period when the overspending occurred. The commissioner shall recoup funds spent in excess of the allocation only in cases when statewide spending exceeds the appropriation designated for the home and community-based services waivers. Nothing in this subdivision shall be construed as reducing the county or tribe's responsibility to offer and make available feasible home and community-based options to eligible waiver recipients within the resources allocated to it for that purpose. new text end

Sec. 34.

Minnesota Statutes 2014, section 256B.49, is amended by adding a subdivision to read:

new text begin Subd. 27. new text end

new text begin Use of waiver allocations. new text end

new text begin (a) Effective until June 30, 2018, county and tribal agencies are responsible for authorizing the annual allocation made by the commissioner. In the event a county or tribal agency authorizes less than 97 percent of the allocation, while maintaining a list of persons waiting for waiver services, the county or tribal agency must submit a corrective action plan to the commissioner for approval. The commissioner may determine a plan is unnecessary given the size of the allocation and capacity for new enrollment. The plan must state the actions the agency will take to assure reasonable and timely access to home and community-based waiver services for persons waiting for services. new text end

new text begin (b) Effective July 1, 2018, county and tribal agencies are responsible for spending the annual allocation made by the commissioner. In the event a county or tribal agency spends less than 97 percent of the allocation, while maintaining a list of persons waiting for waiver services, the county or tribal agency must submit a corrective action plan to the commissioner for approval. The commissioner may determine a plan is unnecessary given the size of the allocation and capacity for new enrollment. The plan must state the actions the agency will take to assure reasonable and timely access to home and community-based waiver services for persons waiting for services. new text end

new text begin (c) If a county or tribe does not submit a plan when required or implement the changes required, the commissioner shall assure access to waiver services within the county or tribe's available allocation, and take other actions needed to assure that all waiver participants in that county or tribe are receiving appropriate waiver services to meet their needs. new text end

Sec. 35.

Minnesota Statutes 2014, section 256B.4913, subdivision 4a, is amended to read:

Subd. 4a.

Rate stabilization adjustment.

(a) For purposes of this subdivision, "implementation period" means the period beginning January 1, 2014, and ending on the last day of the month in which the rate management system is populated with the data necessary to calculate rates for substantially all individuals receiving home and community-based waiver services under sections 256B.092 and 256B.49. "Banding period" means the time period beginning on January 1, 2014, and ending upon the expiration of the 12-month period defined in paragraph (c), clause (5).

(b) For purposes of this subdivision, the historical rate for all service recipients means the individual reimbursement rate for a recipient in effect on December 1, 2013, except that:

(1) for a day service recipient who was not authorized to receive these waiver services prior to January 1, 2014; added a new service or services on or after January 1, 2014; or changed providers on or after January 1, 2014, the historical rate must be the authorized rate for the provider in the county of service, effective December 1, 2013; or

(2) for a unit-based service with programming or a unit-based service without programming recipient who was not authorized to receive these waiver services prior to January 1, 2014; added a new service or services on or after January 1, 2014; or changed providers on or after January 1, 2014, the historical rate must be the weighted average authorized rate for each provider number in the county of service, effective December 1, 2013; or

(3) for residential service recipients who change providers on or after January 1, 2014, the historical rate must be set by each lead agency within their county aggregate budget using their respective methodology for residential services effective December 1, 2013, for determining the provider rate for a similarly situated recipient being served by that provider.

(c) The commissioner shall adjust individual reimbursement rates determined under this section so that the unit rate is no higher or lower than:

(1) 0.5 percent from the historical rate for the implementation period;

(2) 0.5 percent from the rate in effect in clause (1), for the 12-month period immediately following the time period of clause (1);

(3) deleted text begin 1.0deleted text end new text begin 0.5 new text end percent from the rate in effect in clause (2), for the 12-month period immediately following the time period of clause (2);

(4) 1.0 percent from the rate in effect in clause (3), for the 12-month period immediately following the time period of clause (3); deleted text begin anddeleted text end

(5) 1.0 percent from the rate in effect in clause (4), for the 12-month period immediately following the time period of clause (4)new text begin ; andnew text end

new text begin (6) no adjustment to the rate in effect in clause (5) for the 12-month period immediately following the time period of clause (5). During this banding rate period, the commissioner shall not enforce any rate decrease or increase that would otherwise result from the end of the banding period. The commissioner shall, upon enactment, seek federal approval for the addition of this banding periodnew text end .

(d) The commissioner shall review all changes to rates that were in effect on December 1, 2013, to verify that the rates in effect produce the equivalent level of spending and service unit utilization on an annual basis as those in effect on October 31, 2013.

(e) By December 31, 2014, the commissioner shall complete the review in paragraph (d), adjust rates to provide equivalent annual spending, and make appropriate adjustments.

(f) During the banding period, the Medicaid Management Information System (MMIS) service agreement rate must be adjusted to account for change in an individual's need. The commissioner shall adjust the Medicaid Management Information System (MMIS) service agreement rate by:

(1) calculating a service rate under section 256B.4914, subdivision 6, 7, 8, or 9, for the individual with variables reflecting the level of service in effect on December 1, 2013;

(2) calculating a service rate under section 256B.4914, subdivision 6, 7, 8, or 9, for the individual with variables reflecting the updated level of service at the time of application; and

(3) adding to or subtracting from the Medicaid Management Information System (MMIS) service agreement rate, the difference between the values in clauses (1) and (2).

(g) This subdivision must not apply to rates for recipients served by providers new to a given county after January 1, 2014. Providers of personal supports services who also acted as fiscal support entities must be treated as new providers as of January 1, 2014.

Sec. 36.

Minnesota Statutes 2014, section 256B.4913, subdivision 5, is amended to read:

Subd. 5.

Stakeholder consultationnew text begin and county trainingnew text end .

new text begin (a) new text end The commissioner shall continue consultation on regular intervals with the existing stakeholder group established as part of the rate-setting methodology process and others, to gather input, concerns, and data, to assist in the full implementation of the new rate payment system and to make pertinent information available to the public through the department's Web site.

new text begin (b) The commissioner shall offer training at least annually for county personnel responsible for administering the rate-setting framework in a manner consistent with this section and section 256B.4914. new text end

new text begin (c) The commissioner shall maintain an online instruction manual explaining the rate-setting framework. The manual shall be consistent with this section and section 256B.4914, and shall be accessible to all stakeholders including recipients, representatives of recipients, county or tribal agencies, and license holders. new text end

new text begin (d) The commissioner shall not defer to the county or tribal agency on matters of technical application of the rate-setting framework, and a county or tribal agency shall not set rates in a manner that conflicts with this section or section 256B.4914. new text end

Sec. 37.

Minnesota Statutes 2014, section 256B.4914, subdivision 2, is amended to read:

Subd. 2.

Definitions.

(a) For purposes of this section, the following terms have the meanings given them, unless the context clearly indicates otherwise.

(b) "Commissioner" means the commissioner of human services.

(c) "Component value" means underlying factors that are part of the cost of providing services that are built into the waiver rates methodology to calculate service rates.

(d) "Customized living tool" means a methodology for setting service rates that delineates and documents the amount of each component service included in a recipient's customized living service plan.

(e) "Disability waiver rates system" means a statewide system that establishes rates that are based on uniform processes and captures the individualized nature of waiver services and recipient needs.

(f) "Individual staffing" means the time spent as a one-to-one interaction specific to an individual recipient by staff deleted text begin brought in solelydeleted text end to provide direct support and assistance with activities of daily living, instrumental activities of daily living, and training to participants, and is based on the requirements in each individual's coordinated service and support plan under section 245D.02, subdivision 4b; any coordinated service and support plan addendum under section 245D.02, subdivision 4c; new text begin and new text end an assessment tooldeleted text begin ; anddeleted text end new text begin . new text end Provider observation of an individual's needsnew text begin must also be considerednew text end .

(g) "Lead agency" means a county, partnership of counties, or tribal agency charged with administering waivered services under sections 256B.092 and 256B.49.

(h) "Median" means the amount that divides distribution into two equal groups, one-half above the median and one-half below the median.

(i) "Payment or rate" means reimbursement to an eligible provider for services provided to a qualified individual based on an approved service authorization.

(j) "Rates management system" means a Web-based software application that uses a framework and component values, as determined by the commissioner, to establish service rates.

(k) "Recipient" means a person receiving home and community-based services funded under any of the disability waivers.

(l) "Shared staffing" means time spent by employees, not defined under paragraph (f), providing or available to provide more than one individual with direct support and assistance with activities of daily living as defined under section 256B.0659, subdivision 1, paragraph (b); instrumental activities of daily living as defined under section 256B.0659, subdivision 1, paragraph (i); ancillary activities needed to support individual services; and training to participants, and is based on the requirements in each individual's coordinated service and support plan under section 245D.02, subdivision 4b; any coordinated service and support plan addendum under section 245D.02, subdivision 4c; an assessment tool; and provider observation of an individual's service need. Total shared staffing hours are divided proportionally by the number of individuals who receive the shared service provisions.

(m) "Staffing ratio" means the number of recipients a service provider employee supports during a unit of service based on a uniform assessment tool, provider observation, case history, and the recipient's services of choice, and not based on the staffing ratios under section 245D.31.

(n) "Unit of service" means the following:

(1) for residential support services under subdivision 6, a unit of service is a day. Any portion of any calendar day, within allowable Medicaid rules, where an individual spends time in a residential setting is billable as a day;

(2) for day services under subdivision 7:

(i) for day training and habilitation services, a unit of service is either:

(A) a day unit of service is defined as six or more hours of time spent providing direct services and transportation; or

(B) a partial day unit of service is defined as fewer than six hours of time spent providing direct services and transportation; and

(C) for new day service recipients after January 1, 2014, 15 minute units of service must be used for fewer than six hours of time spent providing direct services and transportation;

(ii) for adult day and structured day services, a unit of service is a day or 15 minutes. A day unit of service is six or more hours of time spent providing direct services;

(iii) for prevocational services, a unit of service is a day or an hour. A day unit of service is six or more hours of time spent providing direct service;

(3) for unit-based services with programming under subdivision 8:

(i) for supported living services, a unit of service is a day or 15 minutes. When a day rate is authorized, any portion of a calendar day where an individual receives services is billable as a day; and

(ii) for all other services, a unit of service is 15 minutes; and

(4) for unit-based services without programming under subdivision 9:

(i) for respite services, a unit of service is a day or 15 minutes. When a day rate is authorized, any portion of a calendar day when an individual receives services is billable as a day; and

(ii) for all other services, a unit of service is 15 minutes.

Sec. 38.

Minnesota Statutes 2014, section 256B.4914, subdivision 6, is amended to read:

Subd. 6.

Payments for residential support services.

(a) Payments for residential support services, as defined in sections 256B.092, subdivision 11, and 256B.49, subdivision 22, must be calculated as follows:

(1) determine the number of shared staffing and individual direct staff hours to meet a recipient's needs provided on site or through monitoring technology;

(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 5. This is defined as the direct-care rate;

(3) for a recipient requiring customization for deaf and hard-of-hearing language accessibility under subdivision 12, add the customization rate provided in subdivision 12 to the result of clause (2). This is defined as the customized direct-care rate;

(4) multiply the number of shared and individual direct staff hours provided on site or through monitoring technology and nursing hours by the appropriate staff wages in subdivision 5, paragraph (a), or the customized direct-care rate;

(5) multiply the number of shared and individual direct staff hours provided on site or through monitoring technology and nursing hours by the product of the supervision span of control ratio in subdivision 5, paragraph (b), clause (1), and the appropriate supervision wage in subdivision 5, paragraph (a), clause (16);

(6) combine the results of clauses (4) and (5), excluding any shared and individual direct staff hours provided through monitoring technology, and multiply the result by one plus the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (b), clause (2). This is defined as the direct staffing cost;

(7) for employee-related expenses, multiply the direct staffing cost, excluding any shared and individual direct staff hours provided through monitoring technology, by one plus the employee-related cost ratio in subdivision 5, paragraph (b), clause (3);

(8) for client programming and supports, the commissioner shall add $2,179; and

(9) for transportation, if provided, the commissioner shall add $1,680, or $3,000 if customized for adapted transport, based on the resident with the highest assessed need.

(b) The total rate must be calculated using the following steps:

(1) subtotal paragraph (a), clauses (7) to (9), and the direct staffing cost of any shared and individual direct staff hours provided through monitoring technology that was excluded in clause (7);

(2) sum the standard general and administrative rate, the program-related expense ratio, and the absence and utilization ratio;

(3) divide the result of clause (1) by one minus the result of clause (2). This is the total payment amount; and

(4) adjust the result of clause (3) by a factor to be determined by the commissioner to adjust for regional differences in the cost of providing services.

(c) The payment methodology for customized living, 24-hour customized living, and residential care services must be the customized living tool. Revisions to the customized living tool must be made to reflect the services and activities unique to disability-related recipient needs.

deleted text begin (d) The commissioner shall establish a Monitoring Technology Review Panel to annually review and approve the plans, safeguards, and rates that include residential direct care provided remotely through monitoring technology. Lead agencies shall submit individual service plans that include supervision using monitoring technology to the Monitoring Technology Review Panel for approval. Individual service plans that include supervision using monitoring technology as of December 31, 2013, shall be submitted to the Monitoring Technology Review Panel, but the plans are not subject to approval. deleted text end

deleted text begin (e)deleted text end new text begin (d)new text end For individuals enrolled prior to January 1, 2014, the days of service authorized must meet or exceed the days of service used to convert service agreements in effect on December 1, 2013, and must not result in a reduction in spending or service utilization due to conversion during the implementation period under section 256B.4913, subdivision 4a. If during the implementation period, an individual's historical rate, including adjustments required under section 256B.4913, subdivision 4a, paragraph (c), is equal to or greater than the rate determined in this subdivision, the number of days authorized for the individual is 365.

deleted text begin (f)deleted text end new text begin (e)new text end The number of days authorized for all individuals enrolling after January 1, 2014, in residential services must include every day that services start and end.

Sec. 39.

Minnesota Statutes 2014, section 256B.4914, subdivision 8, is amended to read:

Subd. 8.

Payments for unit-based services with programming.

Payments for unit-based deleted text begin with programdeleted text end servicesnew text begin with programmingnew text end , including behavior programming, housing access coordination, in-home family support, independent living skills training, hourly supported living services, and supported employment provided to an individual outside of any day or residential service plan must be calculated as follows, unless the services are authorized separately under subdivision 6 or 7:

(1) determine the number of units of service to meet a recipient's needs;

(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 5;

(3) for a recipient requiring customization for deaf and hard-of-hearing language accessibility under subdivision 12, add the customization rate provided in subdivision 12 to the result of clause (2). This is defined as the customized direct-care rate;

(4) multiply the number of direct staff hours by the appropriate staff wage in subdivision 5, paragraph (a), or the customized direct-care rate;

(5) multiply the number of direct staff hours by the product of the supervision span of control ratio in subdivision 5, paragraph (e), clause (1), and the appropriate supervision wage in subdivision 5, paragraph (a), clause (16);

(6) combine the results of clauses (4) and (5), and multiply the result by one plus the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (e), clause (2). This is defined as the direct staffing rate;

(7) for program plan support, multiply the result of clause (6) by one plus the program plan supports ratio in subdivision 5, paragraph (e), clause (4);

(8) for employee-related expenses, multiply the result of clause (7) by one plus the employee-related cost ratio in subdivision 5, paragraph (e), clause (3);

(9) for client programming and supports, multiply the result of clause (8) by one plus the client programming and supports ratio in subdivision 5, paragraph (e), clause (5);

(10) this is the subtotal rate;

(11) sum the standard general and administrative rate, the program-related expense ratio, and the absence and utilization factor ratio;

(12) divide the result of clause (10) by one minus the result of clause (11). This is the total payment amount;

(13) for supported employment provided in a shared manner, divide the total payment amount in clause (12) by the number of service recipients, not to exceed three. For independent living skills training provided in a shared manner, divide the total payment amount in clause (12) by the number of service recipients, not to exceed two; and

(14) adjust the result of clause (13) by a factor to be determined by the commissioner to adjust for regional differences in the cost of providing services.

Sec. 40.

Minnesota Statutes 2014, section 256B.4914, subdivision 10, is amended to read:

Subd. 10.

Updating payment values and additional information.

(a) From January 1, 2014, through December 31, 2017, the commissioner shall develop and implement uniform procedures to refine terms and adjust values used to calculate payment rates in this section.

(b) No later than July 1, 2014, the commissioner shall, within available resources, begin to conduct research and gather data and information from existing state systems or other outside sources on the following items:

(1) differences in the underlying cost to provide services and care across the state; and

(2) mileage, vehicle type, lift requirements, incidents of individual and shared rides, and units of transportation for all day services, which must be collected from providers using the rate management worksheet and entered into the rates management system; and

(3) the distinct underlying costs for services provided by a license holder new text begin under sections 245D.05, 245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services provided by a license holder new text end certified under section 245D.33.

(c) Using a statistically valid set of rates management system data, the commissioner, in consultation with stakeholders, shall analyze for each service the average difference in the rate on December 31, 2013, and the framework rate at the individual, provider, lead agency, and state levels. The commissioner shall issue semiannual reports to the stakeholders on the difference in rates by service and by county during the banding period under section 256B.4913, subdivision 4a. The commissioner shall issue the first report by October 1, 2014.

(d) No later than July 1, 2014, the commissioner, in consultation with stakeholders, shall begin the review and evaluation of the following values already in subdivisions 6 to 9, or issues that impact all services, including, but not limited to:

(1) values for transportation rates for day services;

(2) values for transportation rates in residential services;

(3) values for services where monitoring technology replaces staff time;

(4) values for indirect services;

(5) values for nursing;

(6) component values for independent living skills;

(7) component values for family foster care that reflect licensing requirements;

(8) adjustments to other components to replace the budget neutrality factor;

(9) remote monitoring technology for nonresidential services;

(10) values for basic and intensive services in residential services;

(11) values for the facility use rate in day servicesnew text begin , and the weightings used in the day service ratios and adjustments to those weightingsnew text end ;

(12) values for workers' compensation as part of employee-related expenses;

(13) values for unemployment insurance as part of employee-related expenses;

(14) a component value to reflect costs for individuals with rates previously adjusted for the inclusion of group residential housing rate 3 costs, only for any individual enrolled as of December 31, 2013; and

(15) any changes in state or federal law with an impact on the underlying cost of providing home and community-based services.

(e) The commissioner shall report to the chairs and the ranking minority members of the legislative committees and divisions with jurisdiction over health and human services policy and finance with the information and data gathered under paragraphs (b) to (d) on the following dates:

(1) January 15, 2015, with preliminary results and data;

(2) January 15, 2016, with a status implementation update, and additional data and summary information;

(3) January 15, 2017, with the full report; and

(4) January 15, 2019, with another full report, and a full report once every four years thereafter.

(f) Based on the commissioner's evaluation of the information and data collected in paragraphs (b) to (d), the commissioner shall make recommendations to the legislature by January 15, 2015, to address any issues identified during the first year of implementation. After January 15, 2015, the commissioner may make recommendations to the legislature to address potential issues.

(g) The commissioner shall implement a regional adjustment factor to all rate calculations in subdivisions 6 to 9, effective no later than January 1, 2015. Prior to implementation, the commissioner shall consult with stakeholders on the methodology to calculate the adjustment.

(h) The commissioner shall provide a public notice via LISTSERV in October of each year beginning October 1, 2014, containing information detailing legislatively approved changes in:

(1) calculation values including derived wage rates and related employee and administrative factors;

(2) service utilization;

(3) county and tribal allocation changes; and

(4) information on adjustments made to calculation values and the timing of those adjustments.

The information in this notice must be effective January 1 of the following year.

new text begin (i) No later than July 1, 2016, the commissioner shall develop and implement, in consultation with stakeholders, a methodology sufficient to determine the shared staffing levels necessary to meet, at a minimum, health and welfare needs of individuals who will be living together in shared residential settings, and the required shared staffing activities described in subdivision 2, paragraph (l). This determination methodology must ensure staffing levels are adaptable to meet the needs and desired outcomes for current and prospective residents in shared residential settings. new text end

new text begin (j) When the available shared staffing hours in a residential setting are insufficient to meet the needs of an individual who enrolled in residential services after January 1, 2014, or insufficient to meet the needs of an individual with a service agreement adjustment described in section 256B.4913, subdivision 4a, paragraph (f), then individual staffing hours shall be used. 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. 41.

Minnesota Statutes 2014, section 256B.4914, subdivision 14, is amended to read:

Subd. 14.

Exceptions.

(a) In a format prescribed by the commissioner, lead agencies must identify individuals with exceptional needs that cannot be met under the disability waiver rate system. The commissioner shall use that information to evaluate and, if necessary, approve an alternative payment rate for those individuals.new text begin Whether granted, denied, or modified, the commissioner shall respond to all exception requests in writing. The commissioner shall include in the written response the basis for the action and provide notification of the right to appeal under paragraph (h).new text end

(b) Lead agencies must new text begin act on an exception request within 30 days and notify the initiator of the request of their recommendation in writing. A lead agency shall new text end submit new text begin all new text end exception requests new text begin along with its recommendation new text end to the deleted text begin statedeleted text end new text begin commissionernew text end .

(c) An application for a rate exception may be submitted for the following criteria:

(1) an individual has service needs that cannot be met through additional units of service; deleted text begin ordeleted text end

(2) an individual's rate determined under subdivisions 6, 7, 8, and 9 deleted text begin resultsdeleted text end new text begin is so insufficient that it has resulted new text end in an individual deleted text begin being dischargeddeleted text end new text begin receiving a notice of discharge from the individual's provider; ornew text end

new text begin (3) an individual's service needs, including behavioral changes, require a level of service which necessitates a change in provider or which requires the current provider to propose service changes beyond those currently authorizednew text end .

(d) Exception requests must include the following information:

(1) the service needs required by each individual that are not accounted for in subdivisions 6, 7, 8, and 9;

(2) the service rate requested and the difference from the rate determined in subdivisions 6, 7, 8, and 9;

(3) a basis for the underlying costs used for the rate exception and any accompanying documentation;new text begin andnew text end

(4) deleted text begin the duration of the rate exception; anddeleted text end

deleted text begin (5)deleted text end any contingencies for approval.

(e) Approved rate exceptions shall be managed within lead agency allocations under sections 256B.092 and 256B.49.

(f) Individual disability waiver recipientsnew text begin , an interested party, or the license holder that would receive the rate exception increasenew text end may request that a lead agency submit an exception request. A lead agency that denies such a request shall notify the individual waiver recipientnew text begin , interested party, or license holder new text end of its decision and the reasons for denying the request in writing no later than 30 days after the deleted text begin individual'sdeleted text end request has been madenew text begin and shall submit its denial to the commissioner in accordance with paragraph (b). The reasons for the denial must be based on the failure to meet the criteria in paragraph (c)new text end .

(g) The commissioner shall determine whether to approve or deny an exception request no more than 30 days after receiving the request. If the commissioner denies the request, the commissioner shall notify the lead agency and the individual disability waiver recipientnew text begin , the interested party, and the license holdernew text end in writing of the reasons for the denial.

(h) The individual disability waiver recipient may appeal any denial of an exception request by either the lead agency or the commissioner, pursuant to sections 256.045 and 256.0451. When the denial of an exception request results in the proposed demission of a waiver recipient from a residential or day habilitation program, the commissioner shall issue a temporary stay of demission, when requested by the disability waiver recipient, consistent with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c). The temporary stay shall remain in effect until the lead agency can provide an informed choice of appropriate, alternative services to the disability waiver.

(i) Providers may petition lead agencies to update values that were entered incorrectly or erroneously into the rate management system, based on past service level discussions and determination in subdivision 4, without applying for a rate exception.

new text begin (j) The starting date for the rate exception will be the later of the date of the recipient's change in support or the date of the request to the lead agency for an exception. new text end

new text begin (k) The commissioner shall track all exception requests received and their dispositions. The commissioner shall issue quarterly public exceptions statistical reports, including the number of exception requests received and the numbers granted, denied, withdrawn, and pending. The report shall include the average amount of time required to process exceptions. new text end

new text begin (l) No later than January 15, 2016, the commissioner shall provide research findings on the estimated fiscal impact, the primary cost drivers, and common population characteristics of recipients with needs that cannot be met by the framework rates. new text end

new text begin (m) No later than July 1, 2016, the commissioner shall develop and implement, in consultation with stakeholders, a process to determine eligibility for rate exceptions for individuals with rates determined under the methodology in section 256B.4913, subdivision 4a. Determination of eligibility for an exception will occur as annual service renewals are completed. new text end

new text begin (n) Approved rate exceptions will be implemented at such time that the individual's rate is no longer banded and remain in effect in all cases until an individual's needs change as defined in paragraph (c). new text end

Sec. 42.

Minnesota Statutes 2014, section 256B.4914, subdivision 15, is amended to read:

Subd. 15.

County or tribal allocations.

(a) Upon implementation of the disability waiver rates management system on January 1, 2014, the commissioner shall establish a method of tracking and reporting the fiscal impact of the disability waiver rates management system on individual lead agencies.

(b) Beginning January 1, 2014, the commissioner shall make annual adjustments to lead agencies' home and community-based waivered service budget allocations to adjust for rate differences and the resulting impact on county allocations upon implementation of the disability waiver rates system.

(c) deleted text begin During the first two years of implementation under section 256B.4913, deleted text end Lead agencies exceeding their allocations new text begin shall be subject to the provisions new text end under sections deleted text begin 256B.092deleted text end new text begin 256B.0916, subdivision 11,new text end and deleted text begin 256B.49deleted text end deleted text begin shall only be held liable for spending in excess of their allocations after a reallocation of resources by the commissioner under paragraph (b). The commissioner shall reallocate resources under sections 256B.092, subdivision 12, and 256B.49, subdivision 11a. The commissioner shall notify lead agencies of this process by July 1, 2014deleted text end new text begin 256B.49, subdivision 26new text end .

Sec. 43.

Minnesota Statutes 2014, section 256B.492, is amended to read:

256B.492 HOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE WITH DISABILITIES.

(a) Individuals receiving services under a home and community-based waiver under section 256B.092 or 256B.49 may receive services in the following settings:

(1) deleted text begin an individual's own home or familydeleted text end homenew text begin and community-based settings that comply with all requirements identified by the federal Centers for Medicare and Medicaid Services in the Code of Federal Regulations, title 42, section 441.301(c), and with the requirements of the federally approved transition plan and waiver plans for each home and community-based services waivernew text end ;new text begin andnew text end

(2) deleted text begin a licensed adult foster care or child foster care setting of up to five people or community residential setting of up to five people; anddeleted text end new text begin settings required by the Housing Opportunities for Persons with AIDS Program.new text end

deleted text begin (3) community living settings as defined in section 256B.49, subdivision 23, where individuals with disabilities may reside in all of the units in a building of four or fewer units, and who receive services under a home and community-based waiver occupy no more than the greater of four or 25 percent of the units in a multifamily building of more than four units, unless required by the Housing Opportunities for Persons with AIDS Program. deleted text end

(b) The settings in paragraph (a) must notdeleted text begin :deleted text end

deleted text begin (1) be located in a building that is a publicly or privately operated facility that provides institutional treatment or custodial care; deleted text end

deleted text begin (2) be located in a building on the grounds of or adjacent to a public or private institution; deleted text end

deleted text begin (3) be a housing complex designed expressly around an individual's diagnosis or disability, unless required by the Housing Opportunities for Persons with AIDS Program; deleted text end

deleted text begin (4) be segregated based on a disability, either physically or because of setting characteristics, from the larger community; and deleted text end

deleted text begin (5)deleted text end have the qualities of an institution which include, but are not limited to: regimented meal and sleep times, limitations on visitors, and lack of privacy. Restrictions agreed to and documented in the person's individual service plan shall not result in a residence having the qualities of an institution as long as the restrictions for the person are not imposed upon others in the same residence and are the least restrictive alternative, imposed for the shortest possible time to meet the person's needs.

deleted text begin (c) The provisions of paragraphs (a) and (b) do not apply to any setting in which individuals receive services under a home and community-based waiver as of July 1, 2012, and the setting does not meet the criteria of this section. deleted text end

deleted text begin (d) Notwithstanding paragraph (c), a program in Hennepin County established as part of a Hennepin County demonstration project is qualified for the exception allowed under paragraph (c). deleted text end

deleted text begin (e) Notwithstanding paragraphs (a) and (b), a program in Hennepin County, located in the city of Golden Valley, within the city of Golden Valley's Highway 55 West redevelopment area, that is not a provider-owned or controlled home and community-based setting, and is scheduled to open by July 1, 2016, is exempt from the restrictions in paragraphs (a) and (b). If the program fails to comply with the Centers for Medicare and Medicaid Services rules for home and community-based settings, the exemption is void. deleted text end

deleted text begin (f) The commissioner shall submit an amendment to the waiver plan no later than December 31, 2012. deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 44.

new text begin [256Q.01] PLAN ESTABLISHED. new text end

new text begin A savings plan known as the Minnesota ABLE plan is established. In establishing this plan, the legislature seeks to encourage and assist individuals and families in saving private funds for the purpose of supporting individuals with disabilities to maintain health, independence, and quality of life, and to provide secure funding for disability-related expenses on behalf of designated beneficiaries with disabilities that will supplement, but not supplant, benefits provided through private insurance, the Medicaid program under title XIX of the Social Security Act, the Supplemental Security Income program under title XVI of the Social Security Act, the beneficiary's employment, and other sources. new text end

Sec. 45.

new text begin [256Q.02] CITATION. new text end

new text begin This chapter may be cited as the "Minnesota Achieving a Better Life Experience Act" or "Minnesota ABLE Act." new text end

Sec. 46.

new text begin [256Q.03] DEFINITIONS. new text end

new text begin Subdivision 1. new text end

new text begin Scope. new text end

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

new text begin Subd. 2. new text end

new text begin ABLE account. new text end

new text begin "ABLE account" has the meaning given in section 529A(e)(6) of the Internal Revenue Code. new text end

new text begin Subd. 3. new text end

new text begin ABLE plan or plan. new text end

new text begin "ABLE plan" or "plan" means the qualified ABLE program, as defined in section 529A(b) of the Internal Revenue Code, provided for in this chapter. new text end

new text begin Subd. 4. new text end

new text begin Account. new text end

new text begin "Account" means the formal record of transactions relating to an ABLE plan beneficiary. new text end

new text begin Subd. 5. new text end

new text begin Account owner. new text end

new text begin "Account owner" means the designated beneficiary of the account. new text end

new text begin Subd. 6. new text end

new text begin Annual contribution limit. new text end

new text begin "Annual contribution limit" has the meaning given in section 529A(b)(2) of the Internal Revenue Code. new text end

new text begin Subd. 7. new text end

new text begin Application. new text end

new text begin "Application" means the form executed by a prospective account owner to enter into a participation agreement and open an account in the plan. The application incorporates by reference the participation agreement. new text end

new text begin Subd. 8. new text end

new text begin Board. new text end

new text begin "Board" means the State Board of Investment. new text end

new text begin Subd. 9. new text end

new text begin Commissioner. new text end

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

new text begin Subd. 10. new text end

new text begin Contribution. new text end

new text begin "Contribution" means a payment directly allocated to an account for the benefit of a beneficiary. new text end

new text begin Subd. 11. new text end

new text begin Department. new text end

new text begin "Department" means the Department of Human Services. new text end

new text begin Subd. 12. new text end

new text begin Designated beneficiary or beneficiary. new text end

new text begin "Designated beneficiary" or "beneficiary" has the meaning given in section 529A(e)(3) of the Internal Revenue Code and further defined through regulations issued under that section. new text end

new text begin Subd. 13. new text end

new text begin Earnings. new text end

new text begin "Earnings" means the total account balance minus the investment in the account. new text end

new text begin Subd. 14. new text end

new text begin Eligible individual. new text end

new text begin "Eligible individual" has the meaning given in section 529A(e)(1) of the Internal Revenue Code and further defined through regulations issued under that section. new text end

new text begin Subd. 15. new text end

new text begin Executive director. new text end

new text begin "Executive director" means the executive director of the State Board of Investment. new text end

new text begin Subd. 16. new text end

new text begin Internal Revenue Code. new text end

new text begin "Internal Revenue Code" means the Internal Revenue Code of 1986, as amended. new text end

new text begin Subd. 17. new text end

new text begin Investment in the account. new text end

new text begin "Investment in the account" means the sum of all contributions made to an account by a particular date minus the aggregate amount of contributions included in distributions or rollover distributions, if any, made from the account as of that date. new text end

new text begin Subd. 18. new text end

new text begin Member of the family. new text end

new text begin "Member of the family" has the meaning given in section 529A(e)(4) of the Internal Revenue Code. new text end

new text begin Subd. 19. new text end

new text begin Participation agreement. new text end

new text begin "Participation agreement" means an agreement to participate in the Minnesota ABLE plan between an account owner and the state through its agencies, the commissioner, and the board. new text end

new text begin Subd. 20. new text end

new text begin Person. new text end

new text begin "Person" means an individual, trust, estate, partnership, association, company, corporation, or the state. new text end

new text begin Subd. 21. new text end

new text begin Plan administrator. new text end

new text begin "Plan administrator" means the person selected by the commissioner and the board to administer the daily operations of the ABLE plan and provide record keeping, investment management, and other services for the plan. new text end

new text begin Subd. 22. new text end

new text begin Qualified disability expense. new text end

new text begin "Qualified disability expense" has the meaning given in section 529A(e)(5) of the Internal Revenue Code and further defined through regulations issued under that section. new text end

new text begin Subd. 23. new text end

new text begin Qualified distribution. new text end

new text begin "Qualified distribution" means a withdrawal from an ABLE account to pay the qualified disability expenses of the beneficiary of the account. A qualified withdrawal may be made by the beneficiary, by an agent of the beneficiary who has the power of attorney, or by the beneficiary's legal guardian. new text end

new text begin Subd. 24. new text end

new text begin Rollover distribution. new text end

new text begin "Rollover distribution" means a transfer of funds made: new text end

new text begin (1) from one account in another state's qualified ABLE program to an account for the benefit of the same designated beneficiary or an eligible individual who is a family member of the former designated beneficiary; or new text end

new text begin (2) from one account to another account for the benefit of an eligible individual who is a family member of the former designated beneficiary. new text end

new text begin Subd. 25. new text end

new text begin Total account balance. new text end

new text begin "Total account balance" means the amount in an account on a particular date or the fair market value of an account on a particular date. new text end

Sec. 47.

new text begin [256Q.04] ABLE PLAN REQUIREMENTS. new text end

new text begin Subdivision 1. new text end

new text begin State residency requirement. new text end

new text begin The designated beneficiary of an ABLE account must be a resident of Minnesota, or the resident of a state that has entered into a contract with Minnesota to provide its residents access to the Minnesota ABLE plan. new text end

new text begin Subd. 2. new text end

new text begin Single account requirement. new text end

new text begin No more than one ABLE account shall be established per beneficiary, except as permitted under section 529A(c)(4) of the Internal Revenue Code. new text end

new text begin Subd. 3. new text end

new text begin Accounts-type plan. new text end

new text begin The plan must be operated as an accounts-type plan. A separate account must be maintained for each designated beneficiary for whom contributions are made. new text end

new text begin Subd. 4. new text end

new text begin Contribution and account requirements. new text end

new text begin Contributions to an ABLE account are subject to the requirements of section 529A(b)(2) of the Internal Revenue Code prohibiting noncash contributions and contributions in excess of the annual contribution limit. The total account balance may not exceed the maximum account balance limit imposed under section 136G.09, subdivision 8. new text end

new text begin Subd. 5. new text end

new text begin Limited investment direction. new text end

new text begin Designated beneficiaries may not direct the investment of assets in their accounts more than twice in any calendar year. new text end

new text begin Subd. 6. new text end

new text begin Security for loans. new text end

new text begin An interest in an account must not be used as security for a loan. new text end

Sec. 48.

new text begin [256Q.05] ABLE PLAN ADMINISTRATION. new text end

new text begin Subdivision 1. new text end

new text begin Plan to comply with federal law. new text end

new text begin The commissioner shall ensure that the plan meets the requirements for an ABLE account under section 529A of the Internal Revenue Code, including any regulations released after the effective date of this section. The commissioner may request a private letter ruling or rulings from the Internal Revenue Service or Secretary of Health and Human Services and must take any necessary steps to ensure that the plan qualifies under relevant provisions of federal law. new text end

new text begin Subd. 2. new text end

new text begin Plan rules and procedures. new text end

new text begin (a) The commissioner shall establish the rules, terms, and conditions for the plan, subject to the requirements of this chapter and section 529A of the Internal Revenue Code. new text end

new text begin (b) The commissioner shall prescribe the application forms, procedures, and other requirements that apply to the plan. new text end

new text begin Subd. 3. new text end

new text begin Consultation with other state agencies; annual fee. new text end

new text begin In designing and establishing the plan's requirements and in negotiating or entering into contracts with third parties under subdivision 4, the commissioner shall consult with the executive director of the board and the commissioner of the Office of Higher Education. The commissioner and the executive director shall establish an annual fee, equal to a percentage of the average daily net assets of the plan, to be imposed on account owners to recover the costs of administration, record keeping, and investment management as provided in subdivision 5. new text end

new text begin Subd. 4. new text end

new text begin Administration. new text end

new text begin The commissioner shall administer the plan, including accepting and processing applications, verifying state residency, verifying eligibility, maintaining account records, making payments, and undertaking any other necessary tasks to administer the plan. Notwithstanding other requirements of this chapter, the commissioner shall adopt rules for purposes of implementing and administering the plan. The commissioner may contract with one or more third parties to carry out some or all of these administrative duties, including providing incentives. The commissioner and the board may jointly contract with third-party providers, if the commissioner and board determine that it is desirable to contract with the same entity or entities for administration and investment management. new text end

new text begin Subd. 5. new text end

new text begin Authority to impose fees. new text end

new text begin The commissioner, or the commissioner's designee, may impose annual fees, as provided in subdivision 3, on account owners to recover the costs of administration. The commissioner must keep the fees as low as possible, consistent with efficient administration, so that the returns on savings invested in the plan are as high as possible. new text end

new text begin Subd. 6. new text end

new text begin Federally mandated reporting. new text end

new text begin (a) As required under section 529A(d) of the Internal Revenue Code, the commissioner or the commissioner's designee shall submit a notice to the Secretary of the Treasury upon the establishment of each ABLE account. The notice must contain the name and state of residence of the designated beneficiary and other information as the secretary may require. new text end

new text begin (b) As required under section 529A(d) of the Internal Revenue Code, the commissioner or the commissioner's designee shall submit electronically on a monthly basis to the Commissioner of Social Security, in a manner specified by the Commissioner of Social Security, statements on relevant distributions and account balances from all ABLE accounts. new text end

new text begin Subd. 7. new text end

new text begin Data. new text end

new text begin (a) Data on ABLE accounts and designated beneficiaries of ABLE accounts are private data on individuals or nonpublic data as defined in section 13.02. new text end

new text begin (b) The commissioner may share or disseminate data classified as private or nonpublic in this subdivision as follows: new text end

new text begin (1) with other state or federal agencies, only to the extent necessary to verify identity of, determine the eligibility of, or process applications for an eligible individual participating in the Minnesota ABLE plan; and new text end

new text begin (2) with a nongovernmental person, only to the extent necessary to carry out the functions of the Minnesota ABLE plan, provided the commissioner has entered into a data-sharing agreement with the person, as provided in section 13.05, subdivision 6, prior to sharing data under this clause or a contract with that person that complies with section 13.05, subdivision 11, as applicable. new text end

Sec. 49.

new text begin [256Q.06] PLAN ACCOUNTS. new text end

new text begin Subdivision 1. new text end

new text begin Contributions to an account. new text end

new text begin Any person may make contributions to an ABLE account on behalf of a designated beneficiary. Contributions to an account made by persons other than the account owner become the property of the account owner. A person does not acquire an interest in an ABLE account by making contributions to an account. Contributions to an account must be made in cash, by check, or by other commercially acceptable means, as permitted by the Internal Revenue Service and approved by the plan administrator in cooperation with the commissioner and the board. new text end

new text begin Subd. 2. new text end

new text begin Contribution and account limitations. new text end

new text begin Contributions to an ABLE account are subject to the requirements of section 529A(b) of the Internal Revenue Code. The total account balance of an ABLE account may not exceed the maximum account balance limit imposed under section 136G.09, subdivision 8. The plan administrator must reject any portion of a contribution to an account that exceeds the annual contribution limit or that would cause the total account balance to exceed the maximum account balance limit imposed under section 136G.09, subdivision 8. new text end

new text begin Subd. 3. new text end

new text begin Authority of account owner. new text end

new text begin An account owner is the only person entitled to: new text end

new text begin (1) request distributions; new text end

new text begin (2) request rollover distributions; or new text end

new text begin (3) change the beneficiary of an ABLE account to a member of the family of the current beneficiary, but only if the beneficiary to whom the ABLE account is transferred is an eligible individual. new text end

new text begin Subd. 4. new text end

new text begin Effect of plan changes on participation agreement. new text end

new text begin Amendments to this chapter automatically amend the participation agreement. Any amendments to the operating procedures and policies of the plan automatically amend the participation agreement after adoption by the commissioner or the board. new text end

new text begin Subd. 5. new text end

new text begin Special account to hold plan assets in trust. new text end

new text begin All assets of the plan, including contributions to accounts, are held in trust for the exclusive benefit of account owners. Assets must be held in a separate account in the state treasury to be known as the Minnesota ABLE plan account or in accounts with the third-party provider selected pursuant to section 256Q.05, subdivision 4. Plan assets are not subject to claims by creditors of the state, are not part of the general fund, and are not subject to appropriation by the state. Payments from the Minnesota ABLE plan account shall be made under this chapter. new text end

Sec. 50.

new text begin [256Q.07] INVESTMENT OF ABLE ACCOUNTS. new text end

new text begin Subdivision 1. new text end

new text begin State Board of Investment to invest. new text end

new text begin The State Board of Investment shall invest the money deposited in accounts in the plan. new text end

new text begin Subd. 2. new text end

new text begin Permitted investments. new text end

new text begin The board may invest the accounts in any permitted investment under section 11A.24, except that the accounts may be invested without limit in investment options from open-ended investment companies registered under the federal Investment Company Act of 1940, United States Code, title 15, sections 80a-1 to 80a-64. new text end

new text begin Subd. 3. new text end

new text begin Contracting authority. new text end

new text begin The board may contract with one or more third parties for investment management, record keeping, or other services in connection with investing the accounts. The board and commissioner may jointly contract with third-party providers, if the commissioner and board determine that it is desirable to contract with the same entity or entities for administration and investment management. new text end

Sec. 51.

new text begin [256Q.08] ACCOUNT DISTRIBUTIONS. new text end

new text begin Subdivision 1. new text end

new text begin Qualified distribution methods. new text end

new text begin (a) Qualified distributions may be made: new text end

new text begin (1) directly to participating providers of goods and services that are qualified disability expenses, if purchased for a beneficiary; new text end

new text begin (2) in the form of a check payable to both the beneficiary and provider of goods or services that are qualified disability expenses; or new text end

new text begin (3) directly to the beneficiary, if the beneficiary has already paid qualified disability expenses. new text end

new text begin (b) Qualified distributions must be withdrawn proportionally from contributions and earnings in an account owner's account on the date of distribution as provided in section 529A of the Internal Revenue Code. new text end

new text begin Subd. 2. new text end

new text begin Distributions upon death of a beneficiary. new text end

new text begin Upon the death of a beneficiary, the amount remaining in the beneficiary's account must be distributed pursuant to section 529A(f) of the Internal Revenue Code. new text end

new text begin Subd. 3. new text end

new text begin Nonqualified distribution. new text end

new text begin An account owner may request a nonqualified distribution from an account at any time. Nonqualified distributions are based on the total account balances in an account owner's account and must be withdrawn proportionally from contributions and earnings as provided in section 529A of the Internal Revenue Code. The earnings portion of a nonqualified distribution is subject to a federal additional tax pursuant to section 529A of the Internal Revenue Code. For purposes of this subdivision, "earnings portion" means the ratio of the earnings in the account to the total account balance, immediately prior to the distribution, multiplied by the distribution. new text end

Sec. 52.

new text begin INDIVIDUAL PROVIDERS OF DIRECT SUPPORT SERVICES. new text end

new text begin The labor agreement between the state of Minnesota and the Service Employees International Union Healthcare Minnesota, submitted to the Legislative Coordinating Commission on March 2, 2015, is ratified. new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 53.

new text begin RATE INCREASE FOR DIRECT SUPPORT SERVICES PROVIDERS WORKFORCE NEGOTIATIONS. new text end

new text begin (a) If the labor agreement between the state of Minnesota and the Service Employees International Union Healthcare Minnesota under Minnesota Statutes, section 179A.54, is approved pursuant to Minnesota Statutes, sections 3.855 and 179A.22, the commissioner of human services shall increase reimbursement rates, individual budgets, grants, or allocations by 1.53 percent for services provided on or after July 1, 2015, and by an additional 0.2 percent for services provided on or after July 1, 2016, to implement the minimum hourly wage and paid time off provisions of that agreement. new text end

new text begin (b) The rate changes described in this section apply to direct support services provided through a covered program, as defined in Minnesota Statutes, section 256B.0711, subdivision 1. new text end

Sec. 54.

new text begin CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET METHODOLOGY EXCEPTION. new text end

new text begin (a) No later than September 30, 2015, if necessary, the commissioner of human services shall submit an amendment to the Centers for Medicare and Medicaid Services for the home and community-based services waivers authorized under Minnesota Statutes, sections 256B.092 and 256B.49, to establish an exception to the consumer-directed community supports budget methodology to provide up to 20 percent more funds for: new text end

new text begin (1) consumer-directed community supports participants who have graduated from high school and have a coordinated service and support plan which identifies the need for more services under consumer-directed community supports, either prior to graduation or in order to increase the amount of time a person works or to improve their employment opportunities, than the amount they are eligible to receive under the current consumer-directed community supports budget methodology; and new text end

new text begin (2) home and community-based waiver participants who are currently using licensed services for employment supports or services during the day which cost more annually than the person would spend under a consumer-directed community supports plan for individualized employment supports or services during the day. new text end

new text begin (b) The exception under paragraph (a) is limited to those persons who can demonstrate either that they will have to leave consumer-directed community supports and use other waiver services because their need for day or employment supports cannot be met within the consumer-directed community supports budget limits or they will move to consumer-directed community supports and their services will cost less than services currently being used. new text end

new text begin EFFECTIVE DATE. new text end

new text begin The exception under this section is effective October 1, 2015, or upon federal approval, whichever is later. The commissioner of human services shall notify the revisor of statutes when this occurs. new text end

Sec. 55.

new text begin HOME AND COMMUNITY-BASED SERVICES INCENTIVE POOL. new text end

new text begin The commissioner of human services shall develop an initiative to provide incentives for innovation in achieving integrated competitive employment, living in the most integrated setting, and other outcomes determined by the commissioner. The commissioner shall seek requests for proposals and shall contract with one or more entities to provide incentive payments for meeting identified outcomes. The initial requests for proposals must be issued by October 1, 2016. new text end

Sec. 56.

new text begin DIRECTION TO COMMISSIONER; REPORTS REQUIRED. new text end

new text begin The commissioner of human services shall develop and submit reports to the chairs and ranking minority members of the house of representatives and senate committees and divisions with jurisdiction over health and human services policy and finance on the implementation of Minnesota Statutes, sections 256B.0916, subdivisions 2, 11, and 12, and 256B.49, subdivisions 26 and 27. The commissioner shall submit two reports, one by February 15, 2018, and the second by February 15, 2019. new text end

Sec. 57.

new text begin INSTRUCTIONS TO THE COMMISSIONER. new text end

new text begin The commissioner shall determine the number of individuals who were determined to be ineligible to receive community first services and supports because they did not require constant supervision and cuing in order to accomplish activities of daily living. The commissioner shall issue a report with these findings to the chairs and ranking minority members of the house and senate committees with jurisdiction over human services programs. new text end

Sec. 58.

new text begin REPEALER. new text end

new text begin Laws 2012, chapter 247, article 4, section 47, as amended by Laws 2014, chapter 312, article 27, section 72, new text end new text begin is repealed upon the effective date of section 54. new text end

ARTICLE 8

HEALTH DEPARTMENT AND PUBLIC HEALTH

Section 1.

Minnesota Statutes 2014, section 16A.724, subdivision 2, is amended to read:

Subd. 2.

Transfers.

(a) Notwithstanding section 295.581, to the extent available resources in the health care access fund exceed expenditures in that fund, effective for the biennium beginning July 1, 2007, the commissioner of management and budget shall transfer the excess funds from the health care access fund to the general fund on June 30 of each year, provided that the amount transferred in any fiscal biennium shall not exceed $96,000,000. The purpose of this transfer is to meet the rate increase required under Laws 2003, First Special Session chapter 14, article 13C, section 2, subdivision 6.

(b) For fiscal years 2006 to 2011, MinnesotaCare shall be a forecasted program, and, if necessary, the commissioner shall reduce these transfers from the health care access fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary, transfer sufficient funds from the general fund to the health care access fund to meet annual MinnesotaCare expenditures.

deleted text begin (c) Notwithstanding section 295.581, to the extent available resources in the health care access fund exceed expenditures in that fund after the transfer required in paragraph (a), effective for the biennium beginning July 1, 2013, the commissioner of management and budget shall transfer $1,000,000 each fiscal year from the health access fund to the medical education and research costs fund established under section 62J.692, for distribution under section 62J.692, subdivision 4, paragraph (c). deleted text end

Sec. 2.

Minnesota Statutes 2014, section 62J.498, is amended to read:

62J.498 HEALTH INFORMATION EXCHANGE.

Subdivision 1.

Definitions.

The following definitions apply to sections 62J.498 to 62J.4982:

new text begin (a) "Clinical data repository" means a real time database that consolidates data from a variety of clinical sources to present a unified view of a single patient and is used by a state-certified health information exchange service provider to enable health information exchange among health care providers that are not related health care entities as defined in section 144.291, subdivision 2, paragraph (j). This does not include clinical data that are submitted to the commissioner for public health purposes required or permitted by law, including any rules adopted by the commissioner. new text end

deleted text begin (a)deleted text end new text begin (b)new text end "Clinical transaction" means any meaningful use transactionnew text begin or other health information exchange transactionnew text end that is not covered by section 62J.536.

deleted text begin (b)deleted text end new text begin (c)new text end "Commissioner" means the commissioner of health.

deleted text begin (c) "Direct health information exchange" means the electronic transmission of health-related information through a direct connection between the electronic health record systems of health care providers without the use of a health data intermediary. deleted text end

(d) "Health care provider" or "provider" means a health care provider or provider as defined in section 62J.03, subdivision 8.

(e) "Health data intermediary" means an entity that provides the deleted text begin infrastructure deleted text end new text begin technical capabilities or related products and servicesnew text end to deleted text begin connect computer systems or other electronic devices used by health care providers, laboratories, pharmacies, health plans, third-party administrators, or pharmacy benefit managers to facilitate the secure transmission of health information, includingdeleted text end new text begin enable health information exchange among health care providers that are not related health care entities as defined in section 144.291, subdivision 2, paragraph (j). This includes but is not limited to: health information service providers (HISP), electronic health record vendors, andnew text end pharmaceutical electronic data intermediaries as defined in section 62J.495. deleted text begin This does not include health care providers engaged in direct health information exchange.deleted text end

(f) "Health information exchange" means the electronic transmission of health-related information between organizations according to nationally recognized standards.

(g) "Health information exchange service provider" means a health data intermediary or health information organization deleted text begin that has been issued a certificate of authority by the commissioner under section 62J.4981deleted text end .

(h) "Health information organization" means an organization that oversees, governs, and facilitates deleted text begin thedeleted text end new text begin health informationnew text end exchange deleted text begin of health-related informationdeleted text end among deleted text begin organizations according to nationally recognized standardsdeleted text end new text begin health care providers that are not related health care entities as defined in section 144.291, subdivision 2, paragraph (j), to improve coordination of patient care and the efficiency of health care deliverynew text end .

(i) "HITECH Act" means the Health Information Technology for Economic and Clinical Health Act as defined in section 62J.495.

(j) "Major participating entity" means:

(1) a participating entity that receives compensation for services that is greater than 30 percent of the health information organization's gross annual revenues from the health information exchange service provider;

(2) a participating entity providing administrative, financial, or management services to the health information organization, if the total payment for all services provided by the participating entity exceeds three percent of the gross revenue of the health information organization; and

(3) a participating entity that nominates or appoints 30 percent or more of the board of directors new text begin or equivalent governing body new text end of the health information organization.

new text begin (k) "Master patient index" means an electronic database that holds unique identifiers of patients registered at a care facility and is used by a state-certified health information exchange service provider to enable health information exchange among health care providers that are not related health care entities as defined in section 144.291, subdivision 2, paragraph (j). This does not include data that are submitted to the commissioner for public health purposes required or permitted by law, including any rules adopted by the commissioner. new text end

deleted text begin (k)deleted text end new text begin (l)new text end "Meaningful use" means use of certified electronic health record technology deleted text begin that includes e-prescribing, and is connected in a manner that provides for the electronic exchange of health information and used for the submission of clinical quality measures deleted text end new text begin to improve quality, safety, and efficiency and reduce health disparities; engage patients and families; improve care coordination and population and public health; and maintain privacy and security of patient health information new text end as established by the Center for Medicare and Medicaid Services and the Minnesota Department of Human Services pursuant to sections 4101, 4102, and 4201 of the HITECH Act.

deleted text begin (l)deleted text end new text begin (m)new text end "Meaningful use transaction" means an electronic transaction that a health care provider must exchange to receive Medicare or Medicaid incentives or avoid Medicare penalties pursuant to sections 4101, 4102, and 4201 of the HITECH Act.

deleted text begin (m)deleted text end new text begin (n)new text end "Participating entity" means any of the following persons, health care providers, companies, or other organizations with which a health information organization or health data intermediary has contracts or other agreements for the provision of health information exchange deleted text begin service providersdeleted text end new text begin servicesnew text end :

(1) a health care facility licensed under sections 144.50 to 144.56, a nursing home licensed under sections 144A.02 to 144A.10, and any other health care facility otherwise licensed under the laws of this state or registered with the commissioner;

(2) a health care provider, and any other health care professional otherwise licensed under the laws of this state or registered with the commissioner;

(3) a group, professional corporation, or other organization that provides the services of individuals or entities identified in clause (2), including but not limited to a medical clinic, a medical group, a home health care agency, an urgent care center, and an emergent care center;

(4) a health plan as defined in section 62A.011, subdivision 3; and

(5) a state agency as defined in section 13.02, subdivision 17.

deleted text begin (n)deleted text end new text begin (o)new text end "Reciprocal agreement" means an arrangement in which two or more health information exchange service providers agree to share in-kind services and resources to allow for the pass-through of deleted text begin meaningful usedeleted text end new text begin clinicalnew text end transactions.

deleted text begin (o)deleted text end new text begin (p)new text end "State-certified health data intermediary" means a health data intermediary thatdeleted text begin : deleted text end new text begin has been issued a certificate of authority to operate in Minnesota.new text end

deleted text begin (1) provides a subset of the meaningful use transaction capabilities necessary for hospitals and providers to achieve meaningful use of electronic health records; deleted text end

deleted text begin (2) is not exclusively engaged in the exchange of meaningful use transactions covered by section 62J.536; and deleted text end

deleted text begin (3) has been issued a certificate of authority to operate in Minnesota. deleted text end

deleted text begin (p)deleted text end new text begin (q)new text end "State-certified health information organization" means a deleted text begin nonprofitdeleted text end health information organization that deleted text begin provides transaction capabilities necessary to fully support clinical transactions required for meaningful use of electronic health records thatdeleted text end has been issued a certificate of authority to operate in Minnesota.

Subd. 2.

Health information exchange oversight.

(a) The commissioner shall protect the public interest on matters pertaining to health information exchange. The commissioner shall:

(1) review and act on applications from health data intermediaries and health information organizations for certificates of authority to operate in Minnesota;

(2) provide ongoing monitoring to ensure compliance with criteria established under sections 62J.498 to 62J.4982;

(3) respond to public complaints related to health information exchange services;

(4) take enforcement actions as necessary, including the imposition of fines, suspension, or revocation of certificates of authority as outlined in section 62J.4982;

(5) provide a biennial report on the status of health information exchange services that includes but is not limited to:

(i) recommendations on actions necessary to ensure that health information exchange services are adequate to meet the needs of Minnesota citizens and providers statewide;

(ii) recommendations on enforcement actions to ensure that health information exchange service providers act in the public interest without causing disruption in health information exchange services;

(iii) recommendations on updates to criteria for obtaining certificates of authority under this section; and

(iv) recommendations on standard operating procedures for health information exchange, including but not limited to the management of consumer preferences; and

(6) other duties necessary to protect the public interest.

(b) As part of the application review process for certification under paragraph (a), prior to issuing a certificate of authority, the commissioner shall:

(1) deleted text begin hold public hearings that provide an adequate opportunity for participating entities and consumers to provide feedback and recommendations on the application under consideration. The commissioner shalldeleted text end make all portions of the application classified as public data available to the publicnew text begin fornew text end at least ten days deleted text begin in advance of the hearingdeleted text end new text begin while an application is under considerationnew text end . new text begin At the request of the commissioner, new text end the applicant shall participate in deleted text begin thedeleted text end new text begin a publicnew text end hearing by presenting an overview of their application and responding to questions from interested parties;new text begin andnew text end

(2) deleted text begin make available all feedback and recommendations gathered at the hearing available to the public prior to issuing a certificate of authority; anddeleted text end

deleted text begin (3)deleted text end consult with hospitals, physicians, and other deleted text begin professionals eligible to receive meaningful use incentive payments or subject to penalties as established in the HITECH Act, and their respective statewide associations,deleted text end new text begin providersnew text end prior to issuing a certificate of authority.

(c) When the commissioner is actively considering a suspension or revocation of a certificate of authority as described in section 62J.4982, subdivision 3, all investigatory data that are collected, created, or maintained related to the suspension or revocation are classified as confidential data on individuals and as protected nonpublic data in the case of data not on individuals.

(d) The commissioner may disclose data classified as protected nonpublic or confidential under paragraph (c) if disclosing the data will protect the health or safety of patients.

(e) After the commissioner makes a final determination regarding a suspension or revocation of a certificate of authority, all minutes, orders for hearing, findings of fact, conclusions of law, and the specification of the final disciplinary action, are classified as public data.

Sec. 3.

Minnesota Statutes 2014, section 62J.4981, is amended to read:

62J.4981 CERTIFICATE OF AUTHORITY TO PROVIDE HEALTH INFORMATION EXCHANGE SERVICES.

Subdivision 1.

Authority to require organizations to apply.

The commissioner shall require deleted text begin an entity providing health information exchange servicesdeleted text end new text begin a health data intermediary or a health information organizationnew text end to apply for a certificate of authority under this section. An applicant may continue to operate until the commissioner acts on the application. If the application is denied, the applicant is considered a health information deleted text begin organizationdeleted text end new text begin exchange service providernew text end whose certificate of authority has been revoked under section 62J.4982, subdivision 2, paragraph (d).

Subd. 2.

Certificate of authority for health data intermediaries.

(a) A health data intermediary deleted text begin that provides health information exchange services for the transmission of one or more clinical transactions necessary for hospitals, providers, or eligible professionals to achieve meaningful usedeleted text end must be deleted text begin registered withdeleted text end new text begin certified bynew text end the state and comply with requirements established in this section.

(b) Notwithstanding any law to the contrary, any corporation organized to do so may apply to the commissioner for a certificate of authority to establish and operate as a health data intermediary in compliance with this section. No person shall establish or operate a health data intermediary in this state, nor sell or offer to sell, or solicit offers to purchase or receive advance or periodic consideration in conjunction with a health data intermediary contract unless the organization has a certificate of authority or has an application under active consideration under this section.

(c) In issuing the certificate of authority, the commissioner shall determine whether the applicant for the certificate of authority has demonstrated that the applicant meets the following minimum criteria:

deleted text begin (1) interoperate with at least one state-certified health information organization; deleted text end

deleted text begin (2) provide an option for Minnesota entities to connect to their services through at least one state-certified health information organization; deleted text end

deleted text begin (3) have a record locator service as defined in section 144.291, subdivision 2, paragraph (i), that is compliant with the requirements of section 144.293, subdivision 8, when conducting meaningful use transactions; and deleted text end

deleted text begin (4)deleted text end new text begin (1)new text end hold reciprocal agreements with at least one state-certified health information organization to deleted text begin enabledeleted text end access deleted text begin to record locator services to finddeleted text end patient data, and for the transmission and receipt of deleted text begin meaningful usedeleted text end new text begin clinicalnew text end transactions deleted text begin consistent with the format and content required by national standards established by Centers for Medicare and Medicaid Servicesdeleted text end . Reciprocal agreements must meet the requirements established in subdivision 5deleted text begin .deleted text end new text begin ; andnew text end

new text begin (2) participate in statewide shared health information exchange services as defined by the commissioner to support interoperability between state-certified health information organizations and state-certified health data intermediaries. new text end

Subd. 3.

Certificate of authority for health information organizations.

(a) A health information organization deleted text begin that provides all electronic capabilities for the transmission of clinical transactions necessary for meaningful use of electronic health recordsdeleted text end must obtain a certificate of authority from the commissioner and demonstrate compliance with the criteria in paragraph (c).

(b) Notwithstanding any law to the contrary,deleted text begin a nonprofit corporation organized to do sodeleted text end new text begin an organizationnew text end may apply for a certificate of authority to establish and operate a health information organization under this section. No person shall establish or operate a health information organization in this state, nor sell or offer to sell, or solicit offers to purchase or receive advance or periodic consideration in conjunction with a health information organization or health information contract unless the organization has a certificate of authority under this section.

(c) In issuing the certificate of authority, the commissioner shall determine whether the applicant for the certificate of authority has demonstrated that the applicant meets the following minimum criteria:

(1) the entity is a legally establisheddeleted text begin , nonprofitdeleted text end organization;

(2) appropriate insurance, including liability insurance, for the operation of the health information organization is in place and sufficient to protect the interest of the public and participating entities;

(3) strategic and operational plans deleted text begin clearlydeleted text end address new text begin governance, technical infrastructure, legal and policy issues, finance, and business operations in regard to new text end how the organization will expand deleted text begin technical capacity of the health information organization deleted text end to support providers in achieving deleted text begin meaningful use of electronic health recordsdeleted text end new text begin health information exchange goalsnew text end over time;

(4) the entity addresses the parameters to be used with participating entities and other health information deleted text begin organizationsdeleted text end new text begin exchange service providersnew text end for deleted text begin meaningful use deleted text end new text begin clinicalnew text end transactions, compliance with Minnesota law, and interstate health information exchange deleted text begin indeleted text end trust agreements;

(5) the entity's board of directors new text begin or equivalent governing body new text end is composed of members that broadly represent the health information organization's participating entities and consumers;

(6) the entity maintains a professional staff responsible to the board of directorsnew text begin or equivalent governing body new text end with the capacity to ensure accountability to the organization's mission;

(7) the organization is compliant with deleted text begin criteria established under the Health Information Exchange Accreditation Program of the Electronic Healthcare Network Accreditation Commission (EHNAC) or equivalent criteria establisheddeleted text end new text begin national certification and accreditation programs designatednew text end by the commissioner;

(8) the entity maintains deleted text begin adeleted text end new text begin the capability to query for patient information based on national standards. The query capability may utilize a master patient index, clinical data repository, ornew text end record locator service as defined in section 144.291, subdivision 2, paragraph (i)deleted text begin , that isdeleted text end new text begin . The entity must benew text end compliant with the requirements of section 144.293, subdivision 8, when conducting deleted text begin meaningful usedeleted text end new text begin clinicalnew text end transactions;

(9) the organization demonstrates interoperability with all other state-certified health information organizations using nationally recognized standards;

(10) the organization demonstrates compliance with all privacy and security requirements required by state and federal law; and

(11) the organization uses financial policies and procedures consistent with generally accepted accounting principles and has an independent audit of the organization's financials on an annual basis.

(d) Health information organizations that have obtained a certificate of authority must:

(1) meet the requirements established for connecting to the deleted text begin Nationwide Health Information Network (NHIN) within the federally mandated timeline or within a time frame established by the commissioner and published in the State Register. If the state timeline for implementation varies from the federal timeline, the State Register notice shall include an explanation for the variationdeleted text end new text begin National eHealth Exchangenew text end ;

(2) annually submit strategic and operational plans for review by the commissioner that address:

deleted text begin (i) increasing adoption rates to include a sufficient number of participating entities to achieve financial sustainability; and deleted text end

deleted text begin (ii)deleted text end new text begin (i)new text end progress in achieving objectives included in previously submitted strategic and operational plans across the following domains: business and technical operations, technical infrastructure, legal and policy issues, finance, and organizational governance;

deleted text begin (3) develop and maintain a business plan that addresses: deleted text end

deleted text begin (i)deleted text end new text begin (ii)new text end plans for ensuring the necessary capacity to support deleted text begin meaningful usedeleted text end new text begin clinical new text end transactions;

deleted text begin (ii)deleted text end new text begin (iii)new text end approach for attaining financial sustainability, including public and private financing strategies, and rate structures;

deleted text begin (iii)deleted text end new text begin (iv)new text end rates of adoption, utilization, and transaction volume, and mechanisms to support health information exchange; and

deleted text begin (iv)deleted text end new text begin (v)new text end an explanation of methods employed to address the needs of community clinics, critical access hospitals, and free clinics in accessing health information exchange services;

deleted text begin (4) annually submit a rate plan to the commissioner outlining fee structures for health information exchange services for approval by the commissioner. The commissioner shall approve the rate plan if it: deleted text end

deleted text begin (i) distributes costs equitably among users of health information services; deleted text end

deleted text begin (ii) provides predictable costs for participating entities; deleted text end

deleted text begin (iii) covers all costs associated with conducting the full range of meaningful use clinical transactions, including access to health information retrieved through other state-certified health information exchange service providers; and deleted text end

deleted text begin (iv) provides for a predictable revenue stream for the health information organization and generates sufficient resources to maintain operating costs and develop technical infrastructure necessary to serve the public interest; deleted text end

deleted text begin (5)deleted text end new text begin (3)new text end enter into reciprocal agreements with all other state-certified health information organizations new text begin and state-certified health data intermediaries new text end to enable access to deleted text begin record locator services to finddeleted text end patient data, and new text begin for the new text end transmission and receipt of deleted text begin meaningful usedeleted text end new text begin clinical new text end transactions deleted text begin consistent with the format and content required by national standards established by Centers for Medicare and Medicaid Servicesdeleted text end . Reciprocal agreements must meet the requirements in subdivision 5; deleted text begin anddeleted text end

new text begin (4) participate in statewide shared health information exchange services as defined by the commissioner to support interoperability between state-certified health information organizations and state-certified health data intermediaries; and new text end

deleted text begin (6)deleted text end new text begin (5)new text end comply with additional requirements for the certification or recertification of health information organizations that may be established by the commissioner.

Subd. 4.

Application for certificate of authority for health information exchange service providers.

(a) Each application for a certificate of authority shall be in a form prescribed by the commissioner and verified by an officer or authorized representative of the applicant. Each application shall include the followingnew text begin in addition to information described in the criteria in subdivisions 2 and 3new text end :

(1) new text begin for health information organizations only, new text end a copy of the basic organizational document, if any, of the applicant and of each major participating entity, such as the articles of incorporation, or other applicable documents, and all amendments to it;

(2) new text begin for health information organizations only, new text end a list of the names, addresses, and official positions of the following:

(i) all members of the board of directorsnew text begin or equivalent governing bodynew text end , and the principal officers and, if applicable, shareholders of the applicant organization; and

(ii) all members of the board of directorsnew text begin or equivalent governing bodynew text end , and the principal officers of each major participating entity and, if applicable, each shareholder beneficially owning more than ten percent of any voting stock of the major participating entity;

(3) new text begin for health information organizations only, new text end the name and address of each participating entity and the agreed-upon duration of each contract or agreement if applicable;

(4) a copy of each standard agreement or contract intended to bind the participating entities and the health information deleted text begin organizationdeleted text end new text begin exchange service providernew text end . Contractual provisions shall be consistent with the purposes of this section, in regard to the services to be performed under the standard agreement or contract, the manner in which payment for services is determined, the nature and extent of responsibilities to be retained by the health information organization, and contractual termination provisions;

deleted text begin (5) a copy of each contract intended to bind major participating entities and the health information organization. Contract information filed with the commissioner under this section shall be nonpublic as defined in section 13.02, subdivision 9; deleted text end

deleted text begin (6)deleted text end new text begin (5)new text end a statement generally describing the health information deleted text begin organizationdeleted text end new text begin exchange service providernew text end , its health information exchange contracts, facilities, and personnel, including a statement describing the manner in which the applicant proposes to provide participants with comprehensive health information exchange services;

deleted text begin (7) financial statements showing the applicant's assets, liabilities, and sources of financial support, including a copy of the applicant's most recent certified financial statement; deleted text end

deleted text begin (8) strategic and operational plans that specifically address how the organization will expand technical capacity of the health information organization to support providers in achieving meaningful use of electronic health records over time, a description of the proposed method of marketing the services, a schedule of proposed charges, and a financial plan that includes a three-year projection of the expenses and income and other sources of future capital; deleted text end

deleted text begin (9)deleted text end new text begin (6)new text end a statement reasonably describing the geographic area or areas to be served and the type or types of participants to be served;

deleted text begin (10)deleted text end new text begin (7)new text end a description of the complaint procedures to be used as required under this section;

deleted text begin (11)deleted text end new text begin (8)new text end a description of the mechanism by which participating entities will have an opportunity to participate in matters of policy and operation;

deleted text begin (12)deleted text end new text begin (9)new text end a copy of any pertinent agreements between the health information organization and insurers, including liability insurers, demonstrating coverage is in place;

deleted text begin (13)deleted text end new text begin (10)new text end a copy of the conflict of interest policy that applies to all members of the board of directorsnew text begin or equivalent governing bodynew text end and the principal officers of the health information organization; and

deleted text begin (14)deleted text end new text begin (11)new text end other information as the commissioner may reasonably require to be provided.

(b) Within deleted text begin 30deleted text end new text begin 45new text end days after the receipt of the application for a certificate of authority, the commissioner shall determine whether or not the application submitted meets the requirements for completion in paragraph (a), and notify the applicant of any further information required for the application to be processed.

(c) Within 90 days after the receipt of a complete application for a certificate of authority, the commissioner shall issue a certificate of authority to the applicant if the commissioner determines that the applicant meets the minimum criteria requirements of subdivision 2 for health data intermediaries or subdivision 3 for health information organizations. If the commissioner determines that the applicant is not qualified, the commissioner shall notify the applicant and specify the reasons for disqualification.

(d) Upon being granted a certificate of authority to operate as a new text begin state-certified new text end health information organizationnew text begin or state-certified health data intermediarynew text end , the organization must operate in compliance with the provisions of this section. Noncompliance may result in the imposition of a fine or the suspension or revocation of the certificate of authority according to section 62J.4982.

Subd. 5.

Reciprocal agreements between health information exchange entities.

(a) Reciprocal agreements between two health information organizations or between a health information organization and a health data intermediary must include a fair and equitable model for charges between the entities that:

(1) does not impede the secure transmission of new text begin clinical new text end transactions deleted text begin necessary to achieve meaningful usedeleted text end ;

(2) does not charge a fee for the exchange of meaningful use transactions transmitted according to nationally recognized standards where no additional value-added service is rendered to the sending or receiving health information organization or health data intermediary either directly or on behalf of the client;

(3) is consistent with fair market value and proportionately reflects the value-added services accessed as a result of the agreement; and

(4) prevents health care stakeholders from being charged multiple times for the same service.

(b) Reciprocal agreements must include comparable quality of service standards that ensure equitable levels of services.

(c) Reciprocal agreements are subject to review and approval by the commissioner.

(d) Nothing in this section precludes a state-certified health information organization or state-certified health data intermediary from entering into contractual agreements for the provision of value-added services beyond meaningful usenew text begin transactionsnew text end .

deleted text begin (e) The commissioner of human services or health, when providing access to data or services through a certified health information organization, must offer the same data or services directly through any certified health information organization at the same pricing, if the health information organization pays for all connection costs to the state data or service. For all external connectivity to the respective agencies through existing or future information exchange implementations, the respective agency shall establish the required connectivity methods as well as protocol standards to be utilized. deleted text end

deleted text begin Subd. 6. deleted text end

deleted text begin State participation in health information exchange. deleted text end

deleted text begin A state agency that connects to a health information exchange service provider for the purpose of exchanging meaningful use transactions must ensure that the contracted health information exchange service provider has reciprocal agreements in place as required by this section. The reciprocal agreements must provide equal access to information supplied by the agency as necessary for meaningful use by the participating entities of the other health information service providers. deleted text end

Sec. 4.

Minnesota Statutes 2014, section 62J.4982, subdivision 4, is amended to read:

Subd. 4.

Coordination.

deleted text begin (a)deleted text end The commissioner shall, to the extent possible, seek the advice of the Minnesota e-Health Advisory Committee, in the review and update of criteria for the certification and recertification of health information exchange service providers when implementing sections 62J.498 to 62J.4982.

deleted text begin (b) By January 1, 2011, the commissioner shall report to the governor and the chairs of the senate and house of representatives committees having jurisdiction over health information policy issues on the status of health information exchange in Minnesota, and provide recommendations on further action necessary to facilitate the secure electronic movement of health information among health providers that will enable Minnesota providers and hospitals to meet meaningful use exchange requirements. deleted text end

Sec. 5.

Minnesota Statutes 2014, section 62J.4982, subdivision 5, is amended to read:

Subd. 5.

Fees and monetary penalties.

(a) The commissioner shall assess fees on every health information exchange service provider subject to sections 62J.4981 and 62J.4982 as follows:

(1) filing an application for certificate of authority to operate as a health information organization, deleted text begin $10,500deleted text end new text begin $7,000new text end ;

(2) filing an application for certificate of authority to operate as a health data intermediary, $7,000;

(3) annual health information organization certificate fee, deleted text begin $14,000deleted text end new text begin $7,000new text end ;new text begin and new text end

(4) annual health data intermediary certificate fee, $7,000deleted text begin ; anddeleted text end

deleted text begin (5) fees for other filings, as specified by ruledeleted text end .

new text begin (b) Fees collected under this section shall be deposited in the state treasury and credited to the state government special revenue fund. new text end

deleted text begin (b)deleted text end new text begin (c)new text end Administrative monetary penalties imposed under this subdivision shall be credited to an account in the special revenue fund and are appropriated to the commissioner for the purposes of sections 62J.498 to 62J.4982.

Sec. 6.

Minnesota Statutes 2014, section 62J.692, subdivision 4, is amended to read:

Subd. 4.

Distribution of funds.

(a) The commissioner shall annually distribute the available medical education funds to all qualifying applicants based on a public program volume factor, which is determined by the total volume of public program revenue received by each training site as a percentage of all public program revenue received by all training sites in the fund pool.

Public program revenue for the distribution formula includes revenue from medical assistance, prepaid medical assistance, general assistance medical care, and prepaid general assistance medical care. Training sites that receive no public program revenue are ineligible for funds available under this subdivision. For purposes of determining training-site level grants to be distributed under this paragraph, total statewide average costs per trainee for medical residents is based on audited clinical training costs per trainee in primary care clinical medical education programs for medical residents. Total statewide average costs per trainee for dental residents is based on audited clinical training costs per trainee in clinical medical education programs for dental students. Total statewide average costs per trainee for pharmacy residents is based on audited clinical training costs per trainee in clinical medical education programs for pharmacy students. Training sites whose training site level grant is less than $5,000, based on the formula described in this paragraph, or that train fewer than 0.1 FTE eligible trainees, are ineligible for funds available under this subdivision. No training sites shall receive a grant per FTE trainee that is in excess of the 95th percentile grant per FTE across all eligible training sites; grants in excess of this amount will be redistributed to other eligible sites based on the formula described in this paragraph.

(b) For funds distributed in fiscal years 2014 and 2015, the distribution formula shall include a supplemental public program volume factor, which is determined by providing a supplemental payment to training sites whose public program revenue accounted for at least 0.98 percent of the total public program revenue received by all eligible training sites. The supplemental public program volume factor shall be equal to ten percent of each training site's grant for funds distributed in fiscal year 2014 and for funds distributed in fiscal year 2015. Grants to training sites whose public program revenue accounted for less than 0.98 percent of the total public program revenue received by all eligible training sites shall be reduced by an amount equal to the total value of the supplemental payment. For fiscal year 2016 and beyond, the distribution of funds shall be based solely on the public program volume factor as described in paragraph (a).

(c) deleted text begin Of available medical education funds, $1,000,000 shall be distributed each year for grants to family medicine residency programs located outside the seven-county metropolitan area, as defined in section 473.121, subdivision 4, focused on eduction and training of family medicine physicians to serve communities outside the metropolitan area. To be eligible for a grant under this paragraph, a family medicine residency program must demonstrate that over the most recent three calendar years, at least 25 percent of its residents practice in Minnesota communities outside the metropolitan area. Grant funds must be allocated proportionally based on the number of residents per eligible residency program.deleted text end

deleted text begin (d)deleted text end Funds distributed shall not be used to displace current funding appropriations from federal or state sources.

deleted text begin (e)deleted text end new text begin (d) new text end Funds shall be distributed to the sponsoring institutions indicating the amount to be distributed to each of the sponsor's clinical medical education programs based on the criteria in this subdivision and in accordance with the commissioner's approval letter. Each clinical medical education program must distribute funds allocated under paragraphs (a) and (b) to the training sites as specified in the commissioner's approval letter. Sponsoring institutions, which are accredited through an organization recognized by the Department of Education or the Centers for Medicare and Medicaid Services, may contract directly with training sites to provide clinical training. To ensure the quality of clinical training, those accredited sponsoring institutions must:

(1) develop contracts specifying the terms, expectations, and outcomes of the clinical training conducted at sites; and

(2) take necessary action if the contract requirements are not met. Action may include the withholding of payments under this section or the removal of students from the site.

deleted text begin (f)deleted text end new text begin (e) new text end Use of funds is limited to expenses related to clinical training program costs for eligible programs.

deleted text begin (g)deleted text end new text begin (f) new text end Any funds not distributed in accordance with the commissioner's approval letter must be returned to the medical education and research fund within 30 days of receiving notice from the commissioner. The commissioner shall distribute returned funds to the appropriate training sites in accordance with the commissioner's approval letter.

deleted text begin (h)deleted text end new text begin (g) new text end A maximum of $150,000 of the funds dedicated to the commissioner under section 297F.10, subdivision 1, clause (2), may be used by the commissioner for administrative expenses associated with implementing this section.

Sec. 7.

Minnesota Statutes 2014, section 62Q.37, subdivision 2, is amended to read:

Subd. 2.

Definitions.

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

(a) "Commissioner" means the commissioner of health for purposes of regulating health maintenance organizations and community integrated service networks, the commissioner of commerce for purposes of regulating nonprofit health service plan corporations, or the commissioner of human services for the purpose of contracting with managed care organizations serving persons enrolled in programs under chapter 256B, 256D, or 256L.

(b) "Health plan company" means (i) a nonprofit health service plan corporation operating under chapter 62C; (ii) a health maintenance organization operating under chapter 62D; (iii) a community integrated service network operating under chapter 62N; or (iv) a managed care organization operating under chapter 256B, 256D, or 256L.

(c) "Nationally recognized independent organization" means (i) an organization that sets specific national standards governing health care quality assurance processes, utilization review, provider credentialing, marketing, and other topics covered by this chapter and other chapters and audits and provides accreditation to those health plan companies that meet those standards. The American Accreditation Health Care Commission (URAC), the National Committee for Quality Assurance (NCQA), deleted text begin and deleted text end the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)new text begin , and the Accreditation Association for Ambulatory Health Care (AAAHC)new text end are, at a minimum, defined as nationally recognized independent organizations; and (ii) the Centers for Medicare and Medicaid Services for purposes of reviews or audits conducted of health plan companies under Part C of Title XVIII of the Social Security Act or under section 1876 of the Social Security Act.

(d) "Performance standard" means those standards relating to quality management and improvement, access and availability of service, utilization review, provider selection, provider credentialing, marketing, member rights and responsibilities, complaints, appeals, grievance systems, enrollee information and materials, enrollment and disenrollment, subcontractual relationships and delegation, confidentiality, continuity and coordination of care, assurance of adequate capacity and services, coverage and authorization of services, practice guidelines, health information systems, and financial solvency.

Sec. 8.

Minnesota Statutes 2014, section 62U.04, subdivision 11, is amended to read:

Subd. 11.

Restricted uses of the all-payer claims data.

(a) Notwithstanding subdivision 4, paragraph (b), and subdivision 5, paragraph (b), the commissioner or the commissioner's designee shall only use the data submitted under subdivisions 4 and 5 for the following purposes:

(1) to evaluate the performance of the health care home program as authorized under sections 256B.0751, subdivision 6, and 256B.0752, subdivision 2;

(2) to study, in collaboration with the reducing avoidable readmissions effectively (RARE) campaign, hospital readmission trends and rates;

(3) to analyze variations in health care costs, quality, utilization, and illness burden based on geographical areas or populations; deleted text begin anddeleted text end

(4) to evaluate the state innovation model (SIM) testing grant received by the Departments of Health and Human Services, including the analysis of health care cost, quality, and utilization baseline and trend information for targeted populations and communitiesdeleted text begin .deleted text end new text begin ; andnew text end

new text begin (5) to compile one or more public use files of summary data or tables that must: new text end

new text begin (i) be available to the public for no or minimal cost by March 1, 2016, and available by Web-based electronic data download by June 30, 2019; new text end

new text begin (ii) not identify individual patients, payers, or providers; new text end

new text begin (iii) be updated by the commissioner, at least annually, with the most current data available; new text end

new text begin (iv) contain clear and conspicuous explanations of the characteristics of the data, such as the dates of the data contained in the files, the absence of costs of care for uninsured patients or nonresidents, and other disclaimers that provide appropriate context; and new text end

new text begin (v) not lead to the collection of additional data elements beyond what is authorized under this section as of June 30, 2015. new text end

(b) The commissioner may publish the results of the authorized uses identified in paragraph (a) so long as the data released publicly do not contain information or descriptions in which the identity of individual hospitals, clinics, or other providers may be discerned.

(c) Nothing in this subdivision shall be construed to prohibit the commissioner from using the data collected under subdivision 4 to complete the state-based risk adjustment system assessment due to the legislature on October 1, 2015.

(d) The commissioner or the commissioner's designee may use the data submitted under subdivisions 4 and 5 for the purpose described in paragraph (a), clause (3), until July 1, 2016.

new text begin (e) The commissioner shall consult with the all-payer claims database work group established under subdivision 12 regarding the technical considerations necessary to create the public use files of summary data described in paragraph (a), clause (5). new text end

Sec. 9.

Minnesota Statutes 2014, section 62U.10, is amended by adding a subdivision to read:

new text begin Subd. 6. new text end

new text begin Projected spending baseline. new text end

new text begin Beginning February 15, 2016, and each February 15 thereafter, the commissioner of health shall report the projected impact on spending from specified health indicators related to various preventable illnesses and death. The impacts shall be reported over a ten-year time frame using a baseline forecast of private and public health care and long-term care spending for residents of this state, beginning with calendar year 2009 projected estimates of costs, and updated annually for each of the following health indicators: new text end

new text begin (1) costs related to rates of obesity, including obesity-related cancers, coronary heart disease, stroke, and arthritis; new text end

new text begin (2) costs related to the utilization of tobacco products; new text end

new text begin (3) costs related to hypertension; new text end

new text begin (4) costs related to diabetes or prediabetes; and new text end

new text begin (5) costs related to dementia and chronic disease among an elderly population over 60, including additional long-term care costs. new text end

Sec. 10.

Minnesota Statutes 2014, section 62U.10, is amended by adding a subdivision to read:

new text begin Subd. 7. new text end

new text begin Outcomes reporting; savings determination. new text end

new text begin (a) Beginning November 1, 2016, and each November 1 thereafter, the commissioner of health shall determine the actual total private and public health care and long-term care spending for Minnesota residents related to each health indicator projected in subdivision 6 for the most recent calendar year available. The commissioner shall determine the difference between the projected and actual spending for each health indicator and for each year, and determine the savings attributable to changes in these health indicators. The assumptions and research methods used to calculate actual spending must be determined to be appropriate by an independent actuarial consultant. If the actual spending is less than the projected spending, the commissioner, in consultation with the commissioners of human services and management and budget, shall use the proportion of spending for state-administered health care programs to total private and public health care spending for each health indicator for the calendar year two years before the current calendar year to determine the percentage of the calculated aggregate savings amount accruing to state-administered health care programs. new text end

new text begin (b) The commissioner may use the data submitted under section 62U.04, subdivisions 4 and 5, to complete the activities required under this section, but may only report publicly on regional data aggregated to granularity of 25,000 lives or greater for this purpose. new text end

Sec. 11.

Minnesota Statutes 2014, section 62U.10, is amended by adding a subdivision to read:

new text begin Subd. 8. new text end

new text begin Transfers. new text end

new text begin When accumulated annual savings accruing to state-administered health care programs, as calculated under subdivision 7, meet or exceed $50,000,000 for all health indicators in aggregate statewide, the commissioner of health shall certify that event to the commissioner of management and budget, no later than December 15 of each year. In the next fiscal year following the certification, the commissioner of management and budget shall transfer $50,000,000 from the general fund to the health care access fund. This transfer shall repeat in each fiscal year following subsequent certifications of additional cumulative savings, up to $50,000,000 per year. The amount necessary to make the transfer is appropriated from the general fund to the commissioner of management and budget. new text end

Sec. 12.

Minnesota Statutes 2014, section 144.1501, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

(a) For purposes of this section, the following definitions apply.

new text begin (b) "Advanced dental therapist" means an individual who is licensed as a dental therapist under section 150A.06, and who is certified as an advanced dental therapist under section 150A.106. new text end

new text begin (c) "Dental therapist" means an individual who is licensed as a dental therapist under section 150A.06. new text end

deleted text begin (b)deleted text end new text begin (d)new text end "Dentist" means an individual who is licensed to practice dentistry.

deleted text begin (c)deleted text end new text begin (e)new text end "Designated rural area" means a new text begin statutory and home rule charternew text end city or township that isdeleted text begin :deleted text end

deleted text begin (1)deleted text end outside the seven-county metropolitan area as defined in section 473.121, subdivision 2deleted text begin ; anddeleted text end new text begin , excluding the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud.new text end

deleted text begin (2) has a population under 15,000. deleted text end

deleted text begin (d)deleted text end new text begin (f)new text end "Emergency circumstances" means those conditions that make it impossible for the participant to fulfill the service commitment, including death, total and permanent disability, or temporary disability lasting more than two years.

new text begin (g) "Mental health professional" means an individual providing clinical services in the treatment of mental illness who is qualified in at least one of the ways specified in section 245.462, subdivision 18. new text end

deleted text begin (e)deleted text end new text begin (h)new text end "Medical resident" means an individual participating in a medical residency in family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.

deleted text begin (f)deleted text end new text begin (i)new text end "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse anesthetist, advanced clinical nurse specialist, or physician assistant.

deleted text begin (g)deleted text end new text begin (j)new text end "Nurse" means an individual who has completed training and received all licensing or certification necessary to perform duties as a licensed practical nurse or registered nurse.

deleted text begin (h)deleted text end new text begin (k)new text end "Nurse-midwife" means a registered nurse who has graduated from a program of study designed to prepare registered nurses for advanced practice as nurse-midwives.

deleted text begin (i)deleted text end new text begin (l)new text end "Nurse practitioner" means a registered nurse who has graduated from a program of study designed to prepare registered nurses for advanced practice as nurse practitioners.

deleted text begin (j)deleted text end new text begin (m)new text end "Pharmacist" means an individual with a valid license issued under chapter 151.

deleted text begin (k)deleted text end new text begin (n)new text end "Physician" means an individual who is licensed to practice medicine in the areas of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.

deleted text begin (l)deleted text end new text begin (o)new text end "Physician assistant" means a person licensed under chapter 147A.

new text begin (p) "Public health nurse" means a registered nurse licensed in Minnesota who has obtained a registration certificate as a public health nurse from the Board of Nursing in accordance with Minnesota Rules, chapter 6316. new text end

deleted text begin (m)deleted text end new text begin (q)new text end "Qualified educational loan" means a government, commercial, or foundation loan for actual costs paid for tuition, reasonable education expenses, and reasonable living expenses related to the graduate or undergraduate education of a health care professional.

deleted text begin (n)deleted text end new text begin (r)new text end "Underserved urban community" means a Minnesota urban area or population included in the list of designated primary medical care health professional shortage areas (HPSAs), medically underserved areas (MUAs), or medically underserved populations (MUPs) maintained and updated by the United States Department of Health and Human Services.

Sec. 13.

Minnesota Statutes 2014, section 144.1501, subdivision 2, is amended to read:

Subd. 2.

Creation of account.

(a) A health professional education loan forgiveness program account is established. The commissioner of health shall use money from the account to establish a loan forgiveness program:

(1) for medical residents new text begin and mental health professionalsnew text end agreeing to practice in designated rural areas or underserved urban communities or specializing in the area of pediatric psychiatry;

(2) for midlevel practitioners agreeing to practice in designated rural areas or to teach at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary program at the undergraduate level or the equivalent at the graduate level;

(3) for nurses who agree to practice in a Minnesota nursing home deleted text begin ordeleted text end new text begin ; annew text end intermediate care facility for persons with developmental disabilitynew text begin ;new text end ornew text begin a hospital if the hospital owns and operates a Minnesota nursing home and a minimum of 50 percent of the hours worked by the nurse is in the nursing home; or agreenew text end to teach at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary program at the undergraduate level or the equivalent at the graduate level;

(4) for other health care technicians agreeing to teach at least 12 credit hours, or 720 hours per year in their designated field in a postsecondary program at the undergraduate level or the equivalent at the graduate level. The commissioner, in consultation with the Healthcare Education-Industry Partnership, shall determine the health care fields where the need is the greatest, including, but not limited to, respiratory therapy, clinical laboratory technology, radiologic technology, and surgical technology;

(5) for pharmacistsnew text begin , advanced dental therapists, dental therapists, and public health nurses new text end who agree to practice in designated rural areas; and

(6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient encounters to state public program enrollees or patients receiving sliding fee schedule discounts through a formal sliding fee schedule meeting the standards established by the United States Department of Health and Human Services under Code of Federal Regulations, title 42, section 51, chapter 303.

(b) Appropriations made to the account do not cancel and are available until expended, except that at the end of each biennium, any remaining balance in the account that is not committed by contract and not needed to fulfill existing commitments shall cancel to the fund.

Sec. 14.

Minnesota Statutes 2014, section 144.1501, subdivision 3, is amended to read:

Subd. 3.

Eligibility.

(a) To be eligible to participate in the loan forgiveness program, an individual must:

(1) be a medical or dental residentdeleted text begin ,deleted text end new text begin ;new text end a licensed pharmacistnew text begin ;new text end or be enrolled in new text begin a training or education program to become new text end a dentist, new text begin dental therapist, advanced dental therapist, mental health professional, pharmacist, public health nurse, new text end midlevel practitioner, registered nurse, or a licensed practical nurse deleted text begin training program deleted text end new text begin . The commissioner may also consider applications submitted by graduates in eligible professions who are licensed and in practicenew text end ; and

(2) submit an application to the commissioner of health.deleted text begin If fewer applications are deleted text end deleted text begin submitted by dental students or residents than there are dentist participant slots available, deleted text end deleted text begin the commissioner may consider applications submitted by dental program graduates deleted text end deleted text begin who are licensed dentists.deleted text end

(b) An applicant selected to participate must sign a contract to agree to serve a minimum three-year full-time service obligation according to subdivision 2, which shall begin no later than March 31 following completion of required trainingnew text begin , with the exception of a nurse, who must agree to serve a minimum two-year full-time service obligation according to subdivision 2, which shall begin no later than March 31 following completion of required trainingnew text end .

Sec. 15.

Minnesota Statutes 2014, section 144.1501, subdivision 4, is amended to read:

Subd. 4.

Loan forgiveness.

The commissioner of health may select applicants each year for participation in the loan forgiveness program, within the limits of available funding. new text begin In considering applications, the commissioner shall give preference to applicants who document diverse cultural competencies. new text end The commissioner shall distribute available funds for loan forgiveness proportionally among the eligible professions according to the vacancy rate for each profession in the required geographic area, facility type, teaching area, patient group, or specialty type specified in subdivision 2. The commissioner shall allocate funds for physician loan forgiveness so that 75 percent of the funds available are used for rural physician loan forgiveness and 25 percent of the funds available are used for underserved urban communities and pediatric psychiatry loan forgiveness. If the commissioner does not receive enough qualified applicants each year to use the entire allocation of funds for any eligible profession, the remaining funds may be allocated proportionally among the other eligible professions according to the vacancy rate for each profession in the required geographic area, patient group, or facility type specified in subdivision 2. Applicants are responsible for securing their own qualified educational loans. The commissioner shall select participants based on their suitability for practice serving the required geographic area or facility type specified in subdivision 2, as indicated by experience or training. The commissioner shall give preference to applicants closest to completing their training. For each year that a participant meets the service obligation required under subdivision 3, up to a maximum of four years, the commissioner shall make annual disbursements directly to the participant equivalent to 15 percent of the average educational debt for indebted graduates in their profession in the year closest to the applicant's selection for which information is available, not to exceed the balance of the participant's qualifying educational loans. Before receiving loan repayment disbursements and as requested, the participant must complete and return to the commissioner a confirmation of practice form provided by the commissioner verifying that the participant is practicing as required under subdivisions 2 and 3. The participant must provide the commissioner with verification that the full amount of loan repayment disbursement received by the participant has been applied toward the designated loans. After each disbursement, verification must be received by the commissioner and approved before the next loan repayment disbursement is made. Participants who move their practice remain eligible for loan repayment as long as they practice as required under subdivision 2.

Sec. 16.

new text begin [144.1506] PRIMARY CARE RESIDENCY EXPANSION GRANT PROGRAM. new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin For purposes of this section, the following definitions apply: new text end

new text begin (1) "eligible primary care residency program" means a program that meets the following criteria: new text end

new text begin (i) is located in Minnesota; new text end

new text begin (ii) trains medical residents in the specialties of family medicine, general internal medicine, general pediatrics, psychiatry, geriatrics, or general surgery; and new text end

new text begin (iii) is accredited by the Accreditation Council for Graduate Medical Education or presents a credible plan to obtain accreditation; new text end

new text begin (2) "eligible project" means a project to establish a new eligible primary care residency program or create at least one new residency slot in an existing eligible primary care residency program; and new text end

new text begin (3) "new residency slot" means the creation of a new residency position and the execution of a contract with a new resident in a residency program. new text end

new text begin Subd. 2. new text end

new text begin Expansion grant program. new text end

new text begin (a) The commissioner of health shall award primary care residency expansion grants to eligible primary care residency programs to plan and implement new residency slots. A planning grant shall not exceed $75,000, and a training grant shall not exceed $150,000 per new residency slot for the first year, $100,000 for the second year, and $50,000 for the third year of the new residency slot. new text end

new text begin (b) Funds may be spent to cover the costs of: new text end

new text begin (1) planning related to establishing an accredited primary care residency program; new text end

new text begin (2) obtaining accreditation by the Accreditation Council for Graduate Medical Education or another national body that accredits residency programs; new text end

new text begin (3) establishing new residency programs or new resident training slots; new text end

new text begin (4) recruitment, training, and retention of new residents and faculty; new text end

new text begin (5) travel and lodging for new residents; new text end

new text begin (6) faculty, new resident, and preceptor salaries related to new residency slots; new text end

new text begin (7) training site improvements, fees, equipment, and supplies required for new primary care resident training slots; and new text end

new text begin (8) supporting clinical education in which trainees are part of a primary care team model. new text end

new text begin Subd. 3. new text end

new text begin Applications for expansion grants. new text end

new text begin Eligible primary care residency programs seeking a grant shall apply to the commissioner. Applications must include the number of new primary care residency slots planned or under contract; attestation that funding will be used to support an increase in the number of available residency slots; a description of the training to be received by the new residents, including the location of training; a description of the project, including all costs associated with the project; all sources of funds for the project; detailed uses of all funds for the project; the results expected; and a plan to maintain the new residency slot after the grant period. The applicant must describe achievable objectives, a timetable, and roles and capabilities of responsible individuals in the organization. new text end

new text begin Subd. 4. new text end

new text begin Consideration of expansion grant applications. new text end

new text begin The commissioner shall review each application to determine whether or not the residency program application is complete and whether the proposed new residency program and any new residency slots are eligible for a grant. The commissioner shall award grants to support up to six family medicine, general internal medicine, or general pediatrics residents; four psychiatry residents; two geriatrics residents; and two general surgery residents. If insufficient applications are received from any eligible specialty, funds may be redistributed to applications from other eligible specialties. new text end

new text begin Subd. 5. new text end

new text begin Program oversight. new text end

new text begin During the grant period, the commissioner may require and collect from grantees any information necessary to evaluate the program. Appropriations made to the program do not cancel and are available until expended. new text end

Sec. 17.

new text begin [144.1911] INTERNATIONAL MEDICAL GRADUATES ASSISTANCE PROGRAM. new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The international medical graduates assistance program is established to address barriers to practice and facilitate pathways to assist immigrant international medical graduates to integrate into the Minnesota health care delivery system, with the goal of increasing access to primary care in rural and underserved areas of the state. new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

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

new text begin (b) "Commissioner" means the commissioner of health. new text end

new text begin (c) "Immigrant international medical graduate" means an international medical graduate who was born outside the United States, now resides permanently in the United States, and who did not enter the United States on a J1 or similar nonimmigrant visa following acceptance into a United States medical residency or fellowship program. new text end

new text begin (d) "International medical graduate" means a physician who received a basic medical degree or qualification from a medical school located outside the United States and Canada. new text end

new text begin (e) "Minnesota immigrant international medical graduate" means an immigrant international medical graduate who has lived in Minnesota for at least two years. new text end

new text begin (f) "Rural community" means a statutory and home rule charter city or township that is outside the seven-county metropolitan area as defined in section 473.121, subdivision 2, excluding the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud. new text end

new text begin (g) "Underserved community" means a Minnesota area or population included in the list of designated primary medical care health professional shortage areas, medically underserved areas, or medically underserved populations (MUPs) maintained and updated by the United States Department of Health and Human Services. new text end

new text begin Subd. 3. new text end

new text begin Program administration. new text end

new text begin In administering the international medical graduates assistance program, the commissioner shall: new text end

new text begin (1) provide overall coordination for the planning, development, and implementation of a comprehensive system for integrating qualified immigrant international medical graduates into the Minnesota health care delivery system, particularly those willing to serve in rural or underserved communities of the state; new text end

new text begin (2) develop and maintain, in partnership with community organizations working with international medical graduates, a voluntary roster of immigrant international medical graduates interested in entering the Minnesota health workforce to assist in planning and program administration, including making available summary reports that show the aggregate number and distribution, by geography and specialty, of immigrant international medical graduates in Minnesota; new text end

new text begin (3) work with graduate clinical medical training programs to address barriers faced by immigrant international medical graduates in securing residency positions in Minnesota, including the requirement that applicants for residency positions be recent graduates of medical school. The annual report required in subdivision 10 shall include any progress in addressing these barriers; new text end

new text begin (4) develop a system to assess and certify the clinical readiness of eligible immigrant international medical graduates to serve in a residency program. The system shall include assessment methods, an operating plan, and a budget. Initially, the commissioner may develop assessments for clinical readiness for practice of one or more primary care specialties, and shall add additional assessments as resources are available. The commissioner may contract with an independent entity or another state agency to conduct the assessments. In order to be assessed for clinical readiness for residency, an eligible international medical graduate must have obtained a certification from the Educational Commission of Foreign Medical Graduates. The commissioner shall issue a Minnesota certificate of clinical readiness for residency to those who pass the assessment; new text end

new text begin (5) explore and facilitate more streamlined pathways for immigrant international medical graduates to serve in nonphysician professions in the Minnesota workforce; and new text end

new text begin (6) study, in consultation with the Board of Medical Practice and other stakeholders, changes necessary in health professional licensure and regulation to ensure full utilization of immigrant international medical graduates in the Minnesota health care delivery system. The commissioner shall include recommendations in the annual report required under subdivision 10, due January 15, 2017. new text end

new text begin Subd. 4. new text end

new text begin Career guidance and support services. new text end

new text begin (a) The commissioner shall award grants to eligible nonprofit organizations to provide career guidance and support services to immigrant international medical graduates seeking to enter the Minnesota health workforce. Eligible grant activities include the following: new text end

new text begin (1) educational and career navigation, including information on training and licensing requirements for physician and nonphysician health care professions, and guidance in determining which pathway is best suited for an individual international medical graduate based on the graduate's skills, experience, resources, and interests; new text end

new text begin (2) support in becoming proficient in medical English; new text end

new text begin (3) support in becoming proficient in the use of information technology, including computer skills and use of electronic health record technology; new text end

new text begin (4) support for increasing knowledge of and familiarity with the United States health care system; new text end

new text begin (5) support for other foundational skills identified by the commissioner; new text end

new text begin (6) support for immigrant international medical graduates in becoming certified by the Educational Commission on Foreign Medical Graduates, including help with preparation for required licensing examinations and financial assistance for fees; and new text end

new text begin (7) assistance to international medical graduates in registering with the program's Minnesota international medical graduate roster. new text end

new text begin (b) The commissioner shall award the initial grants under this subdivision by December 31, 2015. new text end

new text begin Subd. 5. new text end

new text begin Clinical preparation. new text end

new text begin (a) The commissioner shall award grants to support clinical preparation for Minnesota international medical graduates needing additional clinical preparation or experience to qualify for residency. The grant program shall include: new text end

new text begin (1) proposed training curricula; new text end

new text begin (2) associated policies and procedures for clinical training sites, which must be part of existing clinical medical education programs in Minnesota; and new text end

new text begin (3) monthly stipends for international medical graduate participants. Priority shall be given to primary care sites in rural or underserved areas of the state, and international medical graduate participants must commit to serving at least five years in a rural or underserved community of the state. new text end

new text begin (b) The policies and procedures for the clinical preparation grants must be developed by December 31, 2015, including an implementation schedule that begins awarding grants to clinical preparation programs beginning in June of 2016. new text end

new text begin Subd. 6. new text end

new text begin International medical graduate primary care residency grant program and revolving account. new text end

new text begin (a) The commissioner shall award grants to support primary care residency positions designated for Minnesota immigrant physicians who are willing to serve in rural or underserved areas of the state. No grant shall exceed $150,000 per residency position per year. Eligible primary care residency grant recipients include accredited family medicine, internal medicine, obstetrics and gynecology, psychiatry, and pediatric residency programs. Eligible primary care residency programs shall apply to the commissioner. Applications must include the number of anticipated residents to be funded using grant funds and a budget. Notwithstanding any law to the contrary, funds awarded to grantees in a grant agreement do not lapse until the grant agreement expires. Before any funds are distributed, a grant recipient shall provide the commissioner with the following: new text end

new text begin (1) a copy of the signed contract between the primary care residency program and the participating international medical graduate; new text end

new text begin (2) certification that the participating international medical graduate has lived in Minnesota for at least two years and is certified by the Educational Commission on Foreign Medical Graduates. Residency programs may also require that participating international medical graduates hold a Minnesota certificate of clinical readiness for residency, once the certificates become available; and new text end

new text begin (3) verification that the participating international medical graduate has executed a participant agreement pursuant to paragraph (b). new text end

new text begin (b) Upon acceptance by a participating residency program, international medical graduates shall enter into an agreement with the commissioner to provide primary care for at least five years in a rural or underserved area of Minnesota after graduating from the residency program and make payments to the revolving international medical graduate residency account for five years beginning in their second year of postresidency employment. Participants shall pay $15,000 or ten percent of their annual compensation each year, whichever is less. new text end

new text begin (c) A revolving international medical graduate residency account is established as an account in the special revenue fund in the state treasury. The commissioner of management and budget shall credit to the account appropriations, payments, and transfers to the account. Earnings, such as interest, dividends, and any other earnings arising from fund assets, must be credited to the account. Funds in the account are appropriated annually to the commissioner to award grants and administer the grant program established in paragraph (a). Notwithstanding any law to the contrary, any funds deposited in the account do not expire. The commissioner may accept contributions to the account from private sector entities subject to the following provisions: new text end

new text begin (1) the contributing entity may not specify the recipient or recipients of any grant issued under this subdivision; new text end

new text begin (2) the commissioner shall make public the identity of any private contributor to the account, as well as the amount of the contribution provided; and new text end

new text begin (3) a contributing entity may not specify that the recipient or recipients of any funds use specific products or services, nor may the contributing entity imply that a contribution is an endorsement of any specific product or service. new text end

new text begin Subd. 7. new text end

new text begin Voluntary hospital programs. new text end

new text begin A hospital may establish residency programs for foreign-trained physicians to become candidates for licensure to practice medicine in the state of Minnesota. A hospital may partner with organizations, such as the New Americans Alliance for Development, to screen for and identify foreign-trained physicians eligible for a hospital's particular residency program. new text end

new text begin Subd. 8. new text end

new text begin Board of Medical Practice. new text end

new text begin Nothing in this section alters the authority of the Board of Medical Practice to regulate the practice of medicine. new text end

new text begin Subd. 9. new text end

new text begin Consultation with stakeholders. new text end

new text begin The commissioner shall administer the international medical graduates assistance program, including the grant programs described under subdivisions 4, 5, and 6, in consultation with representatives of the following sectors: new text end

new text begin (1) state agencies: new text end

new text begin (i) Board of Medical Practice; new text end

new text begin (ii) Office of Higher Education; and new text end

new text begin (iii) Department of Employment and Economic Development; new text end

new text begin (2) health care industry: new text end

new text begin (i) a health care employer in a rural or underserved area of Minnesota; new text end

new text begin (ii) a health plan company; new text end

new text begin (iii) the Minnesota Medical Association; new text end

new text begin (iv) licensed physicians experienced in working with international medical graduates; and new text end

new text begin (v) the Minnesota Academy of Physician Assistants; new text end

new text begin (3) community-based organizations: new text end

new text begin (i) organizations serving immigrant and refugee communities of Minnesota; new text end

new text begin (ii) organizations serving the international medical graduate community, such as the New Americans Alliance for Development and Women's Initiative for Self Empowerment; and new text end

new text begin (iii) the Minnesota Association of Community Health Centers; new text end

new text begin (4) higher education: new text end

new text begin (i) University of Minnesota; new text end

new text begin (ii) Mayo Clinic School of Health Professions; new text end

new text begin (iii) graduate medical education programs not located at the University of Minnesota or Mayo Clinic School of Health Professions; and new text end

new text begin (iv) Minnesota physician assistant education program; and new text end

new text begin (5) two international medical graduates. new text end

new text begin Subd. 10. new text end

new text begin Report. new text end

new text begin The commissioner shall submit an annual report to the chairs and ranking minority members of the legislative committees with jurisdiction over health care and higher education on the progress of the integration of international medical graduates into the Minnesota health care delivery system. The report shall include recommendations on actions needed for continued progress integrating international medical graduates. The report shall be submitted by January 15 each year, beginning January 15, 2016. new text end

Sec. 18.

Minnesota Statutes 2014, section 144.291, subdivision 2, is amended to read:

Subd. 2.

Definitions.

For the purposes of sections 144.291 to 144.298, the following terms have the meanings given.

(a) "Group purchaser" has the meaning given in section 62J.03, subdivision 6.

(b) "Health information exchange" means a legal arrangement between health care providers and group purchasers to enable and oversee the business and legal issues involved in the electronic exchange of health records between the entities for the delivery of patient care.

(c) "Health record" means any information, whether oral or recorded in any form or medium, that relates to the past, present, or future physical or mental health or condition of a patient; the provision of health care to a patient; or the past, present, or future payment for the provision of health care to a patient.

(d) "Identifying information" means the patient's name, address, date of birth, gender, parent's or guardian's name regardless of the age of the patient, and other nonclinical data which can be used to uniquely identify a patient.

(e) "Individually identifiable form" means a form in which the patient is or can be identified as the subject of the health records.

(f) "Medical emergency" means medically necessary care which is immediately needed to preserve life, prevent serious impairment to bodily functions, organs, or parts, or prevent placing the physical or mental health of the patient in serious jeopardy.

(g) "Patient" means a natural person who has received health care services from a provider for treatment or examination of a medical, psychiatric, or mental condition, the surviving spouse and parents of a deceased patient, or a person the patient appoints in writing as a representative, including a health care agent acting according to chapter 145C, unless the authority of the agent has been limited by the principal in the principal's health care directive. Except for minors who have received health care services under sections 144.341 to 144.347, in the case of a minor, patient includes a parent or guardian, or a person acting as a parent or guardian in the absence of a parent or guardian.

new text begin (h) "Patient information service" means a service providing the following query options: a record locator service as defined in section 144.291, subdivision 2, paragraph (i), or a master patient index or clinical data repository as defined in section 62J.498, subdivision 1. new text end

deleted text begin (h)deleted text end new text begin (i)new text end "Provider" means:

(1) any person who furnishes health care services and is regulated to furnish the services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148D, 148F, 150A, 151, 153, or 153A;

(2) a home care provider licensed under section deleted text begin 144A.46deleted text end new text begin 144A.471new text end ;

(3) a health care facility licensed under this chapter or chapter 144A; and

(4) a physician assistant registered under chapter 147A.

deleted text begin (i)deleted text end new text begin (j)new text end "Record locator service" means an electronic index of patient identifying information that directs providers in a health information exchange to the location of patient health records held by providers and group purchasers.

deleted text begin (j)deleted text end new text begin (k)new text end "Related health care entity" means an affiliate, as defined in section 144.6521, subdivision 3, paragraph (b), of the provider releasing the health records.

Sec. 19.

Minnesota Statutes 2014, section 144.293, subdivision 5, is amended to read:

Subd. 5.

Exceptions to consent requirement.

new text begin (a) new text end This section does not prohibit the release of health records:

(1) for a medical emergency when the provider is unable to obtain the patient's consent due to the patient's condition or the nature of the medical emergency;

(2) to other providers within related health care entities when necessary for the current treatment of the patient; or

(3) to a health care facility licensed by this chapter, chapter 144A, or to the same types of health care facilities licensed by this chapter and chapter 144A that are licensed in another state when a patient:

(i) is returning to the health care facility and unable to provide consent; or

(ii) who resides in the health care facility, has services provided by an outside resource under Code of Federal Regulations, title 42, section 483.75(h), and is unable to provide consent.

new text begin (b) A provider may release a deceased patient's health care records to another provider for the purposes of diagnosing or treating the deceased patient's surviving adult child. 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. 20.

Minnesota Statutes 2014, section 144.293, subdivision 8, is amended to read:

Subd. 8.

Record locator new text begin or patient information new text end service.

(a) A provider or group purchaser may release patient identifying information and information about the location of the patient's health records to a record locator new text begin or patient information new text end service without consent from the patient, unless the patient has elected to be excluded from the service under paragraph (d). The Department of Health may not access the record locator new text begin or patient information new text end service or receive data from the deleted text begin record locatordeleted text end service. Only a provider may have access to patient identifying information in a record locator new text begin or patient information new text end service. Except in the case of a medical emergency, a provider participating in a health information exchange using a record locator new text begin or patient information new text end service does not have access to patient identifying information and information about the location of the patient's health records unless the patient specifically consents to the access. A consent does not expire but may be revoked by the patient at any time by providing written notice of the revocation to the provider.

(b) A health information exchange maintaining a record locator new text begin or patient information new text end service must maintain an audit log of providers accessing information in deleted text begin a record locatordeleted text end new text begin thenew text end service that at least contains information on:

(1) the identity of the provider accessing the information;

(2) the identity of the patient whose information was accessed by the provider; and

(3) the date the information was accessed.

(c) No group purchaser may in any way require a provider to participate in a record locator new text begin or patient information new text end service as a condition of payment or participation.

(d) A provider or an entity operating a record locator new text begin or patient information new text end service must provide a mechanism under which patients may exclude their identifying information and information about the location of their health records from a record locator new text begin or patient information new text end service. At a minimum, a consent form that permits a provider to access a record locator new text begin or patient information new text end service must include a conspicuous check-box option that allows a patient to exclude all of the patient's information from the deleted text begin record locatordeleted text end service. A provider participating in a health information exchange with a record locator new text begin or patient information new text end service who receives a patient's request to exclude all of the patient's information from the deleted text begin record locatordeleted text end service or to have a specific provider contact excluded from the deleted text begin record locatordeleted text end service is responsible for removing that information from the deleted text begin record locatordeleted text end service.

Sec. 21.

Minnesota Statutes 2014, section 144.298, subdivision 2, is amended to read:

Subd. 2.

Liability of provider or other person.

A person who does any of the following is liable to the patient for compensatory damages caused by an unauthorized release or an intentional, unauthorized access, plus costs and reasonable attorney fees:

(1) negligently or intentionally requests or releases a health record in violation of sections 144.291 to 144.297;

(2) forges a signature on a consent form or materially alters the consent form of another person without the person's consent;

(3) obtains a consent form or the health records of another person under false pretenses; or

(4) intentionally violates sections 144.291 to 144.297 by intentionally accessing a record locator new text begin or patient information new text end service without authorization.

Sec. 22.

Minnesota Statutes 2014, section 144.298, subdivision 3, is amended to read:

Subd. 3.

Liability for record locator new text begin or patient information new text end service.

A patient is entitled to receive compensatory damages plus costs and reasonable attorney fees if a health information exchange maintaining a record locator new text begin or patient information new text end service, or an entity maintaining a record locator new text begin or patient information new text end service for a health information exchange, negligently or intentionally violates the provisions of section 144.293, subdivision 8.

Sec. 23.

new text begin [144.3875] EARLY DENTAL PREVENTION INITIATIVE. new text end

new text begin (a) The commissioner of health, in collaboration with the commissioner of human services, shall implement a statewide initiative to increase awareness among communities of color and recent immigrants on the importance of early preventive dental intervention for infants and toddlers before and after primary teeth appear. new text end

new text begin (b) The commissioner shall develop educational materials and information for expectant and new parents within the targeted communities that include the importance of early dental care to prevent early cavities, including proper cleaning techniques and feeding habits, before and after primary teeth appear. new text end

new text begin (c) The commissioner shall develop a distribution plan to ensure that the materials are distributed to expectant and new parents within the targeted communities, including, but not limited to, making the materials available to health care providers, community clinics, WIC sites, and other relevant sites within the targeted communities. new text end

new text begin (d) In developing these materials and distribution plan, the commissioner shall work collaboratively with members of the targeted communities, dental providers, pediatricians, child care providers, and home visiting nurses. new text end

new text begin (e) The commissioner shall, with input from stakeholders listed in paragraph (d), develop and pilot incentives to encourage early dental care within one year of an infant's teeth erupting. new text end

Sec. 24.

new text begin [144.4961] MINNESOTA RADON LICENSING ACT. new text end

new text begin Subdivision 1. new text end

new text begin Citation. new text end

new text begin This section may be cited as the "Minnesota Radon Licensing Act." new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) As used in this section, the following terms have the meanings given them. new text end

new text begin (b) "Mitigation" means the act of repairing or altering a building or building design for the purpose in whole or in part of reducing the concentration of radon in the indoor atmosphere. new text end

new text begin (c) "Radon" means both the radioactive, gaseous element produced by the disintegration of radium, and the short-lived radionuclides that are decay products of radon. new text end

new text begin Subd. 3. new text end

new text begin Rulemaking. new text end

new text begin The commissioner of health shall adopt rules for licensure and enforcement of applicable laws and rules relating to indoor radon in dwellings and other buildings, with the exception of newly constructed Minnesota homes according to section 326B.106, subdivision 6. The commissioner shall coordinate, oversee, and implement all state functions in matters concerning the presence, effects, measurement, and mitigation of risks of radon in dwellings and other buildings. new text end

new text begin Subd. 4. new text end

new text begin System tag. new text end

new text begin All radon mitigation systems installed in Minnesota on or after October 1, 2017, must have a radon mitigation system tag provided by the commissioner. A radon mitigation professional must attach the tag to the radon mitigation system in a visible location. new text end

new text begin Subd. 5. new text end

new text begin License required annually. new text end

new text begin A license is required annually for every person, firm, or corporation that sells a device or performs a service for compensation to detect the presence of radon in the indoor atmosphere, performs laboratory analysis, or performs a service to mitigate radon in the indoor atmosphere. This section does not apply to retail stores that only sell or distribute radon sampling but are not engaged in the manufacture of radon sampling devices. new text end

new text begin Subd. 6. new text end

new text begin Exemptions. new text end

new text begin Radon systems installed in newly constructed Minnesota homes according to section 326B.106, subdivision 6, prior to the issuance of a certificate of occupancy are not required to follow the requirements of this section. new text end

new text begin Subd. 7. new text end

new text begin License applications and other reports. new text end

new text begin The professionals, companies, and laboratories listed in subdivision 8 must submit applications for licenses, system tags, and any other reporting required under this section and Minnesota Rules on forms prescribed by the commissioner. new text end

new text begin Subd. 8. new text end

new text begin Licensing fees. new text end

new text begin (a) All radon license applications submitted to the commissioner of health must be accompanied by the required fees. If the commissioner determines that insufficient fees were paid, the necessary additional fees must be paid before the commissioner approves the application. The commissioner shall charge the following fees for each radon license: new text end

new text begin (1) Each measurement professional license, $300 per year. "Measurement professional" means any person who performs a test to determine the presence and concentration of radon in a building they do not own or lease; provides professional or expert advice on radon testing, radon exposure, or health risks related to radon exposure; or makes representations of doing any of these activities. new text end

new text begin (2) Each mitigation professional license, $500 per year. "Mitigation professional" means an individual who performs radon mitigation in a building they do not own or lease; provides professional or expert advice on radon mitigation or radon entry routes; or provides on-site supervision of radon mitigation and mitigation technicians; or makes representations of doing any of these activities. This license also permits the licensee to perform the activities of a measurement professional described in clause (1). new text end

new text begin (3) Each mitigation company license, $500 per year. "Mitigation company" means any business or government entity that performs or authorizes employees to perform radon mitigation. This fee is waived if the company is a sole proprietorship. new text end

new text begin (4) Each radon analysis laboratory license, $500 per year. "Radon analysis laboratory" means a business entity or government entity that analyzes passive radon detection devices to determine the presence and concentration of radon in the devices. This fee is waived if the laboratory is a government entity and is only distributing test kits for the general public to use in Minnesota. new text end

new text begin (5) Each Minnesota Department of Health radon mitigation system tag, $75 per tag. "Minnesota Department of Health radon mitigation system tag" or "system tag" means a unique identifiable radon system label provided by the commissioner of health. new text end

new text begin (b) Fees collected under this section shall be deposited in the state treasury and credited to the state government special revenue fund. new text end

new text begin Subd. 9. new text end

new text begin Enforcement. new text end

new text begin The commissioner shall enforce this section under the provisions of sections 144.989 to 144.993. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2015, except subdivisions 4 and 5, which are effective October 1, 2017. new text end

Sec. 25.

new text begin [144.566] VIOLENCE AGAINST HEALTH CARE WORKERS. new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) The following definitions apply to this section and have the meanings given. new text end

new text begin (b) "Act of violence" means an act by a patient or visitor against a health care worker that includes kicking, scratching, urinating, sexually harassing, or any act defined in sections 609.221 to 609.2241. new text end

new text begin (c) "Commissioner" means the commissioner of health. new text end

new text begin (d) "Health care worker" means any person, whether licensed or unlicensed, employed by, volunteering in, or under contract with a hospital, who has direct contact with a patient of the hospital for purposes of either medical care or emergency response to situations potentially involving violence. new text end

new text begin (e) "Hospital" means any facility licensed as a hospital under section 144.55. new text end

new text begin (f) "Incident response" means the actions taken by hospital administration and health care workers during and following an act of violence. new text end

new text begin (g) "Interfere" means to prevent, impede, discourage, or delay a health care worker's ability to report acts of violence, including by retaliating or threatening to retaliate against a health care worker. new text end

new text begin (h) "Preparedness" means the actions taken by hospital administration and health care workers to prevent a single act of violence or acts of violence generally. new text end

new text begin (i) "Retaliate" means to discharge, discipline, threaten, otherwise discriminate against, or penalize a health care worker regarding the health care worker's compensation, terms, conditions, location, or privileges of employment. new text end

new text begin Subd. 2. new text end

new text begin Hospital duties. new text end

new text begin (a) All hospitals must design and implement preparedness and incident response action plans to acts of violence by January 15, 2016, and review the plan at least annually thereafter. new text end

new text begin (b) A hospital shall designate a committee of representatives of health care workers employed by the hospital, including nonmanagerial health care workers, nonclinical staff, administrators, patient safety experts, and other appropriate personnel to develop preparedness and incident response action plans to acts of violence. The hospital shall, in consultation with the designated committee, implement the plans under paragraph (a). Nothing in this paragraph shall require the establishment of a separate committee solely for the purpose required by this subdivision. new text end

new text begin (c) A hospital shall provide training to all health care workers employed or contracted with the hospital on safety during acts of violence. Each health care worker must receive safety training annually and upon hire. Training must, at a minimum, include: new text end

new text begin (1) safety guidelines for response to and de-escalation of an act of violence; new text end

new text begin (2) ways to identify potentially violent or abusive situations; and new text end

new text begin (3) the hospital's incident response reaction plan and violence prevention plan. new text end

new text begin (d) As part of its annual review required under paragraph (a), the hospital must review with the designated committee: new text end

new text begin (1) the effectiveness of its preparedness and incident response action plans; new text end

new text begin (2) the most recent gap analysis as provided by the commissioner; and new text end

new text begin (3) the number of acts of violence that occurred in the hospital during the previous year, including injuries sustained, if any, and the unit in which the incident occurred. new text end

new text begin (e) A hospital shall make its action plans and the information listed in paragraph (d) available to local law enforcement and, if any of its workers are represented by a collective bargaining unit, to the exclusive bargaining representatives of those collective bargaining units. new text end

new text begin (f) A hospital, including any individual, partner, association, or any person or group of persons acting directly or indirectly in the interest of the hospital, shall not interfere with or discourage a health care worker if the health care worker wishes to contact law enforcement or the commissioner regarding an act of violence. new text end

new text begin (g) The commissioner may impose an administrative fine of up to $250 for failure to comply with the requirements of subdivision 2. new text end

Sec. 26.

new text begin [144.586] REQUIREMENTS FOR CERTAIN NOTICES AND DISCHARGE PLANNING. new text end

new text begin Subdivision 1. new text end

new text begin Observation stay notice. new text end

new text begin (a) Each hospital, as defined under section 144.50, subdivision 2, shall provide oral and written notice to each patient that the hospital places in observation status of such placement not later than 24 hours after such placement. The oral and written notices must include: new text end

new text begin (1) a statement that the patient is not admitted to the hospital but is under observation status; new text end

new text begin (2) a statement that observation status may affect the patient's Medicare coverage for: new text end

new text begin (i) hospital services, including medications and pharmaceutical supplies; or new text end

new text begin (ii) home or community-based care or care at a skilled nursing facility upon the patient's discharge; and new text end

new text begin (3) a recommendation that the patient contact the patient's health insurance provider or the Office of the Ombudsman for Long-Term Care or Office of the Ombudsman for State Managed Health Care Programs or the Beneficiary and Family Centered Care Quality Improvement Organization to better understand the implications of placement in observation status. new text end

new text begin (b) The hospital shall document the date in the patient's record that the notice required in paragraph (a) was provided to the patient, the patient's designated representative such as the patient's health care agent, legal guardian, conservator, or another person acting as the patient's representative. new text end

new text begin Subd. 2. new text end

new text begin Postacute care discharge planning. new text end

new text begin Each hospital, including hospitals designated as critical access hospitals, must comply with the federal hospital requirements for discharge planning which include: new text end

new text begin (1) conducting a discharge planning evaluation that includes an evaluation of: new text end

new text begin (i) the likelihood of the patient needing posthospital services and of the availability of those services; and new text end

new text begin (ii) the patient's capacity for self-care or the possibility of the patient being cared for in the environment from which the patient entered the hospital; new text end

new text begin (2) timely completion of the discharge planning evaluation under clause (1) by hospital personnel so that appropriate arrangements for posthospital care are made before discharge, and to avoid unnecessary delays in discharge; new text end

new text begin (3) including the discharge planning evaluation under clause (1) in the patient's medical record for use in establishing an appropriate discharge plan. The hospital must discuss the results of the evaluation with the patient or individual acting on behalf of the patient. The hospital must reassess the patient's discharge plan if the hospital determines that there are factors that may affect continuing care needs or the appropriateness of the discharge plan; and new text end

new text begin (4) providing counseling, as needed, for the patient and family members or interested persons to prepare them for posthospital care. The hospital must provide a list of available Medicare-eligible home care agencies or skilled nursing facilities that serve the patient's geographic area, or other area requested by the patient if such care or placement is indicated and appropriate. Once the patient has designated their preferred providers, the hospital will assist the patient in securing care covered by their health plan or within the care network. The hospital must not specify or otherwise limit the qualified providers that are available to the patient. The hospital must document in the patient's record that the list was presented to the patient or to the individual acting on the patient's behalf. new text end

Sec. 27.

Minnesota Statutes 2014, section 144.9501, subdivision 6d, is amended to read:

Subd. 6d.

Certified lead firm.

"Certified lead firm" means a person that employs individuals to perform regulated lead worknew text begin , with the exception of renovation,new text end and deleted text begin that deleted text end is certified by the commissioner under section 144.9505.

Sec. 28.

Minnesota Statutes 2014, section 144.9501, is amended by adding a subdivision to read:

new text begin Subd. 6e. new text end

new text begin Certified renovation firm. new text end

new text begin "Certified renovation firm" means a person that employs individuals to perform renovation and is certified by the commissioner under section 144.9505. new text end

Sec. 29.

Minnesota Statutes 2014, section 144.9501, subdivision 22b, is amended to read:

Subd. 22b.

Lead sampling technician.

"Lead sampling technician" means an individual who performs clearance inspections for renovation sites and lead dust sampling for nonabatement sitesdeleted text begin , and who is registered with the commissioner under section 144.9505deleted text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 30.

Minnesota Statutes 2014, section 144.9501, subdivision 26b, is amended to read:

Subd. 26b.

Renovation.

"Renovation" means the modification of any new text begin pre-1978 new text end affected property that results in the disturbance of new text begin known or presumed lead-containing new text end painted surfacesnew text begin defined under section 144.9508new text end , unless that activity is performed as deleted text begin an abatementdeleted text end new text begin lead hazard reductionnew text end . A renovation performed for the purpose of converting a building or part of a building into an affected property is a renovation under this subdivision.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 31.

Minnesota Statutes 2014, section 144.9501, is amended by adding a subdivision to read:

new text begin Subd. 26c. new text end

new text begin Lead renovator. new text end

new text begin "Lead renovator" means an individual who directs individuals who perform renovations. A lead renovator also performs renovation, surface coating testing, and cleaning verification. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 32.

Minnesota Statutes 2014, section 144.9505, is amended to read:

144.9505 deleted text begin LICENSINGdeleted text end new text begin CREDENTIALINGnew text end OF LEAD FIRMS AND PROFESSIONALS.

Subdivision 1.

Licensing deleted text begin anddeleted text end new text begin ,new text end certificationdeleted text begin ; generallydeleted text end new text begin , and permittingnew text end .

(a) deleted text begin All deleted text end Fees deleted text begin received shall be paiddeleted text end new text begin collected under this section shall be depositednew text end into the state treasury and credited to the deleted text begin lead abatement licensing and certification account and are appropriated to the commissioner to cover costs incurred under this section and section 144.9508deleted text end new text begin state government special revenue fundnew text end .

(b) Persons shall not advertise or otherwise present themselves as lead supervisors, lead workers, lead inspectors, lead risk assessors, lead sampling technicians, lead project designers, deleted text begin ordeleted text end new text begin renovation firms, or new text end lead firms unless they have licenses or certificates issued by deleted text begin or are registered withdeleted text end the commissioner under this section.

(c) The fees required in this section for inspectors, risk assessors, and certified lead firms are waived for state or local government employees performing services for or as an assessing agency.

(d) An individual who is the owner of property on which regulated lead work is to be performed or an adult individual who is related to the property owner, as defined under section 245A.02, subdivision 13, is exempt from the requirements to obtain a license and pay a fee according to this section.

(e) A person that employs individuals to perform regulated lead work outside of the person's property must obtain certification as a certified lead firm. An individual who performs deleted text begin regulated lead workdeleted text end new text begin lead hazard reduction, lead hazard screens, lead inspections, lead risk assessments, clearance inspections, lead project designer services, lead sampling technician services, swab team services, and activities performed to comply with lead ordersnew text end must be employed by a certified lead firm, unless the individual is a sole proprietor and does not employ any other deleted text begin individual who performs regulated lead workdeleted text end new text begin individualsnew text end , the individual is employed by a person that does not perform regulated lead work outside of the person's property, or the individual is employed by an assessing agency.

Subd. 1a.

Lead worker license.

Before an individual performs regulated lead work as a worker, the individual shall first obtain a license from the commissioner. No license shall be issued unless the individual shows evidence of successfully completing a training course in lead hazard control. The commissioner shall specify the course of training and testing requirements and shall charge a $50 fee new text begin annually new text end for the license. License fees are nonrefundable and must be submitted with each application. The license must be carried by the individual and be readily available for review by the commissioner and other public health officials charged with the health, safety, and welfare of the state's citizens.

Subd. 1b.

Lead supervisor license.

Before an individual performs regulated lead work as a supervisor, the individual shall first obtain a license from the commissioner. No license shall be issued unless the individual shows evidence of experience and successful completion of a training course in lead hazard control. The commissioner shall specify the course of training, experience, and testing requirements and shall charge a $50 fee new text begin annually new text end for the license. License fees are nonrefundable and must be submitted with each application. The license must be carried by the individual and be readily available for review by the commissioner and other public health officials charged with the health, safety, and welfare of the state's citizens.

Subd. 1c.

Lead inspector license.

Before an individual performs lead inspection services, the individual shall first obtain a license from the commissioner. No license shall be issued unless the individual shows evidence of successfully completing a training course in lead inspection. The commissioner shall specify the course of training and testing requirements and shall charge a $50 fee new text begin annually new text end for the license. License fees are nonrefundable and must be submitted with each application. The license must be carried by the individual and be readily available for review by the commissioner and other public health officials charged with the health, safety, and welfare of the state's citizens.

Subd. 1d.

Lead risk assessor license.

Before an individual performs lead risk assessor services, the individual shall first obtain a license from the commissioner. No license shall be issued unless the individual shows evidence of experience and successful completion of a training course in lead risk assessment. The commissioner shall specify the course of training, experience, and testing requirements and shall charge a $100 fee new text begin annually new text end for the license. License fees are nonrefundable and must be submitted with each application. The license must be carried by the individual and be readily available for review by the commissioner and other public health officials charged with the health, safety, and welfare of the state's citizens.

Subd. 1e.

Lead project designer license.

Before an individual performs lead project designer services, the individual shall first obtain a license from the commissioner. No license shall be issued unless the individual shows evidence of experience and successful completion of a training course in lead project design. The commissioner shall specify the course of training, experience, and testing requirements and shall charge a $100 fee new text begin annually new text end for the license. License fees are nonrefundable and must be submitted with each application. The license must be carried by the individual and be readily available for review by the commissioner and other public health officials charged with the health, safety, and welfare of the state's citizens.

deleted text begin Subd. 1f. deleted text end

deleted text begin Lead sampling technician. deleted text end

deleted text begin An individual performing lead sampling technician services shall first register with the commissioner. The commissioner shall not register an individual unless the individual shows evidence of successfully completing a training course in lead sampling. The commissioner shall specify the course of training and testing requirements. Proof of registration must be carried by the individual and be readily available for review by the commissioner and other public health officials charged with the health, safety, and welfare of the state's citizens. deleted text end

Subd. 1g.

Certified lead firm.

A person who employs individuals to perform regulated lead worknew text begin , with the exception of renovation,new text end outside of the person's property must obtain certification as a lead firm. The certificate must be in writing, contain an expiration date, be signed by the commissioner, and give the name and address of the person to whom it is issued. new text begin A lead firm certificate is valid for one year. new text end The certification fee is $100, is nonrefundable, and must be submitted with each application. The new text begin lead firm new text end certificate or a copy of the certificate must be readily available at the worksite for review by the contracting entity, the commissioner, and other public health officials charged with the health, safety, and welfare of the state's citizens.

new text begin Subd. 1h. new text end

new text begin Certified renovation firm. new text end

new text begin A person who employs individuals to perform renovation activities outside of the person's property must obtain certification as a renovation firm. The certificate must be in writing, contain an expiration date, be signed by the commissioner, and give the name and address of the person to whom it is issued. A renovation firm certificate is valid for two years. The certification fee is $100, is nonrefundable, and must be submitted with each application. The renovation firm certificate or a copy of the certificate must be readily available at the worksite for review by the contracting entity, the commissioner, and other public health officials charged with the health, safety, and welfare of the state's citizens. new text end

new text begin Subd. 1i. new text end

new text begin Lead training course. new text end

new text begin Before a person provides training to lead workers, lead supervisors, lead inspectors, lead risk assessors, lead project designers, lead sampling technicians, and lead renovators, the person shall first obtain a permit from the commissioner. The permit must be in writing, contain an expiration date, be signed by the commissioner, and give the name and address of the person to whom it is issued. A training course permit is valid for two years. Training course permit fees shall be nonrefundable and must be submitted with each application in the amount of $500 for an initial training course, $250 for renewal of a permit for an initial training course, $250 for a refresher training course, and $125 for renewal of a permit of a refresher training course. new text end

Subd. 3.

Licensed building contractor; information.

The commissioner shall provide health and safety information on lead abatement and lead hazard reduction to all residential building contractors licensed under section 326B.805. The information must include the lead-safe practices and any other materials describing ways to protect the health and safety of both employees and residents.

Subd. 4.

Notice of regulated lead work.

(a) At least five working days before starting work at each regulated lead worksite, the person performing the regulated lead work shall give written notice to the commissioner and the appropriate board of health.

(b) This provision does not apply to lead hazard screen, lead inspection, lead risk assessment, lead sampling technician, renovation, or lead project design activities.

Subd. 6.

Duties of contracting entity.

A contracting entity intending to have regulated lead work performed for its benefit shall include in the specifications and contracts for the work a requirement that the work be performed by contractors and subcontractors licensed by the commissioner under sections 144.9501 to 144.9512 and according to rules adopted by the commissioner related to regulated lead work. No contracting entity shall allow regulated lead work to be performed for its benefit unless the contracting entity has seen that the person has a valid license or certificate. A contracting entity's failure to comply with this subdivision does not relieve a person from any responsibility under sections 144.9501 to 144.9512.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 33.

Minnesota Statutes 2014, section 144.9508, is amended to read:

144.9508 RULES.

Subdivision 1.

Sampling and analysis.

The commissioner shall adopt, by rule, methods for:

(1) lead inspections, lead hazard screens, lead risk assessments, and clearance inspections;

(2) environmental surveys of lead in paint, soil, dust, and drinking water to determine areas at high risk for toxic lead exposure;

(3) soil sampling for soil used as replacement soil;

(4) drinking water sampling, which shall be done in accordance with lab certification requirements and analytical techniques specified by Code of Federal Regulations, title 40, section 141.89; and

(5) sampling to determine whether at least 25 percent of the soil samples collected from a census tract within a standard metropolitan statistical area contain lead in concentrations that exceed 100 parts per million.

Subd. 2.

Regulated lead work standards and methods.

(a) The commissioner shall adopt rules establishing regulated lead work standards and methods in accordance with the provisions of this section, for lead in paint, dust, drinking water, and soil in a manner that protects public health and the environment for all residences, including residences also used for a commercial purpose, child care facilities, playgrounds, and schools.

(b) In the rules required by this section, the commissioner shall require lead hazard reduction of intact paint only if the commissioner finds that the intact paint is on a chewable or lead-dust producing surface that is a known source of actual lead exposure to a specific individual. The commissioner shall prohibit methods that disperse lead dust into the air that could accumulate to a level that would exceed the lead dust standard specified under this section. The commissioner shall work cooperatively with the commissioner of administration to determine which lead hazard reduction methods adopted under this section may be used for lead-safe practices including prohibited practices, preparation, disposal, and cleanup. The commissioner shall work cooperatively with the commissioner of the Pollution Control Agency to develop disposal procedures. In adopting rules under this section, the commissioner shall require the best available technology for regulated lead work methods, paint stabilization, and repainting.

(c) The commissioner of health shall adopt regulated lead work standards and methods for lead in bare soil in a manner to protect public health and the environment. The commissioner shall adopt a maximum standard of 100 parts of lead per million in bare soil. The commissioner shall set a soil replacement standard not to exceed 25 parts of lead per million. Soil lead hazard reduction methods shall focus on erosion control and covering of bare soil.

(d) The commissioner shall adopt regulated lead work standards and methods for lead in dust in a manner to protect the public health and environment. Dust standards shall use a weight of lead per area measure and include dust on the floor, on the window sills, and on window wells. Lead hazard reduction methods for dust shall focus on dust removal and other practices which minimize the formation of lead dust from paint, soil, or other sources.

(e) The commissioner shall adopt lead hazard reduction standards and methods for lead in drinking water both at the tap and public water supply system or private well in a manner to protect the public health and the environment. The commissioner may adopt the rules for controlling lead in drinking water as contained in Code of Federal Regulations, title 40, part 141. Drinking water lead hazard reduction methods may include an educational approach of minimizing lead exposure from lead in drinking water.

(f) The commissioner of the Pollution Control Agency shall adopt rules to ensure that removal of exterior lead-based coatings from residences and steel structures by abrasive blasting methods is conducted in a manner that protects health and the environment.

(g) All regulated lead work standards shall provide reasonable margins of safety that are consistent with more than a summary review of scientific evidence and an emphasis on overprotection rather than underprotection when the scientific evidence is ambiguous.

(h) No unit of local government shall have an ordinance or regulation governing regulated lead work standards or methods for lead in paint, dust, drinking water, or soil that require a different regulated lead work standard or method than the standards or methods established under this section.

(i) Notwithstanding paragraph (h), the commissioner may approve the use by a unit of local government of an innovative lead hazard reduction method which is consistent in approach with methods established under this section.

(j) The commissioner shall adopt rules for issuing lead orders required under section 144.9504, rules for notification of abatement or interim control activities requirements, and other rules necessary to implement sections 144.9501 to 144.9512.

(k) The commissioner shall adopt rules consistent with section 402(c)(3) of the Toxic Substances Control Act to ensure that renovation in a pre-1978 affected property where a child or pregnant female resides is conducted in a manner that protects health and the environment.new text begin Notwithstanding sections 14.125 and 14.128, the authority to adopt these rules does not expire.new text end

(l) The commissioner shall adopt rules consistent with sections 406(a) and 406(b) of the Toxic Substances Control Act.new text begin Notwithstanding sections 14.125 and 14.128, the authority to adopt these rules does not expire.new text end

Subd. 2a.

Lead standards for exterior surfaces and street dust.

The commissioner may, by rule, establish lead standards for exterior horizontal surfaces, concrete or other impervious surfaces, and street dust on residential property to protect the public health and the environment.

Subd. 3.

Licensure and certification.

The commissioner shall adopt rules to license lead supervisors, lead workers, lead project designers, lead inspectors, lead risk assessors, and lead sampling technicians. The commissioner shall also adopt rules requiring certification of firms that perform regulated lead work. The commissioner shall require periodic renewal of licenses and certificates and shall establish the renewal periods.

Subd. 4.

Lead training course.

The commissioner shall establish by rule requirements for training course providers and the renewal period for each lead-related training course required for certification or licensure. The commissioner shall establish criteria in rules for the content and presentation of training courses intended to qualify trainees for licensure under subdivision 3. The commissioner shall establish criteria in rules for the content and presentation of training courses for lead renovation and lead sampling technicians. deleted text begin Training course permit fees shall be nonrefundable and must be submitted with each application in the amount of $500 for an initial training course, $250 for renewal of a permit for an initial training course, $250 for a refresher training course, and $125 for renewal of a permit of a refresher training course.deleted text end

Subd. 5.

Variances.

In adopting the rules required under this section, the commissioner shall provide variance procedures for any provision in rules adopted under this section, except for the numerical standards for the concentrations of lead in paint, dust, bare soil, and drinking water. A variance shall be considered only according to the procedures and criteria in Minnesota Rules, parts 4717.7000 to 4717.7050.

new text begin EFFECTIVE DATE. new text end

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

Sec. 34.

new text begin [144.999] LIFE-SAVING ALLERGY MEDICATION. 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 following terms have the meanings given. new text end

new text begin (b) "Administer" means the direct application of an epinephrine auto-injector to the body of an individual. new text end

new text begin (c) "Authorized entity" means entities that fall in the categories of recreation camps, colleges and universities, preschools and daycares, and any other category of entities or organizations that the commissioner authorizes to obtain and administer epinephrine auto-injectors without a prescription. This definition does not include a school covered under section 121A.2207. new text end

new text begin (d) "Commissioner" means the commissioner of health. new text end

new text begin (e) "Epinephrine auto-injector" means a single-use device used for the automatic injection of a premeasured dose of epinephrine into the human body. new text end

new text begin (f) "Provide" means to supply one or more epinephrine auto-injectors to an individual or the individual's parent, legal guardian, or caretaker. new text end

new text begin Subd. 2. new text end

new text begin Commissioner duties. new text end

new text begin The commissioner may identify additional categories of entities or organizations to be authorized entities if the commissioner determines that individuals may come in contact with allergens capable of causing anaphylaxis. Beginning July 1, 2016, the commissioner may annually review the categories of authorized entities and may authorize additional categories of authorized entities as the commissioner deems appropriate. The commissioner may contract with a vendor to perform the review and identification of authorized entities. new text end

new text begin Subd. 3. new text end

new text begin Obtaining and storing epinephrine auto-injectors. new text end

new text begin (a) Notwithstanding section 151.37, an authorized entity may obtain and possess epinephrine auto-injectors to be provided or administered to an individual if, in good faith, an owner, manager, employee, or agent of an authorized entity believes that the individual is experiencing anaphylaxis regardless of whether the individual has a prescription for an epinephrine auto-injector. The administration of an epinephrine auto-injector in accordance with this section is not the practice of medicine. new text end

new text begin (b) An authorized entity may obtain epinephrine auto-injectors from pharmacies licensed as wholesale drug distributors pursuant to section 151.47. Prior to obtaining an epinephrine auto-injector, an owner, manager, or authorized agent of the entity must present to the pharmacy a valid certificate of training obtained pursuant to subdivision 5. new text end

new text begin (c) An authorized entity shall store epinephrine auto-injectors in a location readily accessible in an emergency and in accordance with the epinephrine auto-injector's instructions for use and any additional requirements that may be established by the commissioner. An authorized entity shall designate employees or agents who have completed the training program required under subdivision 5 to be responsible for the storage, maintenance, and control of epinephrine auto-injectors obtained and possessed by the authorized entity. new text end

new text begin Subd. 4. new text end

new text begin Use of epinephrine auto-injectors. new text end

new text begin (a) An owner, manager, employee, or agent of an authorized entity who has completed the training required under subdivision 5 may: new text end

new text begin (1) provide an epinephrine auto-injector for immediate administration to an individual or the individual's parent, legal guardian, or caregiver if the owner, manager, employee, or agent believes, in good faith, the individual is experiencing anaphylaxis, regardless of whether the individual has a prescription for an epinephrine auto-injector or has previously been diagnosed with an allergy; or new text end

new text begin (2) administer an epinephrine auto-injector to an individual who the owner, manager, employee, or agent believes, in good faith, is experiencing anaphylaxis, regardless of whether the individual has a prescription for an epinephrine auto-injector or has previously been diagnosed with an allergy. new text end

new text begin (b) Nothing in this section shall be construed to require any authorized entity to maintain a stock of epinephrine auto-injectors. new text end

new text begin Subd. 5. new text end

new text begin Training. new text end

new text begin (a) In order to use an epinephrine auto-injector as authorized under subdivision 4, an individual must complete, every two years, an anaphylaxis training program conducted by a nationally recognized organization experienced in training laypersons in emergency health treatment, a statewide organization with experience providing training on allergies and anaphylaxis under the supervision of board-certified allergy medical advisors, or an entity or individual approved by the commissioner to provide an anaphylaxis training program. The commissioner may approve specific entities or individuals to conduct the training program or may approve categories of entities or individuals to conduct the training program. Training may be conducted online or in person and, at a minimum, must cover: new text end

new text begin (1) how to recognize signs and symptoms of severe allergic reactions, including anaphylaxis; new text end

new text begin (2) standards and procedures for the storage and administration of an epinephrine auto-injector; and new text end

new text begin (3) emergency follow-up procedures. new text end

new text begin (b) The entity or individual conducting the training shall issue a certificate to each person who successfully completes the anaphylaxis training program. The commissioner may develop, approve, and disseminate a standard certificate of completion. The certificate of completion shall be valid for two years from the date issued. new text end

new text begin Subd. 6. new text end

new text begin Good samaritan protections. new text end

new text begin Any act or omission taken pursuant to this section by an authorized entity that possesses and makes available epinephrine auto-injectors and its employees or agents, a pharmacy or manufacturer that dispenses epinephrine auto-injectors to an authorized entity, or an individual or entity that conducts the training described in subdivision 5 is considered "emergency care, advice, or assistance" under section 604A.01. new text end

Sec. 35.

Minnesota Statutes 2014, section 144A.70, subdivision 6, is amended to read:

Subd. 6.

Supplemental nursing services agency.

"Supplemental nursing services agency" means a person, firm, corporation, partnership, or association engaged for hire in the business of providing or procuring temporary employment in health care facilities for nurses, nursing assistants, nurse aides, deleted text begin anddeleted text end orderliesnew text begin , and other licensed health professionalsnew text end . Supplemental nursing services agency does not include an individual who only engages in providing the individual's services on a temporary basis to health care facilities. Supplemental nursing services agency does not include a professional home care agency licensed deleted text begin as a Class A providerdeleted text end under section deleted text begin 144A.46deleted text end deleted text begin and rules adopted thereunderdeleted text end new text begin 144A.471new text end that only provides staff to other home care providers.

Sec. 36.

Minnesota Statutes 2014, section 144A.70, is amended by adding a subdivision to read:

new text begin Subd. 7. new text end

new text begin Oversight. new text end

new text begin The commissioner is responsible for the oversight of supplemental nursing services agencies through annual unannounced surveys, complaint investigations under sections 144A.51 to 144A.53, and other actions necessary to ensure compliance with sections 144A.70 to 144A.74. new text end

Sec. 37.

Minnesota Statutes 2014, section 144A.71, is amended to read:

144A.71 SUPPLEMENTAL NURSING SERVICES AGENCY REGISTRATION.

Subdivision 1.

Duty to register.

A person who operates a supplemental nursing services agency shall register deleted text begin the agencydeleted text end new text begin annuallynew text end with the commissioner. Each separate location of the business of a supplemental nursing services agency shall register the agency with the commissioner. Each separate location of the business of a supplemental nursing services agency shall have a separate registration.new text begin Fees collected under this section shall be deposited in the state treasury and credited to the state government special revenue fund.new text end

Subd. 2.

Application information and fee.

The commissioner shall establish forms and procedures for processing each supplemental nursing services agency registration application. An application for a supplemental nursing services agency registration must include at least the following:

(1) the names and addresses of the owner or owners of the supplemental nursing services agency;

(2) if the owner is a corporation, copies of its articles of incorporation and current bylaws, together with the names and addresses of its officers and directors;

(3) satisfactory proof of compliance with section 144A.72, subdivision 1, clauses (5) to (7);

(4) any other relevant information that the commissioner determines is necessary to properly evaluate an application for registration; deleted text begin anddeleted text end

(5) deleted text begin the annual registration fee for a supplemental nursing services agency, which is $891.deleted text end new text begin a policy and procedure that describes how the supplemental nursing services agency's records will be immediately available at all times to the commissioner; andnew text end

new text begin (6) a registration fee of $2,035. new text end

new text begin If a supplemental nursing services agency fails to provide the items in this subdivision to the department, the commissioner shall immediately suspend or refuse to issue the supplemental nursing services agency registration. The supplemental nursing services agency may appeal the commissioner's findings according to section 144A.475, subdivisions 3a and 7, except that the hearing must be conducted by an administrative law judge within 60 calendar days of the request for hearing assignment. new text end

Subd. 3.

Registration not transferable.

A registration issued by the commissioner according to this section is effective for a period of one year from the date of its issuance unless the registration is revoked or suspended under section 144A.72, subdivision 2, or unless the supplemental nursing services agency is sold or ownership or management is transferred. When a supplemental nursing services agency is sold or ownership or management is transferred, the registration of the agency must be voided and the new owner or operator may apply for a new registration.

Sec. 38.

Minnesota Statutes 2014, section 144A.72, is amended to read:

144A.72 REGISTRATION REQUIREMENTS; PENALTIES.

Subdivision 1.

Minimum criteria.

new text begin (a) new text end The commissioner shall require that, as a condition of registration:

(1) the supplemental nursing services agency shall document that each temporary employee provided to health care facilities currently meets the minimum licensing, training, and continuing education standards for the position in which the employee will be working;

(2) the supplemental nursing services agency shall comply with all pertinent requirements relating to the health and other qualifications of personnel employed in health care facilities;

(3) the supplemental nursing services agency must not restrict in any manner the employment opportunities of its employees;

(4) the supplemental nursing services agency shall carry medical malpractice insurance to insure against the loss, damage, or expense incident to a claim arising out of the death or injury of any person as the result of negligence or malpractice in the provision of health care services by the supplemental nursing services agency or by any employee of the agency;

(5) the supplemental nursing services agency shall carry an employee dishonesty bond in the amount of $10,000;

(6) the supplemental nursing services agency shall maintain insurance coverage for workers' compensation for all nurses, nursing assistants, nurse aides, and orderlies provided or procured by the agency;

(7) the supplemental nursing services agency shall file with the commissioner of revenue: (i) the name and address of the bank, savings bank, or savings association in which the supplemental nursing services agency deposits all employee income tax withholdings; and (ii) the name and address of any nurse, nursing assistant, nurse aide, or orderly whose income is derived from placement by the agency, if the agency purports the income is not subject to withholding;

(8) the supplemental nursing services agency must not, in any contract with any employee or health care facility, require the payment of liquidated damages, employment fees, or other compensation should the employee be hired as a permanent employee of a health care facility; deleted text begin anddeleted text end

(9) the supplemental nursing services agency shall document that each temporary employee provided to health care facilities is an employee of the agency and is not an independent contractordeleted text begin .deleted text end new text begin ; andnew text end

new text begin (10) the supplemental nursing services agency shall retain all records for five calendar years. All records of the supplemental nursing services agency must be immediately available to the department. new text end

new text begin (b) In order to retain registration, the supplemental nursing services agency must provide services to a health care facility during the year preceding the supplemental nursing services agency's registration renewal date. new text end

Subd. 2.

Penalties.

deleted text begin A pattern ofdeleted text end Failure to comply with this section shall subject the supplemental nursing services agency to revocation or nonrenewal of its registration. Violations of section 144A.74 are subject to a fine equal to 200 percent of the amount billed or received in excess of the maximum permitted under that section.

Subd. 3.

Revocation.

Notwithstanding subdivision 2, the registration of a supplemental nursing services agency that knowingly supplies to a health care facility a person with an illegally or fraudulently obtained or issued diploma, registration, license, certificate, or background study shall be revoked by the commissioner. The commissioner shall notify the supplemental nursing services agency 15 days in advance of the date of revocation.

Subd. 4.

Hearing.

(a) No supplemental nursing services agency's registration may be revoked without a hearing held as a contested case in accordance with deleted text begin chapter 14. The hearing must commence within 60 days after the proceedings are initiated deleted text end new text begin section 144A.475, subdivisions 3a and 7, except the hearing must be conducted by an administrative law judge within 60 calendar days of the request for assignmentnew text end .

(b) If a controlling person has been notified by the commissioner of health that the supplemental nursing services agency will not receive an initial registration or that a renewal of the registration has been denied, the controlling person or a legal representative on behalf of the supplemental nursing services agency may request and receive a hearing on the denial. deleted text begin Thisdeleted text end new text begin Thenew text end hearing shall be deleted text begin held as a contested case in accordance with chapter 14deleted text end new text begin a contested case in accordance with section 144A.475, subdivisions 3a and 7, except the hearing must be conducted by an administrative law judge within 60 calendar days of the request for assignmentnew text end .

Subd. 5.

Period of ineligibility.

(a) The controlling person of a supplemental nursing services agency whose registration has not been renewed or has been revoked because of noncompliance with the provisions of sections 144A.70 to 144A.74 shall not be eligible to apply for nor will be granted a registration for five years following the effective date of the nonrenewal or revocation.

(b) The commissioner shall not issue or renew a registration to a supplemental nursing services agency if a controlling person includes any individual or entity who was a controlling person of a supplemental nursing services agency whose registration was not renewed or was revoked as described in paragraph (a) for five years following the effective date of nonrenewal or revocation.

Sec. 39.

Minnesota Statutes 2014, section 144A.73, is amended to read:

144A.73 COMPLAINT SYSTEM.

The commissioner shall establish a system for reporting complaints against a supplemental nursing services agency or its employees. Complaints may be made by any member of the public. deleted text begin Written complaints must be forwarded to the employer of each person against whom a complaint is made. The employer shall promptly report to the commissioner any corrective action takendeleted text end new text begin Complaints against a supplemental nursing services agency shall be investigated by the Office of Health Facility Complaints under sections 144A.51 to 144A.53new text end .

Sec. 40.

Minnesota Statutes 2014, section 144A.75, subdivision 13, is amended to read:

Subd. 13.

Residential hospice facility.

new text begin (a) new text end "Residential hospice facility" means a facility that resembles a single-family home located in a residential area that directly provides 24-hour residential and support services in a home-like setting for hospice patients as an integral part of the continuum of home care provided by a hospice and that houses:

(1) no more than eight hospice patients; or

(2) at least nine and no more than 12 hospice patients with the approval of the local governing authority, notwithstanding section 462.357, subdivision 8.

new text begin (b) Residential hospice facility also means a facility that directly provides 24-hour residential and support services for hospice patients and that: new text end

new text begin (1) houses no more than 21 hospice patients; new text end

new text begin (2) meets hospice certification regulations adopted pursuant to title XVIII of the federal Social Security Act, United States Code, title 42, section 1395, et seq.; and new text end

new text begin (3) is located on St. Anthony Avenue in St. Paul, Minnesota, and was licensed as a 40-bed non-Medicare certified nursing home as of January 1, 2015. 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. 41.

Minnesota Statutes 2014, section 144D.01, is amended by adding a subdivision to read:

new text begin Subd. 3a. new text end

new text begin Direct-care staff. new text end

new text begin "Direct-care staff" means staff and employees who provide home care services listed in section 144A.471, subdivisions 6 and 7. new text end

Sec. 42.

new text begin [144D.066] ENFORCEMENT OF DEMENTIA CARE TRAINING REQUIREMENTS. new text end

new text begin Subdivision 1. new text end

new text begin Enforcement. new text end

new text begin (a) The commissioner shall enforce the dementia care training standards for staff working in housing with services settings and for housing managers according to clauses (1) to (3): new text end

new text begin (1) for dementia care training requirements in section 144D.065, the commissioner shall review training records as part of the home care provider survey process for direct care staff and supervisors of direct care staff, in accordance with section 144A.474. The commissioner may also request and review training records at any time during the year; new text end

new text begin (2) for dementia care training standards in section 144D.065, the commissioner shall review training records for maintenance, housekeeping, and food service staff and other staff not providing direct care working in housing with services settings as part of the housing with services registration application and renewal application process in accordance with section 144D.03. The commissioner may also request and review training records at any time during the year; and new text end

new text begin (3) for housing managers, the commissioner shall review the statement verifying compliance with the required training described in section 144D.10, paragraph (d), through the housing with services registration application and renewal application process in accordance with section 144D.03. The commissioner may also request and review training records at any time during the year. new text end

new text begin (b) The commissioner shall specify the required forms and what constitutes sufficient training records for the items listed in paragraph (a), clauses (1) to (3). new text end

new text begin Subd. 2. new text end

new text begin Fines for noncompliance. new text end

new text begin (a) Beginning January 1, 2017, the commissioner may impose a $200 fine for every staff person required to obtain dementia care training who does not have training records to show compliance. For violations of subdivision 1, paragraph (a), clause (1), the fine will be imposed upon the home care provider, and may be appealed under the contested case procedure in section 144A.475, subdivisions 3a, 4, and 7. For violations of subdivision 1, paragraph (a), clauses (2) and (3), the fine will be imposed on the housing with services registrant and may be appealed under the contested case procedure in section 144A.475, subdivisions 3a, 4, and 7. Prior to imposing the fine, the commissioner must allow two weeks for staff to complete the required training. Fines collected under this section shall be deposited in the state treasury and credited to the state government special revenue fund. new text end

new text begin (b) The housing with services registrant and home care provider must allow for the required training as part of employee and staff duties. Imposition of a fine by the commissioner does not negate the need for the required training. Continued noncompliance with the requirements of sections 144D.065 and 144D.10 may result in revocation or nonrenewal of the housing with services registration or home care license. The commissioner shall make public the list of all housing with services establishments that have complied with the training requirements. new text end

new text begin Subd. 3. new text end

new text begin Technical assistance. new text end

new text begin From January 1, 2016, to December 31, 2016, the commissioner shall provide technical assistance instead of imposing fines for noncompliance with the training requirements. During the year of technical assistance, the commissioner shall review the training records to determine if the records meet the requirements and inform the home care provider. The commissioner shall also provide information about available training resources. new text end

Sec. 43.

Minnesota Statutes 2014, section 145.4131, subdivision 1, is amended to read:

Subdivision 1.

Forms.

(a) Within 90 days of July 1, 1998, the commissioner shall prepare a reporting form for use by physicians or facilities performing abortions. A copy of this section shall be attached to the form. A physician or facility performing an abortion shall obtain a form from the commissioner.

(b) The form shall require the following information:

(1) the number of abortions performed by the physician in the previous calendar year, reported by month;

(2) the method used for each abortion;

(3) the approximate gestational age expressed in one of the following increments:

(i) less than nine weeks;

(ii) nine to ten weeks;

(iii) 11 to 12 weeks;

(iv) 13 to 15 weeks;

(v) 16 to 20 weeks;

(vi) 21 to 24 weeks;

(vii) 25 to 30 weeks;

(viii) 31 to 36 weeks; or

(ix) 37 weeks to term;

(4) the age of the woman at the time the abortion was performed;

(5) the specific reason for the abortion, including, but not limited to, the following:

(i) the pregnancy was a result of rape;

(ii) the pregnancy was a result of incest;

(iii) economic reasons;

(iv) the woman does not want children at this time;

(v) the woman's emotional health is at stake;

(vi) the woman's physical health is at stake;

(vii) the woman will suffer substantial and irreversible impairment of a major bodily function if the pregnancy continues;

(viii) the pregnancy resulted in fetal anomalies; or

(ix) unknown or the woman refused to answer;

(6) the number of prior induced abortions;

(7) the number of prior spontaneous abortions;

(8) whether the abortion was paid for by:

(i) private coverage;

(ii) public assistance health coverage; or

(iii) self-pay;

(9) whether coverage was under:

(i) a fee-for-service plan;

(ii) a capitated private plan; or

(iii) other;

(10) complications, if any, for each abortion and for the aftermath of each abortion. Space for a description of any complications shall be available on the form; deleted text begin anddeleted text end

(11) the medical specialty of the physician performing the abortionnew text begin ;new text end

new text begin (12) whether the abortion resulted in a born alive infant, as defined in section 145.423, subdivision 4, and: new text end

new text begin (i) any medical actions taken to preserve the life of the born alive infant; new text end

new text begin (ii) whether the born alive infant survived; and new text end

new text begin (iii) the status of the born alive infant, should the infant survive, if knownnew text end .

Sec. 44.

Minnesota Statutes 2014, section 145.423, is amended to read:

145.423 ABORTION; LIVE BIRTHS.

Subdivision 1.

Recognition; medical care.

A deleted text begin live child borndeleted text end new text begin born alive infantnew text end as a result of an abortion shall be fully recognized as a human person, and accorded immediate protection under the law. All reasonable measures consistent with good medical practice, including the compilation of appropriate medical records, shall be takennew text begin by the responsible medical personnelnew text end to preserve the life and health of the deleted text begin childdeleted text end new text begin born alive infantnew text end .

Subd. 2.

Physician required.

When an abortion is performed after the twentieth week of pregnancy, a physician, other than the physician performing the abortion, shall be immediately accessible to take all reasonable measures consistent with good medical practice, including the compilation of appropriate medical records, to preserve the life and health of any deleted text begin live birthdeleted text end new text begin born alive infantnew text end that is the result of the abortion.

Subd. 3.

Death.

If a deleted text begin childdeleted text end new text begin born alive infantnew text end described in subdivision 1 dies after birth, the body shall be disposed of in accordance with the provisions of section 145.1621.

new text begin Subd. 4. new text end

new text begin Definition of born alive infant. new text end

new text begin (a) In determining the meaning of any Minnesota statute, or of any ruling, regulation, or interpretation of the various administrative bureaus and agencies of Minnesota, the words "person," "human being," "child," and "individual" shall include every infant member of the species Homo sapiens who is born alive at any stage of development. new text end

new text begin (b) As used in this section, the term "born alive," with respect to a member of the species Homo sapiens, means the complete expulsion or extraction from his or her mother of that member, at any stage of development, who, after such expulsion or extraction, breathes or has a beating heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, regardless of whether the umbilical cord has been cut, and regardless of whether the expulsion or extraction occurs as a result of a natural or induced labor, cesarean section, or induced abortion. new text end

new text begin (c) Nothing in this section shall be construed to affirm, deny, expand, or contract any legal status or legal right applicable to any member of the species Homo sapiens at any point prior to being born alive, as defined in this section. new text end

new text begin Subd. 5. new text end

new text begin Civil and disciplinary actions. new text end

new text begin (a) Any person upon whom an abortion has been performed, or the parent or guardian of the mother if the mother is a minor, and the abortion results in the infant having been born alive, may maintain an action for death of or injury to the born alive infant against the person who performed the abortion if the death or injury was a result of simple negligence, gross negligence, wantonness, willfulness, intentional conduct, or another violation of the legal standard of care. new text end

new text begin (b) Any responsible medical personnel that does not take all reasonable measures consistent with good medical practice to preserve the life and health of the born alive infant, as required by subdivision 1, may be subject to the suspension or revocation of that person's professional license by the professional board with authority over that person. Any person who has performed an abortion and against whom judgment has been rendered pursuant to paragraph (a) shall be subject to an automatic suspension of the person's professional license for at least one year and said license shall be reinstated only after the person's professional board requires compliance with this section by all board licensees. new text end

new text begin (c) Nothing in this subdivision shall be construed to hold the mother of the born alive infant criminally or civilly liable for the actions of a physician, nurse, or other licensed health care provider in violation of this section to which the mother did not give her consent. new text end

new text begin Subd. 6. new text end

new text begin Protection of privacy in court proceedings. new text end

new text begin In every civil action brought under this section, the court shall rule whether the anonymity of any female upon whom an abortion has been performed or attempted shall be preserved from public disclosure if she does not give her consent to such disclosure. The court, upon motion or sua sponte, shall make such a ruling and, upon determining that her anonymity should be preserved, shall issue orders to the parties, witnesses, and counsel and shall direct the sealing of the record and exclusion of individuals from courtrooms or hearing rooms to the extent necessary to safeguard her identity from public disclosure. Each order must be accompanied by specific written findings explaining why the anonymity of the female should be preserved from public disclosure, why the order is essential to that end, how the order is narrowly tailored to serve that interest, and why no reasonable, less restrictive alternative exists. This section may not be construed to conceal the identity of the plaintiff or of witnesses from the defendant. new text end

new text begin Subd. 7. new text end

new text begin Status of born alive infant. new text end

new text begin Unless the abortion is performed to save the life of the woman or fetus, or, unless one or both of the parents of the born alive infant agree within 30 days of the birth to accept the parental rights and responsibilities for the child, the child shall be an abandoned ward of the state and the parents shall have no parental rights or obligations as if the parental rights had been terminated pursuant to section 260C.301. The child shall be provided for pursuant to chapter 256J. new text end

new text begin Subd. 8. new text end

new text begin Severability. new text end

new text begin If any one or more provision, section, subdivision, sentence, clause, phrase, or word of this section or the application of it to any person or circumstance is found to be unconstitutional, it is declared to be severable and the balance of this section shall remain effective notwithstanding such unconstitutionality. The legislature intends that it would have passed this section, and each provision, section, subdivision, sentence, clause, phrase, or word, regardless of the fact that any one provision, section, subdivision, sentence, clause, phrase, or word is declared unconstitutional. new text end

new text begin Subd. 9. new text end

new text begin Short title. new text end

new text begin This act may be cited as the "Born Alive Infants Protection Act." new text end

Sec. 45.

Minnesota Statutes 2014, section 145.928, subdivision 13, is amended to read:

Subd. 13.

deleted text begin Reportdeleted text end new text begin Reportsnew text end .

new text begin (a) new text end The commissioner shall submit a biennial report to the legislature on the local community projects, tribal government, and community health board prevention activities funded under this section. These reports must include information on grant recipients, activities that were conducted using grant funds, evaluation data, and outcome measures, if available. These reports are due by January 15 of every other year, beginning in the year 2003.

new text begin (b) The commissioner shall submit an annual report to the chairs and ranking minority members of the house of representatives and senate committees with jurisdiction over public health on grants made under subdivision 7 to decrease racial and ethnic disparities in infant mortality rates. The report must provide specific information on the amount of each grant awarded to each agency or organization, the population served by each agency or organization, outcomes of the programs funded by each grant, and the amount of the appropriation retained by the commissioner for administrative and associated expenses. The commissioner shall issue a report each January 15 for the previous fiscal year beginning January 15, 2016. new text end

Sec. 46.

Minnesota Statutes 2014, section 145.928, is amended by adding a subdivision to read:

new text begin Subd. 15. new text end

new text begin Promising strategies. new text end

new text begin For all grants awarded under this section, the commissioner shall consider applicants that present evidence of a promising strategy to accomplish the applicant's objective. A promising strategy shall be given the same weight as a research or evidence-based strategy based on potential value and measurable outcomes. new text end

Sec. 47.

Minnesota Statutes 2014, section 145.986, subdivision 1a, is amended to read:

Subd. 1a.

Grants to local communities.

(a) Beginning July 1, 2009, the commissioner of health shall award competitive grants to community health boards and tribal governments to convene, coordinate, and implement evidence-based strategies targeted at reducing the percentage of Minnesotans who are obese or overweight and to reduce the use of tobacco. Grants shall be awarded to all community health boards and tribal governments whose proposals demonstrate the ability to implement programs designed to achieve the purposes in subdivision 1 and other requirements of this section.

(b) Grantee activities shall:

(1) be based on scientific evidence;

(2) be based on community input;

(3) address behavior change at the individual, community, and systems levels;

(4) occur in community, school, work site, and health care settings;

(5) be focused on policy, systems, and environmental changes that support healthy behaviors; and

(6) address the health disparities and inequities that exist in the grantee's community.

(c) To receive a grant under this section, community health boards and tribal governments must submit proposals to the commissioner. A local match of ten percent of the total funding allocation is required. This local match may include funds donated by community partners.

(d) In order to receive a grant, community health boards and tribal governments must submit a health improvement plan to the commissioner of health for approval. The commissioner may require the plan to identify a community leadership team, community partners, and a community action plan that includes an assessment of area strengths and needs, proposed action strategies, technical assistance needs, and a staffing plan.

(e) The grant recipient must implement the health improvement plan, evaluate the effectiveness of the strategies, and modify or discontinue strategies found to be ineffective.

(f) Grant recipients shall report their activities and their progress toward the outcomes established under subdivision 2 to the commissioner in a format and at a time specified by the commissioner.

(g) All grant recipients shall be held accountable for making progress toward the measurable outcomes established in subdivision 2. The commissioner shall require a corrective action plan and may reduce the funding level of grant recipients that do not make adequate progress toward the measurable outcomes.

new text begin (h) Beginning November 1, 2015, the commissioner shall offer grant recipients the option of using a grant awarded under this subdivision to implement health improvement strategies that improve the health status, delay the expression of dementia, or slow the progression of dementia, for a targeted population at risk for dementia and shall award at least two of the grants awarded on November 1, 2015, for these purposes. The grants must meet all other requirements of this section. The commissioner shall coordinate grant planning activities with the commissioner of human services, the Minnesota Board on Aging, and community-based organizations with a focus on dementia. Each grant must include selected outcomes and evaluation measures related to the incidence or progression of dementia among the targeted population using the procedure described in subdivision 2. new text end

Sec. 48.

Minnesota Statutes 2014, section 145.986, subdivision 2, is amended to read:

Subd. 2.

Outcomes.

(a) The commissioner shall set measurable outcomes to meet the goals specified in subdivision 1, and annually review the progress of grant recipients in meeting the outcomes.

(b) The commissioner shall measure current public health status, using existing measures and data collection systems when available, to determine baseline data against which progress shall be monitored.

new text begin (c) For grants awarded on or after July 1, 2016, the commissioner, in coordination with each grant recipient under section 145.986, must identify: new text end

new text begin (1) each geographic area or population to be targeted; new text end

new text begin (2) the policy, systems, or environmental strategy to be used to address one or more of the health indicators listed in section 62U.10, subdivision 6; and new text end

new text begin (3) the selected outcomes and evaluation measures for the grant, related to one or more of the health indicators listed in section 62U.10, subdivision 6, within the geographic area or among the population targeted. new text end

Sec. 49.

Minnesota Statutes 2014, section 145.986, subdivision 4, is amended to read:

Subd. 4.

Evaluation.

(a) Using the outcome measures established in subdivision 3, the commissioner shall conduct a biennial evaluation of the statewide health improvement program funded under this section. Grant recipients shall cooperate with the commissioner in the evaluation and provide the commissioner with the information necessary to conduct the evaluationnew text begin , including information on any impact on the health indicators listed in section 62U.10, subdivision 6, within the geographic area or among the population targetednew text end .

(b) Grant recipients will collect, monitor, and submit to the Department of Health baseline and annual data and provide information to improve the quality and impact of community health improvement strategies.

(c) For the purposes of carrying out the grant program under this section, including for administrative purposes, the commissioner shall award contracts to appropriate entities to assist in designing and implementing evaluation systems.

(d) Contracts awarded under paragraph (c) may be used to:

(1) develop grantee monitoring and reporting systems to track grantee progress, including aggregated and disaggregated data;

(2) manage, analyze, and report program evaluation data results; and

(3) utilize innovative support tools to analyze and predict the impact of prevention strategies on health outcomes and state health care costs over time.

Sec. 50.

Minnesota Statutes 2014, section 145A.131, subdivision 1, is amended to read:

Subdivision 1.

Funding formula for community health boards.

(a) Base funding for each community health board eligible for a local public health grant under section 145A.03, subdivision 7, shall be determined by each community health board's fiscal year 2003 allocations, prior to unallotment, for the following grant programs: community health services subsidy; state and federal maternal and child health special projects grants; family home visiting grants; TANF MN ENABL grants; TANF youth risk behavior grants; and available women, infants, and children grant funds in fiscal year 2003, prior to unallotment, distributed based on the proportion of WIC participants served in fiscal year 2003 within the CHS service area.

(b) Base funding for a community health board eligible for a local public health grant under section 145A.03, subdivision 7, as determined in paragraph (a), shall be adjusted by the percentage difference between the base, as calculated in paragraph (a), and the funding available for the local public health grant.

(c) Multicounty or multicity community health boards shall receive a local partnership base of up to $5,000 per year for each county or city in the case of a multicity community health board included in the community health board.

(d) The State Community Health Advisory Committee may recommend a formula to the commissioner to use in distributing deleted text begin state and federaldeleted text end funds to community health boards deleted text begin organized and operating under sections 145A.03 to 145A.131 to achieve locally identified priorities under section 145A.04, subdivision 1a, for use in distributing funds to community health boards beginning January 1, 2006, and thereafterdeleted text end .

new text begin (e) Notwithstanding any adjustment in paragraph (b), community health boards, all or a portion of which are located outside of the counties of Anoka, Chisago, Carver, Dakota, Hennepin, Isanti, Ramsey, Scott, Sherburne, Washington, and Wright, are eligible to receive an increase equal to ten percent of the grant award to the community health board under paragraph (a) starting July 1, 2015. The increase in calendar year 2015 shall be prorated for the last six months of the year. For calendar years beginning on or after January 1, 2016, the amount distributed under this paragraph shall be adjusted each year based on available funding and the number of eligible community health boards. new text end

Sec. 51.

Minnesota Statutes 2014, section 149A.20, subdivision 5, is amended to read:

Subd. 5.

Examinations.

After having met the educational requirements of subdivision 4, a person must attain a passing score on the National Board Examination administered by the Conference of Funeral Service Examining Boards of the United States, Inc. or any other examination that, in the determination of the commissioner, adequately and accurately assesses the knowledge and skills required to practice mortuary science. In addition, a person must attain a passing score on the state licensing examination administered by or on behalf of the commissioner. The state examination shall encompass the laws and rules of Minnesota that pertain to the practice of mortuary science. The commissioner shall make available copies of all pertinent laws and rules prior to administration of the state licensing examination.new text begin If a passing score is not attained on the state examination, the individual must wait two weeks before they can retake the examination.new text end

Sec. 52.

Minnesota Statutes 2014, section 149A.20, subdivision 6, is amended to read:

Subd. 6.

Internship.

(a) A person who attains a passing score on both examinations in subdivision 5 must complete a registered internship under the direct supervision of an individual currently licensed to practice mortuary science in Minnesota. Interns must file with the commissioner:

(1) the appropriate fee; and

(2) a registration form indicating the name and home address of the intern, the date the internship begins, and the name, license number, and business address of the supervising mortuary science licensee.

(b) Any changes in information provided in the registration must be immediately reported to the commissioner. The internship shall be a minimum of deleted text begin one calendar year and a maximum of three calendar years in duration;deleted text end new text begin 2,080 hours to be completed within a three-year period,new text end however, the commissioner may waive up to deleted text begin three monthsdeleted text end new text begin 520 hoursnew text end of the internship time requirement upon satisfactory completion of a clinical or practicum in mortuary science administered through the program of mortuary science of the University of Minnesota or a substantially similar programnew text begin approved by the commissionernew text end . Registrations must be renewed on an annual basis if they exceed one calendar year. During the internship period, the intern must be under the direct supervision of a person holding a current license to practice mortuary science in Minnesota. An intern may be registered under only one licensee at any given time and may be directed and supervised only by the registered licensee. The registered licensee shall have only one intern registered at any given time. The commissioner shall issue to each registered intern a registration permit that must be displayed with the other establishment and practice licenses. While under the direct supervision of the licensee, the intern must deleted text begin actively participate in the embalming of at least 25 dead human bodies and in the arrangements for and direction of at least 25 funeralsdeleted text end new text begin complete 25 case reports in each of the following areas: embalming, funeral arrangements, and servicesnew text end . Case reports, on forms provided by the commissioner, shall be completed by the interndeleted text begin , signed by the supervising licensee,deleted text end and filed with the commissioner deleted text begin for at least 25 embalmings and funerals in which the intern participatesdeleted text end new text begin prior to the completion of the internshipnew text end . Information contained in these reports that identifies the subject or the family of the subject embalmed or the subject or the family of the subject of the funeral shall be classified as licensing data under section 13.41, subdivision 2.

Sec. 53.

Minnesota Statutes 2014, section 149A.40, subdivision 11, is amended to read:

Subd. 11.

Continuing education.

The commissioner deleted text begin maydeleted text end new text begin shallnew text end require new text begin 15 new text end continuing education hours for renewal of a license to practice mortuary science.new text begin Nine of the hours must be in the following areas: body preparation, care, or handling, 3 CE hours; professional practices, 3 CE hours; regulation and ethics, 3 CE hours. Continuing education hours shall be reported to the commissioner every other year based on the licensee's license number. Licensees whose license ends in an odd number must report CE hours at renewal time every odd year. If a licensee's license ends in an even number, the licensee must report the licensee's CE hours at renewal time every even year.new text end

Sec. 54.

Minnesota Statutes 2014, section 149A.65, is amended to read:

149A.65 FEES.

Subdivision 1.

Generally.

This section establishes the fees for registrations, examinations, initial and renewal licenses, and late fees authorized under the provisions of this chapter.

Subd. 2.

Mortuary science fees.

Fees for mortuary science are:

(1) deleted text begin $50deleted text end new text begin $75new text end for the initial and renewal registration of a mortuary science intern;

(2) deleted text begin $100deleted text end new text begin $125 new text end for the mortuary science examination;

(3) deleted text begin $125deleted text end new text begin $200new text end for issuance of initial and renewal mortuary science licenses;

(4) deleted text begin $25deleted text end new text begin $100new text end late fee charge for a license renewal; and

(5) deleted text begin $200deleted text end new text begin $250new text end for issuing a mortuary science license by endorsement.

Subd. 3.

Funeral directors.

The license renewal fee for funeral directors is deleted text begin $125 deleted text end new text begin $200new text end . The late fee charge for a license renewal is deleted text begin $25deleted text end new text begin $100new text end .

Subd. 4.

Funeral establishments.

The initial and renewal fee for funeral establishments is deleted text begin $300deleted text end new text begin $425new text end . The late fee charge for a license renewal is deleted text begin $25deleted text end new text begin $100new text end .

Subd. 5.

Crematories.

The initial and renewal fee for a crematory is deleted text begin $300deleted text end new text begin $425new text end . The late fee charge for a license renewal is deleted text begin $25deleted text end new text begin $100new text end .

Subd. 6.

Alkaline hydrolysis facilities.

The initial and renewal fee for an alkaline hydrolysis facility is deleted text begin $300deleted text end new text begin $425new text end . The late fee charge for a license renewal is deleted text begin $25deleted text end new text begin $100new text end .

Subd. 7.

State government special revenue fund.

Fees collected by the commissioner under this section must be deposited in the state treasury and credited to the state government special revenue fund.

Sec. 55.

Minnesota Statutes 2014, section 149A.92, subdivision 1, is amended to read:

Subdivision 1.

deleted text begin Exemptiondeleted text end new text begin Establishment updatenew text end .

deleted text begin All funeral establishments having a preparation and embalming room that has not been used for the preparation or embalming of a dead human body in the 12 calendar months prior to July 1, 1997, are exempt from the minimum requirements in subdivisions 2 to 6, except as provided in this section.deleted text end new text begin (a) Notwithstanding subdivision 11, a funeral establishment with other establishment locations that uses one preparation and embalming room for all establishment locations has until July 1, 2017, to bring the other establishment locations that are not used for preparation or embalming into compliance with this section so long as the preparation and embalming room that is used complies with the minimum standards in this section.new text end

new text begin (b) new text end At the time that ownership of a funeral establishment changes, the physical location of the establishment changes, or the building housing the funeral establishment or business space of the establishment is remodeled the existing preparation and embalming room must be brought into compliance with the minimum standards in this sectionnew text begin and in accordance with subdivision 11new text end .

Sec. 56.

Minnesota Statutes 2014, section 149A.97, subdivision 7, is amended to read:

Subd. 7.

Reports to commissioner.

Every funeral provider lawfully doing business in Minnesota that accepts funds under subdivision 2 must make a complete annual report to the commissioner. The reports may be on forms provided by the commissioner or substantially similar forms containing, at least, identification and the state of each trust account, including all transactions involving principal and accrued interest, and must be filed by March 31 of the calendar year following the reporting year along with a filing fee of $25 for each report. Fees shall be paid to the commissioner of management and budget, state of Minnesota, for deposit in the state government special revenue fund in the state treasury. Reports must be signed by an authorized representative of the funeral provider and notarized under oath. All reports to the commissioner shall be reviewed for account inaccuracies or possible violations of this section. If the commissioner has a reasonable belief to suspect that there are account irregularities or possible violations of this section, the commissioner shall report that belief, in a timely manner, to the state auditornew text begin or other state agencies as determined by the commissionernew text end . new text begin The commissioner may require a funeral provider reporting preneed trust accounts under this section to arrange for and pay an independent third-party auditing firm to complete an audit of the preneed trust accounts every other year. The funeral provider shall report the findings of the audit to the commissioner by March 31 of the calendar year following the reporting year. This report is in addition to the annual report.new text end The commissioner shall also file an annual letter with the state auditor disclosing whether or not any irregularities or possible violations were detected in review of the annual trust fund reports filed by the funeral providers. This letter shall be filed with the state auditor by May 31 of the calendar year following the reporting year.

Sec. 57.

Minnesota Statutes 2014, section 157.15, subdivision 8, is amended to read:

Subd. 8.

Lodging establishment.

"Lodging establishment" meansnew text begin : (1)new text end a building, structure, enclosure, or any part thereof used as, maintained as, advertised as, or held out to be a place where sleeping accommodations are furnished to the public as regular roomers, for periods of one week or more, and having five or more beds to let to the publicdeleted text begin .deleted text end new text begin ; or (2) a building, structure, or enclosure or any part thereof located within ten miles distance from a hospital or medical center and maintained as, advertised as, or held out to be a place where sleeping accommodations are furnished exclusively to patients, their families, and caregivers while the patient is receiving or waiting to receive health care treatments or procedures for periods of one week or more, and where no supportive services, as defined under section 157.17, subdivision 1, paragraph (a), or health supervision services, as defined under section 157.17, subdivision 1, paragraph (b), or home care services, as defined under section 144A.471, subdivisions 6 and 7, are provided.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. 58.

new text begin WORKING GROUP ON VIOLENCE AGAINST ASIAN WOMEN AND CHILDREN. new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The commissioner of health, in collaboration with the commissioners of human services and public safety, and the Council on Asian-Pacific Minnesotans, shall create a multidisciplinary working group to address violence against Asian women and children by July 1, 2015. new text end

new text begin Subd. 2. new text end

new text begin The working group. new text end

new text begin The commissioner of health, in collaboration with the commissioners of human services and public safety, and the Council on Asian-Pacific Minnesotans, shall appoint 15 members representing the following groups to participate in the working group: new text end

new text begin (1) advocates; new text end

new text begin (2) survivors; new text end

new text begin (3) service providers; new text end

new text begin (4) community leaders; new text end

new text begin (5) city and county attorneys; new text end

new text begin (6) city officials; new text end

new text begin (7) law enforcement; and new text end

new text begin (8) health professionals. new text end

new text begin At least eight of the members of the working group must be from the Asian-Pacific Islander community. new text end

new text begin Subd. 3. new text end

new text begin Duties. new text end

new text begin (a) The working group must study the nature, scope, and prevalence of violence against Asian women and children in Minnesota, including domestic violence, trafficking, international abusive marriage, stalking, sexual assault, and other violence. new text end

new text begin (b) The working group may: new text end

new text begin (1) evaluate the adequacy and effectiveness of existing support programs; new text end

new text begin (2) conduct a needs assessment of culturally and linguistically appropriate programs and interventions; new text end

new text begin (3) identify barriers in delivering services to Asian women and children; new text end

new text begin (4) identify promising prevention and intervention strategies in addressing violence against Asian women and children; and new text end

new text begin (5) propose mechanisms to collect and monitor data on violence against Asian women and children. new text end

new text begin Subd. 4. new text end

new text begin Chair. new text end

new text begin The commissioner of health shall designate one member to serve as chair of the working group. new text end

new text begin Subd. 5. new text end

new text begin First meeting. new text end

new text begin The chair shall convene the first meeting by September 10, 2015. new text end

new text begin Subd. 6. new text end

new text begin Compensation; expense reimbursement. new text end

new text begin Members of the working group shall be compensated and reimbursed for expenses under Minnesota Statutes, section 15.059, subdivision 3. new text end

new text begin Subd. 7. new text end

new text begin Report. new text end

new text begin By January 1, 2017, the working group must submit its recommendations and any draft legislation necessary to implement those recommendations to the commissioners of health, human services, and public safety, and the Council on Asian-Pacific Minnesotans. The Council on Asian-Pacific Minnesotans shall submit a report of findings and recommendations to the chair and ranking minority members of the committees in the house of representatives and senate having jurisdiction over health and human services and public safety by February 15, 2017. new text end

new text begin Subd. 8. new text end

new text begin Sunset. new text end

new text begin The working group on violence against Asian women and children sunsets the day after the Council on Asian-Pacific Minnesotans submits the report under subdivision 7. 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. 59.

new text begin HEALTH EQUITY GRANTS. new text end

new text begin For the competitive grants awarded under Laws 2014, chapter 312, article 30, section 3, subdivision 2, the commissioner of health shall consider applicants who present evidence of a promising strategy to accomplish the applicant's objective. A promising strategy shall be given the same weight as a research or evidence-based strategy based on potential value and measurable outcomes. new text end

new text begin EFFECTIVE DATE. new text end

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

ARTICLE 9

HEALTH CARE DELIVERY

Section 1.

new text begin [62A.67] SHORT TITLE. new text end

new text begin Sections 62A.67 to 62A.672 may be cited as the "Minnesota Telemedicine Act." new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2016. new text end

Sec. 2.

new text begin [62A.671] DEFINITIONS. new text end

new text begin Subdivision 1. new text end

new text begin Applicability. new text end

new text begin For purposes of sections 62A.67 to 62A.672, the terms defined in this section have the meanings given. new text end

new text begin Subd. 2. new text end

new text begin Distant site. new text end

new text begin "Distant site" means a site at which a licensed health care provider is located while providing health care services or consultations by means of telemedicine. new text end

new text begin Subd. 3. new text end

new text begin Health care provider. new text end

new text begin "Health care provider" has the meaning provided in section 62A.63, subdivision 2. new text end

new text begin Subd. 4. new text end

new text begin Health carrier. new text end

new text begin "Health carrier" has the meaning provided in section 62A.011, subdivision 2. new text end

new text begin Subd. 5. new text end

new text begin Health plan. new text end

new text begin "Health plan" means a health plan as defined in section 62A.011, subdivision 3, and includes dental plans as defined in section 62Q.76, subdivision 3, but does not include dental plans that provide indemnity-based benefits, regardless of expenses incurred and are designed to pay benefits directly to the policyholder. new text end

new text begin Subd. 6. new text end

new text begin Licensed health care provider. new text end

new text begin "Licensed health care provider" means a health care provider who is: new text end

new text begin (1) licensed under chapter 147, 147A, 148, 148B, 148E, 148F, 150A, or 153; a mental health professional as defined under section 245.462, subdivision 18, or 245.4871, subdivision 27; or vendor of medical care defined in section 256B.02, subdivision 7; and new text end

new text begin (2) authorized within their respective scope of practice to provide the particular service with no supervision or under general supervision. new text end

new text begin Subd. 7. new text end

new text begin Originating site. new text end

new text begin "Originating site" means a site including, but not limited to, a health care facility at which a patient is located at the time health care services are provided to the patient by means of telemedicine. new text end

new text begin Subd. 8. new text end

new text begin Store-and-forward technology. new text end

new text begin "Store-and-forward technology" means the transmission of a patient's medical information from an originating site to a health care provider at a distant site without the patient being present, or the delivery of telemedicine that does not occur in real time via synchronous transmissions. new text end

new text begin Subd. 9. new text end

new text begin Telemedicine. new text end

new text begin "Telemedicine" means the delivery of health care services or consultations while the patient is at an originating site and the licensed health care provider is at a distant site. A communication between licensed health care providers that consists solely of a telephone conversation, e-mail, or facsimile transmission does not constitute telemedicine consultations or services. A communication between a licensed health care provider and a patient that consists solely of an e-mail or facsimile transmission does not constitute telemedicine consultations or services. Telemedicine may be provided by means of real-time two-way, interactive audio and visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support health care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, and care management of a patient's health care. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2016. new text end

Sec. 3.

new text begin [62A.672] COVERAGE OF TELEMEDICINE SERVICES. new text end

new text begin Subdivision 1. new text end

new text begin Coverage of telemedicine. new text end

new text begin (a) A health plan sold, issued, or renewed by a health carrier for which coverage of benefits begins on or after January 1, 2017, shall include coverage for telemedicine benefits in the same manner as any other benefits covered under the policy, plan, or contract, and shall comply with the regulations of this section. new text end

new text begin (b) Nothing in this section shall be construed to: new text end

new text begin (1) require a health carrier to provide coverage for services that are not medically necessary; new text end

new text begin (2) prohibit a health carrier from establishing criteria that a health care provider must meet to demonstrate the safety or efficacy of delivering a particular service via telemedicine for which the health carrier does not already reimburse other health care providers for delivering via telemedicine, so long as the criteria are not unduly burdensome or unreasonable for the particular service; or new text end

new text begin (3) prevent a health carrier from requiring a health care provider to agree to certain documentation or billing practices designed to protect the health carrier or patients from fraudulent claims so long as the practices are not unduly burdensome or unreasonable for the particular service. new text end

new text begin Subd. 2. new text end

new text begin Parity between telemedicine and in-person services. new text end

new text begin A health carrier shall not exclude a service for coverage solely because the service is provided via telemedicine and is not provided through in-person consultation or contact between a licensed health care provider and a patient. new text end

new text begin Subd. 3. new text end

new text begin Reimbursement for telemedicine services. new text end

new text begin (a) A health carrier shall reimburse the distant site licensed health care provider for covered services delivered via telemedicine on the same basis and at the same rate as the health carrier would apply to those services if the services had been delivered in person by the distant site licensed health care provider. new text end

new text begin (b) It is not a violation of this subdivision for a health carrier to include a deductible, co-payment, or coinsurance requirement for a health care service provided via telemedicine, provided that the deductible, co-payment, or coinsurance is not in addition to, and does not exceed, the deductible, co-payment, or coinsurance applicable if the same services were provided through in-person contact. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2016. new text end

Sec. 4.

Minnesota Statutes 2014, section 62U.02, subdivision 1, is amended to read:

Subdivision 1.

Development.

(a) The commissioner of health shall develop a standardized set of measures by which to assess the quality of health care services offered by health care providers, including health care providers certified as health care homes under section 256B.0751. Quality measures must be based on medical evidence and be developed through a process in which providers participate. The measures shall be used for the quality incentive payment system developed in subdivision 2 and must:

(1) include uniform definitions, measures, and forms for submission of data, to the greatest extent possible;

(2) seek to avoid increasing the administrative burden on health care providers;

(3) be initially based on existing quality indicators for physician and hospital services, which are measured and reported publicly by quality measurement organizations, including, but not limited to, Minnesota Community Measurement and specialty societies;

(4) place a priority on measures of health care outcomes, rather than process measures, wherever possible; and

(5) incorporate measures for primary care, including preventive services, coronary artery and heart disease, diabetes, asthma, depression, and other measures as determined by the commissioner.

new text begin (b) Effective July 1, 2016, the commissioner shall stratify quality measures by race, ethnicity, preferred language, and country of origin beginning with five measures, and stratifying additional measures to the extent resources are available. On or after January 1, 2018, the commissioner may require measures to be stratified by other sociodemographic factors that according to reliable data are correlated with health disparities and have an impact on performance on quality or cost indicators. New methods of stratifying data under this paragraph must be tested and evaluated through pilot projects prior to adding them to the statewide system. In determining whether to add additional sociodemographic factors and developing the methodology to be used, the commissioner shall consider the reporting burden on providers and determine whether there are alternative sources of data that could be used. The commissioner shall ensure that categories and data collection methods are developed in consultation with those communities impacted by health disparities using culturally appropriate community engagement principles and methods. The commissioner shall implement this paragraph in coordination with the contracting entity retained under section 62U.02, subdivision 4, in order to build upon the data stratification methodology that has been developed and tested by the entity. Nothing in this paragraph expands or changes the commissioner's authority to collect, analyze, or report health care data. Any data collected to implement this paragraph must be data that is available or is authorized to be collected under other laws. Nothing in this paragraph grants authority to the commissioner to collect or analyze patient-level or patient-specific data of the patient characteristics identified under this paragraph. new text end

deleted text begin (b)deleted text end new text begin (c)new text end The measures shall be reviewed at least annually by the commissioner.

Sec. 5.

Minnesota Statutes 2014, section 62U.02, subdivision 2, is amended to read:

Subd. 2.

Quality incentive payments.

(a) By July 1, 2009, the commissioner shall develop a system of quality incentive payments under which providers are eligible for quality-based payments that are in addition to existing payment levels, based upon a comparison of provider performance against specified targets, and improvement over time. The targets must be based upon and consistent with the quality measures established under subdivision 1.

(b) To the extent possible, the payment system must adjust for variations in patient population in order to reduce incentives to health care providers to avoid high-risk patients or populationsnew text begin , including those with risk factors related to race, ethnicity, language, country of origin, and sociodemographic factorsnew text end .

(c) The requirements of section 62Q.101 do not apply under this incentive payment system.

Sec. 6.

Minnesota Statutes 2014, section 62U.02, subdivision 3, is amended to read:

Subd. 3.

Quality transparency.

new text begin (a) new text end The commissioner shall establish standards for measuring health outcomes, establish a system for risk adjusting quality measures, and issue annual public reports on provider quality beginning July 1, 2010.

new text begin (b) Effective July 1, 2017, the risk adjustment system established under this subdivision shall adjust for patient characteristics identified under subdivision 1, paragraph (b), that are correlated with health disparities and have an impact on performance on cost and quality measures. The risk adjustment method may consist of reporting based on an actual-to-expected comparison that reflects the characteristics of the patient population served by the clinic or hospital. The commissioner shall implement this paragraph in coordination with any contracting entity retained under section 62U.02, subdivision 4. new text end

new text begin (c)new text end By January 1, 2010, physician clinics and hospitals shall submit standardized electronic information on the outcomes and processes associated with patient care to the commissioner or the commissioner's designee. In addition to measures of care processes and outcomes, the report may include other measures designated by the commissioner, including, but not limited to, care infrastructure and patient satisfaction. The commissioner shall ensure that any quality data reporting requirements established under this subdivision are not duplicative of publicly reported, communitywide quality reporting activities currently under way in Minnesota. Nothing in this subdivision is intended to replace or duplicate current privately supported activities related to quality measurement and reporting in Minnesota.

Sec. 7.

Minnesota Statutes 2014, section 62U.02, subdivision 4, is amended to read:

Subd. 4.

Contracting.

The commissioner may contract with a private entity or consortium of private entities to complete the tasks in subdivisions 1 to 3. The private entity or consortium must be nonprofit and have governance that includes representatives from the following stakeholder groups: health care providersnew text begin , including providers serving high concentrations of patients and communities impacted by health disparities;new text end deleted text begin ,deleted text end health plan companiesdeleted text begin ,deleted text end new text begin ;new text end consumersnew text begin , including consumers representing groups who experience health disparities;new text end deleted text begin ,deleted text end employers or other health care purchasersdeleted text begin ,deleted text end new text begin ;new text end and state government. No one stakeholder group shall have a majority of the votes on any issue or hold extraordinary powers not granted to any other governance stakeholder.

Sec. 8.

Minnesota Statutes 2014, section 144E.001, is amended by adding a subdivision to read:

new text begin Subd. 5h. new text end

new text begin Community medical response emergency medical technician. new text end

new text begin "Community medical response emergency medical technician" or "CEMT" means a person who is certified as an emergency medical technician, who is a member of a registered medical response unit under section 144E.275, and who meets the requirements for additional certification as a CEMT as specified in section 144E.275, subdivision 7. new text end

Sec. 9.

Minnesota Statutes 2014, section 144E.275, subdivision 1, is amended to read:

Subdivision 1.

Definition.

For purposes of this section, the following definitions apply:

(a) "Medical response unit" means an organized service recognized by a local political subdivision whose primary responsibility is to respond to medical emergencies to provide initial medical care before the arrival of a licensed ambulance service.new text begin Medical response units may also provide CEMT services as permitted under subdivision 7.new text end

(b) "Specialized medical response unit" means an organized service recognized by a board-approved authority other than a local political subdivision that responds to medical emergencies as needed or as required by local procedure or protocol.

Sec. 10.

Minnesota Statutes 2014, section 144E.275, is amended by adding a subdivision to read:

new text begin Subd. 7. new text end

new text begin Community medical response emergency medical technician. new text end

new text begin (a) To be eligible for certification by the board as a CEMT, an individual shall: new text end

new text begin (1) be currently certified as an EMT or AEMT; new text end

new text begin (2) have two years of service as an EMT or AEMT; new text end

new text begin (3) be a member of a registered medical response unit as defined under this section; new text end

new text begin (4) successfully complete a CEMT training program from a college or university that has been approved by the board or accredited by a board-approved national accrediting organization. The training must include clinical experience under the supervision of the medical response unit medical director, an advanced practice registered nurse, a physician assistant, or a public health nurse operating under the direct authority of a local unit of government; new text end

new text begin (5) successfully complete a training program that includes training in providing culturally appropriate care; and new text end

new text begin (6) complete a board-approved application form. new text end

new text begin (b) A CEMT must practice in accordance with protocols and supervisory standards established by the medical response unit medical director in accordance with section 144E.265. new text end

new text begin (c) A CEMT may provide services within the CEMT skill set as approved by the medical response unit medical director. new text end

new text begin (d) A CEMT may provide episodic individual patient education and prevention education but only as directed by a patient care plan developed by the patient's primary physician, an advanced practice registered nurse, or a physician assistant, in conjunction with the medical response unit medical director and relevant local health care providers. The patient care plan must ensure that the services provided by the CEMT are consistent with services offered by the patient's health care home, if one exists, that the patient receives the necessary services, and that there is no duplication of services to the patient. new text end

new text begin (e) A CEMT is subject to all certification, disciplinary, complaint, and other regulatory requirements that apply to EMTs under this chapter. new text end

new text begin (f) A CEMT may not provide services as defined in section 144A.471, subdivisions 6 and 7, except a CEMT may provide verbal or visual reminders to the patient to: new text end

new text begin (1) take a regularly scheduled medication, but not to provide or bring the patient medication; and new text end

new text begin (2) follow regularly scheduled treatment or exercise plans. new text end

Sec. 11.

Minnesota Statutes 2014, section 151.58, subdivision 2, is amended to read:

Subd. 2.

Definitions.

For purposes of this section only, the terms defined in this subdivision have the meanings given.

(a) "Automated drug distribution system" or "system" means a mechanical system approved by the board that performs operations or activities, other than compounding or administration, related to the storage, packaging, or dispensing of drugs, and collects, controls, and maintains all required transaction information and records.

(b) "Health care facility" means a nursing home licensed under section 144A.02; a housing with services establishment registered under section 144D.01, subdivision 4, in which a home provider licensed under chapter 144A is providing centralized storage of medications; new text begin a boarding care home licensed under sections 144.50 to 144.58 that is providing centralized storage of medications; new text end or a Minnesota sex offender program facility operated by the Department of Human Services.

(c) "Managing pharmacy" means a pharmacy licensed by the board that controls and is responsible for the operation of an automated drug distribution system.

Sec. 12.

Minnesota Statutes 2014, section 151.58, subdivision 5, is amended to read:

Subd. 5.

Operation of automated drug distribution systems.

(a) The managing pharmacy and the pharmacist in charge are responsible for the operation of an automated drug distribution system.

(b) Access to an automated drug distribution system must be limited to pharmacy and nonpharmacy personnel authorized to procure drugs from the system, except that field service technicians may access a system located in a health care facility for the purposes of servicing and maintaining it while being monitored either by the managing pharmacy, or a licensed nurse within the health care facility. In the case of an automated drug distribution system that is not physically located within a licensed pharmacy, access for the purpose of procuring drugs shall be limited to licensed nurses. Each person authorized to access the system must be assigned an individual specific access code. Alternatively, access to the system may be controlled through the use of biometric identification procedures. A policy specifying time access parameters, including time-outs, logoffs, and lockouts, must be in place.

(c) For the purposes of this section only, the requirements of section 151.215 are met if the following clauses are met:

(1) a pharmacist employed by and working at the managing pharmacy, or at a pharmacy that is acting as a central services pharmacy for the managing pharmacy, pursuant to Minnesota Rules, part 6800.4075, must review, interpret, and approve all prescription drug orders before any drug is distributed from the system to be administered to a patient. A pharmacy technician may perform data entry of prescription drug orders provided that a pharmacist certifies the accuracy of the data entry before the drug can be released from the automated drug distribution system. A pharmacist employed by and working at the managing pharmacy must certify the accuracy of the filling of any cassettes, canisters, or other containers that contain drugs that will be loaded into the automated drug distribution systemnew text begin , unless the filled cassettes, canisters, or containers have been provided by a repackager registered with the United States Food and Drug Administration and licensed by the board as a manufacturernew text end ; and

(2) when the automated drug dispensing system is located and used within the managing pharmacy, a pharmacist must personally supervise and take responsibility for all packaging and labeling associated with the use of an automated drug distribution system.

(d) Access to drugs when a pharmacist has not reviewed and approved the prescription drug order is permitted only when a formal and written decision to allow such access is issued by the pharmacy and the therapeutics committee or its equivalent. The committee must specify the patient care circumstances in which such access is allowed, the drugs that can be accessed, and the staff that are allowed to access the drugs.

(e) In the case of an automated drug distribution system that does not utilize bar coding in the loading process, the loading of a system located in a health care facility may be performed by a pharmacy technician, so long as the activity is continuously supervised, through a two-way audiovisual system by a pharmacist on duty within the managing pharmacy. In the case of an automated drug distribution system that utilizes bar coding in the loading process, the loading of a system located in a health care facility may be performed by a pharmacy technician or a licensed nurse, provided that the managing pharmacy retains an electronic record of loading activities.

(f) The automated drug distribution system must be under the supervision of a pharmacist. The pharmacist is not required to be physically present at the site of the automated drug distribution system if the system is continuously monitored electronically by the managing pharmacy. A pharmacist on duty within a pharmacy licensed by the board must be continuously available to address any problems detected by the monitoring or to answer questions from the staff of the health care facility. The licensed pharmacy may be the managing pharmacy or a pharmacy which is acting as a central services pharmacy, pursuant to Minnesota Rules, part 6800.4075, for the managing pharmacy.

Sec. 13.

Minnesota Statutes 2014, section 256B.0625, subdivision 3b, is amended to read:

Subd. 3b.

Telemedicine deleted text begin consultationsdeleted text end new text begin servicesnew text end .

new text begin (a) new text end Medical assistance covers new text begin medically necessary services and consultations delivered by a licensed health care provider vianew text end telemedicine deleted text begin consultations. Telemedicine consultations must be made via two-way, interactive video or store-and-forward technology. Store-and-forward technology includes telemedicine consultations that do not occur in real time via synchronous transmissions, and that do not require a face-to-face encounter with the patient for all or any part of any such telemedicine consultation. The patient record must include a written opinion from the consulting physician providing the telemedicine consultation. A communication between two physicians that consists solely of a telephone conversation is not a telemedicine consultationdeleted text end new text begin in the same manner as if the service or consultation was delivered in personnew text end . Coverage is limited to three telemedicine deleted text begin consultationsdeleted text end new text begin servicesnew text end per deleted text begin recipientdeleted text end new text begin enrolleenew text end per calendar week. Telemedicine deleted text begin consultationsdeleted text end new text begin servicesnew text end shall be paid at the full allowable rate.

new text begin (b) The commissioner shall establish criteria that a health care provider must attest to in order to demonstrate the safety or efficacy of delivering a particular service via telemedicine. The attestation may include that the health care provider: new text end

new text begin (1) has identified the categories or types of services the health care provider will provide via telemedicine; new text end

new text begin (2) has written policies and procedures specific to telemedicine services that are regularly reviewed and updated; new text end

new text begin (3) has policies and procedures that adequately address patient safety before, during, and after the telemedicine service is rendered; new text end

new text begin (4) has established protocols addressing how and when to discontinue telemedicine services; and new text end

new text begin (5) has an established quality assurance process related to telemedicine services. new text end

new text begin (c) As a condition of payment, a licensed health care provider must document each occurrence of a health service provided by telemedicine to a medical assistance enrollee. Health care service records for services provided by telemedicine must meet the requirements set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and must document: new text end

new text begin (1) the type of service provided by telemedicine; new text end

new text begin (2) the time the service began and the time the service ended, including an a.m. and p.m. designation; new text end

new text begin (3) the licensed health care provider's basis for determining that telemedicine is an appropriate and effective means for delivering the service to the enrollee; new text end

new text begin (4) the mode of transmission of the telemedicine service and records evidencing that a particular mode of transmission was utilized; new text end

new text begin (5) the location of the originating site and the distant site; new text end

new text begin (6) if the claim for payment is based on a physician's telemedicine consultation with another physician, the written opinion from the consulting physician providing the telemedicine consultation; and new text end

new text begin (7) compliance with the criteria attested to by the health care provider in accordance with paragraph (b). new text end

new text begin (d) For purposes of this subdivision, unless otherwise covered under this chapter, "telemedicine" is defined as the delivery of health care services or consultations while the patient is at an originating site and the licensed health care provider is at a distant site. A communication between licensed health care providers, or a licensed health care provider and a patient that consists solely of a telephone conversation, e-mail, or facsimile transmission does not constitute telemedicine consultations or services. Telemedicine may be provided by means of real-time two-way, interactive audio and visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support health care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, and care management of a patient's health care. new text end

new text begin (e) For purposes of this section, "licensed health care provider" is defined under section 62A.671, subdivision 6; "health care provider" is defined under section 62A.671, subdivision 3; and "originating site" is defined under section 62A.671, subdivision 7. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2016. new text end

Sec. 14.

Minnesota Statutes 2014, section 256B.0625, subdivision 13, is amended to read:

Subd. 13.

Drugs.

(a) Medical assistance covers drugs, except for fertility drugs when specifically used to enhance fertility, if prescribed by a licensed practitioner and dispensed by a licensed pharmacist, by a physician enrolled in the medical assistance program as a dispensing physician, or by a physician, physician assistant, or a nurse practitioner employed by or under contract with a community health board as defined in section 145A.02, subdivision 5, for the purposes of communicable disease control.

(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply, unless authorized by the commissioner.

(c) For the purpose of this subdivision and subdivision 13d, an "active pharmaceutical ingredient" is defined as a substance that is represented for use in a drug and when used in the manufacturing, processing, or packaging of a drug becomes an active ingredient of the drug product. An "excipient" is defined as an inert substance used as a diluent or vehicle for a drug. The commissioner shall establish a list of active pharmaceutical ingredients and excipients which are included in the medical assistance formulary. Medical assistance covers selected active pharmaceutical ingredients and excipients used in compounded prescriptions when the compounded combination is specifically approved by the commissioner or when a commercially available product:

(1) is not a therapeutic option for the patient;

(2) does not exist in the same combination of active ingredients in the same strengths as the compounded prescription; and

(3) cannot be used in place of the active pharmaceutical ingredient in the compounded prescription.

(d) Medical assistance covers the following over-the-counter drugs when prescribed by a licensed practitioner or by a licensed pharmacist who meets standards established by the commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, family planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults with documented vitamin deficiencies, vitamins for children under the age of seven and pregnant or nursing women, and any other over-the-counter drug identified by the commissioner, in consultation with the formulary committee, as necessary, appropriate, and cost-effective for the treatment of certain specified chronic diseases, conditions, or disorders, and this determination shall not be subject to the requirements of chapter 14. A pharmacist may prescribe over-the-counter medications as provided under this paragraph for purposes of receiving reimbursement under Medicaid. When prescribing over-the-counter drugs under this paragraph, licensed pharmacists must consult with the recipient to determine necessity, provide drug counseling, review drug therapy for potential adverse interactions, and make referrals as needed to other health care professionals. Over-the-counter medications must be dispensed in a quantity that is the deleted text begin lowerdeleted text end new text begin lowestnew text end of: (1) the number of dosage units contained in the manufacturer's original package; deleted text begin anddeleted text end (2) the number of dosage units required to complete the patient's course of therapynew text begin ; or (3) if applicable, the number of dosage units dispensed from a system using retrospective billing, as provided under subdivision 13e, paragraph (b)new text end .

(e) Effective January 1, 2006, medical assistance shall not cover drugs that are coverable under Medicare Part D as defined in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), for individuals eligible for drug coverage as defined in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Public Law 108-173, section 1860D-1(a)(3)(A). For these individuals, medical assistance may cover drugs from the drug classes listed in United States Code, title 42, section 1396r-8(d)(2), subject to this subdivision and subdivisions 13a to 13g, except that drugs listed in United States Code, title 42, section 1396r-8(d)(2)(E), shall not be covered.

(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing Program and dispensed by 340B covered entities and ambulatory pharmacies under common ownership of the 340B covered entity. Medical assistance does not cover drugs acquired through the federal 340B Drug Pricing Program and dispensed by 340B contract pharmacies.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2016, or upon federal approval, whichever is later. new text end

Sec. 15.

Minnesota Statutes 2014, section 256B.0625, subdivision 13e, is amended to read:

Subd. 13e.

Payment rates.

(a) The basis for determining the amount of payment shall be the lower of the actual acquisition costs of the drugs or the maximum allowable cost by the commissioner plus the fixed dispensing fee; or the usual and customary price charged to the public. The amount of payment basis must be reduced to reflect all discount amounts applied to the charge by any provider/insurer agreement or contract for submitted charges to medical assistance programs. The net submitted charge may not be greater than the patient liability for the service. The pharmacy dispensing fee shall be $3.65 new text begin for legend prescription drugsnew text end , except that the dispensing fee for intravenous solutions which must be compounded by the pharmacist shall be $8 per bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral nutritional products dispensed in quantities greater than one liter. new text begin The pharmacy dispensing fee for over the counter drugs shall be $3.65, except that the fee shall be $1.31 for retrospectively billing pharmacies when billing for quantities less than the number of units contained in the manufacturer's original package. new text end Actual acquisition cost includes quantity and other special discounts except time and cash discounts. The actual acquisition cost of a drug shall be estimated by the commissioner at wholesale acquisition cost plus four percent for independently owned pharmacies located in a designated rural area within Minnesota, and at wholesale acquisition cost plus two percent for all other pharmacies. A pharmacy is "independently owned" if it is one of four or fewer pharmacies under the same ownership nationally. A "designated rural area" means an area defined as a small rural area or isolated rural area according to the four-category classification of the Rural Urban Commuting Area system developed for the United States Health Resources and Services Administration. Effective January 1, 2014, the actual acquisition cost of a drug acquired through the federal 340B Drug Pricing Program shall be estimated by the commissioner at wholesale acquisition cost minus 40 percent. Wholesale acquisition cost is defined as the manufacturer's list price for a drug or biological to wholesalers or direct purchasers in the United States, not including prompt pay or other discounts, rebates, or reductions in price, for the most recent month for which information is available, as reported in wholesale price guides or other publications of drug or biological pricing data. The maximum allowable cost of a multisource drug may be set by the commissioner and it shall be comparable to, but no higher than, the maximum amount paid by other third-party payors in this state who have maximum allowable cost programs. Establishment of the amount of payment for drugs shall not be subject to the requirements of the Administrative Procedure Act.

(b) new text begin Pharmacies dispensing prescriptions to residents of long-term care facilities using an automated drug distribution system meeting the requirements of section 151.58, or a packaging system meeting the packaging standards set forth in Minnesota Rules, part 6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ retrospective billing for prescription drugs dispensed to long-term care facility residents. A retrospectively billing pharmacy must submit a claim only for the quantity of medication used by the enrolled recipient during the defined billing period. A retrospectively billing pharmacy must use a billing period not less than one calendar month or 30 days.new text end

new text begin (c) new text end An additional dispensing fee of $.30 may be added to the dispensing fee paid to pharmacists for legend drug prescriptions dispensed to residents of long-term care facilities when a unit dose blister card system, approved by the department, is used. Under this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. The National Drug Code (NDC) from the drug container used to fill the blister card must be identified on the claim to the department. The unit dose blister card containing the drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, that govern the return of unused drugs to the pharmacy for reuse. deleted text begin Thedeleted text end new text begin Anew text end pharmacy provider deleted text begin will bedeleted text end new text begin using packaging that meets the standards set forth in Minnesota Rules, part 6800.2700, is new text end required to credit the department for the actual acquisition cost of all unused drugs that are eligible for reusenew text begin , unless the pharmacy is using retrospective billingnew text end . The commissioner may permit the drug clozapine to be dispensed in a quantity that is less than a 30-day supply.

deleted text begin (c)deleted text end new text begin (d)new text end Whenever a maximum allowable cost has been set for a multisource drug, payment shall be the lower of the usual and customary price charged to the public or the maximum allowable cost established by the commissioner unless prior authorization for the brand name product has been granted according to the criteria established by the Drug Formulary Committee as required by subdivision 13f, paragraph (a), and the prescriber has indicated "dispense as written" on the prescription in a manner consistent with section 151.21, subdivision 2.

deleted text begin (d)deleted text end new text begin (e)new text end The basis for determining the amount of payment for drugs administered in an outpatient setting shall be the lower of the usual and customary cost submitted by the provider, 106 percent of the average sales price as determined by the United States Department of Health and Human Services pursuant to title XVIII, section 1847a of the federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner. If average sales price is unavailable, the amount of payment must be lower of the usual and customary cost submitted by the provider, the wholesale acquisition cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner. Effective January 1, 2014, the commissioner shall discount the payment rate for drugs obtained through the federal 340B Drug Pricing Program by 20 percent. The payment for drugs administered in an outpatient setting shall be made to the administering facility or practitioner. A retail or specialty pharmacy dispensing a drug for administration in an outpatient setting is not eligible for direct reimbursement.

deleted text begin (e)deleted text end new text begin (f)new text end The commissioner may negotiate lower reimbursement rates for specialty pharmacy products than the rates specified in paragraph (a). The commissioner may require individuals enrolled in the health care programs administered by the department to obtain specialty pharmacy products from providers with whom the commissioner has negotiated lower reimbursement rates. Specialty pharmacy products are defined as those used by a small number of recipients or recipients with complex and chronic diseases that require expensive and challenging drug regimens. Examples of these conditions include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of cancer. Specialty pharmaceutical products include injectable and infusion therapies, biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies that require complex care. The commissioner shall consult with the formulary committee to develop a list of specialty pharmacy products subject to this paragraph. In consulting with the formulary committee in developing this list, the commissioner shall take into consideration the population served by specialty pharmacy products, the current delivery system and standard of care in the state, and access to care issues. The commissioner shall have the discretion to adjust the reimbursement rate to prevent access to care issues.

deleted text begin (f)deleted text end new text begin (g)new text end Home infusion therapy services provided by home infusion therapy pharmacies must be paid at rates according to subdivision 8d.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2016, or upon federal approval, whichever is later. new text end

Sec. 16.

Minnesota Statutes 2014, section 256B.072, is amended to read:

256B.072 PERFORMANCE REPORTING AND QUALITY IMPROVEMENT SYSTEM.

(a) The commissioner of human services shall establish a performance reporting system for health care providers who provide health care services to public program recipients covered under chapters 256B, 256D, and 256L, reporting separately for managed care and fee-for-service recipients.

(b) The measures used for the performance reporting system for medical groups shall include measures of care for asthma, diabetes, hypertension, and coronary artery disease and measures of preventive care services. The measures used for the performance reporting system for inpatient hospitals shall include measures of care for acute myocardial infarction, heart failure, and pneumonia, and measures of care and prevention of surgical infections. In the case of a medical group, the measures used shall be consistent with measures published by nonprofit Minnesota or national organizations that produce and disseminate health care quality measures or evidence-based health care guidelines. In the case of inpatient hospital measures, the commissioner shall appoint the Minnesota Hospital Association and Stratis Health to advise on the development of the performance measures to be used for hospital reporting. To enable a consistent measurement process across the community, the commissioner may use measures of care provided for patients in addition to those identified in paragraph (a). The commissioner shall ensure collaboration with other health care reporting organizations so that the measures described in this section are consistent with those reported by those organizations and used by other purchasers in Minnesota.

(c) The commissioner may require providers to submit information in a required format to a health care reporting organization or to cooperate with the information collection procedures of that organization. The commissioner may collaborate with a reporting organization to collect information reported and to prevent duplication of reporting.

(d) By October 1, 2007, and annually thereafter, the commissioner shall report through a public Web site the results by medical groups and hospitals, where possible, of the measures under this section, and shall compare the results by medical groups and hospitals for patients enrolled in public programs to patients enrolled in private health plans. To achieve this reporting, the commissioner may collaborate with a health care reporting organization that operates a Web site suitable for this purpose.

new text begin (e) Performance measures must be stratified as provided under section 62U.02, subdivision 1, paragraph (b), and risk-adjusted as specified in section 62U.02, subdivision 3, paragraph (b). new text end

Sec. 17.

new text begin PROPOSAL FOR CHILD PROTECTION FOCUSED "COMMUNITY MEDICAL RESPONSE EMERGENCY MEDICAL TECHNICIAN" (CEMT) MODEL. new text end

new text begin The commissioner shall develop a proposal for a pilot project to create a community-based support system that coordinates services between child protection services and community emergency medical technicians. This pilot project model shall be developed with the input of stakeholders that represent both child protection services and community emergency medical technicians. The model must be designed so that the collaborative effort results in increased safety for children and increased support for families. The pilot project model must be reviewed by the Task Force on the Protection of Children, and the commissioner shall make recommendations for the pilot project to the members of the legislative committees with primary jurisdiction over CEMT and child protection issues no later than January 15, 2016. new text end

Sec. 18.

new text begin COMMUNITY MEDICAL RESPONSE EMERGENCY MEDICAL TECHNICIAN SERVICES COVERED UNDER THE MEDICAL ASSISTANCE PROGRAM. new text end

new text begin (a) The commissioner of human services, in consultation with representatives of emergency medical service providers, public health nurses, community health workers, the Minnesota State Fire Chiefs Association, the Minnesota Professional Firefighters Association, the Minnesota State Firefighters Department Association, Minnesota Academy of Family Physicians, Minnesota Licensed Practical Nurses Association, Minnesota Nurses Association, and local public health agencies, shall determine specified services and payment rates for these services to be performed by community medical response emergency medical technicians certified under Minnesota Statutes, section 144E.275, subdivision 7, and covered by medical assistance under Minnesota Statutes, section 256B.0625. Services must be in the CEMT skill set and may include interventions intended to prevent avoidable ambulance transportation or hospital emergency department use. new text end

new text begin (b) In order to be eligible for payment, services provided by a community medical response emergency medical technician must be: new text end

new text begin (1) ordered by a medical response unit medical director; new text end

new text begin (2) part of a patient care plan that has been developed in coordination with the patient's primary physician, advanced practice registered nurse, and relevant local health care providers; and new text end

new text begin (3) billed by an eligible medical assistance enrolled provider that employs or contracts with the community medical response emergency medical technician. new text end

new text begin In determining the community medical response emergency medical technician services to include under medical assistance coverage, the commissioner of human services shall consider the potential of hospital admittance and emergency room utilization reductions as well as increased access to quality care in rural communities. new text end

new text begin (c) The commissioner of human services shall submit the list of services to be covered by medical assistance to the chairs and ranking minority members of the legislative committees with jurisdiction over health and human services policy and spending by February 15, 2016. These services shall not be covered by medical assistance until legislation providing coverage for the services is enacted in law. new text end

Sec. 19.

new text begin EVALUATION OF COMMUNITY MEDICAL RESPONSE EMERGENCY MEDICAL TECHNICIAN SERVICES. new text end

new text begin If legislation is enacted to cover community medical response emergency medical technician services with medical assistance, the commissioner of human services shall evaluate the effect of medical assistance and MinnesotaCare coverage for those services on the cost and quality of care under those programs and the coordination of those services with the health care home services. The commissioner shall present findings to the chairs and ranking minority members of the legislative committees with jurisdiction over health and human services policy and spending by December 1, 2017. The commissioner shall require medical assistance and MinnesotaCare enrolled providers that employ or contract with community medical response emergency medical technicians to provide to the commissioner, in the form and manner specified by the commissioner, the utilization, cost, and quality data necessary to conduct this evaluation. new text end

ARTICLE 10

HEALTH LICENSING BOARDS

Section 1.

Minnesota Statutes 2014, section 148.52, is amended to read:

148.52 BOARD OF OPTOMETRY.

The Board of Optometry shall consist of two public members as defined by section 214.02 and five deleted text begin qualifieddeleted text end new text begin Minnesota licensednew text end optometrists appointed by the governor. Membership terms, compensation of members, removal of members, the filling of membership vacancies, and fiscal year and reporting requirements shall be as provided in sections 214.07 to 214.09.

The provision of staff, administrative services and office space; the review and processing of complaints; the setting of board fees; and other provisions relating to board operations shall be as provided in chapter 214.

Sec. 2.

Minnesota Statutes 2014, section 148.54, is amended to read:

148.54 BOARD; SEAL.

The Board of Optometry shall elect from among its members a presidentnew text begin , vice president, and secretarynew text end and may adopt a seal.

Sec. 3.

Minnesota Statutes 2014, section 148.57, subdivision 1, is amended to read:

Subdivision 1.

Examination.

(a) A person not authorized to practice optometry in the state and desiring to do so shall apply to the state Board of Optometry by filling out and swearing to an application for a license granted by the board and accompanied by a fee deleted text begin in an amount of $87deleted text end new text begin established by the board, not to exceed the amount specified in section 148.59new text end . With the submission of the application form, the candidate shall prove that the candidate:

(1) is of good moral character;

(2) has obtained a clinical doctorate degree from a board-approved school or college of optometry, or is currently enrolled in the final year of study at such an institution; and

(3) has passed all parts of an examination.

(b) The examination shall include both a written portion and a clinical practical portion and shall thoroughly test the fitness of the candidate to practice in this state. In regard to the written and clinical practical examinations, the board may:

(1) prepare, administer, and grade the examination itself;

(2) recognize and approve in whole or in part an examination prepared, administered and graded by a national board of examiners in optometry; or

(3) administer a recognized and approved examination prepared and graded by or under the direction of a national board of examiners in optometry.

(c) The board shall issue a license to each applicant who satisfactorily passes the examinations and fulfills the other requirements stated in this section deleted text begin and section 148.575 for board certification for the use of legend drugs. Applicants for initial licensure do not need to apply for or possess a certificate as referred to in sections 148.571 to 148.574. The fees mentioned in this section are for the use of the board and in no case shall be refundeddeleted text end .

Sec. 4.

Minnesota Statutes 2014, section 148.57, subdivision 2, is amended to read:

Subd. 2.

Endorsement.

new text begin (a) new text end An optometrist who holds a current license from another state, and who has practiced in that state not less than three years immediately preceding application, may apply for licensure in Minnesota by filling out and swearing to an application for license by endorsement furnished by the board. The completed application with all required documentation shall be filed at the board office along with a fee deleted text begin of $87deleted text end new text begin established by the board, not to exceed the amount specified in section 148.59new text end . The application fee shall be for the use of the board and in no case shall be refunded.

new text begin (b)new text end To verify that the applicant possesses the knowledge and ability essential to the practice of optometry in this state, the applicant must provide evidence of:

(1) having obtained a clinical doctorate degree from a board-approved school or college of optometry;

(2) successful completion of both written and practical examinations for licensure in the applicant's original state of licensure that thoroughly tested the fitness of the applicant to practice;

(3) successful completion of an examination of Minnesota state optometry laws;

(4) compliance with the requirements deleted text begin for board certificationdeleted text end in section 148.575;

(5) compliance with all continuing education required for license renewal in every state in which the applicant currently holds an active license to practice; and

(6) being in good standing with every state board from which a license has been issued.

new text begin (c) new text end Documentation from a national certification system or program, approved by the board, which supports any of the listed requirements, may be used as evidence. The applicant may then be issued a license if the requirements for licensure in the other state are deemed by the board to be equivalent to those of sections 148.52 to 148.62.

Sec. 5.

Minnesota Statutes 2014, section 148.57, is amended by adding a subdivision to read:

new text begin Subd. 5. new text end

new text begin Change of address. new text end

new text begin A person regulated by the board shall maintain a current name and address with the board and shall notify the board in writing within 30 days of any change in name or address. If a name change only is requested, the regulated person must request revised credentials and return the current credentials to the board. The board may require the regulated person to substantiate the name change by submitting official documentation from a court of law or agency authorized under law to receive and officially record a name change. If an address change only is requested, no request for revised credentials is required. If the regulated person's current credentials have been lost, stolen, or destroyed, the person shall provide a written explanation to the board. new text end

Sec. 6.

Minnesota Statutes 2014, section 148.574, is amended to read:

148.574 PROHIBITIONS RELATING TO LEGEND DRUGSdeleted text begin ; AUTHORIZING SALES BY PHARMACISTS UNDER CERTAIN CONDITIONSdeleted text end .

deleted text begin An optometrist shall not purchase, possess, administer, prescribe or give any legend drug as defined in section 151.01 or 152.02 to any person except as is expressly authorized by sections 148.571 to 148.577. Nothing in chapter 151 shall prevent a pharmacist from selling topical ocular drugs to an optometrist authorized to use such drugs according to sections 148.571 to 148.577.deleted text end Notwithstanding sections 151.37 and 152.12, an optometrist is prohibited from dispensing legend drugs at retail, unless the legend drug is within the scope designated in section 148.56, subdivision 1, and is administered to the eye through an ophthalmic good as defined in section 145.711, subdivision 4.

Sec. 7.

Minnesota Statutes 2014, section 148.575, subdivision 2, is amended to read:

Subd. 2.

deleted text begin Board certifieddeleted text end new text begin Requirementsnew text end defined.

deleted text begin "Board certified" means thatdeleted text end A licensed optometrist deleted text begin has been issued a certificate by the Board of Optometry certifying that the optometrist has complieddeleted text end new text begin shall complynew text end with the following requirements for the use of legend drugs deleted text begin described in section 148.576deleted text end :

deleted text begin (1) successful completion of at least 60 hours of study in general and ocular pharmacology emphasizing drugs used for examination or treatment purposes, their systemic effects and management or referral of adverse reactions; deleted text end

deleted text begin (2)deleted text end new text begin (1)new text end successful completion of at least 100 hours of study in the examination, diagnosis, and treatment of conditions of the human eye with legend drugs;

deleted text begin (3)deleted text end new text begin (2)new text end successful completion of two years of supervised clinical experience in differential diagnosis of eye disease or disorders as part of optometric training or one year of that experience and ten years of actual clinical experience as a licensed optometrist; and

deleted text begin (4)deleted text end new text begin (3)new text end successful completion of a nationally standardized examination approved or administered by the board on the subject of treatment and management of ocular disease.

Sec. 8.

Minnesota Statutes 2014, section 148.577, is amended to read:

148.577 STANDARD OF CARE.

A licensed optometrist deleted text begin who is board certified under section 148.575deleted text end is held to the same standard of care in the use of those legend drugs as physicians licensed by the state of Minnesota.

Sec. 9.

Minnesota Statutes 2014, section 148.59, is amended to read:

148.59 LICENSE RENEWAL; deleted text begin FEEdeleted text end new text begin LICENSE AND REGISTRATION FEESnew text end .

A licensed optometrist shall pay to the state Board of Optometry a fee as set by the board in order to renew a license as provided by board rule.new text begin No fees shall be refunded. Fees may not exceed the following amounts but may be adjusted lower by board direction and are for the exclusive use of the board: new text end

new text begin (1) optometry licensure application, $160; new text end

new text begin (2) optometry annual licensure renewal, $135; new text end

new text begin (3) optometry late penalty fee, $75; new text end

new text begin (4) annual license renewal card, $10; new text end

new text begin (5) continuing education provider application, $45; new text end

new text begin (6) emeritus registration, $10; new text end

new text begin (7) endorsement/reciprocity application, $160; new text end

new text begin (8) replacement of initial license, $12; and new text end

new text begin (9) license verification, $50. new text end

Sec. 10.

Minnesota Statutes 2014, section 148.603, is amended to read:

148.603 deleted text begin FORMS OFdeleted text end new text begin GROUNDS FORnew text end DISCIPLINARY deleted text begin ACTIONSdeleted text end new text begin ACTIONnew text end .

deleted text begin When grounds exist under section 148.57, subdivision 3, or other statute or rule which the board is authorized to enforce, the board may take one or more of the following disciplinary actions, provided that disciplinary or corrective action may not be imposed by the board on any regulated person except after a contested case hearing conducted pursuant to chapter 14 or by consent of the parties: deleted text end

deleted text begin (1) deny an application for a credential; deleted text end

deleted text begin (2) revoke the regulated person's credential; deleted text end

deleted text begin (3) suspend the regulated person's credential; deleted text end

deleted text begin (4) impose limitations on the regulated person's credential; deleted text end

deleted text begin (5) impose conditions on the regulated person's credential; deleted text end

deleted text begin (6) censure or reprimand the regulated person; deleted text end

deleted text begin (7) impose a civil penalty not exceeding $10,000 for each separate violation, the amount of the civil penalty to be fixed so as to deprive the person of any economic advantage gained by reason of the violation or to discourage similar violations or to reimburse the board for the cost of the investigation and proceeding. For purposes of this section, the cost of the investigation and proceeding may include, but is not limited to, fees paid for services provided by the Office of Administrative Hearings, legal and investigative services provided by the Office of the Attorney General, court reporters, witnesses, reproduction of records, board members' per diem compensation, board staff time, and travel costs and expenses incurred by board staff and board members; or deleted text end

deleted text begin (8) when grounds exist under section 148.57, subdivision 3, or a board rule, enter into an agreement with the regulated person for corrective action which may include requiring the regulated person: deleted text end

deleted text begin (i) to complete an educational course or activity; deleted text end

deleted text begin (ii) to submit to the executive director or designated board member a written protocol or reports designed to prevent future violations of the same kind; deleted text end

deleted text begin (iii) to meet with a board member or board designee to discuss prevention of future violations of the same kind; or deleted text end

deleted text begin (iv) to perform other action justified by the facts. deleted text end

deleted text begin Listing the measures in clause (8) does not preclude the board from including them in an order for disciplinary action. deleted text end new text begin The board may refuse to grant a license or may impose disciplinary action as described in section 148.607 against any optometrist for the following: new text end

new text begin (1) failure to demonstrate the qualifications or satisfy the requirements for a license contained in this chapter or in rules of the board. The burden of proof shall be on the applicant to demonstrate the qualifications or the satisfaction of the requirements; new text end

new text begin (2) obtaining a license by fraud or cheating, or attempting to subvert the licensing examination process. Conduct which subverts or attempts to subvert the licensing examination process includes, but is not limited to: (i) conduct which violates the security of the examination materials, such as removing examination materials from the examination room or having unauthorized possession of any portion of a future, current, or previously administered licensing examination; (ii) conduct which violates the standard of test administration, such as communicating with another examinee during administration of the examination, copying another examinee's answers, permitting another examinee to copy one's answers, or possessing unauthorized materials; or (iii) impersonating an examinee or permitting an impersonator to take the examination on one's own behalf; new text end

new text begin (3) conviction, during the previous five years, of a felony or gross misdemeanor, reasonably related to the practice of optometry. Conviction as used in this section shall include a conviction of an offense which if committed in this state would be deemed a felony or gross misdemeanor without regard to its designation elsewhere, or a criminal proceeding where a finding or verdict of guilt is made or returned but the adjudication of guilt is either withheld or not entered thereon; new text end

new text begin (4) revocation, suspension, restriction, limitation, or other disciplinary action against the person's optometry license in another state or jurisdiction, failure to report to the board that charges regarding the person's license have been brought in another state or jurisdiction, or having been refused a license by any other state or jurisdiction; new text end

new text begin (5) advertising which is false or misleading, which violates any rule of the board, or which claims without substantiation the positive cure of any disease; new text end

new text begin (6) violating a rule adopted by the board or an order of the board, a state or federal law, which relates to the practice of optometry, or a state or federal narcotics or controlled substance law; new text end

new text begin (7) engaging in any unethical conduct; conduct likely to deceive, defraud, or harm the public, or demonstrating a willful or careless disregard for the health, welfare, or safety of a patient; or practice of optometry which is professionally incompetent, in that it may create unnecessary danger to any patient's life, health, or safety, which in any of the cases, proof of actual injury need not be established; new text end

new text begin (8) failure to supervise an optometrist's assistant or failure to supervise an optometrist under any agreement with the board; new text end

new text begin (9) aiding or abetting an unlicensed person in the practice of optometry, except that it is not a violation of this section for an optometrist to employ, supervise, or delegate functions to a qualified person who may or may not be required to obtain a license or registration to provide health services if that person is practicing within the scope of that person's license or registration or delegated authority; new text end

new text begin (10) adjudication as mentally incompetent, mentally ill, or developmentally disabled, or as a chemically dependent person, a person dangerous to the public, a sexually dangerous person, or a person who has a sexual psychopathic personality by a court of competent jurisdiction, within or without this state. Such adjudication shall automatically suspend a license for the duration of the license unless the board orders otherwise; new text end

new text begin (11) engaging in unprofessional conduct which includes any departure from or the failure to conform to the minimal standards of acceptable and prevailing practice in which case actual injury to a patient need not be established; new text end

new text begin (12) inability to practice optometry with reasonable skill and safety to patients by reason of illness, use of alcohol, drugs, narcotics, chemicals, or any other type of material or as a result of any mental or physical condition, including deterioration through the aging process or loss of motor skills; new text end

new text begin (13) revealing a privileged communication from or relating to a patient except when otherwise required or permitted by law; new text end

new text begin (14) improper management of medical records, including failure to maintain adequate medical records, to comply with a patient's request made pursuant to sections 144.291 to 144.298 or to furnish a medical record or report required by law; new text end

new text begin (15) fee splitting, including without limitation: new text end

new text begin (i) paying, offering to pay, receiving, or agreeing to receive a commission, rebate, or remuneration, directly or indirectly, primarily for the referral of patients or the prescription of drugs or devices; and new text end

new text begin (ii) dividing fees with another optometrist, other health care provider, or a professional corporation, unless the division is in proportion to the services provided and the responsibility assumed by each professional and the optometrist has disclosed the terms of the division; new text end

new text begin (16) engaging in abusive or fraudulent billing practices, including violations of the federal Medicare and Medicaid laws or state medical assistance laws; new text end

new text begin (17) becoming addicted or habituated to a drug or intoxicant; new text end

new text begin (18) prescribing a drug or device for other than accepted therapeutic or experimental or investigative purposes authorized by the state or a federal agency; new text end

new text begin (19) engaging in conduct with a patient which is sexual or may reasonably be interpreted by the patient as sexual, or in any verbal behavior which is seductive or sexually demeaning to a patient; new text end

new text begin (20) failure to make reports as required by section 148.604 or to cooperate with an investigation of the board as required by section 148.606; new text end

new text begin (21) knowingly providing false or misleading information that is directly related to the care of a patient; and new text end

new text begin (22) practice of a board-regulated profession under lapsed or nonrenewed credentials. new text end

Sec. 11.

new text begin [148.604] REPORTING OBLIGATIONS. new text end

new text begin Subdivision 1. new text end

new text begin Permission to report. new text end

new text begin A person who has knowledge of any conduct constituting grounds for discipline under sections 148.52 to 148.62 may report the violation to the board. new text end

new text begin Subd. 2. new text end

new text begin Institutions. new text end

new text begin Any hospital, clinic, prepaid medical plan, or other health care institution or organization located in this state shall report to the board any action taken by the institution or organization or any of its administrators or medical or other committees to revoke, suspend, restrict, or condition an optometrist's privilege to practice or treat patients in the institution, or as part of the organization, any denial of privileges, or any other disciplinary action. The institution or organization shall also report the resignation of any optometrist prior to the conclusion of any disciplinary proceeding, or prior to the commencement of formal charges but after the optometrist had knowledge that formal charges were contemplated or in preparation. Each report made under this subdivision must state the nature of the action taken, state in detail the reasons for the action, and identify the specific patient medical records upon which the action was based. No report shall be required of an optometrist voluntarily limiting the practice of the optometrist at a hospital provided that the optometrist notifies all hospitals where the optometrist has privileges of the voluntary limitation and the reasons for it. new text end

new text begin Subd. 3. new text end

new text begin Licensed professionals. new text end

new text begin A licensed optometrist shall report to the board personal knowledge of any conduct by any optometrist which the person reasonably believes constitutes grounds for disciplinary action under sections 148.52 to 148.62, including any conduct indicating that the person may be incompetent, may have engaged in unprofessional conduct, or may be physically unable to safely engage in the practice of optometry. new text end

new text begin Subd. 4. new text end

new text begin Self-reporting. new text end

new text begin An optometrist shall report to the board any personal action which would require that a report be filed with the board by any person, health care facility, business, or organization pursuant to subdivisions 2 and 3. new text end

new text begin Subd. 5. new text end

new text begin Deadlines; forms; rulemaking. new text end

new text begin Reports required by subdivisions 2 to 4 must be submitted not later than 30 days after the occurrence of the reportable event or transaction. The board may provide forms for the submission of reports required by this section, may require that reports be submitted on the forms provided, and may adopt rules necessary to ensure prompt and accurate reporting. new text end

new text begin Subd. 6. new text end

new text begin Subpoenas. new text end

new text begin The board may issue subpoenas for the production of any reports required by subdivisions 2 to 4 or any related documents. new text end

Sec. 12.

new text begin [148.605] IMMUNITY. new text end

new text begin Subdivision 1. new text end

new text begin Reporting. new text end

new text begin Any person, health care facility, business, or organization is immune from civil liability or criminal prosecution for submitting a report to the board pursuant to section 148.604 or for otherwise reporting to the board violations or alleged violations of section 148.603, if they are acting in good faith and in the exercise of reasonable care. new text end

new text begin Subd. 2. new text end

new text begin Investigation; indemnification. new text end

new text begin (a) Members of the board, persons employed by the board, and consultants retained by the board for the purpose of investigation of violations, the preparation of charges, and management of board orders on behalf of the board are immune from civil liability and criminal prosecution for any actions, transactions, or publications in the execution of, or relating to, their duties under sections 148.52 to 148.62, if they are acting in good faith and in the exercise of reasonable care. new text end

new text begin (b) Members of the board and persons employed by the board or engaged in maintaining records and making reports regarding adverse health care events are immune from civil liability and criminal prosecution for any actions, transactions, or publications in the execution of, or relating to, their duties under sections 148.52 to 148.62, if they are acting in good faith and in the exercise of reasonable care. new text end

new text begin (c) For purposes of this section, a member of the board or a consultant described in paragraph (a) is considered a state employee under section 3.736, subdivision 9. new text end

Sec. 13.

new text begin [148.606] OPTOMETRIST COOPERATION. new text end

new text begin An optometrist who is the subject of an investigation by or on behalf of the board shall cooperate fully with the investigation. Cooperation includes responding fully and promptly to any question raised by or on behalf of the board relating to the subject of the investigation and providing copies of patient medical records, as reasonably requested by the board, to assist the board in its investigation. If the board does not have written consent from a patient permitting access to the patient's records, the optometrist shall delete any data in the record which identifies the patient before providing it to the board. The board shall maintain any records obtained pursuant to this section as investigative data pursuant to chapter 13. new text end

Sec. 14.

new text begin [148.607] DISCIPLINARY ACTIONS. new text end

new text begin When the board finds that a licensed optometrist under section 148.57 has violated a provision or provisions of sections 148.52 to 148.62, it may do one or more of the following: new text end

new text begin (1) revoke the license; new text end

new text begin (2) suspend the license; new text end

new text begin (3) impose limitations or conditions on the optometrist's practice of optometry, including the limitation of scope of practice to designated field specialties; the imposition of retraining or rehabilitation requirements; the requirement of practice under supervision; or the conditioning of continued practice on demonstration of knowledge or skills by appropriate examination or other review of skill and competence; new text end

new text begin (4) impose a civil penalty not exceeding $10,000 for each separate violation, the amount of the civil penalty to be fixed so as to deprive the optometrist of any economic advantage gained by reason of the violation charged or to reimburse the board for the cost of the investigation and proceeding; and new text end

new text begin (5) censure or reprimand the licensed optometrist. new text end

Sec. 15.

Minnesota Statutes 2014, section 148E.075, is amended to read:

148E.075 deleted text begin INACTIVE LICENSESdeleted text end new text begin ALTERNATE LICENSESnew text end .

Subdivision 1.

deleted text begin Inactive statusdeleted text end new text begin Temporary leave licensenew text end .

(a) deleted text begin A licensee qualifies for inactive status under either of the circumstances described in paragraph (b) or (c).deleted text end

deleted text begin (b) A licensee qualifies for inactive status when the licensee is granted temporary leave from active practice.deleted text end A licensee qualifies for temporary leave from active practice if the licensee demonstrates to the satisfaction of the board that the licensee is not engaged in the practice of social work in any setting, including settings in which social workers are exempt from licensure according to section 148E.065. A licensee who is granted temporary leave from active practice may reactivate the license according to section 148E.080.

new text begin (b) A licensee may maintain a temporary leave license for no more than four consecutive years. new text end

deleted text begin (c) A licensee qualifies for inactive status when a licensee is granted an emeritus license. A licensee qualifies for an emeritus license if the licensee demonstrates to the satisfaction of the board that: deleted text end

deleted text begin (1) the licensee is retired from social work practice; and deleted text end

deleted text begin (2) the licensee is not engaged in the practice of social work in any setting, including settings in which social workers are exempt from licensure according to section 148E.065. deleted text end

deleted text begin A licensee who possesses an emeritus license may reactivate the license according to section 148E.080. deleted text end

new text begin (c) A licensee who is granted temporary leave from active practice may reactivate the license according to section 148E.080. If a licensee does not apply for reactivation within 60 days following the end of the consecutive four-year period, the license automatically expires. An individual with an expired license may apply for new licensure according to section 148E.055. new text end

new text begin (d) Except as provided in paragraph (e), a licensee who holds a temporary leave license must not practice, attempt to practice, offer to practice, or advertise or hold out as authorized to practice social work. new text end

new text begin (e) The board may grant a variance to the requirements of paragraph (d) if a licensee on temporary leave license provides emergency social work services. A variance is granted only if the board provides the variance in writing to the licensee. The board may impose conditions or restrictions on the variance. new text end

new text begin (f) In making representations of professional status to the public, when holding a temporary leave license, a licensee must state that the license is not active and that the licensee cannot practice social work. new text end

new text begin Subd. 1a. new text end

new text begin Emeritus inactive license. new text end

new text begin (a) A licensee qualifies for an emeritus inactive license if the licensee demonstrates to the satisfaction of the board that the licensee is: new text end

new text begin (1) retired from social work practice; and new text end

new text begin (2) not engaged in the practice of social work in any setting, including settings in which social workers are exempt from licensure according to section 148E.065. new text end

new text begin (b) A licensee with an emeritus inactive license may apply for reactivation according to section 148E.080 only during the four years following the granting of the emeritus inactive license. However, after four years following the granting of the emeritus inactive license, an individual may apply for new licensure according to section 148E.055. new text end

new text begin (c) Except as provided in paragraph (d), a licensee who holds an emeritus inactive license must not practice, attempt to practice, offer to practice, or advertise or hold out as authorized to practice social work. new text end

new text begin (d) The board may grant a variance to the requirements of paragraph (c) if a licensee on emeritus inactive license provides emergency social work services. A variance is granted only if the board provides the variance in writing to the licensee. The board may impose conditions or restrictions on the variance. new text end

new text begin (e) In making representations of professional status to the public, when holding an emeritus inactive license, a licensee must state that the license is not active and that the licensee cannot practice social work. new text end

new text begin Subd. 1b. new text end

new text begin Emeritus active license. new text end

new text begin (a) A licensee qualifies for an emeritus active license if the applicant demonstrates to the satisfaction of the board that the licensee is: new text end

new text begin (1) retired from social work practice; and new text end

new text begin (2) in compliance with the supervised practice requirements, as applicable, under sections 148E.100 to 148E.125. new text end

new text begin (b) A licensee who is issued an emeritus active license is only authorized to engage in: new text end

new text begin (1) pro bono or unpaid social work practice as specified in section 148E.010, subdivisions 6 and 11; or new text end

new text begin (2) paid social work practice not to exceed 240 clock hours per calendar year, for the exclusive purpose to provide licensing supervision as specified in sections 148E.100 to 148E.125; and new text end

new text begin (3) the authorized scope of practice specified in section 148E.050. new text end

new text begin (c) An emeritus active license must be renewed according to the requirements specified in section 148E.070, subdivisions 1, 2, 3, 4, and 5. new text end

new text begin (d) At the time of license renewal a licensee must provide evidence satisfactory to the board that the licensee has, during the renewal term, completed 20 clock hours of continuing education, including at least two clock hours in ethics, as specified in section 148E.130: new text end

new text begin (1) for licensed independent clinical social workers, at least 12 clock hours must be in the clinical content areas specified in section 148E.055, subdivision 5; and new text end

new text begin (2) for social workers providing supervision according to sections 148E.100 to 148E.125, at least three clock hours must be in the practice of supervision. new text end

new text begin (e) Independent study hours must not consist of more than eight clock hours of continuing education per renewal term. new text end

new text begin (f) Failure to renew an active emeritus license on the expiration date will result in an expired license as specified in section 148E.070, subdivision 5. new text end

new text begin (g) The board may grant a variance to the requirements of paragraph (b) if a licensee holding an emeritus active license provides emergency social work services. A variance is granted only if the board provides the variance in writing to the licensee. The board may impose conditions or restrictions on the variance. new text end

new text begin (h) In making representations of professional status to the public, when holding an emeritus active license, a licensee must state that an emeritus active license authorizes only pro bono or unpaid social work practice, or paid social work practice not to exceed 240 clock hours per calendar year, for the exclusive purpose to provide licensing supervision as specified in sections 148E.100 to 148E.125. new text end

new text begin (i) Notwithstanding the time limit and emeritus active license renewal requirements specified in this section, a licensee who possesses an emeritus active license may reactivate the license according to section 148E.080 or apply for new licensure according to section 148E.055. new text end

Subd. 2.

Application.

A licensee may apply for deleted text begin inactive statusdeleted text end new text begin temporary leave license, emeritus inactive license, or emeritus active licensenew text end :

(1) at any time new text begin when currently licensed under section 148E.055, 148E.0555, 148E.0556, or 148E.0557, or when licensed as specified in section 148E.075, new text end by submitting an application deleted text begin for a temporary leave from active practice or for an emeritus licensedeleted text end new text begin form required by the boardnew text end ; or

(2) as an alternative to applying for the renewal of a license by so recording on the application deleted text begin for license renewaldeleted text end new text begin form required by the boardnew text end and submitting the completed, signed application to the board.

An application that is not completed or signed, or that is not accompanied by the correct fee, must be returned to the applicant, along with any fee submitted, and is void. For applications submitted electronically, a "signed application" means providing an attestation as specified by the board.

Subd. 3.

Fee.

(a) Regardless of when the application for deleted text begin inactive statusdeleted text end new text begin temporary leave license or emeritus inactive licensenew text end is submitted, the temporary leave new text begin license new text end or emeritus new text begin inactive new text end license fee specified in section 148E.180, whichever is applicable, must accompany the application. A licensee who is approved for deleted text begin inactive statusdeleted text end new text begin temporary leave license or emeritus inactive licensenew text end before the license expiration date is not entitled to receive a refund for any portion of the license or renewal fee.

(b) If an application for temporary leavenew text begin or emeritus active licensenew text end is received after the license expiration date, the licensee must pay a renewal late fee as specified in section 148E.180 in addition to the temporary leave fee.

new text begin (c) Regardless of when the application for emeritus active license is submitted, the emeritus active license fee is one-half of the renewal fee for the applicable license specified in section 148E.180, subdivision 3, and must accompany the application. A licensee who is approved for emeritus active license before the license expiration date is not entitled to receive a refund for any portion of the license or renewal fee. new text end

deleted text begin Subd. 4. deleted text end

deleted text begin Time limits for temporary leaves. deleted text end

deleted text begin A licensee may maintain an inactive license on temporary leave for no more than five consecutive years. If a licensee does not apply for reactivation within 60 days following the end of the consecutive five-year period, the license automatically expires. deleted text end

deleted text begin Subd. 5. deleted text end

deleted text begin Time limits for emeritus license. deleted text end

deleted text begin A licensee with an emeritus license may not apply for reactivation according to section 148E.080 after five years following the granting of the emeritus license. However, after five years following the granting of the emeritus license, an individual may apply for new licensure according to section 148E.055. deleted text end

deleted text begin Subd. 6. deleted text end

deleted text begin Prohibition on practice. deleted text end

deleted text begin (a) Except as provided in paragraph (b), a licensee whose license is inactive must not practice, attempt to practice, offer to practice, or advertise or hold out as authorized to practice social work. deleted text end

deleted text begin (b) The board may grant a variance to the requirements of paragraph (a) if a licensee on inactive status provides emergency social work services. A variance is granted only if the board provides the variance in writing to the licensee. The board may impose conditions or restrictions on the variance. deleted text end

deleted text begin Subd. 7. deleted text end

deleted text begin Representations of professional status. deleted text end

deleted text begin In making representations of professional status to the public, a licensee whose license is inactive must state that the license is inactive and that the licensee cannot practice social work. deleted text end

Subd. 8.

Disciplinary or other action.

The board may resolve any pending complaints against a licensee before approving an application for deleted text begin inactive statusdeleted text end new text begin an alternate license specified in this sectionnew text end . The board may take action according to sections 148E.255 to 148E.270 against a licensee deleted text begin whose license is inactivedeleted text end new text begin who is issued an alternate license specified in this sectionnew text end based on conduct occurring before the license is inactive or conduct occurring while the license is deleted text begin inactivedeleted text end new text begin effectivenew text end .

Sec. 16.

Minnesota Statutes 2014, section 148E.080, subdivision 1, is amended to read:

Subdivision 1.

Mailing notices to licensees on temporary leave.

The board must mail a notice for reactivation to a licensee on temporary leave at least 45 days before the expiration date of the license according to section 148E.075, subdivision deleted text begin 4deleted text end new text begin 1new text end . Mailing the notice by United States mail to the licensee's last known mailing address constitutes valid mailing. Failure to receive the reactivation notice does not relieve a licensee of the obligation to comply with the provisions of this section to reactivate a license.

Sec. 17.

Minnesota Statutes 2014, section 148E.080, subdivision 2, is amended to read:

Subd. 2.

Reactivation from a temporary leave or emeritus status.

To reactivate a license from a temporary leave or emeritus status, a licensee must do the following within the time period specified in section 148E.075, subdivisions deleted text begin 4 and 5deleted text end new text begin 1, 1a, and 1bnew text end :

(1) complete an application form specified by the board;

(2) document compliance with the continuing education requirements specified in subdivision 4;

(3) submit a supervision plan, if required;

(4) pay the reactivation of deleted text begin an inactive licenseedeleted text end new text begin a licensenew text end fee specified in section 148E.180; and

(5) pay the wall certificate fee according to section 148E.095, subdivision 1, paragraph (b) or (c), if the licensee needs a duplicate license.

Sec. 18.

Minnesota Statutes 2014, section 148E.180, subdivision 2, is amended to read:

Subd. 2.

License fees.

License fees are as follows:

(1) for a licensed social worker, $81;

(2) for a licensed graduate social worker, $144;

(3) for a licensed independent social worker, $216;

(4) for a licensed independent clinical social worker, $238.50;

(5) for an emeritus new text begin inactive new text end license, $43.20; deleted text begin anddeleted text end

(6) new text begin for an emeritus active license, one-half of the renewal fee specified in subdivision 3; andnew text end

new text begin (7) new text end for a temporary leave fee, the same as the renewal fee specified in subdivision 3.

If the licensee's initial license term is less or more than 24 months, the required license fees must be prorated proportionately.

Sec. 19.

Minnesota Statutes 2014, section 148E.180, subdivision 5, is amended to read:

Subd. 5.

Late fees.

Late fees are as follows:

(1) renewal late fee, one-fourth of the renewal fee specified in subdivision 3; deleted text begin anddeleted text end

(2) supervision plan late fee, $40deleted text begin .deleted text end new text begin ; andnew text end

new text begin (3) license late fee, $100 plus the prorated share of the license fee specified in subdivision 2 for the number of months during which the individual practiced social work without a license. new text end

Sec. 20.

Minnesota Statutes 2014, section 150A.091, subdivision 4, is amended to read:

Subd. 4.

Annual license fees.

Each limited faculty or resident dentist shall submit with an annual license renewal application a fee established by the board not to exceed the following amounts:

(1) limited faculty dentist, $168; and

(2) resident dentist or dental provider, deleted text begin $59deleted text end new text begin $85new text end .

Sec. 21.

Minnesota Statutes 2014, section 150A.091, subdivision 5, is amended to read:

Subd. 5.

Biennial license or permit fees.

Each of the following applicants shall submit with a biennial license or permit renewal application a fee as established by the board, not to exceed the following amounts:

(1) dentist or full faculty dentist, deleted text begin $336deleted text end new text begin $475new text end ;

(2) dental therapist, deleted text begin $180deleted text end new text begin $300new text end ;

(3) dental hygienist, deleted text begin $118deleted text end new text begin $200new text end ;

(4) licensed dental assistant, deleted text begin $80deleted text end new text begin $150new text end ; and

(5) dental assistant with a permit as described in Minnesota Rules, part 3100.8500, subpart 3, $24.

Sec. 22.

Minnesota Statutes 2014, section 150A.091, subdivision 11, is amended to read:

Subd. 11.

Certificate application fee for anesthesia/sedation.

Each dentist shall submit with a general anesthesia or moderate sedation application deleted text begin ordeleted text end new text begin ,new text end a contracted sedation provider applicationnew text begin , or biennial renewal, new text end a fee as established by the board not to exceed the following amounts:

(1) for both a general anesthesia and moderate sedation application, deleted text begin $250deleted text end new text begin $400new text end ;

(2) for a general anesthesia application only, deleted text begin $250deleted text end new text begin $400new text end ;

(3) for a moderate sedation application only, deleted text begin $250deleted text end new text begin $400new text end ; and

(4) for a contracted sedation provider application, deleted text begin $250deleted text end new text begin $400new text end .

Sec. 23.

Minnesota Statutes 2014, section 150A.091, is amended by adding a subdivision to read:

new text begin Subd. 17. new text end

new text begin Advanced dental therapy examination fee. new text end

new text begin Any dental therapist eligible to sit for the advanced dental therapy certification examination must submit with the application a fee as established by the board, not to exceed $250. new text end

Sec. 24.

Minnesota Statutes 2014, section 150A.091, is amended by adding a subdivision to read:

new text begin Subd. 18. new text end

new text begin Corporation or professional firm late fee. new text end

new text begin Any corporation or professional firm whose annual fee is not postmarked or otherwise received by the board by the due date of December 31 shall, in addition to the fee, submit a late fee as established by the board, not to exceed $15. new text end

Sec. 25.

Minnesota Statutes 2014, section 150A.31, is amended to read:

150A.31 FEES.

(a) The initial biennial registration fee is $50.

(b) The biennial renewal registration fee is deleted text begin $25deleted text end new text begin not to exceed $80new text end .

(c) The fees specified in this section are nonrefundable and shall be deposited in the state government special revenue fund.

Sec. 26.

Minnesota Statutes 2014, section 151.01, subdivision 15a, is amended to read:

Subd. 15a.

Pharmacy technician.

"Pharmacy technician" means a person not licensed as a pharmacist or new text begin registered as new text end a pharmacist intern, who deleted text begin assists the pharmacist in the preparation and dispensing of medications by performing computer entry of prescription data and other manipulative tasks. A pharmacy technician shall not perform tasks specifically reserved to a licensed pharmacist or requiringdeleted text end new text begin has been trained in pharmacy tasks that do not require thenew text end professional judgmentnew text begin of a licensed pharmacist. A pharmacy technician may not perform tasks specifically reserved to a licensed pharmacistnew text end .

Sec. 27.

Minnesota Statutes 2014, section 151.01, subdivision 27, is amended to read:

Subd. 27.

Practice of pharmacy.

"Practice of pharmacy" means:

(1) interpretation and evaluation of prescription drug orders;

(2) compounding, labeling, and dispensing drugs and devices (except labeling by a manufacturer or packager of nonprescription drugs or commercially packaged legend drugs and devices);

(3) participation in clinical interpretations and monitoring of drug therapy for assurance of safe and effective use of drugs, including the performance of laboratory tests that are waived under the federal Clinical Laboratory Improvement Act of 1988, United States Code, title 42, section 263a et seq., provided that a pharmacist may interpret the results of laboratory tests but may modify drug therapy only pursuant to a protocol or collaborative practice agreement;

(4) participation in drug and therapeutic device selection; drug administration for first dosage and medical emergencies; drug regimen reviews; and drug or drug-related research;

(5) participation in administration of influenza vaccines to all eligible individuals deleted text begin ten deleted text end new text begin sixnew text end years of age and older and all other vaccines to patients deleted text begin 18deleted text end new text begin 13new text end years of age and older by written protocol with a physician licensed under chapter 147, a physician assistant authorized to prescribe drugs under chapter 147A, or an advanced practice registered nurse authorized to prescribe drugs under section 148.235, provided that:

(i) the protocol includes, at a minimum:

(A) the name, dose, and route of each vaccine that may be given;

(B) the patient population for whom the vaccine may be given;

(C) contraindications and precautions to the vaccine;

(D) the procedure for handling an adverse reaction;

(E) the name, signature, and address of the physician, physician assistant, or advanced practice registered nurse;

(F) a telephone number at which the physician, physician assistant, or advanced practice registered nurse can be contacted; and

(G) the date and time period for which the protocol is valid;

(ii) the pharmacist has successfully completed a program approved by the Accreditation Council for Pharmacy Education specifically for the administration of immunizations or a program approved by the board;

(iii) new text begin the pharmacist utilizes the Minnesota Immunization Information Connection to assess the immunization status of individuals prior to the administration of vaccines, except when administering influenza vaccines to individuals age nine and older;new text end

new text begin (iv) new text end the pharmacist reports the administration of the immunization deleted text begin to the patient's primary physician or clinic ordeleted text end to the Minnesota Immunization Information Connection; and

deleted text begin (iv)deleted text end new text begin (v)new text end the pharmacist complies with guidelines for vaccines and immunizations established by the federal Advisory Committee on Immunization Practices, except that a pharmacist does not need to comply with those portions of the guidelines that establish immunization schedules when administering a vaccine pursuant to a valid, patient-specific order issued by a physician licensed under chapter 147, a physician assistant authorized to prescribe drugs under chapter 147A, or an advanced practice nurse authorized to prescribe drugs under section 148.235, provided that the order is consistent with the United States Food and Drug Administration approved labeling of the vaccine;

(6) participation in the initiation, management, modification, and discontinuation of drug therapy according to a written protocol or collaborative practice agreement between: (i) one or more pharmacists and one or more dentists, optometrists, physicians, podiatrists, or veterinarians; or (ii) one or more pharmacists and one or more physician assistants authorized to prescribe, dispense, and administer under chapter 147A, or advanced practice nurses authorized to prescribe, dispense, and administer under section 148.235. Any changes in drug therapy made pursuant to a protocol or collaborative practice agreement must be documented by the pharmacist in the patient's medical record or reported by the pharmacist to a practitioner responsible for the patient's care;

(7) participation in the storage of drugs and the maintenance of records;

(8) patient counseling on therapeutic values, content, hazards, and uses of drugs and devices; and

(9) offering or performing those acts, services, operations, or transactions necessary in the conduct, operation, management, and control of a pharmacy.

Sec. 28.

Minnesota Statutes 2014, section 151.02, is amended to read:

151.02 STATE BOARD OF PHARMACY.

The Minnesota State Board of Pharmacy shall consist of deleted text begin twodeleted text end new text begin threenew text end public members as defined by section 214.02 and deleted text begin fivedeleted text end new text begin sixnew text end pharmacists actively engaged in the practice of pharmacy in this state. Each of said pharmacists shall have had at least five consecutive years of practical experience as a pharmacist immediately preceding appointment.

Sec. 29.

Minnesota Statutes 2014, section 151.065, subdivision 1, is amended to read:

Subdivision 1.

Application fees.

Application fees for licensure and registration are as follows:

(1) pharmacist licensed by examination, deleted text begin $130deleted text end new text begin $145new text end ;

(2) pharmacist licensed by reciprocity, deleted text begin $225deleted text end new text begin $240new text end ;

(3) pharmacy intern, deleted text begin $30deleted text end new text begin $37.50new text end ;

(4) pharmacy technician, deleted text begin $30deleted text end new text begin $37.50new text end ;

(5) pharmacy, deleted text begin $190deleted text end new text begin $225new text end ;

(6) drug wholesaler, legend drugs only, deleted text begin $200deleted text end new text begin $235new text end ;

(7) drug wholesaler, legend and nonlegend drugs, deleted text begin $200deleted text end new text begin $235new text end ;

(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, deleted text begin $175deleted text end new text begin $210new text end ;

(9) drug wholesaler, medical gases, deleted text begin $150deleted text end new text begin $175new text end ;

(10) drug wholesaler, also licensed as a pharmacy in Minnesota, deleted text begin $125deleted text end new text begin $150new text end ;

(11) drug manufacturer, legend drugs only, deleted text begin $200deleted text end new text begin $235new text end ;

(12) drug manufacturer, legend and nonlegend drugs, deleted text begin $200deleted text end new text begin $235new text end ;

(13) drug manufacturer, nonlegend or veterinary legend drugs, deleted text begin $175deleted text end new text begin $210new text end ;

(14) drug manufacturer, medical gases, deleted text begin $150deleted text end new text begin $185new text end ;

(15) drug manufacturer, also licensed as a pharmacy in Minnesota, deleted text begin $125deleted text end new text begin $150new text end ;

(16) medical gas distributor, deleted text begin $75deleted text end new text begin $110new text end ;

(17) controlled substance researcher, deleted text begin $50deleted text end new text begin $75new text end ; and

(18) pharmacy professional corporation, deleted text begin $100deleted text end new text begin $125new text end .

Sec. 30.

Minnesota Statutes 2014, section 151.065, subdivision 2, is amended to read:

Subd. 2.

Original license fee.

The pharmacist original licensure fee, deleted text begin $130deleted text end new text begin $145new text end .

Sec. 31.

Minnesota Statutes 2014, section 151.065, subdivision 3, is amended to read:

Subd. 3.

Annual renewal fees.

Annual licensure and registration renewal fees are as follows:

(1) pharmacist, deleted text begin $130deleted text end new text begin $145new text end ;

(2) pharmacy technician, deleted text begin $30deleted text end new text begin $37.50new text end ;

(3) pharmacy, deleted text begin $190deleted text end new text begin $225new text end ;

(4) drug wholesaler, legend drugs only, deleted text begin $200deleted text end new text begin $235new text end ;

(5) drug wholesaler, legend and nonlegend drugs, deleted text begin $200deleted text end new text begin $235new text end ;

(6) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, deleted text begin $175deleted text end new text begin $210new text end ;

(7) drug wholesaler, medical gases, deleted text begin $150deleted text end new text begin $185new text end ;

(8) drug wholesaler, also licensed as a pharmacy in Minnesota, deleted text begin $125deleted text end new text begin $150new text end ;

(9) drug manufacturer, legend drugs only, deleted text begin $200deleted text end new text begin $235new text end ;

(10) drug manufacturer, legend and nonlegend drugs, deleted text begin $200deleted text end new text begin $235new text end ;

(11) drug manufacturer, nonlegend, veterinary legend drugs, or both, deleted text begin $175deleted text end new text begin $210new text end ;

(12) drug manufacturer, medical gases, deleted text begin $150deleted text end new text begin $185new text end ;

(13) drug manufacturer, also licensed as a pharmacy in Minnesota, deleted text begin $125deleted text end new text begin $150new text end ;

(14) medical gas distributor, deleted text begin $75deleted text end new text begin $110new text end ;

(15) controlled substance researcher, deleted text begin $50deleted text end new text begin $75new text end ; and

(16) pharmacy professional corporation, deleted text begin $45deleted text end new text begin $75new text end .

Sec. 32.

Minnesota Statutes 2014, section 151.065, subdivision 4, is amended to read:

Subd. 4.

Miscellaneous fees.

Fees for issuance of affidavits and duplicate licenses and certificates are as follows:

(1) intern affidavit, deleted text begin $15deleted text end new text begin $20new text end ;

(2) duplicate small license, deleted text begin $15deleted text end new text begin $20new text end ; and

(3) duplicate large certificate, deleted text begin $25deleted text end new text begin $30new text end .

Sec. 33.

Minnesota Statutes 2014, section 151.102, is amended to read:

151.102 PHARMACY TECHNICIAN.

Subdivision 1.

General.

A pharmacy technician may assist a pharmacist in the practice of pharmacy by performing deleted text begin nonjudgmentaldeleted text end tasks deleted text begin anddeleted text end new text begin that are not reserved to, and do not require the professional judgment of, a licensed pharmacist. A pharmacy technician new text end works under the personal and direct supervision of the pharmacist. A pharmacist may supervise deleted text begin twodeleted text end new text begin up to threenew text end techniciansdeleted text begin , as long as thedeleted text end new text begin . Anew text end pharmacist deleted text begin assumes responsibility deleted text end new text begin is responsiblenew text end for all the deleted text begin functionsdeleted text end new text begin worknew text end performed by the techniciansnew text begin who are under the supervision of the pharmacistnew text end . A pharmacy may exceed the ratio of pharmacy technicians to pharmacists permitted in this subdivision or in rule by a total of one technician at any given time in the pharmacy, provided at least one technician in the pharmacy holds a valid certification from the Pharmacy Technician Certification Board or from another national certification body for pharmacy technicians that requires passage of a nationally recognized, psychometrically valid certification examination for certification as determined by the Board of Pharmacy. The Board of Pharmacy may, by rule, set ratios of technicians to pharmacists greater than deleted text begin twodeleted text end new text begin threenew text end to one for the functions specified in rule. deleted text begin The delegation of any duties, tasks, or functions by a pharmacist to a pharmacy technician is subject to continuing review and becomes the professional and personal responsibility of the pharmacist who directed the pharmacy technician to perform the duty, task, or function.deleted text end

Subd. 2.

Waivers by board permitted.

A pharmacist in charge in a pharmacy may petition the board for authorization to allow a pharmacist to supervise more than deleted text begin twodeleted text end new text begin three new text end pharmacy technicians. The pharmacist's petition must include provisions addressing deleted text begin the maintenance ofdeleted text end new text begin hownew text end patient care and safetynew text begin will be maintainednew text end . A petition filed with the board under this subdivision shall be deemed approved 90 days after the board receives the petition, unless the board denies the petition within 90 days of receipt and notifies the petitioning pharmacist of the petition's denial and the board's reasons for denial.

Subd. 3.

Registration fee.

The board shall not register an individual as a pharmacy technician unless all applicable fees specified in section 151.065 have been paid.

Sec. 34.

new text begin REPEALER. new text end

new text begin Minnesota Statutes 2014, sections 148.57, subdivisions 3 and 4; 148.571; 148.572; 148.573, subdivision 1; 148.575, subdivisions 1, 3, 5, and 6; 148.576; 148E.060, subdivision 12; and 148E.075, subdivisions 4, 5, 6, and 7, new text end new text begin are repealed. new text end

ARTICLE 11

HEALTH CARE

Section 1.

Minnesota Statutes 2014, section 62A.045, is amended to read:

62A.045 PAYMENTS ON BEHALF OF ENROLLEES IN GOVERNMENT HEALTH PROGRAMS.

(a) As a condition of doing business in Minnesota or providing coverage to residents of Minnesota covered by this section, each health insurer shall comply with the requirements of the federal Deficit Reduction Act of 2005, Public Law 109-171, including any federal regulations adopted under that act, to the extent that it imposes a requirement that applies in this state and that is not also required by the laws of this state. This section does not require compliance with any provision of the federal act prior to the effective date provided for that provision in the federal act. The commissioner shall enforce this section.

For the purpose of this section, "health insurer" includes self-insured plans, group health plans (as defined in section 607(1) of the Employee Retirement Income Security Act of 1974), service benefit plans, managed care organizations, pharmacy benefit managers, or other parties that are by contract legally responsible to pay a claim for a health-care item or service for an individual receiving benefits under paragraph (b).

(b) No plan offered by a health insurer issued or renewed to provide coverage to a Minnesota resident shall contain any provision denying or reducing benefits because services are rendered to a person who is eligible for or receiving medical benefits pursuant to title XIX of the Social Security Act (Medicaid) in this or any other state; chapter 256; 256B; or 256D or services pursuant to section 252.27; 256L.01 to 256L.10; 260B.331, subdivision 2; 260C.331, subdivision 2; or 393.07, subdivision 1 or 2. No health insurer providing benefits under plans covered by this section shall use eligibility for medical programs named in this section as an underwriting guideline or reason for nonacceptance of the risk.

(c) If payment for covered expenses has been made under state medical programs for health care items or services provided to an individual, and a third party has a legal liability to make payments, the rights of payment and appeal of an adverse coverage decision for the individual, or in the case of a child their responsible relative or caretaker, will be subrogated to the state agency. The state agency may assert its rights under this section within three years of the date the service was rendered. 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), and 256L.12; 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.

(d) Notwithstanding any law to the contrary, when a person covered by a plan offered by a health insurer receives medical benefits according to any statute listed in this section, payment for covered services or notice of denial for services billed by the provider must be issued directly to the provider. If a person was receiving medical benefits through the Department of Human Services at the time a service was provided, the provider must indicate this benefit coverage on any claim forms submitted by the provider to the health insurer for those services. If the commissioner of human services notifies the health insurer that the commissioner has made payments to the provider, payment for benefits or notices of denials issued by the health insurer must be issued directly to the commissioner. Submission by the department to the health insurer of the claim on a Department of Human Services claim form is proper notice and shall be considered proof of payment of the claim to the provider and supersedes any contract requirements of the health insurer relating to the form of submission. Liability to the insured for coverage is satisfied to the extent that payments for those benefits are made by the health insurer to the provider or the commissioner as required by this section.

(e) When a state agency has acquired the rights of an individual eligible for medical programs named in this section and has health benefits coverage through a health insurer, the health insurer shall not impose requirements that are different from requirements applicable to an agent or assignee of any other individual covered.

new text begin (f) A health insurer must process a clean claim made by a state agency for covered expenses paid under state medical programs within 90 business days of the claim's submission. A health insurer must process all other claims made by a state agency for covered expenses paid under a state medical program within the timeline set forth in Code of Federal Regulations, title 42, section 447.45(d)(4). new text end

new text begin (g) A health insurer may request a refund of a claim paid in error to the Department of Human Services within two years of the date the payment was made to the department. A request for a refund shall not be honored by the department if the health insurer makes the request after the time period has lapsed. new text end

Sec. 2.

Minnesota Statutes 2014, section 150A.06, subdivision 1b, is amended to read:

Subd. 1b.

Resident dentists.

A person who is a graduate of a dental school and is an enrolled graduate student or student of an accredited advanced dental education program and who is not licensed to practice dentistry in the state shall obtain from the board a license to practice dentistry as a resident dentist. The license must be designated "resident dentist license" and authorizes the licensee to practice dentistry only under the supervision of a licensed dentist. new text begin A University of Minnesota School of Dentistry dental resident holding a resident dentist license is eligible for enrollment in medical assistance, as provided under section 256B.0625, subdivision 9b. new text end A resident dentist license must be renewed annually pursuant to the board's rules. An applicant for a resident dentist license shall pay a nonrefundable fee set by the board for issuing and renewing the license. The requirements of sections 150A.01 to 150A.21 apply to resident dentists except as specified in rules adopted by the board. A resident dentist license does not qualify a person for licensure under subdivision 1.

Sec. 3.

Minnesota Statutes 2014, section 174.29, subdivision 1, is amended to read:

Subdivision 1.

Definition.

For the purpose of sections 174.29 and 174.30 "special transportation service" means motor vehicle transportation provided on a regular basis by a public or private entity or person that is designed exclusively or primarily to serve individuals who are elderly or disabled and who are unable to use regular means of transportation but do not require ambulance service, as defined in section 144E.001, subdivision 3. Special transportation service includes but is not limited to service provided by specially equipped buses, vans, taxis, and volunteers driving private automobiles. new text begin Special transportation service also means those nonemergency medical transportation services under section 256B.0625, subdivision 17, that are subject to the operating standards for special transportation service under sections 174.29 to 174.30 and Minnesota Rules, chapter 8840.new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 4.

Minnesota Statutes 2014, section 174.30, subdivision 3, is amended to read:

Subd. 3.

Other standards; wheelchair securementnew text begin ; protected transportnew text end .

(a) A special transportation service that transports individuals occupying wheelchairs is subject to the provisions of sections 299A.11 to 299A.18 concerning wheelchair securement devices. The commissioners of transportation and public safety shall cooperate in the enforcement of this section and sections 299A.11 to 299A.18 so that a single inspection is sufficient to ascertain compliance with sections 299A.11 to 299A.18 and with the standards adopted under this section. Representatives of the Department of Transportation may inspect wheelchair securement devices in vehicles operated by special transportation service providers to determine compliance with sections 299A.11 to 299A.18 and to issue certificates under section 299A.14, subdivision 4.

(b) In place of a certificate issued under section 299A.14, the commissioner may issue a decal under subdivision 4 for a vehicle equipped with a wheelchair securement device if the device complies with sections 299A.11 to 299A.18 and the decal displays the information in section 299A.14, subdivision 4.

new text begin (c) For vehicles designated as protected transport under section 256B.0625, subdivision 17, paragraph (h), the commissioner of transportation, during the commissioner's inspection, shall check to ensure the safety provisions contained in that paragraph are in working order. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 5.

Minnesota Statutes 2014, section 174.30, subdivision 4, is amended to read:

Subd. 4.

Vehicle and equipment inspection; rules; decal; complaint contact informationnew text begin ; restrictions on name of servicenew text end .

(a) The commissioner shall inspect or provide for the inspection of vehicles at least annually. In addition to scheduled annual inspections and reinspections scheduled for the purpose of verifying that deficiencies have been corrected, unannounced inspections of any vehicle may be conducted.

(b) On determining that a vehicle or vehicle equipment is in a condition that is likely to cause an accident or breakdown, the commissioner shall require the vehicle to be taken out of service immediately. The commissioner shall require that vehicles and equipment not meeting standards be repaired and brought into conformance with the standards and shall require written evidence of compliance from the operator before allowing the operator to return the vehicle to service.

(c) The commissioner shall provide in the rules procedures for inspecting vehicles, removing unsafe vehicles from service, determining and requiring compliance, and reviewing driver qualifications.

(d) The commissioner shall design a distinctive decal to be issued to special transportation service providers with a current certificate of compliance under this section. A decal is valid for one year from the last day of the month in which it is issued. A person who is subject to the operating standards adopted under this section may not provide special transportation service in a vehicle that does not conspicuously display a decal issued by the commissioner.

(e) new text begin All special transportation service providers shall pay an annual fee of $45 to obtain a decal. Providers of ambulance service, as defined in section 144E.001, subdivision 3, are exempt from the annual fee. Fees collected under this paragraph must be deposited in the trunk highway fund, and are appropriated to the commissioner to pay for costs related to administering the special transportation service program.new text end

new text begin (f) new text end Special transportation service providers shall prominently display in each vehicle all contact information for the submission of complaints regarding the transportation services provided to that individual. All vehicles providing service under section 473.386 shall display contact information for the Metropolitan Council. All other special transportation service vehicles shall display contact information for the commissioner of transportation.

new text begin (g) Nonemergency medical transportation providers must comply with Minnesota Rules, part 8840.5450, except that a provider may use the phrase "nonemergency medical transportation" in its name or in advertisements or information describing the service. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 6.

Minnesota Statutes 2014, section 174.30, is amended by adding a subdivision to read:

new text begin Subd. 4b. new text end

new text begin Variance from the standards. new text end

new text begin A nonemergency medical transportation provider who was not subject to the standards in this section prior to July 1, 2014, must apply for a variance from the commissioner if the provider cannot meet the standards by January 1, 2017. The commissioner may grant or deny the variance application. Variances, if granted, shall not exceed 60 days unless extended by the commissioner. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 7.

Minnesota Statutes 2014, section 174.30, is amended by adding a subdivision to read:

new text begin Subd. 10. new text end

new text begin Background studies. new text end

new text begin (a) Providers of special transportation service regulated under this section must initiate background studies in accordance with chapter 245C on the following individuals: new text end

new text begin (1) each person with a direct or indirect ownership interest of five percent or higher in the transportation service provider; new text end

new text begin (2) each controlling individual as defined under section 245A.02; new text end

new text begin (3) managerial officials as defined in section 245A.02; new text end

new text begin (4) each driver employed by the transportation service provider; new text end

new text begin (5) each individual employed by the transportation service provider to assist a passenger during transport; and new text end

new text begin (6) all employees of the transportation service agency who provide administrative support, including those who: new text end

new text begin (i) may have face-to-face contact with or access to passengers, their personal property, or their private data; new text end

new text begin (ii) perform any scheduling or dispatching tasks; or new text end

new text begin (iii) perform any billing activities. new text end

new text begin (b) The transportation service provider must initiate the background studies required under paragraph (a) using the online NETStudy system operated by the commissioner of human services. new text end

new text begin (c) The transportation service provider shall not permit any individual to provide any service listed in paragraph (a) until the transportation service provider has received notification from the commissioner of human services indicating that the individual: new text end

new text begin (1) is not disqualified under chapter 245C; or new text end

new text begin (2) is disqualified, but has received a set-aside of that disqualification according to section 245C.23 related to that transportation service provider. new text end

new text begin (d) When a local or contracted agency is authorizing a ride under section 256B.0625, subdivision 17, by a volunteer driver, and the agency authorizing the ride has reason to believe the volunteer driver has a history that would disqualify the individual or that may pose a risk to the health or safety of passengers, the agency may initiate a background study to be completed according to chapter 245C using the commissioner of human services' online NETStudy system, or through contacting the Department of Human Services background study division for assistance. The agency that initiates the background study under this paragraph shall be responsible for providing the volunteer driver with the privacy notice required under section 245C.05, subdivision 2c, and payment for the background study required under section 245C.10, subdivision 13, before the background study is completed. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2016. new text end

Sec. 8.

Minnesota Statutes 2014, section 245C.03, is amended by adding a subdivision to read:

new text begin Subd. 12. new text end

new text begin Providers of special transportation service. new text end

new text begin The commissioner shall conduct background studies on any individual required under section 174.30 to have a background study completed under this chapter. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2016. new text end

Sec. 9.

Minnesota Statutes 2014, section 245C.10, is amended by adding a subdivision to read:

new text begin Subd. 13. new text end

new text begin Providers of special transportation service. new text end

new text begin The commissioner shall recover the cost of background studies initiated by providers of special transportation service under section 174.30 through a fee of no more than $20 per study. The fees collected under this subdivision are appropriated to the commissioner for the purpose of conducting background studies. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2016. new text end

Sec. 10.

Minnesota Statutes 2014, section 256.015, subdivision 7, is amended to read:

Subd. 7.

Cooperation with information requests required.

(a) Upon the request of the commissioner of human services:

(1) any state agency or third-party payer shall cooperate by furnishing information to help establish a third-party liability, as required by the federal Deficit Reduction Act of 2005, Public Law 109-171;

(2) any employer or third-party payer shall cooperate by furnishing a data file containing information about group health insurance plan or medical benefit plan coverage of its employees or insureds within 60 days of the request.new text begin The information in the data file must include at least the following: full name, date of birth, Social Security number if collected and stored in a system routinely used for producing data files by the employer or third-party payer, employer name, policy identification number, group identification number, and plan or coverage type.new text end

(b) For purposes of section 176.191, subdivision 4, the commissioner of labor and industry may allow the commissioner of human services and county agencies direct access and data matching on information relating to workers' compensation claims in order to determine whether the claimant has reported the fact of a pending claim and the amount paid to or on behalf of the claimant to the commissioner of human services.

(c) For the purpose of compliance with section 169.09, subdivision 13, and federal requirements under Code of Federal Regulations, title 42, section 433.138 (d)(4), the commissioner of public safety shall provide accident data as requested by the commissioner of human services. The disclosure shall not violate section 169.09, subdivision 13, paragraph (d).

(d) The commissioner of human services and county agencies shall limit its use of information gained from agencies, third-party payers, and employers to purposes directly connected with the administration of its public assistance and child support programs. The provision of information by agencies, third-party payers, and employers to the department under this subdivision is not a violation of any right of confidentiality or data privacy.

Sec. 11.

Minnesota Statutes 2014, section 256.969, subdivision 1, is amended to read:

Subdivision 1.

Hospital cost index.

(a) The hospital cost index shall be the change in the deleted text begin Consumer Price Index-All Items (United States city average) (CPI-U) forecasted by Data Resources, Inc.deleted text end new text begin Centers for Medicare and Medicaid Services Inpatient Hospital Market Basket. new text end The commissioner shall use the indices as forecasted deleted text begin in the third quarter of the calendar year prior to the rate year. The hospital cost index may be used to adjust the base year operating payment rate through the rate year on an annually compounded basisdeleted text end new text begin for the midpoint of the prior rate year to the midpoint of the current rate yearnew text end .

(b) For fiscal years beginning on or after July 1, 1993, the commissioner of human services shall not provide automatic annual inflation adjustments for hospital payment rates under medical assistance. deleted text begin The commissioner of management and budget shall deleted text end deleted text begin include as a budget change request in each biennial detailed expenditure budget submitted deleted text end deleted text begin to the legislature under section deleted text end deleted text begin 16A.11deleted text end deleted text begin annual adjustments in hospital payment rates under deleted text end deleted text begin medical assistance based upon the hospital cost index.deleted text end

Sec. 12.

Minnesota Statutes 2014, section 256.969, subdivision 2b, is amended to read:

Subd. 2b.

Hospital payment rates.

(a) For discharges occurring on or after November 1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according to the following:

(1) critical access hospitals as defined by Medicare shall be paid using a cost-based methodology;

(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology under subdivision 25;

(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation distinct parts as defined by Medicare shall be paid according to the methodology under subdivision 12; and

(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.

(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not be rebased, except that a Minnesota long-term hospital shall be rebased effective January 1, 2011, based on its most recent Medicare cost report ending on or before September 1, 2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on December 31, 2010. For rate setting periods after November 1, 2014, in which the base years are updated, a Minnesota long-term hospital's base year shall remain within the same period as other hospitals.

(c) Effective for discharges occurring on and after November 1, 2014, payment rates for hospital inpatient services provided by hospitals located in Minnesota or the local trade area, except for the hospitals paid under the methodologies described in paragraph (a), clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a manner similar to Medicare. The base year for the rates effective November 1, 2014, shall be calendar year 2012. The rebasing under this paragraph shall be budget neutral, ensuring that the total aggregate payments under the rebased system are equal to the total aggregate payments that were made for the same number and types of services in the base year. Separate budget neutrality calculations shall be determined for payments made to critical access hospitals and payments made to hospitals paid under the DRG system. Only the rate increases or decreases under subdivision 3a or 3c that applied to the hospitals being rebased during the entire base period shall be incorporated into the budget neutrality calculation.

(d) For discharges occurring on or after November 1, 2014, through deleted text begin June 30, 2016 deleted text end new text begin the next rebasing that occursnew text end , the rebased rates under paragraph (c) new text begin that apply to hospitals under paragraph (a), clause (4),new text end shall include adjustments to the projected rates that result in no greater than a five percent increase or decrease from the base year payments for any hospital. Any adjustments to the rates made by the commissioner under this paragraph and paragraph (e) shall maintain budget neutrality as described in paragraph (c).

(e) For discharges occurring on or after November 1, 2014, through deleted text begin June 30, 2016, deleted text end new text begin the next rebasing that occursnew text end the commissioner may make additional adjustments to the rebased rates, and when evaluating whether additional adjustments should be made, the commissioner shall consider the impact of the rates on the following:

(1) pediatric services;

(2) behavioral health services;

(3) trauma services as defined by the National Uniform Billing Committee;

(4) transplant services;

(5) obstetric services, newborn services, and behavioral health services provided by hospitals outside the seven-county metropolitan area;

(6) outlier admissions;

(7) low-volume providers; and

(8) services provided by small rural hospitals that are not critical access hospitals.

(f) Hospital payment rates established under paragraph (c) must incorporate the following:

(1) for hospitals paid under the DRG methodology, the base year payment rate per admission is standardized by the applicable Medicare wage index and adjusted by the hospital's disproportionate population adjustment;

(2) for critical access hospitals, deleted text begin interim per diemdeleted text end payment rates new text begin for discharges between November 1, 2014, and June 30, 2015, new text end shall be deleted text begin based on the ratio of cost and charges reported on the base year Medicare cost report or reports and applied to medical assistance utilization data. Final settlement payments for a state fiscal year must be determined based on a review of the medical assistance cost report required under subdivision 4b for the applicable state fiscal yeardeleted text end new text begin set to the same rate of payment that applied for discharges on October 31, 2014new text end ;

(3) the cost and charge data used to establish hospital payment rates must only reflect inpatient services covered by medical assistance; and

(4) in determining hospital payment rates for discharges occurring on or after the rate year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per discharge shall be based on the cost-finding methods and allowable costs of the Medicare program in effect during the base year or years.

(g) The commissioner shall validate the rates effective November 1, 2014, by applying the rates established under paragraph (c), and any adjustments made to the rates under paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the total aggregate payments for the same number and types of services under the rebased rates are equal to the total aggregate payments made during calendar year 2013.

(h) Effective for discharges occurring on or after July 1, 2017, and every two years thereafter, payment rates under this section shall be rebased to reflect only those changes in hospital costs between the existing base year and the next base year. The commissioner shall establish the base year for each rebasing period considering the most recent year for which filed Medicare cost reports are available. The estimated change in the average payment per hospital discharge resulting from a scheduled rebasing must be calculated and made available to the legislature by January 15 of each year in which rebasing is scheduled to occur, and must include by hospital the differential in payment rates compared to the individual hospital's costs.

new text begin (i) Effective for discharges occurring on or after July 1, 2015, payment rates for critical access hospitals located in Minnesota or the local trade area shall be determined using a new cost-based methodology. The commissioner shall establish within the methodology tiers of payment designed to promote efficiency and cost-effectiveness. Payment rates for hospitals under this paragraph shall be set at a level that does not exceed the total cost for critical access hospitals as reflected in base year cost reports. Until the next rebasing that occurs, the new methodology shall result in no greater than a five percent decrease from the base year payments for any hospital, except a hospital that had payments that were greater than 100 percent of the hospital's costs in the base year shall have their rate set equal to 100 percent of costs in the base year. The rates paid for discharges on and after July 1, 2016, covered under this paragraph shall be increased by the inflation factor in subdivision 1, paragraph (a). The new cost-based rate shall be the final rate and shall not be settled to actual incurred costs. Hospitals shall be assigned a payment tier based on the following criteria: new text end

new text begin (1) hospitals that had payments at or below 80 percent of their costs in the base year shall have a rate set that equals 85 percent of their base year costs; new text end

new text begin (2) hospitals that had payments that were above 80 percent, up to and including 90 percent of their costs in the base year shall have a rate set that equals 95 percent of their base year costs; and new text end

new text begin (3) hospitals that had payments that were above 90 percent of their costs in the base year shall have a rate set that equals 100 percent of their base year costs. new text end

new text begin (j) The commissioner may refine the payment tiers and criteria for critical access hospitals to coincide with the next rebasing under paragraph (h). The factors used to develop the new methodology may include, but are not limited to: new text end

new text begin (1) the ratio between the hospital's costs for treating medical assistance patients and the hospital's charges to the medical assistance program; new text end

new text begin (2) the ratio between the hospital's costs for treating medical assistance patients and the hospital's payments received from the medical assistance program for the care of medical assistance patients; new text end

new text begin (3) the ratio between the hospital's charges to the medical assistance program and the hospital's payments received from the medical assistance program for the care of medical assistance patients; new text end

new text begin (4) the statewide average increases in the ratios identified in clauses (1), (2), and (3); new text end

new text begin (5) the proportion of that hospital's costs that are administrative and trends in administrative costs; and new text end

new text begin (6) geographic location. new text end

Sec. 13.

Minnesota Statutes 2014, section 256.969, subdivision 2d, is amended to read:

Subd. 2d.

Interim payments.

Notwithstanding subdivision 2b, paragraph (c), for discharges occurring on or after November 1, 2014, through deleted text begin June 30, 2015deleted text end new text begin March 1, 2016new text end , the commissioner may implement an interim payment process to pay hospitals, including payments based on each hospital's average payments per claim for state fiscal years 2011 and 2012. These interim payments may be used to pay hospitals if the rebasing under subdivision 2b, paragraph (c), is not implemented by November 1, 2014new text begin , or if electronic systems changes necessary to support the conversion to the International Classification of Diseases, 10th revision (ICD-10) coding system are not completednew text end . Claims paid at interim payment rates shall be reprocessed and paid at the rates established under subdivision 2b, paragraphs (c) and (d), upon implementation of the rebased rates.

Sec. 14.

Minnesota Statutes 2014, section 256.969, subdivision 3a, is amended to read:

Subd. 3a.

Payments.

(a) Acute care hospital billings under the medical assistance program must not be submitted until the recipient is discharged. However, the commissioner shall establish monthly interim payments for inpatient hospitals that have individual patient lengths of stay over 30 days regardless of diagnostic category. Except as provided in section 256.9693, medical assistance reimbursement for treatment of mental illness shall be reimbursed based on diagnostic classifications. Individual hospital payments established under this section and sections 256.9685, 256.9686, and 256.9695, in addition to third-party and recipient liability, for discharges occurring during the rate year shall not exceed, in aggregate, the charges for the medical assistance covered inpatient services paid for the same period of time to the hospital. Services that have rates established under subdivision 11 or 12, must be limited separately from other services. After consulting with the affected hospitals, the commissioner may consider related hospitals one entity and may merge the payment rates while maintaining separate provider numbers. The operating and property base rates per admission or per day shall be derived from the best Medicare and claims data available when rates are established. The commissioner shall determine the best Medicare and claims data, taking into consideration variables of recency of the data, audit disposition, settlement status, and the ability to set rates in a timely manner. The commissioner shall notify hospitals of payment rates 30 days prior to implementation. The rate setting data must reflect the admissions data used to establish relative values. The commissioner may adjust base year cost, relative value, and case mix index data to exclude the costs of services that have been discontinued by the October 1 of the year preceding the rate year or that are paid separately from inpatient services. Inpatient stays that encompass portions of two or more rate years shall have payments established based on payment rates in effect at the time of admission unless the date of admission preceded the rate year in effect by six months or more. In this case, operating payment rates for services rendered during the rate year in effect and established based on the date of admission shall be adjusted to the rate year in effect by the hospital cost index.

(b) For fee-for-service admissions occurring on or after July 1, 2002, the total payment, before third-party liability and spenddown, made to hospitals for inpatient services is reduced by .5 percent from the current statutory rates.

(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service admissions occurring on or after July 1, 2003, made to hospitals for inpatient services before third-party liability and spenddown, is reduced five percent from the current statutory rates. Mental health services within diagnosis related groups 424 to 432 or corresponding APR-DRGs, and facilities defined under subdivision 16 are excluded from this paragraph.

(d) In addition to the reduction in paragraphs (b) and (c), the total payment for fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for inpatient services before third-party liability and spenddown, is reduced 6.0 percent from the current statutory rates. Mental health services within diagnosis related groups 424 to 432 or corresponding APR-DRGs, and facilities defined under subdivision 16 are excluded from this paragraph. Payments made to managed care plans shall be reduced for services provided on or after January 1, 2006, to reflect this reduction.

(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made to hospitals for inpatient services before third-party liability and spenddown, is reduced 3.46 percent from the current statutory rates. Mental health services with diagnosis related groups 424 to 432 or corresponding APR-DRGs, and facilities defined under subdivision 16 are excluded from this paragraph. Payments made to managed care plans shall be reduced for services provided on or after January 1, 2009, through June 30, 2009, to reflect this reduction.

(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2011, made to hospitals for inpatient services before third-party liability and spenddown, is reduced 1.9 percent from the current statutory rates. Mental health services with diagnosis related groups 424 to 432 or corresponding APR-DRGs, and facilities defined under subdivision 16 are excluded from this paragraph. Payments made to managed care plans shall be reduced for services provided on or after July 1, 2009, through June 30, 2011, to reflect this reduction.

(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for inpatient services before third-party liability and spenddown, is reduced 1.79 percent from the current statutory rates. Mental health services with diagnosis related groups 424 to 432 or corresponding APR-DRGs, and facilities defined under subdivision 16 are excluded from this paragraph. Payments made to managed care plans shall be reduced for services provided on or after July 1, 2011, to reflect this reduction.

(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total payment for fee-for-service admissions occurring on or after July 1, 2009, made to hospitals for inpatient services before third-party liability and spenddown, is reduced one percent from the current statutory rates. Facilities defined under subdivision 16 are excluded from this paragraph. Payments made to managed care plans shall be reduced for services provided on or after October 1, 2009, to reflect this reduction.

(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total payment for fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for inpatient services before third-party liability and spenddown, is reduced 1.96 percent from the current statutory rates. Facilities defined under subdivision 16 are excluded from this paragraph. Payments made to managed care plans shall be reduced for services provided on or after January 1, 2011, to reflect this reduction.

(j) Effective for discharges on and after November 1, 2014, from hospitals paid under subdivision 2b, paragraph (a), clauses (1) and (4), the rate adjustments in this subdivision must be incorporated into the rebased rates established under subdivision 2b, paragraph (c), and must not be applied to each claim.

new text begin (k) Effective for discharges on and after July 1, 2015, from hospitals paid under subdivision 2b, paragraph (a), clauses (2) and (3), the rate adjustments in this subdivision must be incorporated into the rates and must not be applied to each claim. new text end

Sec. 15.

Minnesota Statutes 2014, section 256.969, subdivision 3c, is amended to read:

Subd. 3c.

Rateable reduction and readmissions reduction.

(a) The total payment for fee for service admissions occurring on or after September 1, 2011, to October 31, 2014, made to hospitals for inpatient services before third-party liability and spenddown, is reduced ten percent from the current statutory rates. Facilities defined under subdivision 16, long-term hospitals as determined under the Medicare program, children's hospitals whose inpatients are predominantly under 18 years of age, and payments under managed care are excluded from this paragraph.

(b) Effective for admissions occurring during calendar year 2010 and each year after, the commissioner shall calculate a readmission rate for admissions to all hospitals occurring within 30 days of a previous discharge using data from the Reducing Avoidable Readmissions Effectively (RARE) campaign. The commissioner may adjust the readmission rate taking into account factors such as the medical relationship, complicating conditions, and sequencing of treatment between the initial admission and subsequent readmissions.

(c) Effective for payments to all hospitals on or after July 1, 2013, through October 31, 2014, the reduction in paragraph (a) is reduced one percentage point for every percentage point reduction in the overall readmissions rate between the two previous calendar years to a maximum of five percent.

(d) The exclusion from the rate reduction in paragraph (a) shall apply to a hospital located in Hennepin County with a licensed capacity of 1,700 beds as of September 1, 2011, for admissions of children under 18 years of age occurring on or after September 1, 2011, through August 31, 2013, but shall not apply to payments for admissions occurring on or after September 1, 2013, through October 31, 2014.

(e) Effective for discharges on or after November 1, 2014, from hospitals paid under subdivision 2b, paragraph (a), clauses (1) and (4), the rate adjustments in this subdivision must be incorporated into the rebased rates established under subdivision 2b, paragraph (c), and must not be applied to each claim.

new text begin (f) Effective for discharges on and after July 1, 2015, from hospitals paid under subdivision 2b, paragraph (a), clauses (2) and (3), the rate adjustments in this subdivision must be incorporated into the rates and must not be applied to each claim. new text end

Sec. 16.

Minnesota Statutes 2014, section 256.969, subdivision 9, is amended to read:

Subd. 9.

Disproportionate numbers of low-income patients served.

(a) For admissions occurring on or after July 1, 1993, the medical assistance disproportionate population adjustment shall comply with federal law and shall be paid to a hospital, excluding regional treatment centers and facilities of the federal Indian Health Service, with a medical assistance inpatient utilization rate in excess of the arithmetic mean. The adjustment must be determined as follows:

(1) for a hospital with a medical assistance inpatient utilization rate above the arithmetic mean for all hospitals excluding regional treatment centers and facilities of the federal Indian Health Service but less than or equal to one standard deviation above the mean, the adjustment must be determined by multiplying the total of the operating and property payment rates by the difference between the hospital's actual medical assistance inpatient utilization rate and the arithmetic mean for all hospitals excluding regional treatment centers and facilities of the federal Indian Health Service; and

(2) for a hospital with a medical assistance inpatient utilization rate above one standard deviation above the mean, the adjustment must be determined by multiplying the adjustment that would be determined under clause (1) for that hospital by 1.1. deleted text begin The commissioner may establish a separate disproportionate population payment rate deleted text end deleted text begin adjustment for critical access hospitals. deleted text end The commissioner shall report annually on the number of hospitals likely to receive the adjustment authorized by this paragraph. The commissioner shall specifically report on the adjustments received by public hospitals and public hospital corporations located in cities of the first class.

(b) Certified public expenditures made by Hennepin County Medical Center shall be considered Medicaid disproportionate share hospital payments. Hennepin County and Hennepin County Medical Center shall report by June 15, 2007, on payments made beginning July 1, 2005, or another date specified by the commissioner, that may qualify for reimbursement under federal law. Based on these reports, the commissioner shall apply for federal matching funds.

(c) Upon federal approval of the related state plan amendment, paragraph (b) is effective retroactively from July 1, 2005, or the earliest effective date approved by the Centers for Medicare and Medicaid Services.

new text begin (d) Effective July 1, 2015, disproportionate share hospital (DSH) payments shall be paid in accordance with a new methodology using 2012 as the base year. Annual payments made under this paragraph shall equal the total amount of payments made for 2012. A licensed children's hospital shall receive only a single DSH factor for children's hospitals. Other DSH factors may be combined to arrive at a single factor for each hospital that is eligible for DSH payments. The new methodology shall make payments only to hospitals located in Minnesota and include the following factors: new text end

new text begin (1) a licensed children's hospital with at least 1,000 fee-for-service discharges in the base year shall receive a factor of 0.868. A licensed children's hospital with less than 1,000 fee-for-service discharges in the base year shall receive a factor of 0.7880; new text end

new text begin (2) a hospital that has in effect for the initial rate year a contract with the commissioner to provide extended psychiatric inpatient services under section 256.9693 shall receive a factor of 0.0160; new text end

new text begin (3) a hospital that has received payment from the fee-for-service program for at least 20 transplant services in the base year shall receive a factor of 0.0435; new text end

new text begin (4) a hospital that has a medical assistance utilization rate in the base year between 20 percent up to one standard deviation above the statewide mean utilization rate shall receive a factor of 0.0468; new text end

new text begin (5) a hospital that has a medical assistance utilization rate in the base year that is at least one standard deviation above the statewide mean utilization rate but is less than three standard deviations above the mean shall receive a factor of 0.2300; and new text end

new text begin (6) a hospital that has a medical assistance utilization rate in the base year that is at least three standard deviations above the statewide mean utilization rate shall receive a factor of 0.3711. new text end

new text begin (e) Any payments or portion of payments made to a hospital under this subdivision that are subsequently returned to the commissioner because the payments are found to exceed the hospital-specific DSH limit for that hospital shall be redistributed, proportionate to the number of fee-for-service discharges, to other DSH-eligible nonchildren's hospitals that have a medical assistance utilization rate that is at least one standard deviation above the mean. new text end

Sec. 17.

new text begin [256B.0561] PERIODIC DATA MATCHING TO EVALUATE CONTINUED ELIGIBILITY. new text end

new text begin Subdivision 1. new text end

new text begin Definition. new text end

new text begin For the purposes of this section, "periodic data matching" means obtaining updated electronic information about medical assistance and MinnesotaCare recipients on the MNsure information system from federal and state data sources accessible to the MNsure information system and using that data to evaluate continued eligibility between regularly scheduled renewals. new text end

new text begin Subd. 2. new text end

new text begin Periodic data matching. new text end

new text begin (a) Beginning March 1, 2016, the commissioner shall conduct periodic data matching to identify recipients who, based on available electronic data, may not meet eligibility criteria for the public health care program in which the recipient is enrolled. The commissioner shall conduct data matching for medical assistance or MinnesotaCare recipients at least once during a recipient's 12-month period of eligibility. new text end

new text begin (b) If data matching indicates a recipient may no longer qualify for medical assistance or MinnesotaCare, the commissioner must notify the recipient and allow the recipient no more than 30 days to confirm the information obtained through the periodic data matching or provide a reasonable explanation for the discrepancy to the state or county agency directly responsible for the recipient's case. If a recipient does not respond within the advance notice period or does not respond with information that demonstrates eligibility or provides a reasonable explanation for the discrepancy within the 30-day time period, the commissioner shall terminate the recipient's eligibility in the manner provided for by the laws and regulations governing the health care program for which the recipient has been identified as being ineligible. new text end

new text begin (c) The commissioner shall not terminate eligibility for a recipient who is cooperating with the requirements of paragraph (b) and needs additional time to provide information in response to the notification. new text end

new text begin (d) Any termination of eligibility for benefits under this section may be appealed as provided for in sections 256.045 to 256.0451, and the laws governing the health care programs for which eligibility is terminated. new text end

new text begin Subd. 3. new text end

new text begin Recipient communication requirements. new text end

new text begin The commissioner shall include in all communications with recipients affected by the periodic data matching the following contact information for: (1) the state or county agency directly responsible for the recipient's case; and (2) consumer assistance partners who may be able to assist the recipient in the periodic data matching process. new text end

new text begin Subd. 4. new text end

new text begin Report. new text end

new text begin By September 1, 2017, and each September 1 thereafter, the commissioner shall submit a report to the chairs and ranking minority members of the house and senate committees with jurisdiction over human services finance that includes the number of cases affected by periodic data matching under this section, the number of recipients identified as possibly ineligible as a result of a periodic data match, and the number of recipients whose eligibility was terminated as a result of a periodic data match. The report must also specify, for recipients whose eligibility was terminated, how many cases were closed due to failure to cooperate. new text end

new text begin Subd. 5. new text end

new text begin Federal compliance. new text end

new text begin The commissioner shall ensure that the implementation of this section complies with the Affordable Care Act, including the state's maintenance of effort requirements. The commissioner shall not terminate eligibility under this section if eligibility terminations would not conform with federal requirements, including requirements not yet codified in Minnesota Statutes. new text end

Sec. 18.

Minnesota Statutes 2014, section 256B.06, is amended by adding a subdivision to read:

new text begin Subd. 6. new text end

new text begin Legal referral and assistance grants. new text end

new text begin (a) The commissioner shall award grants to one or more nonprofit programs that provide legal services based on indigency to provide legal services to individuals with emergency medical conditions or chronic health conditions who are not currently eligible for medical assistance or other public health care programs based on their legal status, but who may meet eligibility requirements with legal assistance. new text end

new text begin (b) The grantees, in collaboration with hospitals and safety net providers, shall provide referral assistance to connect individuals identified in paragraph (a) with alternative resources and services to assist in meeting their health care needs. new text end

Sec. 19.

Minnesota Statutes 2014, section 256B.0625, is amended by adding a subdivision to read:

new text begin Subd. 9b. new text end

new text begin Dental services provided by faculty members and resident dentists at a dental school. new text end

new text begin (a) A dentist who is not enrolled as a medical assistance provider, is a faculty or adjunct member at the University of Minnesota or a resident dentist licensed under section 150A.06, subdivision 1b, and is providing dental services at a dental clinic owned or operated by the University of Minnesota, may be enrolled as a medical assistance provider if the provider completes and submits to the commissioner an agreement form developed by the commissioner. The agreement must specify that the faculty or adjunct member or resident dentist: new text end

new text begin (1) will not receive payment for the services provided to medical assistance or MinnesotaCare enrollees performed at the dental clinics owned or operated by the University of Minnesota; new text end

new text begin (2) will not be listed in the medical assistance or MinnesotaCare provider directory; and new text end

new text begin (3) is not required to serve medical assistance and MinnesotaCare enrollees when providing nonvolunteer services in a private practice. new text end

new text begin (b) A dentist or resident dentist enrolled under this subdivision as a fee-for-service provider shall not otherwise be enrolled in or receive payments from medical assistance or MinnesotaCare as a fee-for-service provider. new text end

Sec. 20.

Minnesota Statutes 2014, section 256B.0625, subdivision 13h, is amended to read:

Subd. 13h.

Medication therapy management services.

(a) Medical assistance deleted text begin and deleted text end deleted text begin general assistance medical care coverdeleted text end new text begin coversnew text end medication therapy management services for a recipient taking deleted text begin three or moredeleted text end prescriptions to treat or prevent one or more chronic medical conditionsdeleted text begin ; a recipient with a drug therapy problem that is identified by the commissioner or identified by a pharmacist and approved by the commissioner; or prior authorized by the commissioner that has resulted or is likely to result in significant nondrug program costs. The commissioner may cover medical therapy management services under MinnesotaCare if the commissioner determines this is cost-effectivedeleted text end . For purposes of this subdivision, "medication therapy management" means the provision of the following pharmaceutical care services by a licensed pharmacist to optimize the therapeutic outcomes of the patient's medications:

(1) performing or obtaining necessary assessments of the patient's health status;

(2) formulating a medication treatment plan;

(3) monitoring and evaluating the patient's response to therapy, including safety and effectiveness;

(4) performing a comprehensive medication review to identify, resolve, and prevent medication-related problems, including adverse drug events;

(5) documenting the care delivered and communicating essential information to the patient's other primary care providers;

(6) providing verbal education and training designed to enhance patient understanding and appropriate use of the patient's medications;

(7) providing information, support services, and resources designed to enhance patient adherence with the patient's therapeutic regimens; and

(8) coordinating and integrating medication therapy management services within the broader health care management services being provided to the patient.

Nothing in this subdivision shall be construed to expand or modify the scope of practice of the pharmacist as defined in section 151.01, subdivision 27.

(b) To be eligible for reimbursement for services under this subdivision, a pharmacist must meet the following requirements:

(1) have a valid license issued by the Board of Pharmacy of the state in which the medication therapy management service is being performed;

(2) have graduated from an accredited college of pharmacy on or after May 1996, or completed a structured and comprehensive education program approved by the Board of Pharmacy and the American Council of Pharmaceutical Education for the provision and documentation of pharmaceutical care management services that has both clinical and didactic elements;

(3) be practicing in an ambulatory care setting as part of a multidisciplinary team or have developed a structured patient care process that is offered in a private or semiprivate patient care area that is separate from the commercial business that also occurs in the setting, or in home settings, including long-term care settings, group homes, and facilities providing assisted living services, but excluding skilled nursing facilities; and

(4) make use of an electronic patient record system that meets state standards.

(c) For purposes of reimbursement for medication therapy management services, the commissioner may enroll individual pharmacists as medical assistance deleted text begin and general assistance medical caredeleted text end providers. The commissioner may also establish contact requirements between the pharmacist and recipient, including limiting the number of reimbursable consultations per recipient.

(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing within a reasonable geographic distance of the patient, a pharmacist who meets the requirements may provide the services via two-way interactive video. Reimbursement shall be at the same rates and under the same conditions that would otherwise apply to the services provided. To qualify for reimbursement under this paragraph, the pharmacist providing the services must meet the requirements of paragraph (b), and must be located within an ambulatory care setting deleted text begin approved by the commissionerdeleted text end new text begin that meets the requirements of paragraph (b), clause (3)new text end . The patient must also be located within an ambulatory care setting deleted text begin approved by the commissionerdeleted text end new text begin that meets the requirements of paragraph (b), clause (3)new text end . Services provided under this paragraph may not be transmitted into the patient's residence.

deleted text begin (e) The commissioner shall establish a pilot project for an intensive medication therapy management program for patients identified by the commissioner with multiple chronic conditions and a high number of medications who are at high risk of preventable hospitalizations, emergency room use, medication complications, and suboptimal treatment outcomes due to medication-related problems. For purposes of the pilot project, medication therapy management services may be provided in a patient's home or community setting, in addition to other authorized settings. The commissioner may waive existing payment policies and establish special payment rates for the pilot project. The pilot project must be designed to produce a net savings to the state compared to the estimated costs that would otherwise be incurred for similar patients without the program. The pilot project must begin by January 1, 2010, and end June 30, 2012. deleted text end

new text begin (e) Medication therapy management services may be delivered into a patient's residence via secure interactive video if the medication therapy management services are performed electronically during a covered home care visit by an enrolled provider. Reimbursement shall be at the same rates and under the same conditions that would otherwise apply to the services provided. To qualify for reimbursement under this paragraph, the pharmacist providing the services must meet the requirements of paragraph (b) and must be located within an ambulatory care setting that meets the requirements of paragraph (b), clause (3). new text end

Sec. 21.

Minnesota Statutes 2014, section 256B.0625, subdivision 17, is amended to read:

Subd. 17.

Transportation costs.

(a) "Nonemergency medical transportation service" means motor vehicle transportation provided by a public or private person that serves Minnesota health care program beneficiaries who do not require emergency ambulance service, as defined in section 144E.001, subdivision 3, to obtain covered medical services. deleted text begin Nonemergency medical transportation service includes, but is not deleted text end deleted text begin limited to, special transportation service, defined in section deleted text end deleted text begin 174.29, subdivision 1deleted text end deleted text begin .deleted text end

(b) Medical assistance covers medical transportation costs incurred solely for obtaining emergency medical care or transportation costs incurred by eligible persons in obtaining emergency or nonemergency medical care when paid directly to an ambulance company, common carrier, or other recognized providers of transportation services. Medical transportation must be provided by:

(1) nonemergency medical transportation providers who meet the requirements of this subdivision;

(2) ambulances, as defined in section 144E.001, subdivision 2;

(3) taxicabs deleted text begin anddeleted text end new text begin ;new text end

new text begin (4) new text end public transit, as defined in section 174.22, subdivision 7; or

deleted text begin (4)deleted text end new text begin (5)new text end not-for-hire vehicles, including volunteer drivers.

(c) Medical assistance covers nonemergency medical transportation provided by nonemergency medical transportation providers enrolled in the Minnesota health care programs. All nonemergency medical transportation providers must comply with the operating standards for special transportation service as defined in sections 174.29 to 174.30 and Minnesota Rules, chapter 8840, and in consultation with the Minnesota Department of Transportation. All nonemergency medical transportation providers shall bill for nonemergency medical transportation services in accordance with Minnesota health care programs criteria. Publicly operated transit systems, volunteers, and not-for-hire vehicles are exempt from the requirements outlined in this paragraph.

(d) The administrative agency of nonemergency medical transportation must:

(1) adhere to the policies defined by the commissioner in consultation with the Nonemergency Medical Transportation Advisory Committee;

(2) pay nonemergency medical transportation providers for services provided to Minnesota health care programs beneficiaries to obtain covered medical services;

(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled trips, and number of trips by mode; and

(4) by July 1, 2016, in accordance with subdivision 18e, utilize a Web-based single administrative structure assessment tool that meets the technical requirements established by the commissioner, reconciles trip information with claims being submitted by providers, and ensures prompt payment for nonemergency medical transportation services.

(e) Until the commissioner implements the single administrative structure and delivery system under subdivision 18e, clients shall obtain their level-of-service certificate from the commissioner or an entity approved by the commissioner that does not dispatch rides for clients using modes new text begin of transportation new text end under paragraph (h), clauses (4), (5), (6), and (7).

(f) The commissioner may use an order by the recipient's attending physician or a medical or mental health professional to certify that the recipient requires nonemergency medical transportation services. Nonemergency medical transportation providers shall perform driver-assisted services for eligible individuals, when appropriate. Driver-assisted service includes passenger pickup at and return to the individual's residence or place of business, assistance with admittance of the individual to the medical facility, and assistance in passenger securement or in securing of wheelchairs or stretchers in the vehicle. deleted text begin Nonemergency medical transportation providers must have trip logs, which include pickup and drop-off times, signed by the medical provider or client attesting mileage traveled to obtain covered medical services, whichever is deemed most appropriate. Nonemergency medical transportation providers may not bill for separate base rates for the continuation of a trip beyond the original destination. Nonemergency medical transportation providers must take clients to the health care provider, using the most direct route, and must not exceed 30 miles for a trip to a primary care provider or 60 miles for a trip to a specialty care provider, unless the client receives authorization from the local agency. The minimum medical assistance reimbursement rates for special transportation services are:deleted text end

deleted text begin (1)(i) $17 for the base rate and $1.35 per mile for special transportation services to eligible persons who need a wheelchair-accessible van; deleted text end

deleted text begin (ii) $11.50 for the base rate and $1.30 per mile for special transportation services to eligible persons who do not need a wheelchair-accessible van; and deleted text end

deleted text begin (iii) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for special transportation services to eligible persons who need a stretcher-accessible vehicle; and deleted text end

deleted text begin (2)deleted text end new text begin Nonemergency medical transportation providers must take clients to the health care provider using the most direct route, and must not exceed 30 miles for a trip to a primary care provider or 60 miles for a trip to a specialty care provider, unless the client receives authorization from the local agency.new text end

new text begin Nonemergency medical transportation providers may not bill for separate base rates for the continuation of a trip beyond the original destination. Nonemergency medical transportation providers must maintain trip logs, which include pickup and drop-off times, signed by the medical provider or client, whichever is deemed most appropriate, attesting to mileage traveled to obtain covered medical services. new text end Clients requesting client mileage reimbursement must sign the trip log attesting mileage traveled to obtain covered medical services.

deleted text begin (g) The covered modes of nonemergency medical transportation include transportation provided directly by clients or family members of clients with their own transportation, volunteers using their own vehicles, taxicabs, and public transit, or provided to a client who needs a stretcher-accessible vehicle, a lift/ramp equipped vehicle, or a vehicle that is not stretcher-accessible or lift/ramp equipped designed to transport ten or fewer persons. Upon implementation of a new rate structure, a new covered mode of nonemergency medical transportation shall include transportation provided to a client who needs a protected vehicle that is not an ambulance or police car and has safety locks, a video recorder, and a transparent thermoplastic partition between the passenger and the vehicle driver. deleted text end

deleted text begin (h)deleted text end new text begin (g)new text end The administrative agency shall use the level of service process established by the commissioner in consultation with the Nonemergency Medical Transportation Advisory Committee to determine the client's most appropriate mode of transportation. If public transit or a certified transportation provider is not available to provide the appropriate service mode for the client, the client may receive a onetime service upgrade.

new text begin (h) new text end The deleted text begin newdeleted text end new text begin covered new text end modes of transportation, which may not be implemented without a new rate structure, are:

(1) client reimbursement, which includes client mileage reimbursement provided to clients who have their own transportationnew text begin , new text end ornew text begin tonew text end family new text begin or an acquaintance new text end who provides transportation to the client;

(2) volunteer transport, which includes transportation by volunteers using their own vehicle;

(3) unassisted transport, which includes transportation provided to a client by a taxicab or public transit. If a taxicab or deleted text begin publicly operateddeleted text end new text begin publicnew text end transit deleted text begin systemdeleted text end is not available, the client can receive transportation from another nonemergency medical transportation provider;

(4) assisted transport, which includes transport provided to clients who require assistance by a nonemergency medical transportation provider;

(5) lift-equipped/ramp transport, which includes transport provided to a client who is dependent on a device and requires a nonemergency medical transportation provider with a vehicle containing a lift or ramp;

(6) protected transport, which includes transport new text begin provided new text end to a client who has received a prescreening that has deemed other forms of transportation inappropriate and who requires a providernew text begin : (i) with a protected vehicle that is not an ambulance or police car and has safety locks, a video recorder, and a transparent thermoplastic partition between the passenger and the vehicle driver; and (ii) who isnew text end certified as a protected transport provider; and

(7) stretcher transport, which includes transport for a client in a prone or supine position and requires a nonemergency medical transportation provider with a vehicle that can transport a client in a prone or supine position.

(i) deleted text begin In accordance with subdivision 18e, by July 1, 2016,deleted text end The local agency shall be the single administrative agency and shall administer and reimburse for modes defined in paragraph (h) according to deleted text begin a new rate structure, once this is adopteddeleted text end new text begin paragraphs (l) and (m) when the commissioner has developed, made available, and funded the Web-based single administrative structure, assessment tool, and level of need assessment under subdivision 18e. The local agency's financial obligation is limited to funds provided by the state or federal governmentnew text end .

(j) The commissioner shall:

(1) in consultation with the Nonemergency Medical Transportation Advisory Committee, verify that the mode and use of nonemergency medical transportation is appropriate;

(2) verify that the client is going to an approved medical appointment; and

(3) investigate all complaints and appeals.

(k) The administrative agency shall pay for the services provided in this subdivision and seek reimbursement from the commissioner, if appropriate. As vendors of medical care, local agencies are subject to the provisions in section 256B.041, the sanctions and monetary recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.

(l) new text begin Payments for nonemergency medical transportation must be paid based on the client's assessed mode under paragraph (g), not the type of vehicle used to provide the service. The medical assistance reimbursement rates for nonemergency medical transportation services that are payable by or on behalf of the commissioner for nonemergency medical transportation services are:new text end

new text begin (1) $0.22 per mile for client reimbursement; new text end

new text begin (2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer transport; new text end

new text begin (3) equivalent to the standard fare for unassisted transport when provided by public transit, and $11 for the base rate and $1.30 per mile when provided by a nonemergency medical transportation provider; new text end

new text begin (4) $13 for the base rate and $1.30 per mile for assisted transport; new text end

new text begin (5) $18 for the base rate and $1.55 per mile for lift-equipped/ramp transport; new text end

new text begin (6) $75 for the base rate and $2.40 per mile for protected transport; and new text end

new text begin (7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for an additional attendant if deemed medically necessary. new text end

deleted text begin The base rates for special transportation services in areas defined under RUCA to be super rural shall be equal to the reimbursement rate established in paragraph (f), clause (1), plus 11.3 percent, and for special deleted text end

new text begin (m) The base rate for nonemergency medical transportation services in areas defined under RUCA to be super rural is equal to 111.3 percent of the respective base rate in paragraph (l), clauses (1) to (7). The mileage rate for nonemergency medical new text end transportation services in areas defined under RUCA to be rural or super rural areasnew text begin isnew text end :

(1) for a trip equal to 17 miles or less, deleted text begin mileage reimbursement shall bedeleted text end equal to 125 percent of the respective mileage rate in paragraph deleted text begin (f)deleted text end new text begin (l)new text end , deleted text begin clausedeleted text end new text begin clauses new text end (1)new text begin to (7)new text end ; and

(2) for a trip between 18 and 50 miles, deleted text begin mileage reimbursement shall bedeleted text end equal to 112.5 percent of the respective mileage rate in paragraph deleted text begin (f)deleted text end new text begin (l)new text end , deleted text begin clausedeleted text end new text begin clauses new text end (1)new text begin to (7)new text end .

deleted text begin (m)deleted text end new text begin (n) new text end For purposes of reimbursement rates for deleted text begin specialdeleted text end new text begin nonemergency medical new text end transportation services under deleted text begin paragraph (c)deleted text end new text begin paragraphs (l) and (m)new text end , the zip code of the recipient's place of residence shall determine whether the urban, rural, or super rural reimbursement rate applies.

deleted text begin (n)deleted text end new text begin (o) new text end For purposes of this subdivision, "rural urban commuting area" or "RUCA" means a census-tract based classification system under which a geographical area is determined to be urban, rural, or super rural.

deleted text begin (o) Effective for services provided on or after September 1, 2011, nonemergency transportation rates, including special transportation, taxi, and other commercial carriers, are reduced 4.5 percent. Payments made to managed care plans and county-based purchasing plans must be reduced for services provided on or after January 1, 2012, to reflect this reduction. deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 22.

Minnesota Statutes 2014, section 256B.0625, subdivision 17a, is amended to read:

Subd. 17a.

Payment for ambulance services.

deleted text begin (a)deleted text end Medical assistance covers ambulance services. Providers shall bill ambulance services according to Medicare criteria. Nonemergency ambulance services shall not be paid as emergencies. Effective for services rendered on or after July 1, 2001, medical assistance payments for ambulance services shall be paid at the Medicare reimbursement rate or at the medical assistance payment rate in effect on July 1, 2000, whichever is greater.

deleted text begin (b) Effective for services provided on or after September 1, 2011, ambulance services payment rates are reduced 4.5 percent. Payments made to managed care plans and county-based purchasing plans must be reduced for services provided on or after January 1, 2012, to reflect this reduction. deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 23.

Minnesota Statutes 2014, section 256B.0625, subdivision 18a, is amended to read:

Subd. 18a.

Access to medical services.

(a) Medical assistance reimbursement for meals for persons traveling to receive medical care may not exceed $5.50 for breakfast, $6.50 for lunch, or $8 for dinner.

(b) Medical assistance reimbursement for lodging for persons traveling to receive medical care may not exceed $50 per day unless prior authorized by the local agency.

(c) deleted text begin Medical assistance direct mileage reimbursement to the eligible person or the eligible person's driver may not exceed 20 cents per mile.deleted text end

deleted text begin (d)deleted text end Regardless of the number of employees that an enrolled health care provider may have, medical assistance covers sign and oral language interpreter services when provided by an enrolled health care provider during the course of providing a direct, person-to-person covered health care service to an enrolled recipient with limited English proficiency or who has a hearing loss and uses interpreting services. Coverage for face-to-face oral language interpreter services shall be provided only if the oral language interpreter used by the enrolled health care provider is listed in the registry or roster established under section 144.058.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 24.

Minnesota Statutes 2014, section 256B.0625, subdivision 18e, is amended to read:

Subd. 18e.

Single administrative structure and delivery system.

The commissionernew text begin , in coordination with the commissioner of transportation, new text end shall implement a single administrative structure and delivery system for nonemergency medical transportation, beginning the latter of the date the single administrative assessment tool required in this subdivision is available for use, as determined by the commissioner or by July 1, 2016.

In coordination with the Department of Transportation, the commissioner shall develop and authorize a Web-based single administrative structure and assessment tool, which must operate 24 hours a day, seven days a week, to facilitate the enrollee assessment process for nonemergency medical transportation services. The Web-based tool shall facilitate the transportation eligibility determination process initiated by clients and client advocates; shall include an accessible automated intake and assessment process and real-time identification of level of service eligibility; and shall authorize an appropriate and auditable mode of transportation authorization. The tool shall provide a single framework for reconciling trip information with claiming and collecting complaints regarding inappropriate level of need determinations, inappropriate transportation modes utilized, and interference with accessing nonemergency medical transportation. The Web-based single administrative structure shall operate on a trial basis for one year from implementation and, if approved by the commissioner, shall be permanent thereafter. The commissioner shall seek input from the Nonemergency Medical Transportation Advisory Committee to ensure the software is effective and user-friendly and make recommendations regarding funding of the single administrative system.

new text begin EFFECTIVE DATE. new text end

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

Sec. 25.

Minnesota Statutes 2014, section 256B.0625, subdivision 28a, is amended to read:

Subd. 28a.

Licensed physician assistant services.

(a) Medical assistance covers services performed by a licensed physician assistant if the service is otherwise covered under this chapter as a physician service and if the service is within the scope of practice of a licensed physician assistant as defined in section 147A.09.

(b) Licensed physician assistants, who are supervised by a physician certified by the American Board of Psychiatry and Neurology or eligible for board certification in psychiatry, may bill for medication management and evaluation and management services provided to medical assistance enrollees in inpatient hospital settingsnew text begin , and in outpatient settings after the licensed physician assistant completes 2,000 hours of clinical experience in the evaluation and treatment of mental healthnew text end , consistent with their authorized scope of practice, as defined in section 147A.09, with the exception of performing psychotherapy or diagnostic assessments or providing clinical supervision.

Sec. 26.

Minnesota Statutes 2014, section 256B.0625, subdivision 31, is amended to read:

Subd. 31.

Medical supplies and equipment.

(a) Medical assistance covers medical supplies and equipment. Separate payment outside of the facility's payment rate shall be made for wheelchairs and wheelchair accessories for recipients who are residents of intermediate care facilities for the developmentally disabled. Reimbursement for wheelchairs and wheelchair accessories for ICF/DD recipients shall be subject to the same conditions and limitations as coverage for recipients who do not reside in institutions. A wheelchair purchased outside of the facility's payment rate is the property of the recipient. deleted text begin The commissioner may set reimbursement rates for specified categories of medical supplies at levels below the Medicare payment rate.deleted text end

(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies must enroll as a Medicare provider.

(c) When necessary to ensure access to durable medical equipment, prosthetics, orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare enrollment requirement if:

(1) the vendor supplies only one type of durable medical equipment, prosthetic, orthotic, or medical supply;

(2) the vendor serves ten or fewer medical assistance recipients per year;

(3) the commissioner finds that other vendors are not available to provide same or similar durable medical equipment, prosthetics, orthotics, or medical supplies; and

(4) the vendor complies with all screening requirements in this chapter and Code of Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare and Medicaid Services approved national accreditation organization as complying with the Medicare program's supplier and quality standards and the vendor serves primarily pediatric patients.

(d) Durable medical equipment means a device or equipment that:

(1) can withstand repeated use;

(2) is generally not useful in the absence of an illness, injury, or disability; and

(3) is provided to correct or accommodate a physiological disorder or physical condition or is generally used primarily for a medical purpose.

(e) Electronic tablets may be considered durable medical equipment if the electronic tablet will be used as an augmentative and alternative communication system as defined under subdivision 31a, paragraph (a). To be covered by medical assistance, the device must be locked in order to prevent use not related to communication.

Sec. 27.

Minnesota Statutes 2014, section 256B.0625, subdivision 57, is amended to read:

Subd. 57.

Payment for Part B Medicare crossover claims.

new text begin (a) new text end Effective for services provided on or after January 1, 2012, medical assistance payment for an enrollee's cost-sharing associated with Medicare Part B is limited to an amount up to the medical assistance total allowed, when the medical assistance rate exceeds the amount paid by Medicare.

new text begin (b) new text end Excluded from this limitation are payments for mental health services and payments for dialysis services provided to end-stage renal disease patients. The exclusion for mental health services does not apply to payments for physician services provided by psychiatrists and advanced practice nurses with a specialty in mental health.

new text begin (c) Excluded from this limitation are payments to federally qualified health centers and rural health clinics. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2016. new text end

Sec. 28.

Minnesota Statutes 2014, section 256B.0625, subdivision 58, is amended to read:

Subd. 58.

Early and periodic screening, diagnosis, and treatment services.

Medical assistance covers early and periodic screening, diagnosis, and treatment services (EPSDT). The payment amount for a complete EPSDT screening shall not include charges for deleted text begin vaccinesdeleted text end new text begin health care services and productsnew text end that are available at no cost to the provider and shall not exceed the rate established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.

Sec. 29.

Minnesota Statutes 2014, section 256B.0631, is amended to read:

256B.0631 MEDICAL ASSISTANCE CO-PAYMENTS.

Subdivision 1.

Cost-sharing.

(a) Except as provided in subdivision 2, the medical assistance benefit plan shall include the following cost-sharing for all recipients, effective for services provided on or after September 1, 2011:

(1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes of this subdivision, a visit means an episode of service which is required because of a recipient's symptoms, diagnosis, or established illness, and which is delivered in an ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse, audiologist, optician, or optometrist;

(2) $3.50 for nonemergency visits to a hospital-based emergency room, except that this co-payment shall be increased to $20 upon federal approval;

(3) $3 per brand-name drug prescription and $1 per generic drug prescription, subject to a $12 per month maximum for prescription drug co-payments. No co-payments shall apply to antipsychotic drugs when used for the treatment of mental illness;

(4) deleted text begin effective January 1, 2012,deleted text end a family deductible equal to deleted text begin the maximum amount allowed under Code of Federal Regulations, title 42, part 447.54deleted text end new text begin $2.75 per month per family and adjusted annually by the percentage increase in the medical care component of the CPI-U for the period of September to September of the preceding calendar year, rounded to the next higher five-cent incrementnew text end ; and

(5) deleted text begin for individuals identified by the commissioner with income at or below 100 percent of the federal poverty guidelines,deleted text end total monthly cost-sharing must not exceed five percent of family income. For purposes of this paragraph, family income is the total earned and unearned income of the individual and the individual's spouse, if the spouse is enrolled in medical assistance and also subject to the five percent limit on cost-sharing. new text begin This paragraph does not apply to premiums charged to individuals described under section 256B.057, subdivision 9.new text end

(b) Recipients of medical assistance are responsible for all co-payments and deductibles in this subdivision.

(c) Notwithstanding paragraph (b), the commissioner, through the contracting process under sections 256B.69 and 256B.692, may allow managed care plans and county-based purchasing plans to waive the family deductible under paragraph (a), clause (4). The value of the family deductible shall not be included in the capitation payment to managed care plans and county-based purchasing plans. Managed care plans and county-based purchasing plans shall certify annually to the commissioner the dollar value of the family deductible.

(d) Notwithstanding paragraph (b), the commissioner may waive the collection of the family deductible described under paragraph (a), clause (4), from individuals and allow long-term care and waivered service providers to assume responsibility for payment.

(e) Notwithstanding paragraph (b), the commissioner, through the contracting process under section 256B.0756 shall allow the pilot program in Hennepin County to waive co-payments. The value of the co-payments shall not be included in the capitation payment amount to the integrated health care delivery networks under the pilot program.

Subd. 2.

Exceptions.

Co-payments and deductibles shall be subject to the following exceptions:

(1) children under the age of 21;

(2) pregnant women for services that relate to the pregnancy or any other medical condition that may complicate the pregnancy;

(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or intermediate care facility for the developmentally disabled;

(4) recipients receiving hospice care;

(5) 100 percent federally funded services provided by an Indian health service;

(6) emergency services;

(7) family planning services;

(8) services that are paid by Medicare, resulting in the medical assistance program paying for the coinsurance and deductible;

(9) co-payments that exceed one per day per provider for nonpreventive visits, eyeglasses, and nonemergency visits to a hospital-based emergency room; deleted text begin anddeleted text end

(10) services, fee-for-service payments subject to volume purchase through competitive biddingdeleted text begin .deleted text end new text begin ;new text end

new text begin (11) American Indians who meet the requirements in Code of Federal Regulations, title 42, sections 447.51 and 447.56; new text end

new text begin (12) persons needing treatment for breast or cervical cancer as described under section 256B.057, subdivision 10; and new text end

new text begin (13) services that currently have a rating of A or B from the United States Preventive Services Task Force (USPSTF), immunizations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, and preventive services and screenings provided to women as described in Code of Federal Regulations, title 45, section 147.130. new text end

Subd. 3.

Collection.

(a) The medical assistance reimbursement to the provider shall be reduced by the amount of the co-payment or deductible, except that reimbursements shall not be reduced:

(1) once a recipient has reached the $12 per month maximum for prescription drug co-payments; or

(2) for a recipient deleted text begin identified by the commissioner under 100 percent of the federal poverty guidelinesdeleted text end who has met their monthly five percent cost-sharing limit.

(b) The provider collects the co-payment or deductible from the recipient. Providers may not deny services to recipients who are unable to pay the co-payment or deductible.

(c) Medical assistance reimbursement to fee-for-service providers and payments to managed care plans shall not be increased as a result of the removal of co-payments or deductibles effective on or after January 1, 2009.

new text begin EFFECTIVE DATE. new text end

new text begin The amendment to subdivision 1, paragraph (a), clause (4), is effective retroactively from January 1, 2014. new text end

Sec. 30.

new text begin [256B.0638] OPIOID PRESCRIBING IMPROVEMENT PROGRAM. new text end

new text begin Subdivision 1. new text end

new text begin Program established. new text end

new text begin The commissioner of human services, in conjunction with the commissioner of health, shall coordinate and implement an opioid prescribing improvement program to reduce opioid dependency and substance use by Minnesotans due to the prescribing of opioid analgesics by health care providers. new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the terms defined in this subdivision have the meanings given them. new text end

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

new text begin (c) "Commissioners" means the commissioner of human services and the commissioner of health. new text end

new text begin (d) "DEA" means the United States Drug Enforcement Administration. new text end

new text begin (e) "Minnesota health care program" means a public health care program administered by the commissioner of human services under chapters 256B and 256L, and the Minnesota restricted recipient program. new text end

new text begin (f) "Opioid disenrollment standards" means parameters of opioid prescribing practices that fall outside community standard thresholds for prescribing to such a degree that a provider must be disenrolled as a medical assistance provider. new text end

new text begin (g) "Opioid prescriber" means a licensed health care provider who prescribes opioids to medical assistance and MinnesotaCare enrollees under the fee-for-service system or under a managed care or county-based purchasing plan. new text end

new text begin (h) "Opioid quality improvement standard thresholds" means parameters of opioid prescribing practices that fall outside community standards for prescribing to such a degree that quality improvement is required. new text end

new text begin (i) "Program" means the statewide opioid prescribing improvement program established under this section. new text end

new text begin (j) "Provider group" means a clinic, hospital, or primary or specialty practice group that employs, contracts with, or is affiliated with an opioid prescriber. Provider group does not include a professional association supported by dues-paying members. new text end

new text begin (k) "Sentinel measures" means measures of opioid use that identify variations in prescribing practices during the prescribing intervals. new text end

new text begin Subd. 3. new text end

new text begin Opioid prescribing work group. new text end

new text begin (a) The commissioner of human services, in consultation with the commissioner of health, shall appoint the following voting members to an opioid prescribing work group: new text end

new text begin (1) two consumer members who have been impacted by an opioid abuse disorder or opioid dependence disorder, either personally or with family members; new text end

new text begin (2) one member who is a licensed physician actively practicing in Minnesota and registered as a practitioner with the DEA; new text end

new text begin (3) one member who is a licensed pharmacist actively practicing in Minnesota and registered as a practitioner with the DEA; new text end

new text begin (4) one member who is a licensed nurse practitioner actively practicing in Minnesota and registered as a practitioner with the DEA; new text end

new text begin (5) one member who is a licensed dentist actively practicing in Minnesota and registered as a practitioner with the DEA; new text end

new text begin (6) two members who are nonphysician licensed health care professionals actively engaged in the practice of their profession in Minnesota, and their practice includes treating pain; new text end

new text begin (7) one member who is a mental health professional who is licensed or registered in a mental health profession, who is actively engaged in the practice of that profession in Minnesota, and whose practice includes treating patients with chemical dependency or substance abuse; new text end

new text begin (8) one member who is a medical examiner for a Minnesota county; new text end

new text begin (9) one member of the Health Services Policy Committee established under section 256B.0625, subdivisions 3c to 3e; new text end

new text begin (10) one member who is a medical director of a health plan company doing business in Minnesota; new text end

new text begin (11) one member who is a pharmacy director of a health plan company doing business in Minnesota; and new text end

new text begin (12) one member representing Minnesota law enforcement. new text end

new text begin (b) In addition, the work group shall include the following nonvoting members: new text end

new text begin (1) the medical director for the medical assistance program; new text end

new text begin (2) a member representing the Department of Human Services pharmacy unit; and new text end

new text begin (3) the medical director for the Department of Labor and Industry. new text end

new text begin (c) An honorarium of $200 per meeting and reimbursement for mileage and parking shall be paid to each voting member in attendance. new text end

new text begin Subd. 4. new text end

new text begin Program components. new text end

new text begin (a) The working group shall recommend to the commissioners the components of the statewide opioid prescribing improvement program, including, but not limited to, the following: new text end

new text begin (1) developing criteria for opioid prescribing protocols, including: new text end

new text begin (i) prescribing for the interval of up to four days immediately after an acute painful event; new text end

new text begin (ii) prescribing for the interval of up to 45 days after an acute painful event; and new text end

new text begin (iii) prescribing for chronic pain, which for purposes of this program means pain lasting longer than 45 days after an acute painful event; new text end

new text begin (2) developing sentinel measures; new text end

new text begin (3) developing educational resources for opioid prescribers about communicating with patients about pain management and the use of opioids to treat pain; new text end

new text begin (4) developing opioid quality improvement standard thresholds and opioid disenrollment standards for opioid prescribers and provider groups. In developing opioid disenrollment standards, the standards may be described in terms of the length of time in which prescribing practices fall outside community standards and the nature and amount of opioid prescribing that fall outside community standards; and new text end

new text begin (5) addressing other program issues as determined by the commissioners. new text end

new text begin (b) The opioid prescribing protocols shall not apply to opioids prescribed for patients who are experiencing pain caused by a malignant condition or who are receiving hospice care, or to opioids prescribed as medication-assisted therapy to treat opioid dependency. new text end

new text begin (c) All opioid prescribers who prescribe opioids to Minnesota health care program enrollees must participate in the program in accordance with subdivision 5. Any other prescriber who prescribes opioids may comply with the components of this program described in paragraph (a) on a voluntary basis. new text end

new text begin Subd. 5. new text end

new text begin Program implementation. new text end

new text begin (a) The commissioner shall implement the programs within the Minnesota health care program to improve the health of and quality of care provided to Minnesota health care program enrollees. The commissioner shall annually collect and report to opioid prescribers data showing the sentinel measures of their opioid prescribing patterns compared to their anonymized peers. new text end

new text begin (b) The commissioner shall notify an opioid prescriber and all provider groups with which the opioid prescriber is employed or affiliated when the opioid prescriber's prescribing pattern exceeds the opioid quality improvement standard thresholds. An opioid prescriber and any provider group that receives a notice under this paragraph shall submit to the commissioner a quality improvement plan for review and approval by the commissioner with the goal of bringing the opioid prescriber's prescribing practices into alignment with community standards. A quality improvement plan must include: new text end

new text begin (1) components of the program described in subdivision 4, paragraph (a); new text end

new text begin (2) internal practice-based measures to review the prescribing practice of the opioid prescriber and, where appropriate, any other opioid prescribers employed by or affiliated with any of the provider groups with which the opioid prescriber is employed or affiliated; and new text end

new text begin (3) appropriate use of the prescription monitoring program under section 152.126. new text end

new text begin (c) If, after a year from the commissioner's notice under paragraph (b), the opioid prescriber's prescribing practices do not improve so that they are consistent with community standards, the commissioner shall take one or more of the following steps: new text end

new text begin (1) monitor prescribing practices more frequently than annually; new text end

new text begin (2) monitor more aspects of the opioid prescriber's prescribing practices than the sentinel measures; or new text end

new text begin (3) require the opioid prescriber to participate in additional quality improvement efforts, including but not limited to mandatory use of the prescription monitoring program established under section 152.126. new text end

new text begin (d) The commissioner shall terminate from Minnesota health care programs all opioid prescribers and provider groups whose prescribing practices fall within the applicable opioid disenrollment standards. new text end

new text begin Subd. 6. new text end

new text begin Data practices. new text end

new text begin (a) Reports and data identifying an opioid prescriber are private data on individuals as defined under section 13.02, subdivision 12, until an opioid prescriber is subject to termination as a medical assistance provider under this section. Notwithstanding this data classification, the commissioner shall share with all of the provider groups with which an opioid prescriber is employed or affiliated, a report identifying an opioid prescriber who is subject to quality improvement activities under subdivision 5, paragraph (b) or (c). new text end

new text begin (b) Reports and data identifying a provider group are nonpublic data as defined under section 13.02, subdivision 9, until the provider group is subject to termination as a medical assistance provider under this section. new text end

new text begin (c) Upon termination under this section, reports and data identifying an opioid prescriber or provider group are public, except that any identifying information of Minnesota health care program enrollees must be redacted by the commissioner. new text end

new text begin Subd. 7. new text end

new text begin Annual report to legislature. new text end

new text begin By September 15, 2016, and annually thereafter, the commissioner of human services shall report to the legislature on the implementation of the opioid prescribing improvement program in the Minnesota health care programs. The report must include data on the utilization of opioids within the Minnesota health care programs. new text end

Sec. 31.

Minnesota Statutes 2014, section 256B.0757, is amended to read:

256B.0757 COORDINATED CARE THROUGH A HEALTH HOME.

Subdivision 1.

Provision of coverage.

(a) The commissioner shall provide medical assistance coverage of health home services for eligible individuals with chronic conditions who select a designated providerdeleted text begin , a team of health care professionals, or a health teamdeleted text end as the individual's health home.

(b) The commissioner shall implement this section in compliance with the requirements of the state option to provide health homes for enrollees with chronic conditions, as provided under the Patient Protection and Affordable Care Act, Public Law 111-148, sections 2703 and 3502. Terms used in this section have the meaning provided in that act.

new text begin (c) The commissioner shall establish health homes to serve populations with serious mental illness who meet the eligibility requirements described under subdivision 2, clause (4). The health home services provided by health homes shall focus on both the behavioral and the physical health of these populations. new text end

Subd. 2.

Eligible individual.

An individual is eligible for health home services under this section if the individual is eligible for medical assistance under this chapter and has at least:

(1) two chronic conditions;

(2) one chronic condition and is at risk of having a second chronic condition; deleted text begin ordeleted text end

(3) one serious and persistent mental health conditiondeleted text begin .deleted text end new text begin ; ornew text end

new text begin (4) a condition that meets the definition in section 245.462, subdivision 20, paragraph (a), or 245.4871, subdivision 15, clause (2); and has a current diagnostic assessment as defined in Minnesota Rules, part 9505.0372, subpart 1, item B or C, as performed or reviewed by a mental health professional employed by or under contract with the behavioral health home. The commissioner shall establish criteria for determining continued eligibility. new text end

Subd. 3.

Health home services.

(a) Health home services means comprehensive and timely high-quality services that are provided by a health home. These services include:

(1) comprehensive care management;

(2) care coordination and health promotion;

(3) comprehensive transitional care, including appropriate follow-up, from inpatient to other settings;

(4) patient and family support, including authorized representatives;

(5) referral to community and social support services, if relevant; and

(6) use of health information technology to link services, as feasible and appropriate.

(b) The commissioner shall maximize the number and type of services included in this subdivision to the extent permissible under federal law, including physician, outpatient, mental health treatment, and rehabilitation services necessary for comprehensive transitional care following hospitalization.

Subd. 4.

deleted text begin Health teamsdeleted text end new text begin Designated providernew text end .

new text begin (a) Health home services are voluntary and an eligible individual may choose any designated provider. new text end The commissioner shall establish deleted text begin health teams to support the patient-centereddeleted text end new text begin designated providers to serve as new text end health deleted text begin homedeleted text end new text begin homesnew text end and provide the services described in subdivision 3 to individuals eligible under subdivision 2. The commissioner shall apply for grants deleted text begin or contractsdeleted text end as provided under section 3502 of the Patient Protection and Affordable Care Act to establish health deleted text begin teamsdeleted text end new text begin homesnew text end and provide capitated payments to deleted text begin primary caredeleted text end new text begin designated new text end providers. For purposes of this section, deleted text begin "health teams"deleted text end new text begin "designated provider"new text end means deleted text begin community-based, interdisciplinary, interprofessional teams of health care providers that support primary care practices. These providers may include medical specialists, nurses, advanced practice registered nurses, pharmacists, nutritionists, social workers, behavioral and mental health providers, doctors of chiropractic, licensed complementary and alternative medicine practitioners, and physician assistants.deleted text end new text begin a provider, clinical practice or clinical group practice, rural clinic, community health center, community mental health center, or any other entity that is determined by the commissioner to be qualified to be a health home for eligible individuals. This determination must be based on documentation evidencing that the designated provider has the systems and infrastructure in place to provide health home services and satisfies the qualification standards established by the commissioner in consultation with stakeholders and approved by the Centers for Medicare and Medicaid Services.new text end

new text begin (b) The commissioner shall develop and implement certification standards for designated providers under this subdivision. new text end

Subd. 5.

Payments.

The commissioner shall make payments to each deleted text begin health home and each health teamdeleted text end new text begin designated providernew text end for the provision of health home services new text begin described in subdivision 3 new text end to each eligible individual deleted text begin with chronic conditionsdeleted text end new text begin under subdivision 2new text end that selects the health home as a provider.

Subd. 6.

Coordination.

The commissioner, to the extent feasible, shall ensure that the requirements and payment methods for deleted text begin health homes and health teamsdeleted text end new text begin designated providersnew text end developed under this section are consistent with the requirements and payment methods for health care homes established under sections 256B.0751 and 256B.0753. The commissioner may modify requirements and payment methods under sections 256B.0751 and 256B.0753 in order to be consistent with federal health home requirements and payment methods.

new text begin Subd. 8. new text end

new text begin Evaluation and continued development. new text end

new text begin (a) For continued certification under this section, health homes must meet process, outcome, and quality standards developed and specified by the commissioner. The commissioner shall collect data from health homes as necessary to monitor compliance with certification standards. new text end

new text begin (b) The commissioner may contract with a private entity to evaluate patient and family experiences, health care utilization, and costs. new text end

new text begin (c) The commissioner shall utilize findings from the implementation of behavioral health homes to determine populations to serve under subsequent health home models for individuals with chronic conditions. new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016, 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. 32.

new text begin [256B.0758] HEALTH CARE DELIVERY PILOT PROGRAM. new text end

new text begin (a) The commissioner may establish a health care delivery pilot program to test alternative and innovative integrated health care delivery networks, including accountable care organizations or a community-based collaborative care network created by or including North Memorial Health Care. If required, the commissioner shall seek federal approval of a new waiver request or amend an existing demonstration pilot project waiver. new text end

new text begin (b) Individuals eligible for the pilot program shall be individuals who are eligible for medical assistance under section 256B.055. The commissioner may identify individuals to be enrolled in the pilot program based on zip code or whether the individuals would benefit from an integrated health care delivery network. new text end

new text begin (c) In developing a payment system for the pilot programs, the commissioner shall establish a total cost of care for the individuals enrolled in the pilot program that equals the cost of care that would otherwise be spent for these enrollees in the prepaid medical assistance program. new text end

Sec. 33.

Minnesota Statutes 2014, section 256B.69, subdivision 5a, is amended to read:

Subd. 5a.

Managed care contracts.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Sec. 34.

Minnesota Statutes 2014, section 256B.69, subdivision 5i, is amended to read:

Subd. 5i.

Administrative expenses.

(a) deleted text begin Managed care plan and county-based purchasing plandeleted text end Administrative costs deleted text begin for a prepaid health plan provideddeleted text end new text begin paid to managed care plans and county-based purchasing plansnew text end under this section deleted text begin ordeleted text end new text begin ,new text end section 256B.692new text begin , and section 256L.12new text end must not exceed deleted text begin by more than fivedeleted text end new text begin 6.6new text end percent deleted text begin that prepaid health plan's or county-based purchasing plan's actual calculated administrative spending for the previous calendar year as a percentage of total revenuedeleted text end new text begin of total payments made to all managed care plans and county-based purchasing plans in aggregate across all state public health care programs, based on payments expected to be made at the beginning of each calendar yearnew text end . deleted text begin The penalty for exceeding this limit must be the amount of administrative spending in excess of 105 percent of the actual calculated amount. The commissioner may waive this penalty if the excess administrative spending is the result of unexpected shifts in enrollment or member needs or new program requirements.deleted text end new text begin The commissioner may reduce or eliminate administrative requirements to meet the administrative cost limit. For purposes of this paragraph, administrative costs do not include premium taxes paid under section 297I.05, subdivision 5, provider surcharges paid under section 256.9657, subdivision 3, and health insurance fees under section 9010 of the Affordable Care Act.new text end

(b) The following expenses are not allowable administrative expenses for rate-setting purposes under this section:

(1) charitable contributions made by the managed care plan or the county-based purchasing plan;

(2) deleted text begin any portion of an individual's compensation in excess of $200,000 paid by the managed care plan or county-based purchasing plandeleted text end new text begin compensation of individuals within the organization in excess of $200,000 such that the allocation of compensation for an individual across all state public health care programs in total cannot exceed $200,000new text end ;

(3) any penalties or fines assessed against the managed care plan or county-based purchasing plan; deleted text begin anddeleted text end

(4) any indirect marketing or advertising expenses of the managed care plan or county-based purchasing plannew text begin , including but not limited to costs to promote the managed care or county-based purchasing plan, costs of facilities used for special events, and costs of displays, demonstrations, donations, and promotional items such as memorabilia, models, gifts, and souvenirs. The commissioner may classify an item listed in this clause as an allowable administrative expense for rate-setting purposes, if the commissioner determines that the expense is incidental to an activity related to state pubic health care programs that is an allowable cost for purposes of rate setting;new text end

new text begin (5) any lobbying and political activities, events, or contributions; new text end

new text begin (6) administrative expenses related to the provision of services not covered under the state plan or waiver; new text end

new text begin (7) alcoholic beverages and related costs; new text end

new text begin (8) membership in any social, dining, or country club or organization; and new text end

new text begin (9) entertainment, including amusement, diversion, and social activities, and any costs directly associated with these costs, including but not limited to tickets to shows or sporting events, meals, lodging, rentals, transportation, and gratuitiesnew text end .

For the purposes of this subdivision, compensation includes salaries, bonuses and incentives, other reportable compensation on an IRS 990 form, retirement and other deferred compensation, and nontaxable benefits.new text begin Charitable contributions under clause (1) include payments for or to any organization or entity selected by the managed care plan or county-based purchasing plan that is operated for charitable, educational, political, religious, or scientific purposes, that are not related to medical and administrative services covered under state public health care programs.new text end

new text begin (c) Payments to a quality improvement organization are an allowable administrative expense for rate-setting purposes under this section, to the extent they are allocated to a state public health care program and approved by the commissioner. new text end

new text begin (d) Where reasonably possible, expenses for an administrative item shall be directly allocated so as to assign costs for an item to an individual state public health care program when the cost can be specifically identified with and benefits the individual state public health care program. For administrative services expensed to the state's public health care programs, managed care plans and county-based purchasing plans must clearly identify and separately record expense items listed under paragraph (b) in their accounting systems in a manner that allows for independent verification of unallowable expenses for purposes of determining payment rates for state public health care programs. new text end

new text begin (e) Notwithstanding paragraph (a), the commissioner shall reduce administrative expenses paid to managed care plans and county-based purchasing plans by .50 of a percentage point for contracts beginning January 1, 2016, and ending December 31, 2017. To meet the administrative reductions under this paragraph, the commissioner may reduce or eliminate administrative requirements, exclude additional unallowable administrative expenses identified under this section and resulting from the financial audits conducted under subdivision 9d, and utilize competitive bidding to gain efficiencies through economies of scale from increased enrollment. If the total reduction cannot be achieved through administrative reduction, the commissioner may limit total rate increases on payments to managed care plans and county-based purchasing plans. new text end

Sec. 35.

Minnesota Statutes 2014, section 256B.69, subdivision 9c, is amended to read:

Subd. 9c.

Managed care financial reporting.

(a) The commissioner shall collect detailed data regarding financials, provider payments, provider rate methodologies, and other data as determined by the commissioner. The commissioner, in consultation with the commissioners of health and commerce, and in consultation with managed care plans and county-based purchasing plans, shall set uniform criteria, definitions, and standards for the data to be submitted, and shall require managed care and county-based purchasing plans to comply with these criteria, definitions, and standards when submitting data under this section. In carrying out the responsibilities of this subdivision, the commissioner shall ensure that the data collection is implemented in an integrated and coordinated manner that avoids unnecessary duplication of effort. To the extent possible, the commissioner shall use existing data sources and streamline data collection in order to reduce public and private sector administrative costs. Nothing in this subdivision shall allow release of information that is nonpublic data pursuant to section 13.02.

(b) Effective January 1, 2014, each managed care and county-based purchasing plan must quarterly provide to the commissioner the following information on state public programs, in the form and manner specified by the commissioner, according to guidelines developed by the commissioner in consultation with managed care plans and county-based purchasing plans under contract:

(1) an income statement by program;

(2) financial statement footnotes;

(3) quarterly profitability by program and population group;

(4) a medical liability summary by program and population group;

(5) received but unpaid claims report by program;

(6) services versus payment lags by program for hospital services, outpatient services, physician services, other medical services, and pharmaceutical benefits;

(7) utilization reports that summarize utilization and unit cost information by program for hospitalization services, outpatient services, physician services, and other medical services;

(8) pharmaceutical statistics by program and population group for measures of price and utilization of pharmaceutical services;

(9) subcapitation expenses by population group;

(10) third-party payments by program;

(11) all new, active, and closed subrogation cases by program;

(12) all new, active, and closed fraud and abuse cases by program;

(13) medical loss ratios by program;

(14) administrative expenses by category and subcategory by program that reconcile to other state and federal regulatory agenciesnew text begin , including Minnesota Supplement Report #1Anew text end ;

(15) revenues by program, including investment income;

(16) nonadministrative service payments, provider payments, and reimbursement rates by provider type or service category, by program, paid by the managed care plan under this section or the county-based purchasing plan under section 256B.692 to providers and vendors for administrative services under contract with the plan, including but not limited to:

(i) individual-level provider payment and reimbursement rate data;

(ii) provider reimbursement rate methodologies by provider type, by program, including a description of alternative payment arrangements and payments outside the claims process;

(iii) data on implementation of legislatively mandated provider rate changes; and

(iv) individual-level provider payment and reimbursement rate data and plan-specific provider reimbursement rate methodologies by provider type, by program, including alternative payment arrangements and payments outside the claims process, provided to the commissioner under this subdivision are nonpublic data as defined in section 13.02;

(17) data on the amount of reinsurance or transfer of risk by program; and

(18) contribution to reserve, by program.

(c) In the event a report is published or released based on data provided under this subdivision, the commissioner shall provide the report to managed care plans and county-based purchasing plans 15 days prior to the publication or release of the report. Managed care plans and county-based purchasing plans shall have 15 days to review the report and provide comment to the commissioner.

The quarterly reports shall be submitted to the commissioner no later than 60 days after the end of the previous quarter, except the fourth-quarter report, which shall be submitted by April 1 of each year. The fourth-quarter report shall include audited financial statements, parent company audited financial statements, an income statement reconciliation report, and any other documentation necessary to reconcile the detailed reports to the audited financial statements.

new text begin (d) Managed care plans and county-based purchasing plans shall certify to the commissioner for the purpose of financial reporting for state public health care programs under this subdivision that costs reported for state public health care programs include: new text end

new text begin (1) only services covered under the state plan and waivers, and related allowable administrative expenses; and new text end

new text begin (2) the dollar value of unallowable and nonstate plan services, including both medical and administrative expenditures, that have been excluded. new text end

Sec. 36.

Minnesota Statutes 2014, section 256B.69, subdivision 9d, is amended to read:

Subd. 9d.

Financial deleted text begin auditdeleted text end new text begin and quality assurance auditsnew text end .

deleted text begin (a) The legislative auditor shall contract with an audit firm to conduct a biennial independent third-party financial audit of the information required to be provided by managed care plans and county-based purchasing plans under subdivision 9c, paragraph (b). The audit shall be conducted in accordance with generally accepted government auditing standards issued by the United States Government Accountability Office. The contract with the audit firm shall be designed and administered so as to render the independent third-party audit eligible for a federal subsidy, if available. The contract shall require the audit to include a determination of compliance with the federal Medicaid rate certification process. The contract shall require the audit to determine if the administrative expenses and investment income reported by the managed care plans and county-based purchasing plans are compliant with state and federal law. deleted text end

deleted text begin (b) For purposes of this subdivision, "independent third party" means an audit firm that is independent in accordance with government auditing standards issued by the United States Government Accountability Office and licensed in accordance with chapter 326A. An audit firm under contract to provide services in accordance with this subdivision must not have provided services to a managed care plan or county-based purchasing plan during the period for which the audit is being conducted. deleted text end

deleted text begin (c)deleted text end new text begin (a) new text end The commissioner shall require, in the request for bids and resulting contracts with managed care plans and county-based purchasing plans under this section and section 256B.692, that each managed care plan and county-based purchasing plan submit to and fully cooperate with the independent third-party financial deleted text begin auditdeleted text end new text begin audits by the legislative auditor under subdivision 9enew text end of the information required under subdivision 9c, paragraph (b). Each contract with a managed care plan or county-based purchasing plan under this section or section 256B.692 must provide the commissioner deleted text begin anddeleted text end new text begin ,new text end the deleted text begin audit firmdeleted text end new text begin legislative auditor, and vendors new text end contracting with the legislative auditornew text begin ,new text end access to all data required to complete deleted text begin the audit. For purposes of this subdivision, the contracting audit firm shall have the same investigative power as the legislative auditor under section 3.978, subdivision 2 deleted text end new text begin audits under subdivision 9enew text end .

deleted text begin (d)deleted text end new text begin (b) new text end Each managed care plan and county-based purchasing plan providing services under this section shall provide to the commissioner biweekly encounter data and claims data for state public health care programs and shall participate in a quality assurance program that verifies the timeliness, completeness, accuracy, and consistency of the data provided. The commissioner shall develop written protocols for the quality assurance program and shall make the protocols publicly available. The commissioner shall contract for an independent third-party audit to evaluate the quality assurance protocols as to the capacity of the protocols to ensure complete and accurate data and to evaluate the commissioner's implementation of the protocols. deleted text begin The audit firm under contract to provide this evaluation must meet the requirements in paragraph (b).deleted text end

deleted text begin (e) Upon completion of the audit under paragraph (a) and receipt by the legislative auditor, the legislative auditor shall provide copies of the audit report to the commissioner, the state auditor, the attorney general, and the chairs and ranking minority members of the health and human services finance committees of the legislature.deleted text end new text begin (c)new text end Upon completion of the evaluation under paragraph deleted text begin (d)deleted text end new text begin (b)new text end , the commissioner shall provide copies of the report to the legislative auditor and the chairs and ranking minority members of the deleted text begin health finance committees of the legislaturedeleted text end new text begin legislative committees with jurisdiction over health care policy and financingnew text end .

deleted text begin (f)deleted text end new text begin (d) new text end Any actuary under contract with the commissioner to provide actuarial services must meet the independence requirements under the professional code for fellows in the Society of Actuaries and must not have provided actuarial services to a managed care plan or county-based purchasing plan that is under contract with the commissioner pursuant to this section and section 256B.692 during the period in which the actuarial services are being provided. An actuary or actuarial firm meeting the requirements of this paragraph must certify and attest to the rates paid to the managed care plans and county-based purchasing plans under this section and section 256B.692, and the certification and attestation must be auditable.

new text begin (e) The commissioner, to the extent of available funding, shall conduct ad hoc audits of state public health care program administrative and medical expenses reported by managed care plans and county-based purchasing plans. This includes: financial and encounter data reported to the commissioner under subdivision 9c, including payments to providers and subcontractors; supporting documentation for expenditures; categorization of administrative and medical expenses; and allocation methods used to attribute administrative expenses to state public health care programs. These audits also must monitor compliance with data and financial report certification requirements established by the commissioner for the purposes of managed care capitation payment rate-setting. The managed care plans and county-based purchasing plans shall fully cooperate with the audits in this subdivision. The commissioner shall report to the chairs and ranking minority members of the legislative committees with jurisdiction over health and human services policy and finance by February 1, 2016, and each February 1 thereafter, the number of ad hoc audits conducted in the past calendar year and the results of these audits. new text end

deleted text begin (g)deleted text end new text begin (f) new text end Nothing in this subdivision shall allow the release of information that is nonpublic data pursuant to section 13.02.

Sec. 37.

Minnesota Statutes 2014, section 256B.69, is amended by adding a subdivision to read:

new text begin Subd. 9e. new text end

new text begin Financial audits. new text end

new text begin (a) The legislative auditor shall conduct or contract with vendors to conduct independent third-party financial audits of the information required to be provided by managed care plans and county-based purchasing plans under subdivision 9c, paragraph (b). The audits by the vendors shall be conducted as vendor resources permit and in accordance with generally accepted government auditing standards issued by the United States Government Accountability Office. The contract with the vendors shall be designed and administered so as to render the independent third-party audits eligible for a federal subsidy, if available. The contract shall require the audits to include a determination of compliance with the federal Medicaid rate certification process. new text end

new text begin (b) For purposes of this subdivision, "independent third-party" means a vendor that is independent in accordance with government auditing standards issued by the United States Government Accountability Office. new text end

Sec. 38.

Minnesota Statutes 2014, section 256B.75, is amended to read:

256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.

(a) For outpatient hospital facility fee payments for services rendered on or after October 1, 1992, the commissioner of human services shall pay the lower of (1) submitted charge, or (2) 32 percent above the rate in effect on June 30, 1992, except for those services for which there is a federal maximum allowable payment. Effective for services rendered on or after January 1, 2000, payment rates for nonsurgical outpatient hospital facility fees and emergency room facility fees shall be increased by eight percent over the rates in effect on December 31, 1999, except for those services for which there is a federal maximum allowable payment. Services for which there is a federal maximum allowable payment shall be paid at the lower of (1) submitted charge, or (2) the federal maximum allowable payment. Total aggregate payment for outpatient hospital facility fee services shall not exceed the Medicare upper limit. If it is determined that a provision of this section conflicts with existing or future requirements of the United States government with respect to federal financial participation in medical assistance, the federal requirements prevail. The commissioner may, in the aggregate, prospectively reduce payment rates to avoid reduced federal financial participation resulting from rates that are in excess of the Medicare upper limitations.

(b) Notwithstanding paragraph (a), payment for outpatient, emergency, and ambulatory surgery hospital facility fee services for critical access hospitals designated under section 144.1483, clause (9), shall be paid on a cost-based payment system that is based on the cost-finding methods and allowable costs of the Medicare program.new text begin Effective for services provided on or after July 1, 2015, rates established for critical access hospitals under this paragraph for the applicable payment year shall be the final payment and shall not be settled to actual costs.new text end

(c) Effective for services provided on or after July 1, 2003, rates that are based on the Medicare outpatient prospective payment system shall be replaced by a budget neutral prospective payment system that is derived using medical assistance data. The commissioner shall provide a proposal to the 2003 legislature to define and implement this provision.

(d) For fee-for-service services provided on or after July 1, 2002, the total payment, before third-party liability and spenddown, made to hospitals for outpatient hospital facility services is reduced by .5 percent from the current statutory rate.

(e) In addition to the reduction in paragraph (d), the total payment for fee-for-service services provided on or after July 1, 2003, made to hospitals for outpatient hospital facility services before third-party liability and spenddown, is reduced five percent from the current statutory rates. Facilities defined under section 256.969, subdivision 16, are excluded from this paragraph.

(f) In addition to the reductions in paragraphs (d) and (e), the total payment for fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient hospital facility services before third-party liability and spenddown, is reduced three percent from the current statutory rates. Mental health services and facilities defined under section 256.969, subdivision 16, are excluded from this paragraph.

Sec. 39.

Minnesota Statutes 2014, section 256B.76, subdivision 1, is amended to read:

Subdivision 1.

Physician reimbursement.

(a) Effective for services rendered on or after October 1, 1992, the commissioner shall make payments for physician services as follows:

(1) payment for level one Centers for Medicare and Medicaid Services' common procedural coding system codes titled "office and other outpatient services," "preventive medicine new and established patient," "delivery, antepartum, and postpartum care," "critical care," cesarean delivery and pharmacologic management provided to psychiatric patients, and level three codes for enhanced services for prenatal high risk, shall be paid at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 30, 1992. If the rate on any procedure code within these categories is different than the rate that would have been paid under the methodology in section 256B.74, subdivision 2, then the larger rate shall be paid;

(2) payments for all other services shall be paid at the lower of (i) submitted charges, or (ii) 15.4 percent above the rate in effect on June 30, 1992; and

(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th percentile of 1989, less the percent in aggregate necessary to equal the above increases except that payment rates for home health agency services shall be the rates in effect on September 30, 1992.

(b) Effective for services rendered on or after January 1, 2000, payment rates for physician and professional services shall be increased by three percent over the rates in effect on December 31, 1999, except for home health agency and family planning agency services. The increases in this paragraph shall be implemented January 1, 2000, for managed care.

(c) Effective for services rendered on or after July 1, 2009, payment rates for physician and professional services shall be reduced by five percent, except that for the period July 1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent for the medical assistance and general assistance medical care programs, over the rates in effect on June 30, 2009. This reduction and the reductions in paragraph (d) do not apply to office or other outpatient visits, preventive medicine visits and family planning visits billed by physicians, advanced practice nurses, or physician assistants in a family planning agency or in one of the following primary care practices: general practice, general internal medicine, general pediatrics, general geriatrics, and family medicine. This reduction and the reductions in paragraph (d) do not apply to federally qualified health centers, rural health centers, and Indian health services. Effective October 1, 2009, payments made to managed care plans and county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment reduction described in this paragraph.

(d) Effective for services rendered on or after July 1, 2010, payment rates for physician and professional services shall be reduced an additional seven percent over the five percent reduction in rates described in paragraph (c). This additional reduction does not apply to physical therapy services, occupational therapy services, and speech pathology and related services provided on or after July 1, 2010. This additional reduction does not apply to physician services billed by a psychiatrist or an advanced practice nurse with a specialty in mental health. Effective October 1, 2010, payments made to managed care plans and county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment reduction described in this paragraph.

(e) Effective for services rendered on or after September 1, 2011, through June 30, 2013, payment rates for physician and professional services shall be reduced three percent from the rates in effect on August 31, 2011. This reduction does not apply to physical therapy services, occupational therapy services, and speech pathology and related services.

(f) Effective for services rendered on or after September 1, 2014, payment rates for physician and professional services, including physical therapy, occupational therapy, speech pathology, and mental health services shall be increased by five percent from the rates in effect on August 31, 2014. In calculating this rate increase, the commissioner shall not include in the base rate for August 31, 2014, the rate increase provided under section 256B.76, subdivision 7. This increase does not apply to federally qualified health centers, rural health centers, and Indian health services. Payments made to managed care plans and county-based purchasing plans shall not be adjusted to reflect payments under this paragraph.

new text begin (g) Effective for services rendered on or after July 1, 2015, payment rates for physical therapy, occupational therapy, and speech pathology and related services provided by a hospital meeting the criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause (4), shall be increased by 90 percent from the rates in effect on June 30, 2015. Payments made to managed care plans and county-based purchasing plans shall not be adjusted to reflect payments under this paragraph. new text end

Sec. 40.

Minnesota Statutes 2014, section 256B.76, subdivision 2, is amended to read:

Subd. 2.

Dental reimbursement.

(a) Effective for services rendered on or after October 1, 1992, the commissioner shall make payments for dental services as follows:

(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 30, 1992; and

(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th percentile of 1989, less the percent in aggregate necessary to equal the above increases.

(b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.

(c) Effective for services rendered on or after January 1, 2000, payment rates for dental services shall be increased by three percent over the rates in effect on December 31, 1999.

(d) Effective for services provided on or after January 1, 2002, payment for diagnostic examinations and dental x-rays provided to children under age 21 shall be the lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.

(e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, 2000, for managed care.

(f) Effective for dental services rendered on or after October 1, 2010, by a state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based on the Medicare principles of reimbursement. This payment shall be effective for services rendered on or after January 1, 2011, to recipients enrolled in managed care plans or county-based purchasing plans.

(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal year, a supplemental state payment equal to the difference between the total payments in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated services for the operation of the dental clinics.

(h) If the cost-based payment system for state-operated dental clinics described in paragraph (f) does not receive federal approval, then state-operated dental clinics shall be designated as critical access dental providers under subdivision 4, paragraph (b), and shall receive the critical access dental reimbursement rate as described under subdivision 4, paragraph (a).

(i) Effective for services rendered on or after September 1, 2011, through June 30, 2013, payment rates for dental services shall be reduced by three percent. This reduction does not apply to state-operated dental clinics in paragraph (f).

(j) Effective for services rendered on or after January 1, 2014, payment rates for dental services shall be increased by five percent from the rates in effect on December 31, 2013. This increase does not apply to state-operated dental clinics in paragraph (f), federally qualified health centers, rural health centers, and Indian health services. Effective January 1, 2014, payments made to managed care plans and county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment increase described in this paragraph.

new text begin (k) Effective for services rendered on or after July 1, 2015, the commissioner shall increase payment rates for services furnished by dental providers located outside of the seven-county metropolitan area by the maximum percentage possible above the rates in effect on June 30, 2015, while remaining within the limits of funding appropriated for this purpose. This increase does not apply to state-operated dental clinics in paragraph (f), federally qualified health centers, rural health centers, and Indian health services. Effective January 1, 2016, payments to managed care plans and county-based purchasing plans under sections 256B.69 and 256B.692 shall reflect the payment increase described in this paragraph. The commissioner shall require managed care and county-based purchasing plans to pass on the full amount of the increase, in the form of higher payment rates to dental providers located outside of the seven-county metropolitan area. new text end

Sec. 41.

Minnesota Statutes 2014, section 256B.76, subdivision 4, as amended by Laws 2015, chapter 21, article 1, section 58, is amended to read:

Subd. 4.

Critical access dental providers.

(a) Effective for dental services rendered on or after January 1, 2002, the commissioner shall increase reimbursements to dentists and dental clinics deemed by the commissioner to be critical access dental providers. For dental services rendered on or after July 1, 2007, the commissioner shall increase reimbursement by 35 percent above the reimbursement rate that would otherwise be paid to the critical access dental provider. The commissioner shall pay the managed care plans and county-based purchasing plans in amounts sufficient to reflect increased reimbursements to critical access dental providers as approved by the commissioner.

(b) The commissioner shall designate the following dentists and dental clinics as critical access dental providers:

(1) nonprofit community clinics that:

(i) have nonprofit status in accordance with chapter 317A;

(ii) have tax exempt status in accordance with the Internal Revenue Code, section 501(c)(3);

(iii) are established to provide oral health services to patients who are low income, uninsured, have special needs, and are underserved;

(iv) have professional staff familiar with the cultural background of the clinic's patients;

(v) charge for services on a sliding fee scale designed to provide assistance to low-income patients based on current poverty income guidelines and family size;

(vi) do not restrict access or services because of a patient's financial limitations or public assistance status; and

(vii) have free care available as needed;

(2) federally qualified health centers, rural health clinics, and public health clinics;

(3) city or county owned and operated hospital-based dental clinics;

(4) a dental clinic or dental group owned and operated by a nonprofit corporation in accordance with chapter 317A with more than 10,000 patient encounters per year with patients who are uninsured or covered by medical assistance or MinnesotaCare;

(5) a dental clinic owned and operated by the University of Minnesota or the Minnesota State Colleges and Universities system; and

(6) private practicing dentists if:

(i) the dentist's office is located within a health professional shortage area as defined under Code of Federal Regulations, title 42, part 5, and United States Code, title 42, section 254E;

(ii) more than 50 percent of the dentist's patient encounters per year are with patients who are uninsured or covered by medical assistance or MinnesotaCare;new text begin andnew text end

deleted text begin (iii) the dentist does not restrict access or services because of a patient's financial limitations or public assistance status; and deleted text end

deleted text begin (iv)deleted text end new text begin (iii)new text end the level of service provided by the dentist is critical to maintaining adequate levels of patient access within the service area in which the dentist operates.

Sec. 42.

Minnesota Statutes 2014, section 256B.762, is amended to read:

256B.762 REIMBURSEMENT FOR HEALTH CARE SERVICES.

new text begin (a) new text end Effective for services provided on or after October 1, 2005, payment rates for the following services shall be increased by five percent over the rates in effect on September 30, 2005, when these services are provided as home health services under section 256B.0625, subdivision 6a:

(1) skilled nursing visit;

(2) physical therapy visit;

(3) occupational therapy visit;

(4) speech therapy visit; and

(5) home health aide visit.

new text begin (b) Effective for services provided on or after July 1, 2015, payment rates for managed care and fee-for-service visits for the following services shall be increased by ten percent over the rates in effect on June 30, 2015, when these services are provided as home health services under section 256B.0625, subdivision 6a: new text end

new text begin (1) physical therapy; new text end

new text begin (2) occupational therapy; and new text end

new text begin (3) speech therapy. new text end

new text begin The commissioner shall adjust managed care and county-based purchasing plan capitation rates to reflect the payment rates under this paragraph. new text end

Sec. 43.

Minnesota Statutes 2014, section 256B.766, is amended to read:

256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.

(a) Effective for services provided on or after July 1, 2009, total payments for basic care services, shall be reduced by three percent, except that for the period July 1, 2009, through June 30, 2011, total payments shall be reduced by 4.5 percent for the medical assistance and general assistance medical care programs, prior to third-party liability and spenddown calculation. Effective July 1, 2010, the commissioner shall classify physical therapy services, occupational therapy services, and speech-language pathology and related services as basic care services. The reduction in this paragraph shall apply to physical therapy services, occupational therapy services, and speech-language pathology and related services provided on or after July 1, 2010.

(b) Payments made to managed care plans and county-based purchasing plans shall be reduced for services provided on or after October 1, 2009, to reflect the reduction effective July 1, 2009, and payments made to the plans shall be reduced effective October 1, 2010, to reflect the reduction effective July 1, 2010.

(c) Effective for services provided on or after September 1, 2011, through June 30, 2013, total payments for outpatient hospital facility fees shall be reduced by five percent from the rates in effect on August 31, 2011.

(d) Effective for services provided on or after September 1, 2011, through June 30, 2013, total payments for ambulatory surgery centers facility fees, medical supplies and durable medical equipment not subject to a volume purchase contract, prosthetics and orthotics, renal dialysis services, laboratory services, public health nursing services, physical therapy services, occupational therapy services, speech therapy services, eyeglasses not subject to a volume purchase contract, hearing aids not subject to a volume purchase contract, and anesthesia services shall be reduced by three percent from the rates in effect on August 31, 2011.

(e) Effective for services provided on or after September 1, 2014, payments for ambulatory surgery centers facility fees, hospice services, renal dialysis services, laboratory services, public health nursing services, eyeglasses not subject to a volume purchase contract, and hearing aids not subject to a volume purchase contract shall be increased by three percent and payments for outpatient hospital facility fees shall be increased by three percent. Payments made to managed care plans and county-based purchasing plans shall not be adjusted to reflect payments under this paragraph.

(f) Payments for medical supplies and durable medical equipment not subject to a volume purchase contract, and prosthetics and orthotics, provided on or after July 1, 2014, through June 30, 2015, shall be decreased by .33 percent. Payments for medical supplies and durable medical equipment not subject to a volume purchase contract, and prosthetics and orthotics, provided on or after July 1, 2015, shall be increased by three percent from the rates deleted text begin in effect on June 30, 2014deleted text end new text begin as determined under paragraph (i)new text end .

(g)new text begin Effective for services provided on or after July 1, 2015, payments for outpatient hospital facility fees, medical supplies and durable medical equipment not subject to a volume purchase contract, prosthetics and orthotics, and laboratory services to a hospital meeting the criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause (4), shall be increased by 90 percent from the rates in effect on June 30, 2015. Payments made to managed care plans and county-based purchasing plans shall not be adjusted to reflect payments under this paragraph.new text end

new text begin (h)new text end This section does not apply to physician and professional services, inpatient hospital services, family planning services, mental health services, dental services, prescription drugs, medical transportation, federally qualified health centers, rural health centers, Indian health services, and Medicare cost-sharing.

new text begin (i) Effective July 1, 2015, the medical assistance payment rate for durable medical equipment, prosthetics, orthotics, or supplies shall be restored to the January 1, 2008, medical assistance fee schedule, updated to include subsequent rate increases in the Medicare and medical assistance fee schedules, and including individually priced items for the following categories: enteral nutrition and supplies, customized and other specialized tracheostomy tubes and supplies, electric patient lifts, and durable medical equipment repair and service. This paragraph does not apply to medical supplies and durable medical equipment subject to a volume purchase contract, products subject to the preferred diabetic testing supply program, and items provided to dually eligible recipients when Medicare is the primary payer for the item. new text end

Sec. 44.

Minnesota Statutes 2014, section 256B.767, is amended to read:

256B.767 MEDICARE PAYMENT LIMIT.

(a) Effective for services rendered on or after July 1, 2010, fee-for-service payment rates for physician and professional services under section 256B.76, subdivision 1, and basic care services subject to the rate reduction specified in section 256B.766, shall not exceed the Medicare payment rate for the applicable service, as adjusted for any changes in Medicare payment rates after July 1, 2010. The commissioner shall implement this section after any other rate adjustment that is effective July 1, 2010, and shall reduce rates under this section by first reducing or eliminating provider rate add-ons.

(b) This section does not apply to services provided by advanced practice certified nurse midwives licensed under chapter 148 or traditional midwives licensed under chapter 147D. Notwithstanding this exemption, medical assistance fee-for-service payment rates for advanced practice certified nurse midwives and licensed traditional midwives shall equal and shall not exceed the medical assistance payment rate to physicians for the applicable service.

(c) This section does not apply to mental health services or physician services billed by a psychiatrist or an advanced practice registered nurse with a specialty in mental health.

deleted text begin (d) Effective for durable medical equipment, prosthetics, orthotics, or supplies provided on or after July 1, 2013, through June 30, 2015, the payment rate for items that are subject to the rates established under Medicare's National Competitive Bidding Program shall be equal to the rate that applies to the same item when not subject to the rate established under Medicare's National Competitive Bidding Program. This paragraph does not apply to mail-order diabetic supplies and does not apply to items provided to dually eligible recipients when Medicare is the primary payer of the item. deleted text end

new text begin (d) Effective July 1, 2015, this section shall not apply to durable medical equipment, prosthetics, orthotics, or supplies. new text end

new text begin (e) This section does not apply to physical therapy, occupational therapy, speech pathology and related services, and basic care services provided by a hospital meeting the criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause (4). new text end

Sec. 45.

new text begin [256B.79] INTEGRATED CARE FOR HIGH-RISK PREGNANT WOMEN. 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 following terms have the meanings given them. new text end

new text begin (b) "Adverse outcomes" means maternal opiate addiction, other reportable prenatal substance abuse, low birth weight, or preterm birth. new text end

new text begin (c) "Qualified integrated perinatal care collaborative" or "collaborative" means a combination of (1) members of community-based organizations that represent communities within the identified targeted populations, and (2) local or tribally based service entities, including health care, public health, social services, mental health, chemical dependency treatment, and community-based providers, determined by the commissioner to meet the criteria for the provision of integrated care and enhanced services for enrollees within targeted populations. new text end

new text begin (d) "Targeted populations" means pregnant medical assistance enrollees residing in geographic areas identified by the commissioner as being at above-average risk for adverse outcomes. new text end

new text begin Subd. 2. new text end

new text begin Pilot program established. new text end

new text begin The commissioner shall implement a pilot program to improve birth outcomes and strengthen early parental resilience for pregnant women who are medical assistance enrollees, are at significantly elevated risk for adverse outcomes of pregnancy, and are in targeted populations. The program must promote the provision of integrated care and enhanced services to these pregnant women, including postpartum coordination to ensure ongoing continuity of care, by qualified integrated perinatal care collaboratives. new text end

new text begin Subd. 3. new text end

new text begin Grant awards. new text end

new text begin The commissioner shall award grants to qualifying applicants to support interdisciplinary, integrated perinatal care. Grants must be awarded beginning July 1, 2016. Grant funds must be distributed through a request for proposals process to a designated lead agency within an entity that has been determined to be a qualified integrated perinatal care collaborative or within an entity in the process of meeting the qualifications to become a qualified integrated perinatal care collaborative. Grant awards must be used to support interdisciplinary, team-based needs assessments, planning, and implementation of integrated care and enhanced services for targeted populations. In determining grant award amounts, the commissioner shall consider the identified health and social risks linked to adverse outcomes and attributed to enrollees within the identified targeted population. new text end

new text begin Subd. 4. new text end

new text begin Eligibility for grants. new text end

new text begin To be eligible for a grant under this section, an entity must show that the entity meets or is in the process of meeting qualifications established by the commissioner to be a qualified integrated perinatal care collaborative. These qualifications must include evidence that the entity has or is in the process of developing policies, services, and partnerships to support interdisciplinary, integrated care. The policies, services, and partnerships must meet specific criteria and be approved by the commissioner. The commissioner shall establish a process to review the collaborative's capacity for interdisciplinary, integrated care, to be reviewed at the commissioner's discretion. In determining whether the entity meets the qualifications for a qualified integrated perinatal care collaborative, the commissioner shall verify and review whether the entity's policies, services, and partnerships: new text end

new text begin (1) optimize early identification of drug and alcohol dependency and abuse during pregnancy, effectively coordinate referrals and follow-up of identified patients to evidence-based or evidence-informed treatment, and integrate perinatal care services with behavioral health and substance abuse services; new text end

new text begin (2) enhance access to, and effective use of, needed health care or tribal health care services, public health or tribal public health services, social services, mental health services, chemical dependency services, or services provided by community-based providers by bridging cultural gaps within systems of care and by integrating community-based paraprofessionals such as doulas and community health workers as routinely available service components; new text end

new text begin (3) encourage patient education about prenatal care, birthing, and postpartum care, and document how patient education is provided. Patient education may include information on nutrition, reproductive life planning, breastfeeding, and parenting; new text end

new text begin (4) integrate child welfare case planning with substance abuse treatment planning and monitoring, as appropriate; new text end

new text begin (5) effectively systematize screening, collaborative care planning, referrals, and follow up for behavioral and social risks known to be associated with adverse outcomes and known to be prevalent within the targeted populations; new text end

new text begin (6) facilitate ongoing continuity of care to include postpartum coordination and referrals for interconception care, continued treatment for substance abuse, identification and referrals for maternal depression and other chronic mental health conditions, continued medication management for chronic diseases, and appropriate referrals to tribal or county-based social services agencies and tribal or county-based public health nursing services; and new text end

new text begin (7) implement ongoing quality improvement activities as determined by the commissioner, including collection and use of data from qualified providers on metrics of quality such as health outcomes and processes of care, and the use of other data that has been collected by the commissioner. new text end

new text begin Subd. 5. new text end

new text begin Gaps in communication, support, and care. new text end

new text begin A collaborative receiving a grant under this section must develop means of identifying and reporting gaps in the collaborative's communication, administrative support, and direct care that must be remedied for the collaborative to effectively provide integrated care and enhanced services to targeted populations. new text end

new text begin Subd. 6. new text end

new text begin Report. new text end

new text begin By January 31, 2019, the commissioner shall report to the chairs and ranking minority members of the legislative committees with jurisdiction over health and human services policy and finance on the status and progress of the pilot program. The report must: new text end

new text begin (1) describe the capacity of collaboratives receiving grants under this section; new text end

new text begin (2) contain aggregate information about enrollees served within targeted populations; new text end

new text begin (3) describe the utilization of enhanced prenatal services; new text end

new text begin (4) for enrollees identified with maternal substance use disorders, describe the utilization of substance use treatment and dispositions of any child protection cases; new text end

new text begin (5) contain data on outcomes within targeted populations and compare these outcomes to outcomes statewide, using standard categories of race and ethnicity; and new text end

new text begin (6) include recommendations for continuing the program or sustaining improvements through other means beyond June 30, 2019. new text end

new text begin Subd. 7. new text end

new text begin Expiration. new text end

new text begin This section expires June 30, 2019. new text end

Sec. 46.

Minnesota Statutes 2014, section 256L.01, subdivision 3a, is amended to read:

Subd. 3a.

Family.

(a) new text begin Except as provided in paragraphs (c) and (d), new text end "family" has the meaning given for family and family size as defined in Code of Federal Regulations, title 26, section 1.36B-1.

(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 (c) For an individual who does not expect to file a federal tax return and does not expect to be claimed as a dependent for the applicable tax year, "family" has the meaning given in Code of Federal Regulations, title 42, section 435.603(f)(3). new text end

new text begin (d) For a married couple, "family" has the meaning given in Code of Federal Regulations, title 42, section 435.603(f)(4). 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. 47.

Minnesota Statutes 2014, section 256L.01, subdivision 5, is amended to read:

Subd. 5.

Income.

"Income" has the meaning given for modified adjusted gross income, as defined in Code of Federal Regulations, title 26, section 1.36B-1deleted text begin .deleted text end new text begin , and means a household's projected annual income for the applicable tax yearnew 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. 48.

Minnesota Statutes 2014, section 256L.03, subdivision 5, is amended to read:

Subd. 5.

Cost-sharing.

(a) Except as otherwise provided in this subdivision, the MinnesotaCare benefit plan shall include the following cost-sharing requirements for all enrollees:

(1) $3 per prescription for adult enrollees;

(2) $25 for eyeglasses for adult enrollees;

(3) $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;

(4) $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

(5) a family deductible equal to deleted text begin the maximum amount allowed under Code of Federal Regulations, title 42, part 447.54deleted text end deleted text begin .deleted text end new text begin $2.75 per month per family and adjusted annually by the percentage increase in the medical care component of the CPI-U for the period of September to September of the preceding calendar year, rounded to the next-higher five cent increment.new text end

(b) Paragraph (a) does not apply to children under the age of 21new text begin and to American Indians as defined in Code of Federal Regulations, title 42, section 447.51new text end .

(c) Paragraph (a), clause (3), does not apply to mental health services.

(d) 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 (4), effective January 1, 2011.

(e) 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 (5). 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 (f) The commissioner shall increase co-payments for covered services in a manner sufficient to reduce the actuarial value of the benefit to 94 percent. The cost-sharing changes described in this paragraph do not apply to eligible recipients or services exempt from cost-sharing under state law. The cost-sharing changes described in this paragraph shall not be implemented prior to January 1, 2016. new text end

new text begin (g) The cost-sharing changes authorized under paragraph (f) must satisfy the requirements for cost-sharing under the Basic Health Program as set forth in Code of Federal Regulations, title 42, sections 600.510 and 600.520. new text end

new text begin EFFECTIVE DATE. new text end

new text begin The amendment to paragraph (a), clause (5), is effective retroactively from January 1, 2014. The amendment to paragraph (b) is effective the day following final enactment. new text end

Sec. 49.

Minnesota Statutes 2014, section 256L.04, subdivision 1c, is amended to read:

Subd. 1c.

General requirements.

To be eligible for deleted text begin coverage underdeleted text end 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 MNsure under chapter 62V.

new text begin EFFECTIVE DATE. new text end

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

Sec. 50.

Minnesota Statutes 2014, section 256L.04, subdivision 7b, is amended to read:

Subd. 7b.

Annual income limits adjustment.

The commissioner shall adjust the income limits under this section deleted text begin 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, 2009deleted text end new text begin annually on January 1 as provided in Code of Federal Regulations, title 26, section 1.36B-1(h)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. 51.

Minnesota Statutes 2014, section 256L.05, is amended by adding a subdivision to read:

new text begin Subd. 2a. new text end

new text begin Eligibility and coverage. new text end

new text begin For purposes of this chapter, an individual is eligible for MinnesotaCare following a determination by the commissioner that the individual meets the eligibility criteria for the applicable period of eligibility. For an individual required to pay a premium, coverage is only available in each month of the applicable period of eligibility for which a premium is paid. 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. 52.

Minnesota Statutes 2014, 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. The effective date of coverage for 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's modified adjusted 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.

(c) 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.

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

Sec. 53.

Minnesota Statutes 2014, section 256L.05, subdivision 3a, is amended to read:

Subd. 3a.

deleted text begin Renewaldeleted text end new text begin Redeterminationnew text end of eligibility.

(a) deleted text begin Beginning July 1, 2007,deleted text end An enrollee's eligibility must be deleted text begin renewed every 12 monthsdeleted text end new text begin redetermined on an annual basisnew text end . deleted text begin The 12-month period begins in the month after the month the application is approved.deleted text end new text begin The period of eligibility is the entire calendar year following the year in which eligibility is redetermined. Beginning in calendar year 2015, eligibility redeterminations shall occur during the open enrollment period for qualified health plans as specified in Code of Federal Regulations, title 45, section 155.410.new text end

(b) Each new period of eligibility must take into account any changes in circumstances that impact eligibility and premium amount. deleted text begin An enrollee must provide all the information needed to redetermine eligibility by the first day of the month that ends the eligibility period. The premium for the new period of eligibility must be received deleted text end new text begin Coverage beginsnew text end as provided in section 256L.06 deleted text begin in order for eligibility to continuedeleted text end .

deleted text begin (c) For children enrolled in MinnesotaCare, the first period of renewal begins the month the enrollee turns 21 years of age. deleted text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 54.

Minnesota Statutes 2014, section 256L.05, subdivision 4, is amended to read:

Subd. 4.

Application processing.

The commissioner of human services shall determine an applicant's eligibility for MinnesotaCare no more than deleted text begin 30deleted text end new text begin 45new text end days from the date that the application is received by the Department of Human Servicesnew text begin as set forth in Code of Federal Regulations, title 42, section 435.912new text end . deleted text begin Beginning January 1, 2000, this requirement also applies to local county human services agencies that determine eligibility for MinnesotaCare.deleted text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 55.

Minnesota Statutes 2014, 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 new text begin following the month new text end for which the premium was due. Persons disenrolled for nonpayment deleted text begin 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 disenrollmentdeleted text end new text begin may not reenroll prior to the first day of the month following the payment of an amount equal to two months' premiumsnew 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. 56.

Minnesota Statutes 2014, section 256L.121, subdivision 1, is amended to read:

Subdivision 1.

Competitive process.

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, deleted text begin subdivisions 1deleted text end deleted text begin to 32,deleted text end 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.

Sec. 57.

Minnesota Statutes 2014, section 256L.15, subdivision 1, is amended to read:

Subdivision 1.

Premium determinationnew text begin for MinnesotaCarenew text end .

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

(b) 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.

(c) 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 (d) For premiums effective August 1, 2015, and after, the commissioner, after consulting with the chairs and ranking minority members of the legislative committees with jurisdiction over human services, shall increase premiums under subdivision 2 for recipients based on June 2015 program enrollment. Premium increases shall be sufficient to increase projected revenue to the fund described in section 16A.724 by at least $27,800,000 for the biennium ending June 30, 2017. The commissioner shall publish the revised premium scale on the Department of Human Services Web site and in the State Register no later than June 15, 2015. The revised premium scale applies to all premiums on or after August 1, 2015, in place of the scale under subdivision 2. new text end

new text begin (e) By July 1, 2015, the commissioner shall provide the chairs and ranking minority members of the legislative committees with jurisdiction over human services the revised premium scale effective August 1, 2015, and statutory language to codify the revised premium schedule. new text end

new text begin (f) Premium changes authorized under paragraph (d) must only apply to enrollees not otherwise excluded from paying premiums under state or federal law. Premium changes authorized under paragraph (d) must satisfy the requirements for premiums for the Basic Health Program under title 42 of the Code of Federal Regulations, section 600.505. new text end

Sec. 58.

Minnesota Statutes 2014, section 256L.15, subdivision 2, is amended to read:

Subd. 2.

Sliding fee scale; monthly individual or family income.

(a) The commissioner shall establish a sliding fee scale to determine the percentage of monthly 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 individual or family income.

(b) Beginning January 1, 2014, MinnesotaCare enrollees shall pay premiums according to the premium scale specified in paragraph deleted text begin (c) with the exception that children 20 years of age and younger in families with income at or below 200 percent of the federal poverty guidelines shall pay no premiumsdeleted text end new text begin (d)new text end .

new text begin (c) Paragraph (b) does not apply to: new text end

new text begin (1) children 20 years of age or younger; and new text end

new text begin (2) individuals with household incomes below 35 percent of the federal poverty guidelines. new text end

deleted text begin (c)deleted text end new text begin (d)new text end The following premium scale is established for each individual in the household who is 21 years of age or older and enrolled in MinnesotaCare:

Federal Poverty Guideline Greater than or Equal to Less than Individual Premium Amount
deleted text begin 0% deleted text end new text begin 35% new text end 55% $4
55% 80% $6
80% 90% $8
90% 100% $10
100% 110% $12
110% 120% deleted text begin $15 deleted text end new text begin $14 new text end
120% 130% deleted text begin $18 deleted text end new text begin $15 new text end
130% 140% deleted text begin $21 deleted text end new text begin $16 new text end
140% 150% $25
150% 160% $29
160% 170% $33
170% 180% $38
180% 190% $43
190% $50

new text begin EFFECTIVE DATE. new text end

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

Sec. 59.

Laws 2008, chapter 363, article 18, section 3, subdivision 5, is amended to read:

Subd. 5.

Basic Health Care Grants

(a) MinnesotaCare Grants
Health Care Access -0- (770,000)

Incentive Program and Outreach Grants. Of the appropriation for the Minnesota health care outreach program in Laws 2007, chapter 147, article 19, section 3, subdivision 7, paragraph (b):

(1) $400,000 in fiscal year 2009 from the general fund and $200,000 in fiscal year 2009 from the health care access fund are for the incentive program under Minnesota Statutes, section 256.962, subdivision 5. For the biennium beginning July 1, 2009, base level funding for this activity shall be $360,000 from the general fund and $160,000 from the health care access fund; and

(2) $100,000 in fiscal year 2009 from the general fund and $50,000 in fiscal year 2009 from the health care access fund are for the outreach grants under Minnesota Statutes, section 256.962, subdivision 2. For the biennium beginning July 1, 2009, base level funding for this activity shall be $90,000 from the general fund and $40,000 from the health care access fund.

(b) MA Basic Health Care Grants - Families and Children -0- (17,280,000)

Third-Party Liability. (a) During fiscal year 2009, the commissioner shall employ a contractor paid on a percentage basis to improve third-party collections. Improvement initiatives may include, but not be limited to, efforts to improve postpayment collection from nonresponsive claims and efforts to uncover third-party payers the commissioner has been unable to identify.

(b) In fiscal year 2009, the first $1,098,000 of recoveries, after contract payments and federal repayments, is appropriated to the commissioner for technology-related expenses.

deleted text begin Administrative Costs. (a) For contracts effective on or after January 1, 2009, the commissioner shall limit aggregate administrative costs paid to managed care plans under Minnesota Statutes, section 256B.69, and to county-based purchasing plans under Minnesota Statutes, section 256B.692, to an overall average of 6.6 percent of total contract payments under Minnesota Statutes, sections 256B.69 and 256B.692, for each calendar year. For purposes of this paragraph, administrative costs do not include premium taxes paid under Minnesota Statutes, section 297I.05, subdivision 5, and provider surcharges paid under Minnesota Statutes, section 256.9657, subdivision 3. deleted text end

deleted text begin (b) Notwithstanding any law to the contrary, the commissioner may reduce or eliminate administrative requirements to meet the administrative target under paragraph (a). deleted text end

deleted text begin (c) Notwithstanding any contrary provision of this article, this rider shall not expire. deleted text end

Hospital Payment Delay. Notwithstanding Laws 2005, First Special Session chapter 4, article 9, section 2, subdivision 6, payments from the Medicaid Management Information System that would otherwise have been made for inpatient hospital services for medical assistance enrollees are delayed as follows: (1) for fiscal year 2008, June payments must be included in the first payments in fiscal year 2009; and (2) for fiscal year 2009, June payments must be included in the first payment of fiscal year 2010. The provisions of Minnesota Statutes, section 16A.124, do not apply to these delayed payments. Notwithstanding any contrary provision in this article, this paragraph expires on June 30, 2010.

(c) MA Basic Health Care Grants - Elderly and Disabled (14,028,000) (9,368,000)

Minnesota Disability Health Options Rate Setting Methodology. The commissioner shall develop and implement a methodology for risk adjusting payments for community alternatives for disabled individuals (CADI) and traumatic brain injury (TBI) home and community-based waiver services delivered under the Minnesota disability health options program (MnDHO) effective January 1, 2009. The commissioner shall take into account the weighting system used to determine county waiver allocations in developing the new payment methodology. Growth in the number of enrollees receiving CADI or TBI waiver payments through MnDHO is limited to an increase of 200 enrollees in each calendar year from January 2009 through December 2011. If those limits are reached, additional members may be enrolled in MnDHO for basic care services only as defined under Minnesota Statutes, section 256B.69, subdivision 28, and the commissioner may establish a waiting list for future access of MnDHO members to those waiver services.

MA Basic Elderly and Disabled Adjustments. For the fiscal year ending June 30, 2009, the commissioner may adjust the rates for each service affected by rate changes under this section in such a manner across the fiscal year to achieve the necessary cost savings and minimize disruption to service providers, notwithstanding the requirements of Laws 2007, chapter 147, article 7, section 71.

(d) General Assistance Medical Care Grants -0- (6,971,000)
(e) Other Health Care Grants -0- (17,000)

MinnesotaCare Outreach Grants Special Revenue Account. The balance in the MinnesotaCare outreach grants special revenue account on July 1, 2009, estimated to be $900,000, must be transferred to the general fund.

Grants Reduction. Effective July 1, 2008, base level funding for nonforecast, general fund health care grants issued under this paragraph shall be reduced by 1.8 percent at the allotment level.

Sec. 60.

Laws 2014, chapter 312, article 24, section 45, subdivision 2, is amended to read:

Subd. 2.

Application for and terms of variance.

A new provider may apply to the commissioner, on a form supplied by the commissioner for this purpose, for a variance from special transportation service operating standards. The commissioner may grant or deny the variance application. Variances expire on the earlier of February 1, deleted text begin 2016deleted text end new text begin 2017new text end , or deleted text begin the date that the commissioner of transportation begins certifying new providers under the terms of this act and successor legislationdeleted text end new text begin one year after the date the variance was issued. The commissioner must not grant variances under this subdivision after June 30, 2016new text end .

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2016. new text end

Sec. 61.

new text begin STATEWIDE OPIOID PRESCRIBING IMPROVEMENT PROGRAM. new text end

new text begin The commissioner of human services, in collaboration with the commissioner of health, shall report to the legislature by December 1, 2015, on recommendations made by the opioid prescribing work group under Minnesota Statutes, section 256B.0638, subdivision 4, and steps taken by the commissioner of human services to implement the opioid prescribing improvement program under Minnesota Statutes, section 256B.0638, subdivision 5. new text end

Sec. 62.

new text begin TASK FORCE ON HEALTH CARE FINANCING. new text end

new text begin Subdivision 1. new text end

new text begin Task force. new text end

new text begin (a) The governor shall convene a task force on health care financing to advise the governor and legislature on strategies that will increase access to and improve the quality of health care for Minnesotans. These strategies shall include options for sustainable health care financing, coverage, purchasing, and delivery for all insurance affordability programs, including MNsure, medical assistance, MinnesotaCare, and individuals eligible to purchase coverage with federal advanced premium tax credits and cost-sharing subsidies. new text end

new text begin (b) The task force shall consist of: new text end

new text begin (1) seven members appointed by the senate, four members appointed by the majority leader of the senate, one of whom must be a legislator; and three members appointed by the minority leader of the senate, one of whom must be a legislator; new text end

new text begin (2) seven members of the house of representatives, four members appointed by the speaker of the house, one of whom must be a legislator; and three members appointed by the minority leader of the house of representatives, one of whom must be a legislator; new text end

new text begin (3) 11 members appointed by the governor, including public and private health care experts and consumer representatives. The consumer representatives must include one member from a nonprofit organization with legal expertise representing low-income consumers, at least one member from a broad-based nonprofit consumer advocacy organization, and at least one member from an organization representing consumers of color; and new text end

new text begin (4) the commissioners of human services, commerce, and health, and the executive director of MNsure, or their designees. new text end

new text begin (c) The commissioner of human services and a member of the task force voted by the task force shall serve as cochairs of the task force. The commissioner of human services shall convene the first meeting and the members shall vote on the cochair position at the first meeting. new text end

new text begin Subd. 2. new text end

new text begin Duties. new text end

new text begin (a) The task force shall consider opportunities, including alternatives to MNsure, options under section 1332 of the Patient Protection and Affordable Care Act, and options under a section 1115 waiver of the Social Security Act, including: new text end

new text begin (1) options for providing and financing seamless coverage for persons otherwise eligible for insurance affordability programs, including medical assistance, MinnesotaCare, and advanced premium tax credits used to purchase commercial insurance. This includes, but is not limited to: alignment of eligibility and enrollment requirements; smoothing consumer cost-sharing across programs; alignment and alternatives to benefit sets; alternatives to the individual mandate; the employer mandate and penalties; advanced premium tax credits; and qualified health plans; new text end

new text begin (2) options for transforming health care purchasing and delivery, including, but not limited to: expansion of value-based direct contracting with providers and other entities to reward improved health outcomes and reduced costs, including selective contracting; contracting to provide services to public programs and commercial products; and payment models that support and reward coordination of care across the continuum of services and programs; new text end

new text begin (3) options for alignment, consolidation, and governance of certain operational components, including, but not limited to: MNsure; program eligibility, enrollment, call centers, and contracting; and the shared eligibility IT platform; and new text end

new text begin (4) examining the impact of options on the health care workforce and delivery system, including, but not limited to, rural and safety net providers, clinics, and hospitals. new text end

new text begin (b) In development of the options in paragraph (a), the task force options and recommendations shall include the following goals: new text end

new text begin (1) seamless consumer experience across all programs; new text end

new text begin (2) reducing barriers to accessibility and affordability of coverage; new text end

new text begin (3) improving sustainable financing of health programs, including impact on the state budget; new text end

new text begin (4) assessing the impact of options for innovation on their potential to reduce health disparities; new text end

new text begin (5) expanding innovative health care purchasing and delivery systems strategies that reduce cost and improve health; new text end

new text begin (6) promoting effectively and efficiently aligning program resources and operations; and new text end

new text begin (7) increasing transparency and accountability of program operations. new text end

new text begin Subd. 3. new text end

new text begin Staff. new text end

new text begin (a) The commissioner of human services shall provide staff and administrative services for the task force. The commissioner may accept outside resources to help support its efforts and shall leverage its existing vendor contracts to provide technical expertise to develop options under subdivision 2. The commissioner of human services shall receive expedited review and publication of competitive procurements for additional vendor support needed to support the task force. new text end

new text begin (b) Technical assistance shall be provided by the Departments of Health, Commerce, Human Services, and Management and Budget. new text end

new text begin Subd. 4. new text end

new text begin Report. new text end

new text begin The commissioner of human services shall submit recommendations by January 15, 2016, to the governor and the chairs and ranking minority members of the legislative committees with jurisdiction over health, human services, and commerce policy and finance. new text end

new text begin Subd. 5. new text end

new text begin Expiration. new text end

new text begin The task force expires the day after submitting the report required under subdivision 4. new text end

Sec. 63.

new text begin HEALTH DISPARITIES PAYMENT ENHANCEMENT. new text end

new text begin (a) The commissioner of human services shall develop a methodology to pay a higher payment rate for health care providers and services that takes into consideration the higher cost, complexity, and resources needed to serve patients and populations who experience the greatest health disparities in order to achieve the same health and quality outcomes that are achieved for other patients and populations. In developing the methodology, the commissioner shall take into consideration all existing payment methods and rates, including add-on or enhanced rates paid to providers serving high concentrations of low-income patients or populations or providing access in underserved regions or populations. The new methodology must not result in a net decrease in total payment from all sources for those providers who qualify for additional add-on payments or enhanced payments, including, but not limited to, critical access dental, community clinic add-ons, federally qualified health centers payment rates, and disproportionate share payments. The commissioner shall develop the methodology in consultation with affected stakeholders, including communities impacted by health disparities, using culturally appropriate methods of community engagement. The proposed methodology must include recommendations for how the methodology could be incorporated into payment methods used in both fee-for-service and managed care plans. new text end

new text begin (b) The commissioner shall submit a report on the analysis and provide options for new payment methodologies that incorporate health disparities to the chairs and ranking minority members of the legislative committees with jurisdiction over health care policy and finance by February 1, 2016. The scope of the report and the development work described in paragraph (a) is limited to data currently available to the Department of Human Services; analyses of the data for reliability and completeness; analyses of how these data relate to health disparities, outcomes, and expenditures; and options for incorporating these data or measures into a payment methodology. new text end

Sec. 64.

new text begin CAPITATION PAYMENT DELAY. new text end

new text begin The commissioner of human services shall delay $135,000,000 of the medical assistance capitation payment to managed care plans and county-based purchasing plans due in May 2017 and the payment due in April 2017 for special needs basic care until July 1, 2017. The payment shall be made no earlier than July 1, 2017, and no later than July 31, 2017. new text end

Sec. 65.

new text begin REPEALER. new text end

new text begin (a) new text end new text begin Minnesota Statutes 2014, sections 256.01, subdivision 35; 256.969, subdivisions 23 and 30; and 256B.69, subdivision 32, new text end new text begin are repealed effective July 1, 2015. new text end

new text begin (b) new text end new text begin Minnesota Statutes 2014, sections 256L.02, subdivision 3; and 256L.05, subdivisions 1b, 1c, 3c, and 5, new text end new text begin are repealed effective the day following final enactment. new text end

new text begin (c) new text end new text begin Minnesota Rules, part 8840.5900, subparts 12 and 14, new text end new text begin are repealed effective January 1, 2016. new text end

ARTICLE 12

MNSURE

Section 1.

Minnesota Statutes 2014, section 62A.02, subdivision 2, is amended to read:

Subd. 2.

Approval.

(a) The health plan form shall not be issued, nor shall any application, rider, endorsement, or rate be used in connection with it, until the expiration of 60 days after it has been filed unless the commissioner approves it before that time.

(b) Notwithstanding paragraph (a), a rate filed with respect to a policy of accident and sickness insurance as defined in section 62A.01 by an insurer licensed under chapter 60A, may be used on or after the date of filing with the commissioner. Rates that are not approved or disapproved within the 60-day time period are deemed approved. This paragraph does not apply to Medicare-related coverage as defined in section 62A.3099, subdivision 17.

new text begin (c) For coverage to begin on or after January 1, 2016, and each January 1 thereafter, health plans in the individual and small group markets that are not grandfathered plans to be offered outside MNsure and qualified health plans to be offered inside MNsure must receive rate approval from the commissioner no later than 30 days prior to the beginning of the annual open enrollment period for MNsure. Premium rates for all carriers in the applicable market for the next calendar year must be made available to the public by the commissioner only after all rates for the applicable market are final and approved. Final and approved rates must be publicly released at a uniform time for all individual and small group health plans that are not grandfathered plans to be offered outside MNsure and qualified health plans to be offered inside MNsure, and no later than 30 days prior to the beginning of the annual open enrollment period for MNsure. new text end

Sec. 2.

Minnesota Statutes 2014, section 62V.03, subdivision 2, is amended to read:

Subd. 2.

Application of other law.

(a) MNsure must be reviewed by the legislative auditor under section 3.971. The legislative auditor shall audit the books, accounts, and affairs of MNsure once each year or less frequently as the legislative auditor's funds and personnel permit. Upon the audit of the financial accounts and affairs of MNsure, MNsure is liable to the state for the total cost and expenses of the audit, including the salaries paid to the examiners while actually engaged in making the examination. The legislative auditor may bill MNsure either monthly or at the completion of the audit. All collections received for the audits must be deposited in the general fund and are appropriated to the legislative auditor. Pursuant to section 3.97, subdivision 3a, the Legislative Audit Commission is requested to direct the legislative auditor to report by March 1, 2014, to the legislature on any duplication of services that occurs within state government as a result of the creation of MNsure. The legislative auditor may make recommendations on consolidating or eliminating any services deemed duplicative. The board shall reimburse the legislative auditor for any costs incurred in the creation of this report.

(b) Board members of MNsure are subject to sections 10A.07 and 10A.09. Board members and the personnel of MNsure are subject to section 10A.071.

(c) All meetings of the board shall comply with the open meeting law in chapter 13Ddeleted text begin , except that:deleted text end new text begin .new text end

deleted text begin (1) meetings, or portions of meetings, regarding compensation negotiations with the director or managerial staff may be closed in the same manner and according to the same procedures identified in section 13D.03; deleted text end

deleted text begin (2) meetings regarding contract negotiation strategy may be closed in the same manner and according to the same procedures identified in section 13D.05, subdivision 3, paragraph (c); and deleted text end

deleted text begin (3) meetings, or portions of meetings, regarding not public data described in section 62V.06, subdivision 3, and regarding trade secret information as defined in section 13.37, subdivision 1, paragraph (b), are closed to the public, but must otherwise comply with the procedures identified in chapter 13D. deleted text end

deleted text begin (d) MNsure and provisions specified under this chapter are exempt from: deleted text end

deleted text begin (1) chapter 14, including section 14.386, except as specified in section 62V.05; and deleted text end

deleted text begin (2) chapters 16B and 16C, with the exception of sections 16C.08, subdivision 2, paragraph (b), clauses (1) to (8); 16C.086; 16C.09, paragraph (a), clauses (1) and (3), paragraph (b), and paragraph (c); and section 16C.16. However, MNsure, in consultation with the commissioner of administration, shall implement policies and procedures to establish an open and competitive procurement process for MNsure that, to the extent practicable, conforms to the principles and procedures contained in chapters 16B and 16C. In addition, MNsure may enter into an agreement with the commissioner of administration for other services. deleted text end

deleted text begin (e)deleted text end new text begin (d) new text end The board and the Web site are exempt from chapter 60K. Any employee of MNsure who sells, solicits, or negotiates insurance to individuals or small employers must be licensed as an insurance producer under chapter 60K.

deleted text begin (f)deleted text end new text begin (e) new text end Section 3.3005 applies to any federal funds received by MNsure.

deleted text begin (g) MNsure is exempt from the following sections in chapter 16E: 16E.01, subdivision 3, paragraph (b); 16E.03, subdivisions 3 and 4; 16E.04, subdivision 1, subdivision 2, paragraph (c), and subdivision 3, paragraph (b); 16E.0465; 16E.055; 16E.145; 16E.15; 16E.16; 16E.17; 16E.18; and 16E.22. deleted text end

deleted text begin (h)deleted text end new text begin (f)new text end A MNsure decision that requires a vote of the board, other than a decision that applies only to hiring of employees or other internal management of MNsure, is an "administrative action" under section 10A.01, subdivision 2.

Sec. 3.

Minnesota Statutes 2014, section 62V.05, subdivision 6, is amended to read:

Subd. 6.

Appeals.

(a) The board may conduct hearings, appoint hearing officers, and recommend final orders related to appeals of any MNsure determinations, except for those determinations identified in paragraph (d). An appeal by a health carrier regarding a specific certification or selection determination made by MNsure under subdivision 5 must be conducted as a contested case proceeding under chapter 14, with the report or order of the administrative law judge constituting the final decision in the case, subject to judicial review under sections 14.63 to 14.69. For other appeals, the board shall establish hearing processes which provide for a reasonable opportunity to be heard and timely resolution of the appeal and which are consistent with the requirements of federal law and guidance. An appealing party may be represented by legal counsel at these hearings, but this is not a requirement.

(b) MNsure may establish service-level agreements with state agencies to conduct hearings for appeals. Notwithstanding section 471.59, subdivision 1, a state agency is authorized to enter into service-level agreements for this purpose with MNsure.

(c) For proceedings under this subdivision, MNsure may be represented by an attorney who is an employee of MNsure.

(d) This subdivision does not apply to appeals of determinations where a state agency hearing is available under section 256.045.

new text begin (e) An appellant aggrieved by an order of MNsure issued in an eligibility appeal, as defined in Minnesota Rules, part 7700.0101, may appeal the order to the district court of the appellant's county of residence by serving a written copy of a notice of appeal upon MNsure and any other adverse party of record within 30 days after the date MNsure issued the order, the amended order, or order affirming the original order, and by filing the original notice and proof of service with the court administrator of the district court. Service may be made personally or by mail; service by mail is complete upon mailing; no filing fee shall be required by the court administrator in appeals taken pursuant to this subdivision. MNsure shall furnish all parties to the proceedings with a copy of the decision and a transcript of any testimony, evidence, or other supporting papers from the hearing held before the appeals examiner within 45 days after service of the notice of appeal. new text end

new text begin (f) Any party aggrieved by the failure of an adverse party to obey an order issued by MNsure may compel performance according to the order in the manner prescribed in sections 586.01 to 586.12. new text end

new text begin (g) Any party may obtain a hearing at a special term of the district court by serving a written notice of the time and place of the hearing at least ten days prior to the date of the hearing. The court may consider the matter in or out of chambers, and shall take no new or additional evidence unless it determines that such evidence is necessary for a more equitable disposition of the appeal. new text end

new text begin (h) Any party aggrieved by the order of the district court may appeal the order as in other civil cases. No costs or disbursements shall be taxed against any party nor shall any filing fee or bond be required of any party. new text end

new text begin (i) If MNsure or district court orders eligibility for qualified health plan coverage through MNsure, or eligibility for federal advance payment of premium tax credits or cost-sharing reductions contingent upon full payment of respective premiums, the premiums must be paid or provided pending appeal to the district court, Court of Appeals, or Supreme Court. Provision of eligibility by MNsure pending appeal does not render moot MNsure's position in a court of law. new text end

Sec. 4.

Minnesota Statutes 2014, section 62V.05, subdivision 7, is amended to read:

Subd. 7.

Agreements; consultation.

(a) The board shall:

deleted text begin (1) establish and maintain an agreement with the chief information officer of the Office of MN.IT Services for information technology services that ensures coordination with public health care programs. The board may establish and maintain agreements with the chief information officer of the Office of MN.IT Services for other information technology services, including an agreement that would permit MNsure to administer eligibility for additional health care and public assistance programs under the authority of the commissioner of human services; deleted text end

deleted text begin (2)deleted text end new text begin (1)new text end establish and maintain an agreement with the commissioner of human services for cost allocation and services regarding eligibility determinations and enrollment for public health care programs that use a modified adjusted gross income standard to determine program eligibility. The board may establish and maintain an agreement with the commissioner of human services for other services;

deleted text begin (3)deleted text end new text begin (2)new text end establish and maintain an agreement with the commissioners of commerce and health for services regarding enforcement of MNsure certification requirements for health plans and dental plans offered through MNsure. The board may establish and maintain agreements with the commissioners of commerce and health for other services; and

deleted text begin (4)deleted text end new text begin (3)new text end establish interagency agreements to transfer funds to other state agencies for their costs related to implementing and operating MNsure, excluding medical assistance allocatable costs.

(b) The board shall consult with the commissioners of commerce and health regarding the operations of MNsure.

(c) The board shall consult with Indian tribes and organizations regarding the operation of MNsure.

(d) Beginning March 15, deleted text begin 2014deleted text end new text begin 2016new text end , and each March 15 thereafter, the board shall submit a report to the chairs and ranking minority members of the committees in the senate and house of representatives with primary jurisdiction over commerce, health, and human services on all the agreements entered into with the chief information officer of the Office of MN.IT Services, or the commissioners of human services, health, or commerce in accordance with this subdivision. The report shall include the agency in which the agreement is with; the time period of the agreement; the purpose of the agreement; and a summary of the terms of the agreement. A copy of the agreement must be submitted to the extent practicable.

Sec. 5.

Minnesota Statutes 2014, section 62V.05, subdivision 8, is amended to read:

Subd. 8.

Rulemaking.

deleted text begin (a) If the board's policies, procedures, or other statements are rules, as defined in section 14.02, subdivision 4, the requirements in either paragraph (b) or (c) apply, as applicable. deleted text end

deleted text begin (b) Effective upon enactment until January 1, 2015: deleted text end

deleted text begin (1) the board shall publish notice of proposed rules in the State Register after complying with section 14.07, subdivision 2; deleted text end

deleted text begin (2) interested parties have 21 days to comment on the proposed rules. The board must consider comments it receives. After the board has considered all comments and has complied with section 14.07, subdivision 2, the board shall publish notice of the final rule in the State Register; deleted text end

deleted text begin (3) if the adopted rules are the same as the proposed rules, the notice shall state that the rules have been adopted as proposed and shall cite the prior publication. If the adopted rules differ from the proposed rules, the portions of the adopted rules that differ from the proposed rules shall be included in the notice of adoption, together with a citation to the prior State Register that contained the notice of the proposed rules; and deleted text end

deleted text begin (4) rules published in the State Register before January 1, 2014, take effect upon publication of the notice. Rules published in the State Register on and after January 1, 2014, take effect 30 days after publication of the notice. deleted text end

deleted text begin (c) Beginning January 1, 2015,deleted text end The board may adopt rules to implement any provisions in this chapter using the expedited rulemaking process in section 14.389.

deleted text begin (d) The notice of proposed rules required in paragraph (b) must provide information as to where the public may obtain a copy of the rules. The board shall post the proposed rules on the MNsure Web site at the same time the notice is published in the State Register. deleted text end

Sec. 6.

Minnesota Statutes 2014, section 62V.05, is amended by adding a subdivision to read:

new text begin Subd. 12. new text end

new text begin Prohibition on other product lines. new text end

new text begin MNsure is prohibited from certifying, selecting, or offering products and policies of coverage that do not meet the definition of health plan or dental plan as provided in section 62V.02. new text end

Sec. 7.

new text begin EXPANDED ACCESS TO THE SMALL BUSINESS HEALTH CARE TAX CREDIT. new text end

new text begin (a) The commissioner of human services, in consultation with the Board of Directors of MNsure and the MNsure Legislative Oversight Committee, shall develop a proposal to allow small employers the ability to receive the small business health care tax credit when the small employer pays the premiums on behalf of employees enrolled in either a qualified health plan offered through a small business health options program (SHOP) marketplace or a small group health plan offered outside of the SHOP marketplace within MNsure. To be eligible for the tax credit, the small employer must meet the requirements under the Affordable Care Act, except that employees may be enrolled in a small group health plan product offered outside of MNsure. new text end

new text begin (b) The commissioner shall seek all federal waivers and approvals necessary to implement the proposal in paragraph (a). The commissioner shall submit a draft proposal to the MNsure board and the MNsure Legislative Oversight Committee at least 30 days before submitting a final proposal to the federal government, and shall notify the board and Legislative Oversight Committee of any federal decision or action received regarding the proposal and submitted waiver. 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.

new text begin EXPANDED ACCESS TO QUALIFIED HEALTH PLANS AND SUBSIDIES. new text end

new text begin The commissioner of commerce, in consultation with the Board of Directors of MNsure and the MNsure Legislative Oversight Committee, shall develop a proposal to allow individuals to purchase qualified health plans outside of MNsure directly from health plan companies and to allow eligible individuals to receive advanced premium tax credits and cost-sharing reductions when purchasing these health plans. The commissioner shall seek all federal waivers and approvals necessary to implement this proposal. The commissioner shall submit a draft proposal to the MNsure board and the MNsure Legislative Oversight Committee at least 30 days before submitting a final proposal to the federal government and shall notify the board and legislative oversight committee of any federal decision or action related to the proposal. new text end

Sec. 9.

new text begin REPEALER. new text end

new text begin Minnesota Statutes 2014, section 62V.11, subdivision 3, new text end new text begin is repealed. new text end

ARTICLE 13

HUMAN SERVICES FORECAST ADJUSTMENTS

Section 1.

new text begin DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.new text end

new text begin The dollar amounts shown are added to or, if shown in parentheses, are subtracted from the appropriations in Laws 2013, chapter 108, article 14, as amended by Laws 2014, chapter 312, article 30, from the general fund, or any other fund named, to the Department of Human Services for the purposes specified in this article, to be available for the fiscal years indicated for each purpose. The figure "2015" used in this article means that the appropriations listed are available for the fiscal year ending June 30, 2015. new text end

new text begin APPROPRIATIONS new text end
new text begin Available for the Year new text end
new text begin Ending June 30 new text end
new text begin 2015 new text end

Sec. 2.

new text begin COMMISSIONER OF HUMAN SERVICES new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation new text end

new text begin $ new text end new text begin (255,104,000) new text end
new text begin Appropriations by Fund new text end
new text begin 2015 new text end
new text begin General Fund new text end new text begin (125,910,000) new text end
new text begin Health Care Access new text end new text begin (123,113,000) new text end
new text begin TANF new text end new text begin (6,081,000) new text end

new text begin Subd. 2. new text end

new text begin Forecasted Programs new text end

new text begin (a) MFIP/DWP Grants new text end
new text begin Appropriations by Fund new text end
new text begin General Fund new text end new text begin (1,977,000) new text end
new text begin TANF new text end new text begin (7,079,000) new text end
new text begin (b) MFIP Child Care Assistance Grants new text end new text begin 9,733,000 new text end
new text begin (c) General Assistance Grants new text end new text begin (1,423,000) new text end
new text begin (d) Minnesota Supplemental Aid Grants new text end new text begin (1,121,000) new text end
new text begin (e) Group Residential Housing Grants new text end new text begin (6,314,000) new text end
new text begin (f) MinnesotaCare Grants new text end new text begin (75,675,000) new text end

new text begin This appropriation is from the health care access fund. new text end

new text begin (g) Medical Assistance Grants new text end
new text begin Appropriations by Fund new text end
new text begin General Fund new text end new text begin (124,557,000) new text end
new text begin Health Care Access new text end new text begin (47,438,000) new text end
new text begin (h) Alternative Care Grants new text end new text begin 0 new text end
new text begin (i) CD Entitlement Grants new text end new text begin (251,000) new text end

new text begin Subd. 3. new text end

new text begin Technical Activities new text end

new text begin 998,000 new text end

new text begin This appropriation is from the TANF fund. new text end

Sec. 3.

new text begin EFFECTIVE DATE. new text end

new text begin Sections 1 and 2 are effective the day following final enactment. new text end

ARTICLE 14

HEALTH AND HUMAN SERVICES APPROPRIATIONS

Section 1.

new text begin HEALTH AND HUMAN SERVICES APPROPRIATIONS.new text end

new text begin The sums shown in the columns marked "Appropriations" are appropriated to the agencies and for the purposes specified in this article. The appropriations are from the general fund, or another named fund, and are available for the fiscal years indicated for each purpose. The figures "2016" and "2017" used in this article mean that the appropriations listed under them are available for the fiscal year ending June 30, 2016, or June 30, 2017, respectively. "The first year" is fiscal year 2016. "The second year" is fiscal year 2017. "The biennium" is fiscal years 2016 and 2017. new text end

new text begin APPROPRIATIONS new text end
new text begin Available for the Year new text end
new text begin Ending June 30 new text end
new text begin 2016 new text end new text begin 2017 new text end

Sec. 2.

new text begin COMMISSIONER OF HUMAN SERVICES new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation new text end

new text begin $ new text end new text begin 7,236,563,000 new text end new text begin $ new text end new text begin 7,443,496,000 new text end
new text begin Appropriations by Fund new text end
new text begin 2016 new text end new text begin 2017 new text end
new text begin General new text end new text begin 5,903,939,000 new text end new text begin 6,448,469,000 new text end
new text begin State Government Special Revenue new text end new text begin 4,514,000 new text end new text begin 4,274,000 new text end
new text begin Health Care Access new text end new text begin 1,059,147,000 new text end new text begin 725,326,000 new text end
new text begin Federal TANF new text end new text begin 267,070,000 new text end new text begin 263,531,000 new text end
new text begin Lottery Prize new text end new text begin 1,893,000 new text end new text begin 1,896,000 new text end

new text begin Receipts for Systems Projects. Appropriations and federal receipts for information systems projects for MAXIS, PRISM, MMIS, ISDS, and SSIS must be deposited in the state systems account authorized in Minnesota Statutes, section 256.014. Money appropriated for computer projects approved by the commissioner of the Office of MN.IT Services, funded by the legislature, and approved by the commissioner of management and budget may be transferred from one project to another and from development to operations as the commissioner of human services considers necessary. Any unexpended balance in the appropriation for these projects does not cancel but is available for ongoing development and operations. new text end

new text begin new text begin TANF Maintenance of Effort.new text end (a) In order to meet the basic maintenance of effort (MOE) requirements of the TANF block grant specified under Code of Federal Regulations, title 45, section 263.1, the commissioner may only report nonfederal money expended for allowable activities listed in the following clauses as TANF/MOE expenditures: new text end

new text begin (1) MFIP cash, diversionary work program, and food assistance benefits under Minnesota Statutes, chapter 256J; new text end

new text begin (2) the child care assistance programs under Minnesota Statutes, sections 119B.03 and 119B.05, and county child care administrative costs under Minnesota Statutes, section 119B.15; new text end

new text begin (3) state and county MFIP administrative costs under Minnesota Statutes, chapters 256J and 256K; new text end

new text begin (4) state, county, and tribal MFIP employment services under Minnesota Statutes, chapters 256J and 256K; new text end

new text begin (5) expenditures made on behalf of legal noncitizen MFIP recipients who qualify for the MinnesotaCare program under Minnesota Statutes, chapter 256L; new text end

new text begin (6) qualifying working family credit expenditures under Minnesota Statutes, section 290.0671; and new text end

new text begin (7) qualifying Minnesota education credit expenditures under Minnesota Statutes, section 290.0674. new text end

new text begin (b) The commissioner shall ensure that sufficient qualified nonfederal expenditures are made each year to meet the state's TANF/MOE requirements. For the activities listed in paragraph (a), clauses (2) to (7), the commissioner may only report expenditures that are excluded from the definition of assistance under Code of Federal Regulations, title 45, section 260.31. new text end

new text begin (c) For fiscal years beginning with state fiscal year 2003, the commissioner shall ensure that the maintenance of effort used by the commissioner of management and budget for the February and November forecasts required under Minnesota Statutes, section 16A.103, contains expenditures under paragraph (a), clause (1), equal to at least 16 percent of the total required under Code of Federal Regulations, title 45, section 263.1. new text end

new text begin (d) The requirement in Minnesota Statutes, section 256.011, subdivision 3, that federal grants or aids secured or obtained under that subdivision be used to reduce any direct appropriations provided by law, does not apply if the grants or aids are federal TANF funds. new text end

new text begin (e) For the federal fiscal years beginning on or after October 1, 2007, the commissioner may not claim an amount of TANF/MOE in excess of the 75 percent standard in Code of Federal Regulations, title 45, section 263.1(a)(2), except: new text end

new text begin (1) to the extent necessary to meet the 80 percent standard under Code of Federal Regulations, title 45, section 263.1(a)(1), if it is determined by the commissioner that the state will not meet the TANF work participation target rate for the current year; new text end

new text begin (2) to provide any additional amounts under Code of Federal Regulations, title 45, section 264.5, that relate to replacement of TANF funds due to the operation of TANF penalties; and new text end

new text begin (3) to provide any additional amounts that may contribute to avoiding or reducing TANF work participation penalties through the operation of the excess MOE provisions of Code of Federal Regulations, title 45, section 261.43(a)(2). new text end

new text begin (f) For the purposes of paragraph (e), clauses (1) to (3), the commissioner may supplement the MOE claim with working family credit expenditures or other qualified expenditures to the extent such expenditures are otherwise available after considering the expenditures allowed in this subdivision and subdivision 2. new text end

new text begin (g) Notwithstanding any contrary provision in this article, paragraphs (a) to (f) expire June 30, 2019. new text end

new text begin Working Family Credit Expenditure as TANF/MOE. The commissioner may claim as TANF maintenance of effort up to $6,707,000 per year of working family credit expenditures in each fiscal year. new text end

new text begin Subd. 2. new text end

new text begin Working Family Credit to be Claimed for TANF/MOE new text end

new text begin The commissioner may count the following additional amounts of working family credit expenditures as TANF maintenance of effort: new text end

new text begin (1) fiscal year 2016, $0; new text end

new text begin (2) fiscal year 2017, $1,283,000; new text end

new text begin (3) fiscal year 2018, $0; and new text end

new text begin (4) fiscal year 2019, $0. new text end

new text begin Notwithstanding any contrary provision in this article, this subdivision expires June 30, 2019. new text end

new text begin Subd. 3. new text end

new text begin Central Office new text end

new text begin The amounts that may be spent from this appropriation for each purpose are as follows: new text end

new text begin (a) Operations new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 115,577,000 new text end new text begin 113,733,000 new text end
new text begin State Government Special Revenue new text end new text begin 4,389,000 new text end new text begin 4,149,000 new text end
new text begin Health Care Access new text end new text begin 9,793,000 new text end new text begin 10,076,000 new text end
new text begin Federal TANF new text end new text begin 100,000 new text end new text begin 100,000 new text end

new text begin Administrative Recovery; Set-Aside. The commissioner may invoice local entities through the SWIFT accounting system as an alternative means to recover the actual cost of administering the following provisions: new text end

new text begin (1) Minnesota Statutes, section 125A.744, subdivision 3; new text end

new text begin (2) Minnesota Statutes, section 245.495, paragraph (b); new text end

new text begin (3) Minnesota Statutes, section 256B.0625, subdivision 20, paragraph (k); new text end

new text begin (4) Minnesota Statutes, section 256B.0924, subdivision 6, paragraph (g); new text end

new text begin (5) Minnesota Statutes, section 256B.0945, subdivision 4, paragraph (d); and new text end

new text begin (6) Minnesota Statutes, section 256F.10, subdivision 6, paragraph (b). new text end

new text begin IT Appropriations Generally. This appropriation includes funds for information technology projects, services, and support. Notwithstanding Minnesota Statutes, section 16E.0466, funding for information technology project costs shall be incorporated into the service level agreement and paid to the Office of MN.IT Services by the Department of Human Services under the rates and mechanism specified in that agreement. new text end

new text begin new text begin Periodic Data Matching for Medical Assistance and MinnesotaCare.new text end $1,598,000 in fiscal year 2016 and $2,017,000 in fiscal year 2017 from the general fund are for periodic data matching for medical assistance and MinnesotaCare recipients under Minnesota Statutes, section 256B.0561, and related administrative services. new text end

new text begin new text begin Base Level Adjustment.new text end The general fund base is increased by $1,240,000 in fiscal year 2018 and by $1,291,000 in fiscal year 2019. The health care access fund base is decreased by $455,000 in fiscal year 2018 and by $455,000 in fiscal year 2019. new text end

new text begin (b) Children and Families new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 9,974,000 new text end new text begin 9,829,000 new text end
new text begin Federal TANF new text end new text begin 2,582,000 new text end new text begin 2,582,000 new text end

new text begin Financial Institution Data Match and Payment of Fees. The commissioner is authorized to allocate up to $310,000 each year in fiscal year 2016 and fiscal year 2017 from the PRISM special revenue account to make payments to financial institutions in exchange for performing data matches between account information held by financial institutions and the public authority's database of child support obligors as authorized by Minnesota Statutes, section 13B.06, subdivision 7. new text end

new text begin new text begin Child Support Work Group.new text end $12,000 in fiscal year 2016 is from the general fund for facilitation of the duties of the child support work group. new text end

new text begin new text begin Base Level Adjustment.new text end The general fund base is increased by $31,000 in fiscal year 2018 and by $31,000 in fiscal year 2019. new text end

new text begin (c) Health Care new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 16,667,000 new text end new text begin 16,309,000 new text end
new text begin Health Care Access new text end new text begin 33,185,000 new text end new text begin 34,007,000 new text end

new text begin Periodic Data Matching for Medical Assistance and MinnesotaCare. $116,000 in fiscal year 2017 from the health care access fund is for periodic data matching for medical assistance and MinnesotaCare recipients under Minnesota Statutes, section 256B.0561, and related administrative services. new text end

new text begin Task Force. Of the general fund appropriation, $770,000 in fiscal year 2016 is for administrative services and support to the Task Force on Health Care Financing. This is a onetime appropriation. new text end

new text begin Base Level Adjustment. The general fund base is decreased by $98,000 in fiscal year 2019. The health care access fund base is increased by $43,000 in fiscal year 2018 and by $150,000 in fiscal year 2019. new text end

new text begin (d) Continuing Care new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 32,950,000 new text end new text begin 29,924,000 new text end
new text begin State Government Special Revenue new text end new text begin 125,000 new text end new text begin 125,000 new text end

new text begin Training of Direct Support Services Providers. $250,000 in fiscal year 2017 is for training of individual providers of direct support services as defined in Minnesota Statutes, section 256B.0711, subdivision 1. This appropriation is only available if the labor agreement between the state of Minnesota and the Service Employees International Union Healthcare Minnesota under Minnesota Statutes, section 179A.54, is approved under Minnesota Statutes, sections 3.855 and 179A.22. new text end

new text begin new text begin Deaf and Hard-of-Hearing Services Division. new text end $650,000 in fiscal year 2016 and $500,000 in fiscal year 2017 are from the general fund for the Deaf and Hard-of-Hearing Services Division under Minnesota Statutes, section 256C.233. This is a onetime appropriation. The funds must be used: new text end

new text begin (1) to provide linguistically and culturally appropriate mental health services; new text end

new text begin (2) to ensure that each regional advisory committee meets at least quarterly; new text end

new text begin (3) to increase the number of deafblind Minnesotans receiving services; new text end

new text begin (4) to conduct an analysis of how the regional offices and staff are operated, in consultation with the Commission of Deaf, DeafBlind, and Hard of Hearing Minnesotans; new text end

new text begin (5) during fiscal year 2016, to provide direct services to clients and purchase additional technology for the technology labs; and new text end

new text begin (6) to conduct an analysis of whether deafblind services are being provided in the best and most efficient way possible, with input from deafblind Minnesotans receiving services. new text end

new text begin new text begin Nursing Facilities.new text end $890,000 in fiscal year 2016 is from the general fund for the nursing facility property rate setting appraisals and study. This is a onetime appropriation. new text end

new text begin Base Level Adjustment. The general fund base is decreased by $174,000 in fiscal year 2018 and by $234,000 in fiscal year 2019. new text end

new text begin (e) Chemical and Mental Health new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 7,058,000 new text end new text begin 7,240,000 new text end
new text begin Lottery Prize new text end new text begin 160,000 new text end new text begin 163,000 new text end

new text begin Base Level Adjustment. The general fund base is decreased by $301,000 in fiscal year 2018 and is decreased by $354,000 in fiscal year 2019. new text end

new text begin Subd. 4. new text end

new text begin Forecasted Programs new text end

new text begin The amounts that may be spent from this appropriation for each purpose are as follows: new text end

new text begin (a) MFIP/DWP new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 93,620,000 new text end new text begin 98,452,000 new text end
new text begin Federal TANF new text end new text begin 85,266,000 new text end new text begin 80,971,000 new text end
new text begin (b) MFIP Child Care Assistance new text end new text begin 101,315,000 new text end new text begin 108,521,000 new text end
new text begin (c) General Assistance new text end new text begin 55,117,000 new text end new text begin 57,847,000 new text end

new text begin General Assistance Standard. The commissioner shall set the monthly standard of assistance for general assistance units consisting of an adult recipient who is childless and unmarried or living apart from parents or a legal guardian at $203. The commissioner may reduce this amount according to Laws 1997, chapter 85, article 3, section 54. new text end

new text begin Emergency General Assistance. The amount appropriated for emergency general assistance is limited to no more than $6,729,812 in fiscal year 2016 and $6,729,812 in fiscal year 2017. Funds to counties shall be allocated by the commissioner using the allocation method under Minnesota Statutes, section 256D.06. new text end

new text begin (d) Minnesota Supplemental Aid new text end new text begin 39,668,000 new text end new text begin 41,169,000 new text end
new text begin (e) Group Residential Housing new text end new text begin 155,753,000 new text end new text begin 167,194,000 new text end
new text begin (f) Northstar Care for Children new text end new text begin 41,096,000 new text end new text begin 46,337,000 new text end
new text begin (g) MinnesotaCare new text end new text begin 361,114,000 new text end new text begin 387,081,000 new text end

new text begin This appropriation is from the health care access fund. new text end

new text begin (h) Medical Assistance new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 4,468,089,000 new text end new text begin 4,977,237,000 new text end
new text begin Health Care Access new text end new text begin 650,139,000 new text end new text begin 288,224,000 new text end

new text begin Behavioral Health Services. new text end new text begin $1,000,000 each fiscal year is for behavioral health services provided by hospitals identified under Minnesota Statutes, section 256.969, subdivision 2b, paragraph (a), clause (4). The increase in payments shall be made by increasing the adjustment under Minnesota Statutes, section 256.969, subdivision 2b, paragraph (e), clause (2). new text end

new text begin Base Adjustment. The health care access fund base for medical assistance is decreased by $30,917,000 in fiscal year 2018 and by $16,108,000 in fiscal year 2019. new text end

new text begin (i) Alternative Care new text end new text begin 43,997,000 new text end new text begin 43,590,000 new text end

new text begin Alternative Care Transfer. Any money allocated to the alternative care program that is not spent for the purposes indicated does not cancel but must be transferred to the medical assistance account. new text end

new text begin (j) Chemical Dependency Treatment Fund new text end new text begin 83,868,000 new text end new text begin 86,962,000 new text end

new text begin Subd. 5. new text end

new text begin Grant Programs new text end

new text begin The amounts that may be spent from this appropriation for each purpose are as follows: new text end

new text begin (a) Support Services Grants new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 13,133,000 new text end new text begin 8,715,000 new text end
new text begin Federal TANF new text end new text begin 96,311,000 new text end new text begin 96,311,000 new text end
new text begin (b) Basic Sliding Fee Child Care Assistance Grants new text end new text begin 48,439,000 new text end new text begin 51,559,000 new text end

new text begin Basic Sliding Fee Waiting List Allocation. Notwithstanding Minnesota Statutes, section 119B.03, $5,413,000 in fiscal year 2016 is to reduce the basic sliding fee program waiting list as follows: new text end

new text begin (1) The calendar year 2016 allocation shall be increased to serve families on the waiting list. To receive funds appropriated for this purpose, a county must have: new text end

new text begin (i) a waiting list in the most recent published waiting list month; new text end

new text begin (ii) an average of at least ten families on the most recent six months of published waiting list; and new text end

new text begin (iii) total expenditures in calendar year 2014 that met or exceeded 80 percent of the county's available final allocation. new text end

new text begin (2) Funds shall be distributed proportionately based on the average of the most recent six months of published waiting lists to counties that meet the criteria in clause (1). new text end

new text begin (3) Allocations in calendar years 2017 and beyond shall be calculated using the allocation formula in Minnesota Statutes, section 119B.03. new text end

new text begin (4) The guaranteed floor for calendar year 2017 shall be based on the revised calendar year 2016 allocation. new text end

new text begin Base Level Adjustment. The general fund base is increased by $810,000 in fiscal year 2018 and increased by $821,000 in fiscal year 2019. new text end

new text begin (c) Child Care Development Grants new text end new text begin 1,737,000 new text end new text begin 1,737,000 new text end
new text begin (d) Child Support Enforcement Grants new text end new text begin 50,000 new text end new text begin 50,000 new text end
new text begin (e) Children's Services Grants new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 39,015,000 new text end new text begin 38,665,000 new text end
new text begin Federal TANF new text end new text begin 140,000 new text end new text begin 140,000 new text end

new text begin Safe Place for Newborns. new text end new text begin $350,000 from the general fund in fiscal year 2016 is to distribute information on the Safe Place for Newborns law in Minnesota to increase public awareness of the law. This is a onetime appropriation. new text end

new text begin Child Protection. new text end new text begin $23,350,000 in fiscal year 2016 and $23,350,000 in fiscal year 2017 are to address child protection staffing and services under Minnesota Statutes, section 256M.41. $1,650,000 in fiscal year 2016 and $1,650,000 in fiscal year 2017 are for child protection grants to address child welfare disparities under Minnesota Statutes, section 256E.28. new text end

new text begin Title IV-E Adoption Assistance. Additional federal reimbursement to the state as a result of the Fostering Connections to Success and Increasing Adoptions Act's expanded eligibility for title IV-E adoption assistance is appropriated to the commissioner for postadoption services, including a parent-to-parent support network. new text end

new text begin Adoption Assistance Incentive Grants. Federal funds available during fiscal years 2016 and 2017 for adoption incentive grants are appropriated to the commissioner for postadoption services, including a parent-to-parent support network. new text end

new text begin (f) Children and Community Service Grants new text end new text begin 56,301,000 new text end new text begin 56,301,000 new text end
new text begin (g) Children and Economic Support Grants new text end new text begin 26,778,000 new text end new text begin 26,966,000 new text end

new text begin new text begin Mobile Food Shelf Grants.new text end (a) $1,000,000 in fiscal year 2016 and $1,000,000 in fiscal year 2017 are for a grant to Hunger Solutions. This is a onetime appropriation and is available until June 30, 2017. new text end

new text begin (b) Hunger Solutions shall award grants of up to $75,000 on a competitive basis. Grant applications must include: new text end

new text begin (1) the location of the project; new text end

new text begin (2) a description of the mobile program, including size and scope; new text end

new text begin (3) evidence regarding the unserved or underserved nature of the community in which the project is to be located; new text end

new text begin (4) evidence of community support for the project; new text end

new text begin (5) the total cost of the project; new text end

new text begin (6) the amount of the grant request and how funds will be used; new text end

new text begin (7) sources of funding or in-kind contributions for the project that will supplement any grant award; new text end

new text begin (8) a commitment to mobile programs by the applicant and an ongoing commitment to maintain the mobile program; and new text end

new text begin (9) any additional information requested by Hunger Solutions. new text end

new text begin (c) Priority may be given to applicants who: new text end

new text begin (1) serve underserved areas; new text end

new text begin (2) create a new or expand an existing mobile program; new text end

new text begin (3) serve areas where a high amount of need is identified; new text end

new text begin (4) provide evidence of strong support for the project from citizens and other institutions in the community; new text end

new text begin (5) leverage funding for the project from other private and public sources; and new text end

new text begin (6) commit to maintaining the program on a multilayer basis. new text end

new text begin Homeless Youth Act. Of this appropriation, at least $500,000 must be awarded to providers in greater Minnesota, with at least 25 percent of this amount for new applicant providers. The commissioner shall provide outreach and technical assistance to greater Minnesota providers and new providers to encourage responding to the request for proposals. new text end

new text begin new text begin Stearns County Veterans Housing. new text end $85,000 in fiscal year 2016 and $85,000 in fiscal year 2017 are for a grant to Stearns County to provide administrative funding in support of a service provider serving veterans in Stearns County. The administrative funding grant may be used to support group residential housing services, corrections-related services, veteran services, and other social services related to the service provider serving veterans in Stearns County. new text end

new text begin new text begin Safe Harbor.new text end $800,000 in fiscal year 2016 and $800,000 in fiscal year 2017 are from the general fund for emergency shelter and transitional and long-term housing beds for sexually exploited youth and youth at risk of sexual exploitation. Of this appropriation, $150,000 in fiscal year 2016 and $150,000 in fiscal year 2017 are from the general fund for statewide youth outreach workers connecting sexually exploited youth and youth at risk of sexual exploitation with shelter and services. new text end

new text begin Minnesota Food Assistance Program. Unexpended funds for the Minnesota food assistance program for fiscal year 2016 do not cancel but are available for this purpose in fiscal year 2017. new text end

new text begin Base Level Adjustment. The general fund base is decreased by $816,000 in fiscal year 2018 and is decreased by $606,000 in fiscal year 2019. new text end

new text begin (h) Health Care Grants new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 536,000 new text end new text begin 2,482,000 new text end
new text begin Health Care Access new text end new text begin 3,341,000 new text end new text begin 3,465,000 new text end

new text begin Grants for Periodic Data Matching for Medical Assistance and MinnesotaCare. Of the general fund appropriation, $26,000 in fiscal year 2016 and $1,276,000 in fiscal year 2017 are for grants to counties for costs related to periodic data matching for medical assistance and MinnesotaCare recipients under Minnesota Statutes, section 256B.0561. The commissioner must distribute these grants to counties in proportion to each county's number of cases in the prior year in the affected programs. new text end

new text begin Base Level Adjustment. The general fund base is increased by $1,637,000 in fiscal year 2018 and increased by $1,229,000 in fiscal year 2019. new text end

new text begin (i) Other Long-Term Care Grants new text end new text begin 1,551,000 new text end new text begin 3,069,000 new text end

new text begin new text begin Transition Populations. new text end $1,551,000 in fiscal year 2016 and $1,725,000 in fiscal year 2017 are for home and community-based services transition grants to assist in providing home and community-based services and treatment for transition populations under Minnesota Statutes, section 256.478. new text end

new text begin Base Level Adjustment. The general fund base is increased by $156,000 in fiscal year 2018 and by $581,000 in fiscal year 2019. new text end

new text begin (j) Aging and Adult Services Grants new text end new text begin 28,463,000 new text end new text begin 28,162,000 new text end

new text begin new text begin Dementia Grants. new text end $750,000 in fiscal year 2016 and $750,000 in fiscal year 2017 are for the Minnesota Board on Aging for regional and local dementia grants authorized in Minnesota Statutes, section 256.975, subdivision 11. new text end

new text begin (k) Deaf and Hard-of-Hearing Grants new text end new text begin 2,225,000 new text end new text begin 2,375,000 new text end

new text begin Deaf, Deafblind, and Hard-of-Hearing Grants. $350,000 in fiscal year 2016 and $500,000 in fiscal year 2017 are for deaf and hard-of-hearing grants. The funds must be used to increase the number of deafblind Minnesotans receiving services under Minnesota Statutes, section 256C.261, and to provide linguistically and culturally appropriate mental health services to children who are deaf, deafblind, and hard-of-hearing. This is a onetime appropriation. new text end

new text begin new text begin Base Level Adjustment. new text end The general fund base is decreased by $500,000 in fiscal year 2018 and by $500,000 in fiscal year 2019. new text end

new text begin (l) Disabilities Grants new text end new text begin 20,820,000 new text end new text begin 20,858,000 new text end

new text begin new text begin State Quality Council. new text end $573,000 in fiscal year 2016 and $600,000 in fiscal year 2017 are for the State Quality Council to provide technical assistance and monitoring of person-centered outcomes related to inclusive community living and employment. The funding must be used by the State Quality Council to assure a statewide plan for systems change in person-centered planning that will achieve desired outcomes including increased integrated employment and community living. new text end

new text begin (m) Adult Mental Health Grants new text end
new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 69,992,000 new text end new text begin 71,244,000 new text end
new text begin Health Care Access new text end new text begin 1,575,000 new text end new text begin 2,473,000 new text end
new text begin Lottery Prize new text end new text begin 1,733,000 new text end new text begin 1,733,000 new text end

new text begin Funding Usage. Up to 75 percent of a fiscal year's appropriation for adult mental health grants may be used to fund allocations in that portion of the fiscal year ending December 31. new text end

new text begin Culturally Specific Mental Health Services. new text end new text begin $100,000 in fiscal year 2016 is for grants to nonprofit organizations to provide resources and referrals for culturally specific mental health services to Southeast Asian veterans born before 1965 who do not qualify for services available to veterans formally discharged from the United States armed forces. new text end

new text begin new text begin Problem Gambling.new text end $225,000 in fiscal year 2016 and $225,000 in fiscal year 2017 are from the lottery prize fund for a grant to the state affiliate recognized by the National Council on Problem Gambling. The affiliate must provide services to increase public awareness of problem gambling, education, and training for individuals and organizations providing effective treatment services to problem gamblers and their families, and research related to problem gambling. new text end

new text begin Sustainability Grants. $2,125,000 in fiscal year 2016 and $2,125,000 in fiscal year 2017 are for sustainability grants under Minnesota Statutes, section 256B.0622, subdivision 11. new text end

new text begin new text begin Beltrami County Mental Health Services Grant.new text end $1,000,000 in fiscal year 2016 and $1,000,000 in fiscal year 2017 are from the general fund for a grant to Beltrami County to fund the planning and development of a comprehensive mental health services program under article 2, section 41, Comprehensive Mental Health Program in Beltrami County. This is a onetime appropriation. new text end

new text begin new text begin Base Level Adjustment.new text end The general fund base is increased by $723,000 in fiscal year 2018 and by $723,000 in fiscal year 2019. The health care access fund base is decreased by $1,723,000 in fiscal year 2018 and by $1,723,000 in fiscal year 2019. new text end

new text begin (n) Child Mental Health Grants new text end new text begin 23,386,000 new text end new text begin 24,313,000 new text end

new text begin Services and Supports for First Episode Psychosis. $177,000 in fiscal year 2017 is for grants under Minnesota Statutes, section 245.4889, to mental health providers to pilot evidence-based interventions for youth at risk of developing or experiencing a first episode of psychosis and for a public awareness campaign on the signs and symptoms of psychosis. The base for these grants is $236,000 in fiscal year 2018 and $301,000 in fiscal year 2019. new text end

new text begin Adverse Childhood Experiences. The base for grants under Minnesota Statutes, section 245.4889, to children's mental health and family services collaboratives for adverse childhood experiences (ACEs) training grants and for an interactive Web site connection to support ACEs in Minnesota is $363,000 in fiscal year 2018 and $363,000 in fiscal year 2019. new text end

new text begin Funding Usage. Up to 75 percent of a fiscal year's appropriation for child mental health grants may be used to fund allocations in that portion of the fiscal year ending December 31. new text end

new text begin new text begin Base Level Adjustment.new text end The general fund base is increased by $422,000 in fiscal year 2018 and is increased by $487,000 in fiscal year 2019. new text end

new text begin (o) Chemical Dependency Treatment Support Grants new text end new text begin 1,561,000 new text end new text begin 1,561,000 new text end

new text begin Chemical Dependency Prevention. $150,000 in fiscal year 2016 and $150,000 in fiscal year 2017 are for grants to nonprofit organizations to provide chemical dependency prevention programs in secondary schools. When making grants, the commissioner must consider the expertise, prior experience, and outcomes achieved by applicants that have provided prevention programming in secondary education environments. An applicant for the grant funds must provide verification to the commissioner that the applicant has available and will contribute sufficient funds to match the grant given by the commissioner. This is a onetime appropriation. new text end

new text begin Fetal Alcohol Syndrome Grants. $250,000 in fiscal year 2016 and $250,000 in fiscal year 2017 are for grants to be administered by the Minnesota Organization on Fetal Alcohol Syndrome to provide comprehensive, gender-specific services to pregnant and parenting women suspected of or known to use or abuse alcohol or other drugs. This appropriation is for grants to no fewer than three eligible recipients. Minnesota Organization on Fetal Alcohol Syndrome must report to the commissioner of human services annually by January 15 on the grants funded by this appropriation. The report must include measurable outcomes for the previous year, including the number of pregnant women served and the number of toxic-free babies born. new text end

new text begin new text begin Base Level Adjustment. new text end The general fund base is decreased by $150,000 in fiscal year 2018 and by $150,000 in fiscal year 2019. new text end

new text begin Subd. 6. new text end

new text begin DCT State-Operated Services new text end

new text begin new text begin Transfer Authority for State-Operated Services.new text end Money appropriated for state-operated services may be transferred between fiscal years of the biennium with the approval of the commissioner of management and budget. new text end

new text begin The amounts that may be spent from the appropriation for each purpose are as follows: new text end

new text begin (a) DCT State-Operated Services Mental Health new text end new text begin 130,070,000 new text end new text begin 131,795,000 new text end

new text begin new text begin Increased Capacity at AMRTC. new text end $4,108,000 in fiscal year 2016 and $4,108,000 in fiscal year 2017 are to increase the number of staffed beds at the Anoka Regional Treatment Center so that 15 additional beds are available for patients above the number of beds that are available on June 30, 2015. new text end

new text begin Transfer. new text end new text begin Notwithstanding Minnesota Statutes, section 246.18, subdivision 8, the commissioner of human services shall transfer $2,000,000 in fiscal year 2017 from the account under Minnesota Statutes, section 246.18, subdivision 8, in the special revenue fund to the general fund. This is a onetime transfer for repeal of never implemented grants for mental health specialty treatment services. new text end

new text begin Dedicated Receipts Available. Of the revenue received under Minnesota Statutes, section 246.18, subdivision 8, paragraph (a), up to $1,000,000 each year is available for the purposes of Minnesota Statutes, section 246.18, subdivision 8, paragraph (b), clause (1); and up to $2,713,000 each year is available for the purposes of Minnesota Statutes, section 246.18, subdivision 8, paragraph (b), clause (3). new text end

new text begin Transfers from State-Operated Services Account. (a) If the commissioner of human services notifies the commissioner of management and budget by July 31, 2015, that the fiscal year 2015 general fund expenditures exceed the general fund appropriation for state-operated services mental health to the Department of Human Services, notwithstanding Minnesota Statutes, section 246.18, subdivision 8, the commissioner of human services, with the approval of the commissioner of management and budget, shall transfer up to $1,000,000 in fiscal year 2015 from the account under Minnesota Statutes, section 246.18, subdivision 8, in the special revenue fund to the general fund. The amount transferred under this paragraph must not exceed the amount of the fiscal year 2015 negative balance in the general fund appropriation for state-operated services mental health to the Department of Human Services. The amount transferred under this paragraph, up to $1,000,000 in fiscal year 2015, is appropriated from the general fund to the commissioner of human services for state-operated services mental health expenditures. This paragraph is effective the day following final enactment and expires on October 1, 2015. Any amount transferred under this paragraph that is not expended by September 30, 2015, shall cancel to the account from which the amount was transferred. new text end

new text begin (b) If the commissioner of human services notifies the commissioner of management and budget by July 31, 2015, that the balance in fiscal year 2015 in the Minnesota state-operated community services fund is a negative amount, notwithstanding Minnesota Statutes, section 246.18, subdivision 8, the commissioner of human services, with the approval of the commissioner of management and budget, shall transfer up to $3,200,000 in fiscal year 2015 from the account under Minnesota Statutes, section 246.18, subdivision 8, in the special revenue fund to the Minnesota state-operated community services fund. The amount transferred under this paragraph must not exceed the amount of the fiscal year 2015 negative balance in the Minnesota state-operated community services fund. This paragraph is effective the day following final enactment and expires on October 1, 2015. Any amount transferred under this paragraph that is not expended by September 30, 2015, shall cancel to the account from which the amount was transferred. new text end

new text begin Appropriations Retroactive to Fiscal Year 2015. If the commissioner of human services notifies the commissioner of management and budget by July 31, 2015, that the fiscal year 2015 general fund expenditures exceed the general fund appropriation for state-operated services mental health to the Department of Human Services, up to $5,000,000 of this appropriation in fiscal year 2016 may be used in fiscal year 2015 for state-operated services mental health expenditures. The commissioner of human services must report to the commissioner of management and budget the purpose and amount of any expenditures under this paragraph, and the commissioner of management and budget must approve the total amount attributable to this paragraph. This paragraph is effective the day following final enactment and expires on October 1, 2015. new text end

new text begin (b) DCT State-Operated Services Enterprise Services new text end new text begin 9,626,000 new text end new text begin 6,113,000 new text end

new text begin Community Addiction Recovery Enterprise. $9,626,000 in fiscal year 2016 and $6,113,000 in fiscal year 2017 are for the C.A.R.E. program. The commissioner must transfer these amounts to the enterprise fund for the Community Addiction Recovery Enterprise. The base for this purpose is $5,991,000 in fiscal year 2018 and $5,991,000 in fiscal year 2019. new text end

new text begin Transfers from Consolidated Chemical Dependency Treatment Fund. (a) If the commissioner of human services notifies the commissioner of management and budget by July 31, 2015, that the balance in fiscal year 2015 in the community addiction recovery enterprise fund is a negative amount, notwithstanding Minnesota Statutes, section 254B.06, subdivision 1, the commissioner of human services, with the approval of the commissioner of management and budget, shall transfer $2,000,000 in fiscal year 2015 from the consolidated chemical dependency treatment fund account in the special revenue fund to the community addiction recovery enterprise fund. The amount transferred under this paragraph must not exceed the amount of the fiscal year 2015 negative balance in the community addiction recovery enterprise fund. This paragraph is effective the day following final enactment and expires on October 1, 2015. Any amount transferred under this paragraph that is not expended by September 30, 2015, shall cancel to the account from which the amount was transferred. new text end

new text begin (b) If the commissioner of human services notifies the commissioner of management and budget by July 31, 2015, that the fiscal year 2015 general fund expenditures exceed the general fund appropriation for state-operated services mental health to the Department of Human Services, notwithstanding Minnesota Statutes, section 254B.06, subdivision 1, the commissioner of human services, with the approval of the commissioner of management and budget, shall transfer $1,500,000 in fiscal year 2015 from the consolidated chemical dependency treatment fund account in the special revenue fund to the general fund. $1,500,000 in fiscal year 2015 is appropriated from the general fund to the commissioner of human services for state-operated services mental health expenditures. The amount transferred under this paragraph must not exceed the amount of the fiscal year 2015 negative balance in the general fund appropriation for state-operated services mental health to the Department of Human Services. This paragraph is effective the day following final enactment and expires on October 1, 2015. Any amount transferred under this paragraph that is not expended by September 30, 2015, shall cancel to the account from which the amount was transferred. new text end

new text begin new text begin Base Level Adjustment. new text end The general fund base is decreased by $122,000 in fiscal year 2018 and by $122,000 in fiscal year 2019. new text end

new text begin (c) DCT State-Operated Services Minnesota Security Hospital new text end new text begin 81,821,000 new text end new text begin 83,233,000 new text end

new text begin Base Level Adjustment. The general fund base is increased by $17,000 in fiscal year 2018 and by $34,000 in fiscal year 2019. new text end

new text begin Subd. 7. new text end

new text begin DCT Minnesota Sex Offender Program new text end

new text begin 83,686,000 new text end new text begin 84,927,000 new text end

new text begin Transfer Authority for Minnesota Sex Offender Program. Money appropriated for the Minnesota sex offender program may be transferred between fiscal years of the biennium with the approval of the commissioner of management and budget. new text end

new text begin Limited Carryforward Allowed. Notwithstanding any contrary provision in this article, of this appropriation, up to $875,000 in fiscal year 2016 and $2,625,000 in fiscal year 2017 are available until June 30, 2019. new text end

new text begin Minnesota Sex Offender Program. Any funds from the appropriation made by Laws 2014, chapter 312, article 30, section 2, subdivision 6, that are not used for payment of court-ordered costs in compliance with the United States District Court order of February 20, 2014, in the matter of Karsjens et al. v. Jesson et al., including any funds returned by the court that had been deposited with the court but not spent, may be used by the commissioner of human services to offset past and future litigation expenses in the same matter and to comply with any future orders of the United States District Court. new text end

new text begin Subd. 8. new text end

new text begin Technical Activities new text end

new text begin 82,671,000 new text end new text begin 83,427,000 new text end

new text begin This appropriation is from the federal TANF fund. new text end

new text begin Base Level Adjustment. The TANF fund appropriation is increased by $392,000 in fiscal year 2018 and by $80,000 in fiscal year 2019. new text end

Sec. 3.

new text begin COMMISSIONER OF HEALTH new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation new text end

new text begin $ new text end new text begin 188,912,000 new text end new text begin $ new text end new text begin 188,939,000 new text end
new text begin Appropriations by Fund new text end
new text begin 2016 new text end new text begin 2017 new text end
new text begin General new text end new text begin 89,369,000 new text end new text begin 91,357,000 new text end
new text begin State Government Special Revenue new text end new text begin 53,843,000 new text end new text begin 52,448,000 new text end
new text begin Health Care Access new text end new text begin 33,987,000 new text end new text begin 33,421,000 new text end
new text begin Federal TANF new text end new text begin 11,713,000 new text end new text begin 11,713,000 new text end

new text begin The amounts that may be spent for each purpose are specified in the following subdivisions. new text end

new text begin Subd. 2. new text end

new text begin Health Improvement new text end

new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 68,653,000 new text end new text begin 68,984,000 new text end
new text begin State Government Special Revenue new text end new text begin 6,264,000 new text end new text begin 6,182,000 new text end
new text begin Health Care Access new text end new text begin 33,987,000 new text end new text begin 33,421,000 new text end
new text begin Federal TANF new text end new text begin 11,713,000 new text end new text begin 11,713,000 new text end

new text begin Violence Against Asian Women Working Group. new text end new text begin $200,000 in fiscal year 2016 from the general fund is for the working group on violence against Asian women and children. new text end

new text begin MERC Program. new text end new text begin $1,000,000 in fiscal year 2016 and $1,000,000 in fiscal year 2017 are from the general fund for the MERC program under Minnesota Statutes, section 62J.692, subdivision 4. new text end

new text begin Poison Information Center Grants. new text end new text begin $750,000 in fiscal year 2016 and $750,000 in fiscal year 2017 are from the general fund for regional poison information center grants under Minnesota Statutes, section 145.93. new text end

new text begin Advanced Care Planning. new text end new text begin $250,000 in fiscal year 2016 is from the general fund to award a grant to a statewide advance care planning resource organization that has expertise in convening and coordinating community-based strategies to encourage individuals, families, caregivers, and health care providers to begin conversations regarding end-of-life care choices that express an individual's health care values and preferences and are based on informed health care decisions. This is a onetime appropriation. new text end

new text begin Early Dental Prevention Initiatives. new text end new text begin $172,000 in fiscal year 2016 and $140,000 in fiscal year 2017 are for the development and distribution of the early dental prevention initiative under Minnesota Statutes, section 144.3875. new text end

new text begin International Medical Graduate Assistance Program. new text end new text begin (a) $500,000 in fiscal year 2016 and $500,000 in fiscal year 2017 are from the health care access fund for the grant programs and necessary contracts under Minnesota Statutes, section 144.1911, subdivisions 3, paragraph (a), clause (4), and 4 and 5. The commissioner may use up to $133,000 per year of the appropriation for international medical graduate assistance program administration duties in Minnesota Statutes, section 144.1911, subdivisions 3, 9, and 10, and for administering the grant programs under Minnesota Statutes, section 144.1911, subdivisions 4, 5, and 6. The commissioner shall develop recommendations for any additional funding required for initiatives needed to achieve the objectives of Minnesota Statutes, section 144.1911. The commissioner shall report the funding recommendations to the legislature by January 15, 2016, in the report required under Minnesota Statutes, section 144.1911, subdivision 10. The base for this purpose is $1,000,000 in fiscal years 2018 and 2019. new text end

new text begin (b) $500,000 in fiscal year 2016 and $500,000 in fiscal year 2017 are from the health care access fund for transfer to the revolving international medical graduate residency account established in Minnesota Statutes, section 144.1911, subdivision 6. This is a onetime appropriation. new text end

new text begin Federally Qualified Health Centers. new text end new text begin $1,000,000 in fiscal year 2016 and $1,000,000 in fiscal year 2017 are from the general fund to provide subsidies to federally qualified health centers under Minnesota Statutes, section 145.9269. This is a onetime appropriation. new text end

new text begin Organ Donation. new text end new text begin $200,000 in fiscal year 2016 is from the general fund to establish a grant program to develop and create culturally appropriate outreach programs that provide education about the importance of organ donation. Grants shall be awarded to a federally designated organ procurement organization and hospital system that performs transplants. This is a onetime appropriation. new text end

new text begin Primary Care Residency. new text end new text begin $1,500,000 in fiscal year 2016 and $1,500,000 in fiscal year 2017 are from the general fund for the purposes of the primary care residency expansion grant program under Minnesota Statutes, section 144.1506. new text end

new text begin Somali Women's Health Pilot Program. new text end new text begin (a) The commissioner of health shall establish a pilot program between one or more federally qualified health centers, as defined under Minnesota Statutes, section 145.9269, a nonprofit organization that helps Somali women, and the Minnesota Evaluation Studies Institute, to develop a promising strategy to address the preventative and primary health care needs of, and address health inequities experienced by, first generation Somali women. The pilot program must collaboratively develop a patient flow process for first generation Somali women by: new text end

new text begin (1) addressing and identifying clinical and cultural barriers to Somali women accessing preventative and primary care, including, but not limited to, cervical and breast cancer screenings; new text end

new text begin (2) developing a culturally appropriate health curriculum for Somali women based on the outcomes from the community-based participatory research report "Cultural Traditions and the Reproductive Health of Somali Refugees and Immigrants" to increase the health literacy of Somali women and develop culturally specific health care information; and new text end

new text begin (3) training the federally qualified health center's providers and staff to enhance provider and staff cultural competence regarding the cultural barriers, including female genital cutting. new text end

new text begin (b) The pilot program must develop a process that results in increased screening rates for cervical and breast cancer and can be replicated by other providers serving ethnic minorities. The pilot program must conduct an evaluation of the new patient flow process used by Somali women to access federally qualified health centers services. new text end

new text begin (c) The pilot program must report the outcomes to the commissioner by June 30, 2017. new text end

new text begin (d) $110,000 in fiscal year 2016 is for the Somali women's health pilot program. Of this appropriation, the commissioner may use up to $10,000 to administer the program. This appropriation is available until June 30, 2017. This is a onetime appropriation. new text end

new text begin new text begin Menthol Cigarette Usage in African-American Community Intervention Grants.new text end Of the health care access fund appropriation for the statewide health improvement program, $200,000 in fiscal year 2016 is for at least one grant that must be awarded by the commissioner to implement strategies and interventions to reduce the disproportionately high usage of cigarettes by African-Americans, especially the use of menthol-flavored cigarettes, as well as the disproportionate harm tobacco causes in that community. The grantee shall engage members of the African-American community and community-based organizations. This grant shall be awarded as part of the statewide health improvement program grants awarded on November 1, 2015, and must meet the requirements of Minnesota Statutes, section 145.986. new text end

new text begin Targeted Home Visiting System. (a) $75,000 in fiscal year 2016 is for the commissioner of health, in consultation with the commissioners of human services and education, community health boards, tribal nations, and other home visiting stakeholders, to design baseline training for new home visitors to ensure statewide coordination across home visiting programs. new text end

new text begin (b) $575,000 in fiscal year 2016 and $2,000,000 fiscal year 2017 are to provide grants to community health boards and tribal nations for start-up grants for new nurse-family partnership programs and for grants to expand existing programs to serve first-time mothers, prenatally by 28 weeks gestation until the child is two years of age, who are eligible for medical assistance under Minnesota Statutes, chapter 256B, or the federal Special Supplemental Nutrition Program for Women, Infants, and Children. The commissioner shall award grants to community health boards or tribal nations in metropolitan and rural areas of the state. Priority for all grants shall be given to nurse-family partnership programs that provide services through a Minnesota health care program-enrolled provider that accepts medical assistance. Additionally, priority for grants to rural areas shall be given to community health boards and tribal nations that expand services within regional partnerships that provide the nurse-family partnership program. Funding available under this paragraph may only be used to supplement, not to replace, funds being used for nurse-family partnership home visiting services as of June 30, 2015. new text end

new text begin new text begin Opiate Antagonists. new text end $270,000 in fiscal year 2016 and $20,000 in fiscal year 2017 are from the general fund for grants to the eight regional emergency medical services programs to purchase opiate antagonists and educate and train emergency medical services persons, as defined in Minnesota Statutes, section 144.7401, subdivision 4, clauses (1) and (2), in the use of these antagonists in the event of an opioid or heroin overdose. For the purposes of this paragraph, "opiate antagonist" means naloxone hydrochloride or any similarly acting drug approved by the federal Food and Drug Administration for the treatment of drug overdose. Grants under this paragraph must be distributed to all eight regional emergency medical services programs. This is a onetime appropriation and is available until June 30, 2017. The commissioner may use up to $20,000 of the amount for opiate antagonists for administration. new text end

new text begin Local and Tribal Public Health Grants. (a) $894,000 in fiscal year 2016 and $894,000 in fiscal year 2017 are for an increase in local public health grants for community health boards under Minnesota Statutes, section 145A.131, subdivision 1, paragraph (e). new text end

new text begin (b) $106,000 in fiscal year 2016 and $106,000 in fiscal year 2017 are for an increase in special grants to tribal governments under Minnesota Statutes, section 145A.14, subdivision 2a. new text end

new text begin HCBS Employee Scholarships. new text end new text begin $1,000,000 in fiscal year 2016 and $1,000,000 in fiscal year 2017 are from the general fund for the home and community-based services employee scholarship program under Minnesota Statutes, section 144.1503. The commissioner may use up to $50,000 of the amount for the HCBS employee scholarships for administration. new text end

new text begin Family Planning Special Projects. $1,000,000 in fiscal year 2016 and $1,000,000 in fiscal year 2017 are from the general fund for family planning special project grants under Minnesota Statutes, section 145.925. new text end

new text begin Positive Alternatives. $1,000,000 in fiscal year 2016 and $1,000,000 in fiscal year 2017 are from the general fund for positive abortion alternatives under Minnesota Statutes, section 145.4235. new text end

new text begin Safe Harbor for Sexually Exploited Youth. $700,000 in fiscal year 2016 and $700,000 in fiscal year 2017 are from the general fund for the safe harbor program under Minnesota Statutes, sections 145.4716 to 145.4718. Funds shall be used for grants to increase the number of regional navigators; training for professionals who engage with exploited or at-risk youth; implementing statewide protocols and best practices for effectively identifying, interacting with, and referring sexually exploited youth to appropriate resources; and program operating costs. new text end

new text begin Health Care Grants for Uninsured Individuals. (a) $125,000 in fiscal year 2016 and $125,000 in fiscal year 2017 are from the general fund for dental provider grants in Minnesota Statutes, section 145.929, subdivision 1. new text end

new text begin (b) $437,500 in fiscal year 2016 and $437,500 in fiscal year 2017 are from the general fund for community mental health program grants in Minnesota Statutes, section 145.929, subdivision 2. new text end

new text begin (c) $1,500,000 in fiscal year 2016 and $1,500,000 in fiscal year 2017 are from the general fund for the emergency medical assistance outlier grant program in Minnesota Statutes, section 145.929, subdivision 3. new text end

new text begin (d) $437,500 of the general fund appropriation in fiscal years 2016 and 2017 is for community health center grants under Minnesota Statutes, section 145.9269. A community health center that receives a grant from this appropriation is not eligible for a grant under paragraph (b). new text end

new text begin (e) The commissioner may use up to $25,000 of the appropriations for health care grants for uninsured individuals in fiscal years 2016 and 2017 for grant administration. new text end

new text begin new text begin TANF Appropriations.new text end (a) $1,156,000 of the TANF funds is appropriated each year of the biennium to the commissioner for family planning grants under Minnesota Statutes, section 145.925. new text end

new text begin (b) $3,579,000 of the TANF funds is appropriated each year of the biennium to the commissioner for home visiting and nutritional services listed under Minnesota Statutes, section 145.882, subdivision 7, clauses (6) and (7). Funds must be distributed to community health boards according to Minnesota Statutes, section 145A.131, subdivision 1. new text end

new text begin (c) $2,000,000 of the TANF funds is appropriated each year of the biennium to the commissioner for decreasing racial and ethnic disparities in infant mortality rates under Minnesota Statutes, section 145.928, subdivision 7. new text end

new text begin (d) $4,978,000 of the TANF funds is appropriated each year of the biennium to the commissioner for the family home visiting grant program according to Minnesota Statutes, section 145A.17. $4,000,000 of the funding must be distributed to community health boards according to Minnesota Statutes, section 145A.131, subdivision 1. $978,000 of the funding must be distributed to tribal governments as provided in Minnesota Statutes, section 145A.14, subdivision 2a. new text end

new text begin (e) The commissioner may use up to 6.23 percent of the funds appropriated each fiscal year to conduct the ongoing evaluations required under Minnesota Statutes, section 145A.17, subdivision 7, and training and technical assistance as required under Minnesota Statutes, section 145A.17, subdivisions 4 and 5. new text end

new text begin new text begin TANF Carryforward.new text end Any unexpended balance of the TANF appropriation in the first year of the biennium does not cancel but is available for the second year. new text end

new text begin Health Professional Loan Forgiveness. $2,631,000 in fiscal year 2016 and $2,631,000 in fiscal year 2017 are from the general fund for the purposes of Minnesota Statutes, section 144.1501. Of this appropriation, the commissioner may use up to $131,000 each year to administer the program. new text end

new text begin Minnesota Stroke System. $350,000 in fiscal year 2016 and $350,000 in fiscal year 2017 are from the general fund for the Minnesota stroke system. new text end

new text begin Prevention of Violence in Health Care. new text end new text begin $50,000 in fiscal year 2016 is to continue the prevention of violence in health care program and creating violence prevention resources for hospitals and other health care providers to use in training their staff on violence prevention. This is a onetime appropriation and is available until June 30, 2017. new text end

new text begin new text begin Health Care Savings Determinations. new text end (a) The health care access fund base for the state health improvement program is decreased by $261,000 in fiscal year 2016 and decreased by $110,000 in fiscal year 2017. new text end

new text begin (b) $261,000 in fiscal year 2016 and $110,000 in fiscal year 2017 are from the health care access fund for the forecasting, cost reporting, and analysis required by Minnesota Statutes, section 62U.10, subdivisions 6 and 7. new text end

new text begin Base Level Adjustments. The general fund base is decreased by $1,070,000 in fiscal year 2018 and by $1,020,000 in fiscal year 2019. The state government special revenue fund base is increased by $33,000 in fiscal year 2018. The health care access fund base is increased by $610,000 in fiscal year 2018 and by $23,000 in fiscal year 2019. new text end

new text begin Subd. 3. new text end

new text begin Health Protection new text end

new text begin Appropriations by Fund new text end
new text begin General new text end new text begin 12,506,000 new text end new text begin 14,149,000 new text end
new text begin State Government Special Revenue new text end new text begin 47,579,000 new text end new text begin 46,266,000 new text end

new text begin Base Level Adjustments. The state government special revenue fund base is increased by $322,000 in fiscal year 2018 and by $300,000 in fiscal year 2019. new text end

new text begin Subd. 4. new text end

new text begin Administrative Support Services new text end

new text begin 8,210,000 new text end new text begin 8,224,000 new text end

Sec. 4.

new text begin HEALTH-RELATED BOARDS new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation new text end

new text begin $ new text end new text begin 19,707,000 new text end new text begin $ new text end new text begin 19,597,000 new text end

new text begin This appropriation is from the state government special revenue fund. The amounts that may be spent for each purpose are specified in the following subdivisions. new text end

new text begin Subd. 2. new text end

new text begin Board of Chiropractic Examiners new text end

new text begin 507,000 new text end new text begin 513,000 new text end

new text begin Subd. 3. new text end

new text begin Board of Dentistry new text end

new text begin 2,192,000 new text end new text begin 2,206,000 new text end

new text begin This appropriation includes $864,000 in fiscal year 2016 and $878,000 in fiscal year 2017 for the health professional services program. new text end

new text begin Subd. 4. new text end

new text begin Board of Dietetics and Nutrition Practice new text end

new text begin 113,000 new text end new text begin 115,000 new text end

new text begin Subd. 5. new text end

new text begin Board of Marriage and Family Therapy new text end

new text begin 234,000 new text end new text begin 237,000 new text end

new text begin Subd. 6. new text end

new text begin Board of Medical Practice new text end

new text begin 3,933,000 new text end new text begin 3,962,000 new text end

new text begin Subd. 7. new text end

new text begin Board of Nursing new text end

new text begin 4,189,000 new text end new text begin 4,243,000 new text end

new text begin Subd. 8. new text end

new text begin Board of Nursing Home Administrators new text end

new text begin 2,365,000 new text end new text begin 2,062,000 new text end

new text begin Administrative Services Unit - Operating Costs. Of this appropriation, $1,482,000 in fiscal year 2016 and $1,497,000 in fiscal year 2017 are for operating costs of the administrative services unit. The administrative services unit may receive and expend reimbursements for services performed by other agencies. new text end

new text begin Administrative Services Unit - Volunteer Health Care Provider Program. Of this appropriation, $150,000 in fiscal year 2016 and $150,000 in fiscal year 2017 are to pay for medical professional liability coverage required under Minnesota Statutes, section 214.40. new text end

new text begin Administrative Services Unit - Retirement Costs. Of this appropriation, $320,000 in fiscal year 2016 is a onetime appropriation to the administrative services unit to pay for the retirement costs of health-related board employees. This funding may be transferred to the health board incurring the retirement costs. These funds are available either year of the biennium. new text end

new text begin Administrative Services Unit - Contested Cases and Other Legal Proceedings. Of this appropriation, $200,000 in fiscal year 2016 and $200,000 in fiscal year 2017 are for costs of contested case hearings and other unanticipated costs of legal proceedings involving health-related boards funded under this section. Upon certification by a health-related board to the administrative services unit that the costs will be incurred and that there is insufficient money available to pay for the costs out of money currently available to that board, the administrative services unit is authorized to transfer money from this appropriation to the board for payment of those costs with the approval of the commissioner of management and budget. The commissioner of management and budget must require any board that has an unexpended balance for an amount transferred under this paragraph to transfer the unexpended amount to the administrative services unit to be deposited in the state government special revenue fund. new text end

new text begin Subd. 9. new text end

new text begin Board of Optometry new text end

new text begin 138,000 new text end new text begin 143,000 new text end

new text begin Subd. 10. new text end

new text begin Board of Pharmacy new text end

new text begin 2,847,000 new text end new text begin 2,888,000 new text end

new text begin Subd. 11. new text end

new text begin Board of Physical Therapy new text end

new text begin 354,000 new text end new text begin 359,000 new text end

new text begin Subd. 12. new text end

new text begin Board of Podiatry new text end

new text begin 78,000 new text end new text begin 79,000 new text end

new text begin Subd. 13. new text end

new text begin Board of Psychology new text end

new text begin 874,000 new text end new text begin 884,000 new text end

new text begin Subd. 14. new text end

new text begin Board of Social Work new text end

new text begin 1,141,000 new text end new text begin 1,155,000 new text end

new text begin Subd. 15. new text end

new text begin Board of Veterinary Medicine new text end

new text begin 262,000 new text end new text begin 265,000 new text end

new text begin Subd. 16. new text end

new text begin Board of Behavioral Health and Therapy new text end

new text begin 480,000 new text end new text begin 486,000 new text end

Sec. 5.

new text begin EMERGENCY MEDICAL SERVICES REGULATORY BOARD new text end

new text begin $ new text end new text begin 2,904,000 new text end new text begin $ new text end new text begin 3,037,000 new text end

new text begin Cooper/Sams Volunteer Ambulance Program. $700,000 in fiscal year 2016 and $700,000 in fiscal year 2017 are for the Cooper/Sams volunteer ambulance program under Minnesota Statutes, section 144E.40. new text end

new text begin (a) Of this amount, $611,000 in fiscal year 2016 and $611,000 in fiscal year 2017 are for the ambulance service personnel longevity award and incentive program under Minnesota Statutes, section 144E.40. new text end

new text begin (b) Of this amount, $89,000 in fiscal year 2016 and $89,000 in fiscal year 2017 are for the operations of the ambulance service personnel longevity award and incentive program under Minnesota Statutes, section 144E.40. new text end

new text begin Ambulance Training Grant. $361,000 in fiscal year 2016 and $361,000 in fiscal year 2017 are for training grants. new text end

new text begin EMSRB Board Operations. $1,226,000 in fiscal year 2016 and $1,360,000 in fiscal year 2017 are for board operations. new text end

new text begin new text begin Regional Grants.new text end $585,000 in fiscal year 2016 and $585,000 in fiscal year 2017 are for regional emergency medical services programs, to be distributed equally to the eight emergency medical service regions. new text end

Sec. 6.

new text begin COUNCIL ON DISABILITY new text end

new text begin $ new text end new text begin 622,000 new text end new text begin $ new text end new text begin 629,000 new text end

Sec. 7.

new text begin OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES new text end

new text begin $ new text end new text begin 1,917,000 new text end new text begin $ new text end new text begin 2,032,000 new text end

Sec. 8.

new text begin OMBUDSPERSONS FOR FAMILIES new text end

new text begin $ new text end new text begin 392,000 new text end new text begin $ new text end new text begin 453,000 new text end

Sec. 9.

new text begin COMMISSIONER OF COMMERCE new text end

new text begin $ new text end new text begin 210,000 new text end new text begin $ new text end new text begin 213,000 new text end

new text begin The commissioner of commerce shall develop a proposal to allow individuals to purchase qualified health plans outside of MNsure directly from health plan companies and to allow eligible individuals to receive advanced premium tax credits and cost-sharing reductions when purchasing qualified health plans outside of MNsure. new text end

Sec. 10.

new text begin APPROPRIATION. new text end

new text begin $455,000,000 is appropriated in fiscal year 2015 from the general fund to the commissioner of human services. The commissioner of human services must transfer $455,000,000 from the general fund to the health care access fund by June 30, 2015. 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. 11.

Minnesota Statutes 2014, section 256.01, is amended by adding a subdivision to read:

new text begin Subd. 40. new text end

new text begin Nonfederal share transfers. new text end

new text begin The nonfederal share of activities for which federal administrative reimbursement is appropriated to the commissioner may be transferred to the special revenue fund. new text end

Sec. 12.

new text begin TRANSFERS. new text end

new text begin Subdivision 1. new text end

new text begin Grants. new text end

new text begin The commissioner of human services, with the approval of the commissioner of management and budget, may transfer unencumbered appropriation balances for the biennium ending June 30, 2017, within fiscal years among the MFIP, general assistance, general assistance medical care under Minnesota Statutes 2009 Supplement, section 256D.03, subdivision 3, medical assistance, MinnesotaCare, MFIP child care assistance under Minnesota Statutes, section 119B.05, Minnesota supplemental aid, and group residential housing programs, the entitlement portion of Northstar Care for Children under Minnesota Statutes, chapter 256N, and the entitlement portion of the chemical dependency consolidated treatment fund, and between fiscal years of the biennium. The commissioner shall inform the chairs and ranking minority members of the senate Health and Human Services Finance Division and the house of representatives Health and Human Services Finance Committee quarterly about transfers made under this subdivision. new text end

new text begin Subd. 2. new text end

new text begin Administration. new text end

new text begin Positions, salary money, and nonsalary administrative money may be transferred within the Departments of Health and Human Services as the commissioners consider necessary, with the advance approval of the commissioner of management and budget. The commissioner shall inform the chairs and ranking minority members of the senate Health and Human Services Finance Division and the house of representatives Health and Human Services Finance Committee quarterly about transfers made under this subdivision. new text end

Sec. 13.

new text begin INDIRECT COSTS NOT TO FUND PROGRAMS. new text end

new text begin The commissioners of health and human services shall not use indirect cost allocations to pay for the operational costs of any program for which they are responsible. new text end

Sec. 14.

new text begin EXPIRATION OF UNCODIFIED LANGUAGE. new text end

new text begin All uncodified language contained in this article expires on June 30, 2017, unless a different expiration date is explicit. new text end

Sec. 15.

new text begin EFFECTIVE DATE. new text end

new text begin This article is effective July 1, 2015, unless a different effective date is specified. new text end

Presented to the governor May 20, 2015

Signed by the governor May 22, 2015, 11:03 a.m.

Official Publication of the State of Minnesota
Revisor of Statutes