1.1 	A bill for an act
1.2 	relating to human services; modifying provisions related to continuing care; 
1.3 	redesigning home and community-based services; modifying provisions related 
1.4 	to nursing facility admission and maltreatment; establishing community first 
1.5 	services and supports; requiring a study;amending Minnesota Statutes 2012, 
1.6 	sections 144.0724, subdivision 4; 144A.351; 148E.065, subdivision 4a; 256.01, 
1.7 	subdivisions 2, 24; 256.975, subdivision 7, by adding subdivisions; 256.9754, 
1.8 	subdivision 5, by adding subdivisions; 256B.021, by adding subdivisions; 
1.9 	256B.0911, subdivisions 1, 1a, 3a, 4d, 7, by adding a subdivision; 256B.0913, 
1.10 	subdivision 4, by adding a subdivision; 256B.0915, subdivisions 3a, 5, by 
1.11 	adding a subdivision; 256B.0917, subdivisions 6, 13, by adding subdivisions; 
1.12 	256B.092, by adding a subdivision; 256B.439, subdivisions 1, 2, 3, 4, by adding 
1.13 	a subdivision; 256B.49, subdivisions 12, 14, by adding a subdivision; 256I.05, by 
1.14 	adding a subdivision; 626.557, subdivisions 4, 9, 9e; proposing coding for new 
1.15 	law in Minnesota Statutes, chapter 256B; repealing Minnesota Statutes 2012, 
1.16 	sections 245A.655; 256B.0911, subdivisions 4a, 4b, 4c; 256B.0917, subdivisions 
1.17 	1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 14.
1.18 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.19 	Section 1. Minnesota Statutes 2012, section 144.0724, subdivision 4, is amended to read:
1.20 		Subd. 4.Resident assessment schedule. (a) A facility must conduct and 
1.21 	electronically submit to the commissioner of health case mix assessments that conform 
1.22 	with the assessment schedule defined by Code of Federal Regulations, title 42, section 
1.23 	483.20, and published by the United States Department of Health and Human Services, 
1.24 	Centers for Medicare and Medicaid Services, in the Long Term Care Assessment 
1.25 	Instrument User's Manual, version 3.0, and subsequent updates when issued by the 
1.26 	Centers for Medicare and Medicaid Services. The commissioner of health may substitute 
1.27 	successor manuals or question and answer documents published by the United States 
1.28 	Department of Health and Human Services, Centers for Medicare and Medicaid Services, 
1.29 	to replace or supplement the current version of the manual or document.
2.1 	(b) The assessments used to determine a case mix classification for reimbursement 
2.2 	include the following:
2.3 	(1) a new admission assessment must be completed by day 14 following admission;
2.4 	(2) an annual assessment which must have an assessment reference date (ARD) 
2.5 	within 366 days of the ARD of the last comprehensive assessment;
2.6 	(3) a significant change assessment must be completed within 14 days of the 
2.7 	identification of a significant change; and
2.8 	(4) all quarterly assessments must have an assessment reference date (ARD) within 
2.9 	92 days of the ARD of the previous assessment.
2.10 	(c) In addition to the assessments listed in paragraph (b), the assessments used to 
2.11 	determine nursing facility level of care include the following:
2.12 	(1) preadmission screening completed under section ~~256B.0911, subdivision 4a, by a~~ 
2.13 	~~county, tribe, or managed care organization under contract with the Department of Human~~ 
2.14 	~~Services~~ 256.975, subdivision 7a, by the Senior LinkAge Line or Disability Linkage Line 
2.15 	or other organization under contract with the Minnesota Board on Aging; and
2.16 	(2) a nursing facility level of care determination as provided for under section 
2.17 	256B.0911, subdivision 4e, as part of a face-to-face long-term care consultation assessment 
2.18 	completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or 
2.19 	managed care organization under contract with the Department of Human Services.

2.20 	Sec. 2. Minnesota Statutes 2012, section 144A.351, is amended to read:
2.21 	144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS: 
2.22 	REPORT AND STUDY REQUIRED.
2.23 		Subdivision 1.Report requirements. The commissioners of health and human 
2.24 	services, with the cooperation of counties and in consultation with stakeholders, including 
2.25 	persons who need or are using long-term care services and supports, lead agencies, 
2.26 	regional entities, senior, disability, and mental health organization representatives, service 
2.27 	providers, and community members shall prepare a report to the legislature by August 15, 
2.28 	2013, and biennially thereafter, regarding the status of the full range of long-term care 
2.29 	services and supports for the elderly and children and adults with disabilities and mental 
2.30 	illnesses in Minnesota. The report shall address:
2.31 	(1) demographics and need for long-term care services and supports in Minnesota;
2.32 	(2) summary of county and regional reports on long-term care gaps, surpluses, 
2.33 	imbalances, and corrective action plans;
2.34 	(3) status of long-term care services and related mental health services, housing 
2.35 	options, and supports by county and region including:
3.1 	(i) changes in availability of the range of long-term care services and housing options;
3.2 	(ii) access problems, including access to the least restrictive and most integrated 
3.3 	services and settings, regarding long-term care services; and
3.4 	(iii) comparative measures of long-term care services availability, including serving 
3.5 	people in their home areas near family, and changes over time; and
3.6 	(4) recommendations regarding goals for the future of long-term care services and 
3.7 	supports, policy and fiscal changes, and resource development and transition needs.
3.8 		Subd. 2.Critical access study. The commissioner shall conduct a onetime study 
3.9 	to assess local capacity and availability of home and community-based services for 
3.10 	older adults and people with disabilities. The study must assess critical access at the 
3.11 	community level and identify potential strategies to build home and community-based 
3.12 	service capacity in critical access areas.

3.13 	Sec. 3. Minnesota Statutes 2012, section 148E.065, subdivision 4a, is amended to read:
3.14 		Subd. 4a.City, county, and state social workers. (a) Beginning July 1, 2016, the 
3.15 	licensure of city, county, and state agency social workers is voluntary, except an individual 
3.16 	who is newly employed by a city or state agency after July 1, 2016, must be licensed 
3.17 	if the individual who provides social work services, as those services are defined in 
3.18 	section 148E.010, subdivision 11, paragraph (b), is presented to the public by any title 
3.19 	incorporating the words "social work" or "social worker."
3.20 	(b) City, county, and state agencies employing social workers and staff who are 
3.21 	designated to perform mandated duties under sections 256.975, subdivisions 7 to 7c and 
3.22 	256.01, subdivision 24, are not required to employ licensed social workers.

3.23 	Sec. 4. Minnesota Statutes 2012, section 256.01, subdivision 2, is amended to read:
3.24 		Subd. 2.Specific powers. Subject to the provisions of section 241.021, subdivision 
3.25 	2, the commissioner of human services shall carry out the specific duties in paragraphs (a) 
3.26 	through ~~(cc)~~ (dd):
3.27 	(a) Administer and supervise all forms of public assistance provided for by state law 
3.28 	and other welfare activities or services as are vested in the commissioner. Administration 
3.29 	and supervision of human services activities or services includes, but is not limited to, 
3.30 	assuring timely and accurate distribution of benefits, completeness of service, and quality 
3.31 	program management. In addition to administering and supervising human services 
3.32 	activities vested by law in the department, the commissioner shall have the authority to:
4.1 	(1) require county agency participation in training and technical assistance programs 
4.2 	to promote compliance with statutes, rules, federal laws, regulations, and policies 
4.3 	governing human services;
4.4 	(2) monitor, on an ongoing basis, the performance of county agencies in the 
4.5 	operation and administration of human services, enforce compliance with statutes, rules, 
4.6 	federal laws, regulations, and policies governing welfare services and promote excellence 
4.7 	of administration and program operation;
4.8 	(3) develop a quality control program or other monitoring program to review county 
4.9 	performance and accuracy of benefit determinations;
4.10 	(4) require county agencies to make an adjustment to the public assistance benefits 
4.11 	issued to any individual consistent with federal law and regulation and state law and rule 
4.12 	and to issue or recover benefits as appropriate;
4.13 	(5) delay or deny payment of all or part of the state and federal share of benefits and 
4.14 	administrative reimbursement according to the procedures set forth in section 256.017;
4.15 	(6) make contracts with and grants to public and private agencies and organizations, 
4.16 	both profit and nonprofit, and individuals, using appropriated funds; and
4.17 	(7) enter into contractual agreements with federally recognized Indian tribes with 
4.18 	a reservation in Minnesota to the extent necessary for the tribe to operate a federally 
4.19 	approved family assistance program or any other program under the supervision of the 
4.20 	commissioner. The commissioner shall consult with the affected county or counties in 
4.21 	the contractual agreement negotiations, if the county or counties wish to be included, 
4.22 	in order to avoid the duplication of county and tribal assistance program services. The 
4.23 	commissioner may establish necessary accounts for the purposes of receiving and 
4.24 	disbursing funds as necessary for the operation of the programs.
4.25 	(b) Inform county agencies, on a timely basis, of changes in statute, rule, federal law, 
4.26 	regulation, and policy necessary to county agency administration of the programs.
4.27 	(c) Administer and supervise all child welfare activities; promote the enforcement of 
4.28 	laws protecting disabled, dependent, neglected and delinquent children, and children born 
4.29 	to mothers who were not married to the children's fathers at the times of the conception 
4.30 	nor at the births of the children; license and supervise child-caring and child-placing 
4.31 	agencies and institutions; supervise the care of children in boarding and foster homes or 
4.32 	in private institutions; and generally perform all functions relating to the field of child 
4.33 	welfare now vested in the State Board of Control.
4.34 	(d) Administer and supervise all noninstitutional service to disabled persons, 
4.35 	including those who are visually impaired, hearing impaired, or physically impaired 
4.36 	or otherwise disabled. The commissioner may provide and contract for the care and 
5.1 	treatment of qualified indigent children in facilities other than those located and available 
5.2 	at state hospitals when it is not feasible to provide the service in state hospitals.
5.3 	(e) Assist and actively cooperate with other departments, agencies and institutions, 
5.4 	local, state, and federal, by performing services in conformity with the purposes of Laws 
5.5 	1939, chapter 431.
5.6 	(f) Act as the agent of and cooperate with the federal government in matters of 
5.7 	mutual concern relative to and in conformity with the provisions of Laws 1939, chapter 
5.8 	431, including the administration of any federal funds granted to the state to aid in the 
5.9 	performance of any functions of the commissioner as specified in Laws 1939, chapter 431, 
5.10 	and including the promulgation of rules making uniformly available medical care benefits 
5.11 	to all recipients of public assistance, at such times as the federal government increases its 
5.12 	participation in assistance expenditures for medical care to recipients of public assistance, 
5.13 	the cost thereof to be borne in the same proportion as are grants of aid to said recipients.
5.14 	(g) Establish and maintain any administrative units reasonably necessary for the 
5.15 	performance of administrative functions common to all divisions of the department.
5.16 	(h) Act as designated guardian of both the estate and the person of all the wards of 
5.17 	the state of Minnesota, whether by operation of law or by an order of court, without any 
5.18 	further act or proceeding whatever, except as to persons committed as developmentally 
5.19 	disabled. For children under the guardianship of the commissioner or a tribe in Minnesota 
5.20 	recognized by the Secretary of the Interior whose interests would be best served by 
5.21 	adoptive placement, the commissioner may contract with a licensed child-placing agency 
5.22 	or a Minnesota tribal social services agency to provide adoption services. A contract 
5.23 	with a licensed child-placing agency must be designed to supplement existing county 
5.24 	efforts and may not replace existing county programs or tribal social services, unless the 
5.25 	replacement is agreed to by the county board and the appropriate exclusive bargaining 
5.26 	representative, tribal governing body, or the commissioner has evidence that child 
5.27 	placements of the county continue to be substantially below that of other counties. Funds 
5.28 	encumbered and obligated under an agreement for a specific child shall remain available 
5.29 	until the terms of the agreement are fulfilled or the agreement is terminated.
5.30 	(i) Act as coordinating referral and informational center on requests for service for 
5.31 	newly arrived immigrants coming to Minnesota.
5.32 	(j) The specific enumeration of powers and duties as hereinabove set forth shall in no 
5.33 	way be construed to be a limitation upon the general transfer of powers herein contained.
5.34 	(k) Establish county, regional, or statewide schedules of maximum fees and charges 
5.35 	which may be paid by county agencies for medical, dental, surgical, hospital, nursing and 
5.36 	nursing home care and medicine and medical supplies under all programs of medical 
6.1 	care provided by the state and for congregate living care under the income maintenance 
6.2 	programs.
6.3 	(l) Have the authority to conduct and administer experimental projects to test methods 
6.4 	and procedures of administering assistance and services to recipients or potential recipients 
6.5 	of public welfare. To carry out such experimental projects, it is further provided that the 
6.6 	commissioner of human services is authorized to waive the enforcement of existing specific 
6.7 	statutory program requirements, rules, and standards in one or more counties. The order 
6.8 	establishing the waiver shall provide alternative methods and procedures of administration, 
6.9 	shall not be in conflict with the basic purposes, coverage, or benefits provided by law, and 
6.10 	in no event shall the duration of a project exceed four years. It is further provided that no 
6.11 	order establishing an experimental project as authorized by the provisions of this section 
6.12 	shall become effective until the following conditions have been met:
6.13 	(1) the secretary of health and human services of the United States has agreed, for 
6.14 	the same project, to waive state plan requirements relative to statewide uniformity; and
6.15 	(2) a comprehensive plan, including estimated project costs, shall be approved by 
6.16 	the Legislative Advisory Commission and filed with the commissioner of administration.
6.17 	(m) According to federal requirements, establish procedures to be followed by 
6.18 	local welfare boards in creating citizen advisory committees, including procedures for 
6.19 	selection of committee members.
6.20 	(n) Allocate federal fiscal disallowances or sanctions which are based on quality 
6.21 	control error rates for the aid to families with dependent children program formerly 
6.22 	codified in sections 256.72 to 256.87, medical assistance, or food stamp program in the 
6.23 	following manner:
6.24 	(1) one-half of the total amount of the disallowance shall be borne by the county 
6.25 	boards responsible for administering the programs. For the medical assistance and the 
6.26 	AFDC program formerly codified in sections 256.72 to 256.87, disallowances shall be 
6.27 	shared by each county board in the same proportion as that county's expenditures for the 
6.28 	sanctioned program are to the total of all counties' expenditures for the AFDC program 
6.29 	formerly codified in sections 256.72 to 256.87, and medical assistance programs. For the 
6.30 	food stamp program, sanctions shall be shared by each county board, with 50 percent of 
6.31 	the sanction being distributed to each county in the same proportion as that county's 
6.32 	administrative costs for food stamps are to the total of all food stamp administrative costs 
6.33 	for all counties, and 50 percent of the sanctions being distributed to each county in the 
6.34 	same proportion as that county's value of food stamp benefits issued are to the total of 
6.35 	all benefits issued for all counties. Each county shall pay its share of the disallowance 
6.36 	to the state of Minnesota. When a county fails to pay the amount due hereunder, the 
7.1 	commissioner may deduct the amount from reimbursement otherwise due the county, or 
7.2 	the attorney general, upon the request of the commissioner, may institute civil action 
7.3 	to recover the amount due; and
7.4 	(2) notwithstanding the provisions of clause (1), if the disallowance results from 
7.5 	knowing noncompliance by one or more counties with a specific program instruction, and 
7.6 	that knowing noncompliance is a matter of official county board record, the commissioner 
7.7 	may require payment or recover from the county or counties, in the manner prescribed in 
7.8 	clause (1), an amount equal to the portion of the total disallowance which resulted from the 
7.9 	noncompliance, and may distribute the balance of the disallowance according to clause (1).
7.10 	(o) Develop and implement special projects that maximize reimbursements and 
7.11 	result in the recovery of money to the state. For the purpose of recovering state money, 
7.12 	the commissioner may enter into contracts with third parties. Any recoveries that result 
7.13 	from projects or contracts entered into under this paragraph shall be deposited in the 
7.14 	state treasury and credited to a special account until the balance in the account reaches 
7.15 	$1,000,000. When the balance in the account exceeds $1,000,000, the excess shall be 
7.16 	transferred and credited to the general fund. All money in the account is appropriated to 
7.17 	the commissioner for the purposes of this paragraph.
7.18 	(p) Have the authority to make direct payments to facilities providing shelter 
7.19 	to women and their children according to section 256D.05, subdivision 3. Upon 
7.20 	the written request of a shelter facility that has been denied payments under section 
7.21 	256D.05, subdivision 3, the commissioner shall review all relevant evidence and make 
7.22 	a determination within 30 days of the request for review regarding issuance of direct 
7.23 	payments to the shelter facility. Failure to act within 30 days shall be considered a 
7.24 	determination not to issue direct payments.
7.25 	(q) Have the authority to establish and enforce the following county reporting 
7.26 	requirements:
7.27 	(1) the commissioner shall establish fiscal and statistical reporting requirements 
7.28 	necessary to account for the expenditure of funds allocated to counties for human 
7.29 	services programs. When establishing financial and statistical reporting requirements, the 
7.30 	commissioner shall evaluate all reports, in consultation with the counties, to determine if 
7.31 	the reports can be simplified or the number of reports can be reduced;
7.32 	(2) the county board shall submit monthly or quarterly reports to the department 
7.33 	as required by the commissioner. Monthly reports are due no later than 15 working days 
7.34 	after the end of the month. Quarterly reports are due no later than 30 calendar days after 
7.35 	the end of the quarter, unless the commissioner determines that the deadline must be 
7.36 	shortened to 20 calendar days to avoid jeopardizing compliance with federal deadlines 
8.1 	or risking a loss of federal funding. Only reports that are complete, legible, and in the 
8.2 	required format shall be accepted by the commissioner;
8.3 	(3) if the required reports are not received by the deadlines established in clause (2), 
8.4 	the commissioner may delay payments and withhold funds from the county board until 
8.5 	the next reporting period. When the report is needed to account for the use of federal 
8.6 	funds and the late report results in a reduction in federal funding, the commissioner shall 
8.7 	withhold from the county boards with late reports an amount equal to the reduction in 
8.8 	federal funding until full federal funding is received;
8.9 	(4) a county board that submits reports that are late, illegible, incomplete, or not 
8.10 	in the required format for two out of three consecutive reporting periods is considered 
8.11 	noncompliant. When a county board is found to be noncompliant, the commissioner 
8.12 	shall notify the county board of the reason the county board is considered noncompliant 
8.13 	and request that the county board develop a corrective action plan stating how the 
8.14 	county board plans to correct the problem. The corrective action plan must be submitted 
8.15 	to the commissioner within 45 days after the date the county board received notice 
8.16 	of noncompliance;
8.17 	(5) the final deadline for fiscal reports or amendments to fiscal reports is one year 
8.18 	after the date the report was originally due. If the commissioner does not receive a report 
8.19 	by the final deadline, the county board forfeits the funding associated with the report for 
8.20 	that reporting period and the county board must repay any funds associated with the 
8.21 	report received for that reporting period;
8.22 	(6) the commissioner may not delay payments, withhold funds, or require repayment 
8.23 	under clause (3) or (5) if the county demonstrates that the commissioner failed to 
8.24 	provide appropriate forms, guidelines, and technical assistance to enable the county to 
8.25 	comply with the requirements. If the county board disagrees with an action taken by the 
8.26 	commissioner under clause (3) or (5), the county board may appeal the action according 
8.27 	to sections 14.57 to 14.69; and
8.28 	(7) counties subject to withholding of funds under clause (3) or forfeiture or 
8.29 	repayment of funds under clause (5) shall not reduce or withhold benefits or services to 
8.30 	clients to cover costs incurred due to actions taken by the commissioner under clause 
8.31 	(3) or (5).
8.32 	(r) Allocate federal fiscal disallowances or sanctions for audit exceptions when 
8.33 	federal fiscal disallowances or sanctions are based on a statewide random sample in direct 
8.34 	proportion to each county's claim for that period.
9.1 	(s) Be responsible for ensuring the detection, prevention, investigation, and 
9.2 	resolution of fraudulent activities or behavior by applicants, recipients, and other 
9.3 	participants in the human services programs administered by the department.
9.4 	(t) Require county agencies to identify overpayments, establish claims, and utilize 
9.5 	all available and cost-beneficial methodologies to collect and recover these overpayments 
9.6 	in the human services programs administered by the department.
9.7 	(u) Have the authority to administer a drug rebate program for drugs purchased 
9.8 	pursuant to the prescription drug program established under section 256.955 after the 
9.9 	beneficiary's satisfaction of any deductible established in the program. The commissioner 
9.10 	shall require a rebate agreement from all manufacturers of covered drugs as defined in 
9.11 	section 256B.0625, subdivision 13. Rebate agreements for prescription drugs delivered on 
9.12 	or after July 1, 2002, must include rebates for individuals covered under the prescription 
9.13 	drug program who are under 65 years of age. For each drug, the amount of the rebate shall 
9.14 	be equal to the rebate as defined for purposes of the federal rebate program in United 
9.15 	States Code, title 42, section 1396r-8. The manufacturers must provide full payment 
9.16 	within 30 days of receipt of the state invoice for the rebate within the terms and conditions 
9.17 	used for the federal rebate program established pursuant to section 1927 of title XIX of 
9.18 	the Social Security Act. The manufacturers must provide the commissioner with any 
9.19 	information necessary to verify the rebate determined per drug. The rebate program shall 
9.20 	utilize the terms and conditions used for the federal rebate program established pursuant to 
9.21 	section 1927 of title XIX of the Social Security Act.
9.22 	(v) Have the authority to administer the federal drug rebate program for drugs 
9.23 	purchased under the medical assistance program as allowed by section 1927 of title XIX 
9.24 	of the Social Security Act and according to the terms and conditions of section 1927. 
9.25 	Rebates shall be collected for all drugs that have been dispensed or administered in an 
9.26 	outpatient setting and that are from manufacturers who have signed a rebate agreement 
9.27 	with the United States Department of Health and Human Services.
9.28 	(w) Have the authority to administer a supplemental drug rebate program for drugs 
9.29 	purchased under the medical assistance program. The commissioner may enter into 
9.30 	supplemental rebate contracts with pharmaceutical manufacturers and may require prior 
9.31 	authorization for drugs that are from manufacturers that have not signed a supplemental 
9.32 	rebate contract. Prior authorization of drugs shall be subject to the provisions of section 
9.33 	256B.0625, subdivision 13.
9.34 	(x) Operate the department's communication systems account established in Laws 
9.35 	1993, First Special Session chapter 1, article 1, section 2, subdivision 2, to manage shared 
9.36 	communication costs necessary for the operation of the programs the commissioner 
10.1 	supervises. A communications account may also be established for each regional 
10.2 	treatment center which operates communications systems. Each account must be used 
10.3 	to manage shared communication costs necessary for the operations of the programs the 
10.4 	commissioner supervises. The commissioner may distribute the costs of operating and 
10.5 	maintaining communication systems to participants in a manner that reflects actual usage. 
10.6 	Costs may include acquisition, licensing, insurance, maintenance, repair, staff time and 
10.7 	other costs as determined by the commissioner. Nonprofit organizations and state, county, 
10.8 	and local government agencies involved in the operation of programs the commissioner 
10.9 	supervises may participate in the use of the department's communications technology and 
10.10 	share in the cost of operation. The commissioner may accept on behalf of the state any 
10.11 	gift, bequest, devise or personal property of any kind, or money tendered to the state for 
10.12 	any lawful purpose pertaining to the communication activities of the department. Any 
10.13 	money received for this purpose must be deposited in the department's communication 
10.14 	systems accounts. Money collected by the commissioner for the use of communication 
10.15 	systems must be deposited in the state communication systems account and is appropriated 
10.16 	to the commissioner for purposes of this section.
10.17 	(y) Receive any federal matching money that is made available through the medical 
10.18 	assistance program for the consumer satisfaction survey. Any federal money received for 
10.19 	the survey is appropriated to the commissioner for this purpose. The commissioner may 
10.20 	expend the federal money received for the consumer satisfaction survey in either year of 
10.21 	the biennium.
10.22 	(z) Designate community information and referral call centers and incorporate 
10.23 	cost reimbursement claims from the designated community information and referral 
10.24 	call centers into the federal cost reimbursement claiming processes of the department 
10.25 	according to federal law, rule, and regulations. Existing information and referral centers 
10.26 	provided by Greater Twin Cities United Way or existing call centers for which Greater 
10.27 	Twin Cities United Way has legal authority to represent, shall be included in these 
10.28 	designations upon review by the commissioner and assurance that these services are 
10.29 	accredited and in compliance with national standards. Any reimbursement is appropriated 
10.30 	to the commissioner and all designated information and referral centers shall receive 
10.31 	payments according to normal department schedules established by the commissioner 
10.32 	upon final approval of allocation methodologies from the United States Department of 
10.33 	Health and Human Services Division of Cost Allocation or other appropriate authorities.
10.34 	(aa) Develop recommended standards for foster care homes that address the 
10.35 	components of specialized therapeutic services to be provided by foster care homes with 
10.36 	those services.
11.1 	(bb) Authorize the method of payment to or from the department as part of the 
11.2 	human services programs administered by the department. This authorization includes the 
11.3 	receipt or disbursement of funds held by the department in a fiduciary capacity as part of 
11.4 	the human services programs administered by the department.
11.5 	(cc) Have the authority to administer a drug rebate program for drugs purchased for 
11.6 	persons eligible for general assistance medical care under section 256D.03, subdivision 3. 
11.7 	For manufacturers that agree to participate in the general assistance medical care rebate 
11.8 	program, the commissioner shall enter into a rebate agreement for covered drugs as 
11.9 	defined in section 256B.0625, subdivisions 13 and 13d. For each drug, the amount of the 
11.10 	rebate shall be equal to the rebate as defined for purposes of the federal rebate program in 
11.11 	United States Code, title 42, section 1396r-8. The manufacturers must provide payment 
11.12 	within the terms and conditions used for the federal rebate program established under 
11.13 	section 1927 of title XIX of the Social Security Act. The rebate program shall utilize 
11.14 	the terms and conditions used for the federal rebate program established under section 
11.15 	1927 of title XIX of the Social Security Act.
11.16 	Effective January 1, 2006, drug coverage under general assistance medical care shall 
11.17 	be limited to those prescription drugs that:
11.18 	(1) are covered under the medical assistance program as described in section 
11.19 	256B.0625, subdivisions 13 and 13d; and
11.20 	(2) are provided by manufacturers that have fully executed general assistance 
11.21 	medical care rebate agreements with the commissioner and comply with such agreements. 
11.22 	Prescription drug coverage under general assistance medical care shall conform to 
11.23 	coverage under the medical assistance program according to section 256B.0625, 
11.24 	subdivisions 13 to 13g.
11.25 	The rebate revenues collected under the drug rebate program are deposited in the 
11.26 	general fund.
11.27 	(dd) Designate the agencies that operate the Senior LinkAge Line under section 
11.28 	256.975, subdivision 7, and the Disability Linkage Line under subdivision 24 as the state 
11.29 	of Minnesota Aging and the Disability Resource Centers under United States Code, title 
11.30 	42, section 3001, the Older Americans Act Amendments of 2006 and incorporate cost 
11.31 	reimbursement claims from the designated centers into the federal cost reimbursement 
11.32 	claiming processes of the department according to federal law, rule, and regulations. Any 
11.33 	reimbursement must be appropriated to the commissioner and all Aging and Disability 
11.34 	Resource Center designated agencies shall receive payments of grant funding that supports 
11.35 	the activity and generates the federal financial participation according to Board on Aging 
11.36 	administrative granting mechanisms.

12.1 	Sec. 5. Minnesota Statutes 2012, section 256.01, subdivision 24, is amended to read:
12.2 		Subd. 24.Disability Linkage Line. The commissioner shall establish the Disability 
12.3 	Linkage Line, ~~to~~who shall serve people with disabilities as the designated Aging and 
12.4 	Disability Resource Center under United States Code, title 42, section 3001, the Older 
12.5 	Americans Act Amendments of 2006 in partnership with the Senior LinkAge Line and 
12.6 	shall serve as Minnesota's neutral access point for statewide disability information and 
12.7 	assistance and must be available during business hours through a statewide toll-free 
12.8 	number and the internet. The Disability Linkage Line shall:
12.9 	(1) deliver information and assistance based on national and state standards;
12.10 	(2) provide information about state and federal eligibility requirements, benefits, 
12.11 	and service options;
12.12 	(3) provide benefits and options counseling;
12.13 	(4) make referrals to appropriate support entities;
12.14 	(5) educate people on their options so they can make well-informed choices and link 
12.15 	them to quality profiles;
12.16 	(6) help support the timely resolution of service access and benefit issues;
12.17 	(7) inform people of their long-term community services and supports;
12.18 	(8) provide necessary resources and supports that can lead to employment and 
12.19 	increased economic stability of people with disabilities; ~~and~~
12.20 	(9) serve as the technical assistance and help center for the Web-based tool, 
12.21 	Minnesota's Disability Benefits 101.org~~.~~; and
12.22 	(10) provide preadmission screening for individuals under 60 years of age who are 
12.23 	admitted to a nursing facility from a hospital using the procedures as defined in section 
12.24 	256.975, subdivisions 7a to 7c, and 256B.0911, subdivision 4d.

12.25 	Sec. 6. Minnesota Statutes 2012, section 256.975, subdivision 7, is amended to read:
12.26 		Subd. 7.Consumer information and assistance and long-term care options 
12.27 	counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a 
12.28 	statewide service to aid older Minnesotans and their families in making informed choices 
12.29 	about long-term care options and health care benefits. Language services to persons 
12.30 	with limited English language skills may be made available. The service, known as 
12.31 	Senior LinkAge Line, shall serve older adults as the designated Aging and Disability 
12.32 	Resource Center under United States Code, title 42, section 3001, the Older Americans 
12.33 	Act Amendments of 2006 in partnership with the Disability LinkAge Line under section 
12.34 	256.01, subdivision 24, and must be available during business hours through a statewide 
12.35 	toll-free number and ~~must also be available through~~ the Internet. The Minnesota Board 
13.1 	on Aging shall consult with, and when appropriate work through, the area agencies on 
13.2 	aging to provide and maintain the telephony infrastructure and related support for the 
13.3 	Aging and Disability Resource Center partners which agree by memorandum to access 
13.4 	the infrastructure, including the designated providers of the Senior LinkAge Line and the 
13.5 	Disability Linkage Line.
13.6 	(b) The service must provide long-term care options counseling by assisting older 
13.7 	adults, caregivers, and providers in accessing information and options counseling about 
13.8 	choices in long-term care services that are purchased through private providers or available 
13.9 	through public options. The service must:
13.10 	(1) develop a comprehensive database that includes detailed listings in both 
13.11 	consumer- and provider-oriented formats;
13.12 	(2) make the database accessible on the Internet and through other telecommunication 
13.13 	and media-related tools;
13.14 	(3) link callers to interactive long-term care screening tools and make these tools 
13.15 	available through the Internet by integrating the tools with the database;
13.16 	(4) develop community education materials with a focus on planning for long-term 
13.17 	care and evaluating independent living, housing, and service options;
13.18 	(5) conduct an outreach campaign to assist older adults and their caregivers in 
13.19 	finding information on the Internet and through other means of communication;
13.20 	(6) implement a messaging system for overflow callers and respond to these callers 
13.21 	by the next business day;
13.22 	(7) link callers with county human services and other providers to receive more 
13.23 	in-depth assistance and consultation related to long-term care options;
13.24 	(8) link callers with quality profiles for nursing facilities and other home and 
13.25 	community-based services providers developed by the ~~commissioner~~ commissioners of 
13.26 	health and human services;
13.27 	(9) incorporate information about the availability of housing options, as well as 
13.28 	registered housing with services and consumer rights within the MinnesotaHelp.info 
13.29 	network long-term care database to facilitate consumer comparison of services and costs 
13.30 	among housing with services establishments and with other in-home services and to 
13.31 	support financial self-sufficiency as long as possible. Housing with services establishments 
13.32 	and their arranged home care providers shall provide information that will facilitate price 
13.33 	comparisons, including delineation of charges for rent and for services available. The 
13.34 	commissioners of health and human services shall align the data elements required by 
13.35 	section 144G.06, the Uniform Consumer Information Guide, and this section to provide 
13.36 	consumers standardized information and ease of comparison of long-term care options. 
14.1 	The commissioner of human services shall provide the data to the Minnesota Board on 
14.2 	Aging for inclusion in the MinnesotaHelp.info network long-term care database;
14.3 	(10) provide long-term care options counseling. Long-term care options counselors 
14.4 	shall:
14.5 	(i) for individuals not eligible for case management under a public program or public 
14.6 	funding source, provide interactive decision support under which consumers, family 
14.7 	members, or other helpers are supported in their deliberations to determine appropriate 
14.8 	long-term care choices in the context of the consumer's needs, preferences, values, and 
14.9 	individual circumstances, including implementing a community support plan;
14.10 	(ii) provide Web-based educational information and collateral written materials to 
14.11 	familiarize consumers, family members, or other helpers with the long-term care basics, 
14.12 	issues to be considered, and the range of options available in the community;
14.13 	(iii) provide long-term care futures planning, which means providing assistance to 
14.14 	individuals who anticipate having long-term care needs to develop a plan for the more 
14.15 	distant future; and
14.16 	(iv) provide expertise in benefits and financing options for long-term care, including 
14.17 	Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages, 
14.18 	private pay options, and ways to access low or no-cost services or benefits through 
14.19 	volunteer-based or charitable programs;
14.20 	(11) using risk management and support planning protocols, provide long-term care 
14.21 	options counseling to current residents of nursing homes deemed appropriate for discharge 
14.22 	by the commissioner and older adults who request service after consultation with the 
14.23 	Senior LinkAge Line under clause (12). ~~In order to meet this requirement,~~ The Senior 
14.24 	LinkAge Line shall also receive referrals from the residents or staff of nursing homes. The 
14.25 	Senior LinkAge Line shall identify and contact residents deemed appropriate for discharge 
14.26 	by developing targeting criteria in consultation with the commissioner who shall provide 
14.27 	designated Senior LinkAge Line contact centers with a list of nursing home residents that 
14.28 	meet the criteria as being appropriate for discharge planning via a secure Web portal. 
14.29 	Senior LinkAge Line shall provide these residents, if they indicate a preference to 
14.30 	receive long-term care options counseling, with initial assessment~~, review of risk factors,~~ 
14.31 	~~independent living support consultation, or~~ and, if appropriate, a referral to:
14.32 	(i) long-term care consultation services under section 256B.0911;
14.33 	(ii) designated care coordinators of contracted entities under section 256B.035 for 
14.34 	persons who are enrolled in a managed care plan; or
15.1 	(iii) the long-term care consultation team for those who are ~~appropriate~~ eligible
15.2 	 for relocation service coordination due to high-risk factors or psychological or physical 
15.3 	disability; and
15.4 	(12) develop referral protocols and processes that will assist certified health care 
15.5 	homes and hospitals to identify at-risk older adults and determine when to refer these 
15.6 	individuals to the Senior LinkAge Line for long-term care options counseling under this 
15.7 	section. The commissioner is directed to work with the commissioner of health to develop 
15.8 	protocols that would comply with the health care home designation criteria and protocols 
15.9 	available at the time of hospital discharge. The commissioner shall keep a record of the 
15.10 	number of people who choose long-term care options counseling as a result of this section.

15.11 	Sec. 7. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision 
15.12 	to read:
15.13 		Subd. 7a.Preadmission screening activities related to nursing facility 
15.14 	admissions. (a) All individuals seeking admission to Medicaid certified nursing facilities, 
15.15 	including certified boarding care facilities, must be screened prior to admission regardless 
15.16 	of income, assets, or funding sources for nursing facility care, except as described in 
15.17 	subdivision 7b, paragraphs (a) and (b). The purpose of the screening is to determine the 
15.18 	need for nursing facility level of care as described in section 256B.0911, subdivision 
15.19 	4e, and to complete activities required under federal law related to mental illness and 
15.20 	developmental disability as outlined in paragraph (b).
15.21 	(b) A person who has a diagnosis or possible diagnosis of mental illness or 
15.22 	developmental disability must receive a preadmission screening before admission 
15.23 	regardless of the exemptions outlined in subdivision 7b, paragraphs (a) and (b), to identify 
15.24 	the need for further evaluation and specialized services, unless the admission prior to 
15.25 	screening is authorized by the local mental health authority or the local developmental 
15.26 	disabilities case manager, or unless authorized by the county agency according to Public 
15.27 	Law 101-508.
15.28 	(c) The following criteria apply to the preadmission screening:
15.29 	(1) requests for preadmission screenings must be submitted via an online form 
15.30 	developed by the commissioner;
15.31 	(2) the Senior LinkAge Line must use forms and criteria developed by the 
15.32 	commissioner to identify persons who require referral for further evaluation and 
15.33 	determination of the need for specialized services; and
15.34 	(3) the evaluation and determination of the need for specialized services must be 
15.35 	done by:
16.1 	(i) a qualified independent mental health professional, for persons with a primary or 
16.2 	secondary diagnosis of a serious mental illness; or
16.3 	(ii) a qualified developmental disability professional, for persons with a primary or 
16.4 	secondary diagnosis of developmental disability. For purposes of this requirement, a 
16.5 	qualified developmental disability professional must meet the standards for a qualified 
16.6 	developmental disability professional under Code of Federal Regulations, title 42, section 
16.7 	483.430.
16.8 	(d) The local county mental health authority or the state developmental disability 
16.9 	authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a 
16.10 	nursing facility if the individual does not meet the nursing facility level of care criteria or 
16.11 	needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For 
16.12 	purposes of this section, "specialized services" for a person with developmental disability 
16.13 	means active treatment as that term is defined under Code of Federal Regulations, title 
16.14 	42, section 483.440(a)(1).
16.15 	(e) In assessing a person's needs, the screener shall:
16.16 	(1) use an automated system designated by the commissioner;
16.17 	(2) consult with care transitions coordinators or physician; and
16.18 	(3) consider the assessment of the individual's physician.
16.19 	Other personnel may be included in the level of care determination as deemed 
16.20 	necessary by the screener.

16.21 	Sec. 8. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision 
16.22 	to read:
16.23 		Subd. 7b.Exemptions and emergency admissions. (a) Exemptions from the federal 
16.24 	screening requirements outlined in subdivision 7a, paragraphs (b) and (c), are limited to:
16.25 	(1) a person who, having entered an acute care facility from a certified nursing 
16.26 	facility, is returning to a certified nursing facility; or
16.27 	(2) a person transferring from one certified nursing facility in Minnesota to another 
16.28 	certified nursing facility in Minnesota.
16.29 	(b) Persons who are exempt from preadmission screening for purposes of level of 
16.30 	care determination include:
16.31 	(1) persons described in paragraph (a);
16.32 	(2) an individual who has a contractual right to have nursing facility care paid for 
16.33 	indefinitely by the Veterans' Administration;
16.34 	(3) an individual enrolled in a demonstration project under section 256B.69, 
16.35 	subdivision 8, at the time of application to a nursing facility; and
17.1 	(4) an individual currently being served under the alternative care program or under 
17.2 	a home and community-based services waiver authorized under section 1915(c) of the 
17.3 	federal Social Security Act.
17.4 	(c) Persons admitted to a Medicaid-certified nursing facility from the community 
17.5 	on an emergency basis as described in paragraph (d) or from an acute care facility on a 
17.6 	nonworking day must be screened the first working day after admission.
17.7 	(d) Emergency admission to a nursing facility prior to screening is permitted when 
17.8 	all of the following conditions are met:
17.9 	(1) a person is admitted from the community to a certified nursing or certified 
17.10 	boarding care facility during Senior LinkAge Line nonworking hours for ages 60 and 
17.11 	older and Disability Linkage Line nonworking hours for under age 60;
17.12 	(2) a physician has determined that delaying admission until preadmission screening 
17.13 	is completed would adversely affect the person's health and safety;
17.14 	(3) there is a recent precipitating event that precludes the client from living safely in 
17.15 	the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's 
17.16 	inability to continue to provide care;
17.17 	(4) the attending physician has authorized the emergency placement and has 
17.18 	documented the reason that the emergency placement is recommended; and
17.19 	(5) the Senior LinkAge Line or Disability Linkage Line is contacted on the first 
17.20 	working day following the emergency admission.
17.21 	Transfer of a patient from an acute care hospital to a nursing facility is not considered 
17.22 	an emergency except for a person who has received hospital services in the following 
17.23 	situations: hospital admission for observation, care in an emergency room without hospital 
17.24 	admission, or following hospital 24-hour bed care and from whom admission is being 
17.25 	sought on a nonworking day.
17.26 	(e) A nursing facility must provide written information to all persons admitted 
17.27 	regarding the person's right to request and receive long-term care consultation services as 
17.28 	defined in section 256B.0911, subdivision 1a. The information must be provided prior to 
17.29 	the person's discharge from the facility and in a format specified by the commissioner.

17.30 	Sec. 9. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision 
17.31 	to read:
17.32 		Subd. 7c.Screening requirements. (a) A person may be screened for nursing 
17.33 	facility admission by telephone or in a face-to-face screening interview. The Senior 
17.34 	LinkAge Line shall identify each individual's needs using the following categories:
18.1 	(1) the person needs no face-to-face long-term care consultation assessment 
18.2 	completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or 
18.3 	managed care organization under contract with the Department of Human Services to 
18.4 	determine the need for nursing facility level of care based on information obtained from 
18.5 	other health care professionals;
18.6 	(2) the person needs an immediate face-to-face long-term care consultation 
18.7 	assessment completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, 
18.8 	tribe, or managed care organization under contract with the Department of Human 
18.9 	Services to determine the need for nursing facility level of care and complete activities 
18.10 	required under subdivision 7a; or
18.11 	(3) the person may be exempt from screening requirements as outlined in subdivision 
18.12 	7b, but will need transitional assistance after admission or in-person follow-along after 
18.13 	a return home.
18.14 	(b) Individuals between the ages of 60 and 64 who are admitted to nursing facilities 
18.15 	with only a telephone screening must receive a face-to-face assessment from the long-term 
18.16 	care consultation team member of the county in which the facility is located or from the 
18.17 	recipient's county case manager within 40 calendar days of admission as described in 
18.18 	section 256B.0911, subdivision 4d, paragraph (c).
18.19 	(c) Persons admitted on a nonemergency basis to a Medicaid-certified nursing 
18.20 	facility must be screened prior to admission.
18.21 	(d) Screenings provided by the Senior LinkAge Line must include processes 
18.22 	to identify persons who may require transition assistance described in subdivision 7, 
18.23 	paragraph (b), clause (12), and section 256B.0911, subdivision 3b.

18.24 	Sec. 10. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision 
18.25 	to read:
18.26 		Subd. 7d.Payment for preadmission screening. Funding for preadmission 
18.27 	screening shall be provided to the Minnesota Board on Aging for the population 60 
18.28 	years of age and older by the Department of Human Services to cover screener salaries 
18.29 	and expenses to provide the services described in subdivisions 7a to 7c. The Minnesota 
18.30 	Board on Aging shall employ, or contract with other agencies to employ, within the limits 
18.31 	of available funding, sufficient personnel to provide preadmission screening and level of 
18.32 	care determination services and shall seek to maximize federal funding for the service as 
18.33 	provided under section 256.01, subdivision 2, paragraph (dd).

19.1 	Sec. 11. Minnesota Statutes 2012, section 256.9754, is amended by adding a 
19.2 	subdivision to read:
19.3 		Subd. 3a.Priority for other grants. The commissioner of health shall give 
19.4 	priority to a grantee selected under subdivision 3 when awarding technology-related 
19.5 	grants, if the grantee is using technology as a part of a proposal. The commissioner 
19.6 	of transportation shall give priority to a grantee selected under subdivision 3 when 
19.7 	distributing transportation-related funds to create transportation options for older adults.

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

19.13 	Sec. 13. Minnesota Statutes 2012, section 256.9754, subdivision 5, is amended to read:
19.14 		Subd. 5.Grant preference. The commissioner of human services shall give 
19.15 	preference when awarding grants under this section to areas where nursing facility 
19.16 	closures have occurred or are occurring or areas with service needs identified by section 
19.17 	144A.351. The commissioner may award grants to the extent grant funds are available 
19.18 	and to the extent applications are approved by the commissioner. Denial of approval of an 
19.19 	application in one year does not preclude submission of an application in a subsequent 
19.20 	year. The maximum grant amount is limited to $750,000.

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

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

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

20.16 	Sec. 17. Minnesota Statutes 2012, section 256B.0911, subdivision 1, is amended to read:
20.17 		Subdivision 1.Purpose and goal. (a) The purpose of long-term care consultation 
20.18 	services is to assist persons with long-term or chronic care needs in making care 
20.19 	decisions and selecting support and service options that meet their needs and reflect 
20.20 	their preferences. The availability of, and access to, information and other types of 
20.21 	assistance, including assessment and support planning, is also intended to prevent or delay 
20.22 	institutional placements and to provide access to transition assistance after admission. 
20.23 	Further, the goal of these services is to contain costs associated with unnecessary 
20.24 	institutional admissions. Long-term consultation services must be available to any person 
20.25 	regardless of public program eligibility. The commissioner of human services shall seek 
20.26 	to maximize use of available federal and state funds and establish the broadest program 
20.27 	possible within the funding available.
20.28 	(b) These services must be coordinated with long-term care options counseling 
20.29 	provided under subdivision 4d, section 256.975, ~~subdivision~~ subdivisions 7 to 7c, and 
20.30 	section 256.01, subdivision 24. The lead agency providing long-term care consultation 
20.31 	services shall encourage the use of volunteers from families, religious organizations, social 
20.32 	clubs, and similar civic and service organizations to provide community-based services.

21.1 	Sec. 18. Minnesota Statutes 2012, section 256B.0911, subdivision 1a, is amended to 
21.2 	read:
21.3 		Subd. 1a.Definitions. For purposes of this section, the following definitions apply:
21.4 	(a) Until additional requirements apply under paragraph (b), "long-term care 
21.5 	consultation services" means:
21.6 	(1) intake for and access to assistance in identifying services needed to maintain an 
21.7 	individual in the most inclusive environment;
21.8 	(2) providing recommendations for and referrals to cost-effective community 
21.9 	services that are available to the individual;
21.10 	(3) development of an individual's person-centered community support plan;
21.11 	(4) providing information regarding eligibility for Minnesota health care programs;
21.12 	(5) face-to-face long-term care consultation assessments, which may be completed 
21.13 	in a hospital, nursing facility, intermediate care facility for persons with developmental 
21.14 	disabilities (ICF/DDs), regional treatment centers, or the person's current or planned 
21.15 	residence;
21.16 	~~(6) federally mandated preadmission screening activities described under~~ 
21.17 	~~subdivisions 4a and 4b;~~
21.18 	~~(7)~~ (6) determination of home and community-based waiver and other service 
21.19 	eligibility as required under sections 256B.0913, 256B.0915, and 256B.49, including level 
21.20 	of care determination for individuals who need an institutional level of care as determined 
21.21 	under section 256B.0911, subdivision ~~4a, paragraph (d)~~ 4e, based on assessment and 
21.22 	community support plan development, appropriate referrals to obtain necessary diagnostic 
21.23 	information, and including an eligibility determination for consumer-directed community 
21.24 	supports;
21.25 	~~(8)~~ (7) providing recommendations for institutional placement when there are no 
21.26 	cost-effective community services available;
21.27 	~~(9)~~ (8) providing access to assistance to transition people back to community settings 
21.28 	after institutional admission; and
21.29 	~~(10)~~ (9) providing information about competitive employment, with or without 
21.30 	supports, for school-age youth and working-age adults and referrals to the Disability 
21.31 	Linkage Line and Disability Benefits 101 to ensure that an informed choice about 
21.32 	competitive employment can be made. For the purposes of this subdivision, "competitive 
21.33 	employment" means work in the competitive labor market that is performed on a full-time 
21.34 	or part-time basis in an integrated setting, and for which an individual is compensated at or 
21.35 	above the minimum wage, but not less than the customary wage and level of benefits paid 
21.36 	by the employer for the same or similar work performed by individuals without disabilities.
22.1 	(b) Upon statewide implementation of lead agency requirements in subdivisions 2b, 
22.2 	2c, and 3a, "long-term care consultation services" also means:
22.3 	(1) service eligibility determination for state plan home care services identified in:
22.4 	(i) section 256B.0625, subdivisions 7, 19a, and 19c;
22.5 	(ii) section 256B.0657; or
22.6 	(iii) consumer support grants under section 256.476;
22.7 	(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024, 
22.8 	determination of eligibility for case management services available under sections 
22.9 	256B.0621, subdivision 2, paragraph (4), and 256B.0924 and Minnesota Rules, part 
22.10 	9525.0016;
22.11 	(3) determination of institutional level of care, home and community-based service 
22.12 	waiver, and other service eligibility as required under section 256B.092, determination 
22.13 	of eligibility for family support grants under section 252.32, semi-independent living 
22.14 	services under section 252.275, and day training and habilitation services under section 
22.15 	256B.092; and
22.16 	(4) obtaining necessary diagnostic information to determine eligibility under clauses 
22.17 	(2) and (3).
22.18 	(c) "Long-term care options counseling" means the services provided by the linkage 
22.19 	lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and 
22.20 	also includes telephone assistance and follow up once a long-term care consultation 
22.21 	assessment has been completed.
22.22 	(d) "Minnesota health care programs" means the medical assistance program under 
22.23 	chapter 256B and the alternative care program under section 256B.0913.
22.24 	(e) "Lead agencies" means counties administering or tribes and health plans under 
22.25 	contract with the commissioner to administer long-term care consultation assessment and 
22.26 	support planning services.

22.27 	Sec. 19. Minnesota Statutes 2012, section 256B.0911, subdivision 3a, is amended to 
22.28 	read:
22.29 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, 
22.30 	services planning, or other assistance intended to support community-based living, 
22.31 	including persons who need assessment in order to determine waiver or alternative care 
22.32 	program eligibility, must be visited by a long-term care consultation team within 20 
22.33 	calendar days after the date on which an assessment was requested or recommended. 
22.34 	Upon statewide implementation of subdivisions 2b, 2c, and 5, this requirement also 
22.35 	applies to an assessment of a person requesting personal care assistance services and 
23.1 	private duty nursing. The commissioner shall provide at least a 90-day notice to lead 
23.2 	agencies prior to the effective date of this requirement. Face-to-face assessments must be 
23.3 	conducted according to paragraphs (b) to (i).
23.4 	(b) The lead agency may utilize a team of either the social worker or public health 
23.5 	nurse, or both. Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall 
23.6 	use certified assessors to conduct the assessment. The consultation team members must 
23.7 	confer regarding the most appropriate care for each individual screened or assessed. For 
23.8 	a person with complex health care needs, a public health or registered nurse from the 
23.9 	team must be consulted.
23.10 	(c) The assessment must be comprehensive and include a person-centered assessment 
23.11 	of the health, psychological, functional, environmental, and social needs of referred 
23.12 	individuals and provide information necessary to develop a community support plan that 
23.13 	meets the consumers needs, using an assessment form provided by the commissioner.
23.14 	(d) The assessment must be conducted in a face-to-face interview with the person 
23.15 	being assessed and the person's legal representative, and other individuals as requested by 
23.16 	the person, who can provide information on the needs, strengths, and preferences of the 
23.17 	person necessary to develop a community support plan that ensures the person's health and 
23.18 	safety, but who is not a provider of service or has any financial interest in the provision 
23.19 	of services. For persons who are to be assessed for elderly waiver customized living 
23.20 	services under section 256B.0915, with the permission of the person being assessed or 
23.21 	the person's designated or legal representative, the client's current or proposed provider 
23.22 	of services may submit a copy of the provider's nursing assessment or written report 
23.23 	outlining its recommendations regarding the client's care needs. The person conducting 
23.24 	the assessment will notify the provider of the date by which this information is to be 
23.25 	submitted. This information shall be provided to the person conducting the assessment 
23.26 	prior to the assessment.
23.27 	(e) If the person chooses to use community-based services, the person or the person's 
23.28 	legal representative must be provided with a written community support plan within 40 
23.29 	calendar days of the assessment visit, regardless of whether the individual is eligible for 
23.30 	Minnesota health care programs. The written community support plan must include:
23.31 	(1) a summary of assessed needs as defined in paragraphs (c) and (d);
23.32 	(2) the individual's options and choices to meet identified needs, including all 
23.33 	available options for case management services and providers;
23.34 	(3) identification of health and safety risks and how those risks will be addressed, 
23.35 	including personal risk management strategies;
23.36 	(4) referral information; and
24.1 	(5) informal caregiver supports, if applicable.
24.2 	For a person determined eligible for state plan home care under subdivision 1a, 
24.3 	paragraph (b), clause (1), the person or person's representative must also receive a copy of 
24.4 	the home care service plan developed by the certified assessor.
24.5 	(f) A person may request assistance in identifying community supports without 
24.6 	participating in a complete assessment. Upon a request for assistance identifying 
24.7 	community support, the person must be transferred or referred to long-term care options 
24.8 	counseling services available under sections 256.975, subdivision 7, and 256.01, 
24.9 	subdivision 24, for telephone assistance and follow up.
24.10 	(g) The person has the right to make the final decision between institutional 
24.11 	placement and community placement after the recommendations have been provided, 
24.12 	except as provided in section 256.975, subdivision ~~4a, paragraph (c)~~ 7a, paragraph (d).
24.13 	(h) The lead agency must give the person receiving assessment or support planning, 
24.14 	or the person's legal representative, materials, and forms supplied by the commissioner 
24.15 	containing the following information:
24.16 	(1) written recommendations for community-based services and consumer-directed 
24.17 	options;
24.18 	(2) documentation that the most cost-effective alternatives available were offered to 
24.19 	the individual. For purposes of this clause, "cost-effective" means community services and 
24.20 	living arrangements that cost the same as or less than institutional care. For an individual 
24.21 	found to meet eligibility criteria for home and community-based service programs under 
24.22 	section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally 
24.23 	approved waiver plan for each program;
24.24 	(3) the need for and purpose of preadmission screening conducted by long-term 
24.25 	care options counselors according to section 256.975, subdivisions 7a to 7c, and section 
24.26 	256.01, subdivision 24, if the person selects nursing facility placement. If the individual 
24.27 	selects nursing facility placement, the lead agency shall forward information needed to 
24.28 	complete the level of care determinations and screening for developmental disability and 
24.29 	mental illness collected during the assessment to the long-term care options counselor 
24.30 	using forms provided by the commissioner;
24.31 	(4) the role of long-term care consultation assessment and support planning in 
24.32 	eligibility determination for waiver and alternative care programs, and state plan home 
24.33 	care, case management, and other services as defined in subdivision 1a, paragraphs (a), 
24.34 	clause (7), and (b);
24.35 	(5) information about Minnesota health care programs;
24.36 	(6) the person's freedom to accept or reject the recommendations of the team;
25.1 	(7) the person's right to confidentiality under the Minnesota Government Data 
25.2 	Practices Act, chapter 13;
25.3 	(8) the certified assessor's decision regarding the person's need for institutional level 
25.4 	of care as determined under criteria established in section 256B.0911, subdivision ~~4a,~~ 
25.5 	~~paragraph (d)~~ 4e, and the certified assessor's decision regarding eligibility for all services 
25.6 	and programs as defined in subdivision 1a, paragraphs (a), clause (7), and (b); and
25.7 	(9) the person's right to appeal the certified assessor's decision regarding eligibility 
25.8 	for all services and programs as defined in subdivision 1a, paragraphs (a), clause (7), and 
25.9 	(b), and incorporating the decision regarding the need for institutional level of care or the 
25.10 	lead agency's final decisions regarding public programs eligibility according to section 
25.11 	256.045, subdivision 3.
25.12 	(i) Face-to-face assessment completed as part of eligibility determination for 
25.13 	the alternative care, elderly waiver, community alternatives for disabled individuals, 
25.14 	community alternative care, and brain injury waiver programs under sections 256B.0913, 
25.15 	256B.0915, and 256B.49 is valid to establish service eligibility for no more than 60 
25.16 	calendar days after the date of assessment.
25.17 	(j) The effective eligibility start date for programs in paragraph (i) can never be 
25.18 	prior to the date of assessment. If an assessment was completed more than 60 days 
25.19 	before the effective waiver or alternative care program eligibility start date, assessment 
25.20 	and support plan information must be updated in a face-to-face visit and documented in 
25.21 	the department's Medicaid Management Information System (MMIS). Notwithstanding 
25.22 	retroactive medical assistance coverage of state plan services, the effective date of 
25.23 	eligibility for programs included in paragraph (i) cannot be prior to the date the most 
25.24 	recent updated assessment is completed.

25.25 	Sec. 20. Minnesota Statutes 2012, section 256B.0911, subdivision 4d, is amended to 
25.26 	read:
25.27 		Subd. 4d.Preadmission screening of individuals under ~~65~~ 60 years of age. (a) 
25.28 	It is the policy of the state of Minnesota to ensure that individuals with disabilities or 
25.29 	chronic illness are served in the most integrated setting appropriate to their needs and have 
25.30 	the necessary information to make informed choices about home and community-based 
25.31 	service options.
25.32 	(b) Individuals under ~~65~~ 60 years of age who are admitted to a nursing facility 
25.33 	from a hospital must be screened prior to admission ~~as outlined in subdivisions 4a~~ 
25.34 	~~through 4c~~ according to the requirements outlined in section 256.975, subdivisions 7a 
26.1 	to 7c. This shall be provided by the Disability Linkage Line as required under section 
26.2 	256.01, subdivision 24.
26.3 	(c) Individuals under 65 years of age who are admitted to nursing facilities with 
26.4 	only a telephone screening must receive a face-to-face assessment from the long-term 
26.5 	care consultation team member of the county in which the facility is located or from the 
26.6 	recipient's county case manager within 40 calendar days of admission.
26.7 	~~(d) Individuals under 65 years of age who are admitted to a nursing facility~~ 
26.8 	~~without preadmission screening according to the exemption described in subdivision 4b,~~ 
26.9 	~~paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive~~ 
26.10 	~~a face-to-face assessment within 40 days of admission.~~
26.11 	~~(e)~~ (d) At the face-to-face assessment, the long-term care consultation team member 
26.12 	or county case manager must perform the activities required under subdivision 3b.
26.13 	~~(f)~~ (e) For individuals under 21 years of age, a screening interview which 
26.14 	recommends nursing facility admission must be face-to-face and approved by the 
26.15 	commissioner before the individual is admitted to the nursing facility.
26.16 	~~(g)~~ (f) In the event that an individual under ~~65~~ 60 years of age is admitted to a 
26.17 	nursing facility on an emergency basis, the ~~county~~ Disability Linkage Line must be 
26.18 	notified of the admission on the next working day, and a face-to-face assessment as 
26.19 	described in paragraph (c) must be conducted within 40 calendar days of admission.
26.20 	~~(h)~~ (g) At the face-to-face assessment, the long-term care consultation team member 
26.21 	or the case manager must present information about home and community-based options, 
26.22 	including consumer-directed options, so the individual can make informed choices. If the 
26.23 	individual chooses home and community-based services, the long-term care consultation 
26.24 	team member or case manager must complete a written relocation plan within 20 working 
26.25 	days of the visit. The plan shall describe the services needed to move out of the facility 
26.26 	and a time line for the move which is designed to ensure a smooth transition to the 
26.27 	individual's home and community.
26.28 	~~(i)~~ (h) An individual under 65 years of age residing in a nursing facility shall receive 
26.29 	a face-to-face assessment at least every 12 months to review the person's service choices 
26.30 	and available alternatives unless the individual indicates, in writing, that annual visits are 
26.31 	not desired. In this case, the individual must receive a face-to-face assessment at least 
26.32 	once every 36 months for the same purposes.
26.33 	~~(j)~~ (i) Notwithstanding the provisions of subdivision 6, the commissioner may pay 
26.34 	county agencies directly for face-to-face assessments for individuals under 65 years of age 
26.35 	who are being considered for placement or residing in a nursing facility.
27.1 	(j) Funding for preadmission screening shall be provided to the Disability Linkage 
27.2 	Line for the under 60 population by the Department of Human Services to cover screener 
27.3 	salaries and expenses to provide the services described in subdivisions 7a to 7c. The 
27.4 	Disability Linkage Line shall employ, or contract with other agencies to employ, within 
27.5 	the limits of available funding, sufficient personnel to provider preadmission screening 
27.6 	and level of care determination services and shall seek to maximize federal funding for the 
27.7 	service as provided under section 256.01, subdivision 2, paragraph (dd).

27.8 	Sec. 21. Minnesota Statutes 2012, section 256B.0911, is amended by adding a 
27.9 	subdivision to read:
27.10 		Subd. 4e.Determination of institutional level of care. The determination of the 
27.11 	need for nursing facility, hospital, and intermediate care facility levels of care must be 
27.12 	made according to criteria developed by the commissioner, and in section 256B.092, 
27.13 	using forms developed by the commissioner. Effective January 1, 2014, for individuals 
27.14 	age 21 and older, the determination of need for nursing facility level of care shall be 
27.15 	based on criteria in section 144.0724, subdivision 11. For individuals under age 21, the 
27.16 	determination of the need for nursing facility level of care must be made according to 
27.17 	criteria developed by the commissioner until criteria in section 144.0724, subdivision 11, 
27.18 	becomes effective on or after October 1, 2019.

27.19 	Sec. 22. Minnesota Statutes 2012, section 256B.0911, subdivision 7, is amended to read:
27.20 		Subd. 7.Reimbursement for certified nursing facilities. (a) Medical assistance 
27.21 	reimbursement for nursing facilities shall be authorized for a medical assistance recipient 
27.22 	only if a preadmission screening has been conducted prior to admission or the county has 
27.23 	authorized an exemption. Medical assistance reimbursement for nursing facilities shall 
27.24 	not be provided for any recipient who the local screener has determined does not meet the 
27.25 	level of care criteria for nursing facility placement in section 144.0724, subdivision 11, or, 
27.26 	if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus 
27.27 	Budget Reconciliation Act of 1987 completed unless an admission for a recipient with 
27.28 	mental illness is approved by the local mental health authority or an admission for a 
27.29 	recipient with developmental disability is approved by the state developmental disability 
27.30 	authority.
27.31 	(b) The nursing facility must not bill a person who is not a medical assistance 
27.32 	recipient for resident days that preceded the date of completion of screening activities 
27.33 	as required under section 256.975, subdivisions ~~4a, 4b, and 4c~~ 7a to 7c. The nursing 
28.1 	facility must include unreimbursed resident days in the nursing facility resident day totals 
28.2 	reported to the commissioner.

28.3 	Sec. 23. Minnesota Statutes 2012, section 256B.0913, subdivision 4, is amended to read:
28.4 		Subd. 4.Eligibility for funding for services for nonmedical assistance recipients.
 28.5 	(a) Funding for services under the alternative care program is available to persons who 
28.6 	meet the following criteria:
28.7 	(1) the person has been determined by a community assessment under section 
28.8 	256B.0911 to be a person who would require the level of care provided in a nursing 
28.9 	facility, as determined under section 256B.0911, subdivision ~~4a, paragraph (d)~~ 4e, but for 
28.10 	the provision of services under the alternative care program;
28.11 	(2) the person is age 65 or older;
28.12 	(3) the person would be eligible for medical assistance within 135 days of admission 
28.13 	to a nursing facility;
28.14 	(4) the person is not ineligible for the payment of long-term care services by the 
28.15 	medical assistance program due to an asset transfer penalty under section 256B.0595 or 
28.16 	equity interest in the home exceeding $500,000 as stated in section 256B.056;
28.17 	(5) the person needs long-term care services that are not funded through other 
28.18 	state or federal funding, or other health insurance or other third-party insurance such as 
28.19 	long-term care insurance;
28.20 	(6) except for individuals described in clause (7), the monthly cost of the alternative 
28.21 	care services funded by the program for this person does not exceed 75 percent of the 
28.22 	monthly limit described under section 256B.0915, subdivision 3a. This monthly limit 
28.23 	does not prohibit the alternative care client from payment for additional services, but in no 
28.24 	case may the cost of additional services purchased under this section exceed the difference 
28.25 	between the client's monthly service limit defined under section 256B.0915, subdivision 
28.26 	3, and the alternative care program monthly service limit defined in this paragraph. If 
28.27 	care-related supplies and equipment or environmental modifications and adaptations are or 
28.28 	will be purchased for an alternative care services recipient, the costs may be prorated on a 
28.29 	monthly basis for up to 12 consecutive months beginning with the month of purchase. 
28.30 	If the monthly cost of a recipient's other alternative care services exceeds the monthly 
28.31 	limit established in this paragraph, the annual cost of the alternative care services shall be 
28.32 	determined. In this event, the annual cost of alternative care services shall not exceed 12 
28.33 	times the monthly limit described in this paragraph;
28.34 	(7) for individuals assigned a case mix classification A as described under section 
28.35 	256B.0915, subdivision 3a, paragraph (a), with (i) no dependencies in activities of daily 
29.1 	living, or (ii) up to two dependencies in bathing, dressing, grooming, walking, and eating 
29.2 	when the dependency score in eating is three or greater as determined by an assessment 
29.3 	performed under section 256B.0911, the monthly cost of alternative care services funded 
29.4 	by the program cannot exceed $593 per month for all new participants enrolled in 
29.5 	the program on or after July 1, 2011. This monthly limit shall be applied to all other 
29.6 	participants who meet this criteria at reassessment. This monthly limit shall be increased 
29.7 	annually as described in section 256B.0915, subdivision 3a, paragraph (a). This monthly 
29.8 	limit does not prohibit the alternative care client from payment for additional services, but 
29.9 	in no case may the cost of additional services purchased exceed the difference between the 
29.10 	client's monthly service limit defined in this clause and the limit described in clause (6) 
29.11 	for case mix classification A; and
29.12 	(8) the person is making timely payments of the assessed monthly fee.
29.13 	A person is ineligible if payment of the fee is over 60 days past due, unless the person 
29.14 	agrees to:
29.15 	(i) the appointment of a representative payee;
29.16 	(ii) automatic payment from a financial account;
29.17 	(iii) the establishment of greater family involvement in the financial management of 
29.18 	payments; or
29.19 	(iv) another method acceptable to the lead agency to ensure prompt fee payments.
29.20 	The lead agency may extend the client's eligibility as necessary while making 
29.21 	arrangements to facilitate payment of past-due amounts and future premium payments. 
29.22 	Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be 
29.23 	reinstated for a period of 30 days.
29.24 	(b) Alternative care funding under this subdivision is not available for a person who 
29.25 	is a medical assistance recipient or who would be eligible for medical assistance without a 
29.26 	spenddown or waiver obligation. A person whose initial application for medical assistance 
29.27 	and the elderly waiver program is being processed may be served under the alternative care 
29.28 	program for a period up to 60 days. If the individual is found to be eligible for medical 
29.29 	assistance, medical assistance must be billed for services payable under the federally 
29.30 	approved elderly waiver plan and delivered from the date the individual was found eligible 
29.31 	for the federally approved elderly waiver plan. Notwithstanding this provision, alternative 
29.32 	care funds may not be used to pay for any service the cost of which: (i) is payable by 
29.33 	medical assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to 
29.34 	pay a medical assistance income spenddown for a person who is eligible to participate in the 
29.35 	federally approved elderly waiver program under the special income standard provision.
30.1 	(c) Alternative care funding is not available for a person who resides in a licensed 
30.2 	nursing home, certified boarding care home, hospital, or intermediate care facility, except 
30.3 	for case management services which are provided in support of the discharge planning 
30.4 	process for a nursing home resident or certified boarding care home resident to assist with 
30.5 	a relocation process to a community-based setting.
30.6 	(d) Alternative care funding is not available for a person whose income is greater 
30.7 	than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal 
30.8 	to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal 
30.9 	year for which alternative care eligibility is determined, who would be eligible for the 
30.10 	elderly waiver with a waiver obligation.

30.11 	Sec. 24. Minnesota Statutes 2012, section 256B.0913, is amended by adding a 
30.12 	subdivision to read:
30.13 		Subd. 17.Essential community supports grants. (a) Notwithstanding subdivisions 
30.14 	1 to 14, the purpose of the essential community supports grant program is to provide 
30.15 	targeted services to persons age 65 and older who need essential community support, but 
30.16 	whose needs do not meet the level of care required for nursing facility placement under 
30.17 	section 144.0724, subdivision 11.
30.18 	(b) Essential community supports grants are available not to exceed $400 per person 
30.19 	per month. Essential community supports service grants may be used as authorized within 
30.20 	an authorization period not to exceed 12 months. Grants must be available to a person who:
30.21 	(1) is age 65 or older;
30.22 	(2) is not eligible for medical assistance;
30.23 	(3) would otherwise be financially eligible for the alternative care program under 
30.24 	subdivision 4;
30.25 	(4) has received a community assessment under section 256B.0911, subdivision 3a 
30.26 	or 3b, and does not require the level of care provided in a nursing facility;
30.27 	(5) has a community support plan; and
30.28 	(6) has been determined by a community assessment under section 256B.0911, 
30.29 	subdivision 3a or 3b, to be a person who would require provision of at least one of the 
30.30 	following services, as defined in the approved elderly waiver plan, in order to maintain 
30.31 	their community residence:
30.32 	(i) caregiver support;
30.33 	(ii) homemaker support;
30.34 	(iii) chores; or
30.35 	(iv) a personal emergency response device or system.
31.1 	(c) The person receiving any of the essential community supports in this subdivision 
31.2 	must also receive service coordination, not to exceed $600 in a 12-month authorization 
31.3 	period, as part of their community support plan.
31.4 	(d) A person who has been determined to be eligible for an essential community 
31.5 	supports grant must be reassessed at least annually and continue to meet the criteria in 
31.6 	paragraph (b) to remain eligible for an essential community supports grant.
31.7 	(e) The commissioner is authorized to use federal matching funds for essential 
31.8 	community supports as necessary and to meet demand for essential community supports 
31.9 	grants as outlined in paragraphs (f) and (g), and that amount of federal funds is 
31.10 	appropriated to the commissioner for this purpose.
31.11 	(f) Upon federal approval and following a reasonable implementation period 
31.12 	determined by the commissioner, essential community supports are available to an 
31.13 	individual who:
31.14 	(1) is receiving nursing facility services or home and community-based long-term 
31.15 	services and supports under section 256B.0915 or 256B.49 on the effective date of 
31.16 	implementation of the revised nursing facility level of care under section 144.0724, 
31.17 	subdivision 11;
31.18 	(2) meets one of the following criteria:
31.19 	(i) due to the implementation of the revised nursing facility level of care, loses 
31.20 	eligibility for continuing medical assistance payment of nursing facility services at the 
31.21 	first reassessment under section 144.0724, subdivision 11, paragraph (b), that occurs on or 
31.22 	after the effective date of the revised nursing facility level of care criteria under section 
31.23 	144.0724, subdivision 11; or
31.24 	(ii) due to the implementation of the revised nursing facility level of care, loses 
31.25 	eligibility for continuing medical assistance payment of home and community-based 
31.26 	long-term services and supports under section 256B.0915 or 256B.49 at the first 
31.27 	reassessment required under those sections that occurs on or after the effective date of 
31.28 	implementation of the revised nursing facility level of care under section 144.0724, 
31.29 	subdivision 11;
31.30 	(3) is not eligible for personal care attendant services; and
31.31 	(4) has an assessed need for one or more of the supportive services offered under 
31.32 	essential community supports.
31.33 	Individuals eligible under this paragraph includes individuals who continue to be 
31.34 	eligible for medical assistance state plan benefits and those who are not or are no longer 
31.35 	financially eligible for medical assistance.
32.1 	(g) Upon federal approval and following a reasonable implementation period 
32.2 	determined by the commissioner, the services available through essential community 
32.3 	supports include the services and grants provided in paragraphs (b) and (c), home-delivered 
32.4 	meals, and community living assistance as defined by the commissioner. These services 
32.5 	are available to all eligible recipients including those outlined in paragraphs (b) and (f). 
32.6 	Recipients are eligible if they have a need for any of these services and meet all other 
32.7 	eligibility criteria.

32.8 	Sec. 25. Minnesota Statutes 2012, section 256B.0915, subdivision 3a, is amended to 
32.9 	read:
32.10 		Subd. 3a.Elderly waiver cost limits. (a) The monthly limit for the cost of 
32.11 	waivered services to an individual elderly waiver client except for individuals described in 
32.12 	~~paragraph~~ paragraphs (b) and (d) shall be the weighted average monthly nursing facility 
32.13 	rate of the case mix resident class to which the elderly waiver client would be assigned 
32.14 	under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance 
32.15 	needs allowance as described in subdivision 1d, paragraph (a), until the first day of the 
32.16 	state fiscal year in which the resident assessment system as described in section 256B.438
32.17 	for nursing home rate determination is implemented. Effective on the first day of the state 
32.18 	fiscal year in which the resident assessment system as described in section 256B.438 for 
32.19 	nursing home rate determination is implemented and the first day of each subsequent state 
32.20 	fiscal year, the monthly limit for the cost of waivered services to an individual elderly 
32.21 	waiver client shall be the rate of the case mix resident class to which the waiver client 
32.22 	would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on 
32.23 	the last day of the previous state fiscal year, adjusted by any legislatively adopted home 
32.24 	and community-based services percentage rate adjustment.
32.25 	(b) The monthly limit for the cost of waivered services to an individual elderly 
32.26 	waiver client assigned to a case mix classification A under paragraph (a) with:
32.27 	(1) no dependencies in activities of daily living; or
32.28 	(2) up to two dependencies in bathing, dressing, grooming, walking, and eating 
32.29 	when the dependency score in eating is three or greater as determined by an assessment 
32.30 	performed under section 256B.0911
32.31 	shall be $1,750 per month effective on July 1, 2011, for all new participants enrolled in 
32.32 	the program on or after July 1, 2011. This monthly limit shall be applied to all other 
32.33 	participants who meet this criteria at reassessment. This monthly limit shall be increased 
32.34 	annually as described in paragraph (a).
33.1 	(c) If extended medical supplies and equipment or environmental modifications are 
33.2 	or will be purchased for an elderly waiver client, the costs may be prorated for up to 
33.3 	12 consecutive months beginning with the month of purchase. If the monthly cost of a 
33.4 	recipient's waivered services exceeds the monthly limit established in paragraph (a) or 
33.5 	(b), the annual cost of all waivered services shall be determined. In this event, the annual 
33.6 	cost of all waivered services shall not exceed 12 times the monthly limit of waivered 
33.7 	services as described in paragraph (a) or (b).
33.8 	(d) Effective July 1, 2013, the monthly cost limit of waiver services, including 
33.9 	any necessary home care services described in section 256B.0651, subdivision 2, for 
33.10 	individuals who meet the criteria as ventilator-dependent given in section 256B.0651, 
33.11 	subdivision 1, paragraph (g), shall be the average of the monthly medical assistance 
33.12 	amount established for home care services as described in section 256B.0652, subdivision 
33.13 	7, and the annual average contracted amount established by the commissioner for nursing 
33.14 	facility services for ventilator-dependent individuals. This monthly limit shall be increased 
33.15 	annually as described in paragraph (a).

33.16 	Sec. 26. Minnesota Statutes 2012, section 256B.0915, is amended by adding a 
33.17 	subdivision to read:
33.18 		Subd. 3j.Individual community living support. Upon federal approval, there 
33.19 	is established a new service called individual community living support (ICLS) that is 
33.20 	available on the elderly waiver. ICLS providers may not be the landlord of recipients, nor 
33.21 	have any interest in the recipient's housing. ICLS must be delivered in a single-family 
33.22 	home or apartment where the service recipient or their family owns or rents, as 
33.23 	demonstrated by a lease agreement, and maintains control over the individual unit. Case 
33.24 	managers or care coordinators must develop individual ICLS plans in consultation with 
33.25 	the client using a tool developed by the commissioner. The commissioner shall establish 
33.26 	payment rates and mechanisms to align payments with the type and amount of service 
33.27 	provided, assure statewide uniformity, and assure cost-effectiveness. ICLS shall not be 
33.28 	considered home care services for purposes of section 144A.43.

33.29 	Sec. 27. Minnesota Statutes 2012, section 256B.0915, subdivision 5, is amended to read:
33.30 		Subd. 5.Assessments and reassessments for waiver clients. (a) Each client 
33.31 	shall receive an initial assessment of strengths, informal supports, and need for services 
33.32 	in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a 
33.33 	client served under the elderly waiver must be conducted at least every 12 months and at 
33.34 	other times when the case manager determines that there has been significant change in 
34.1 	the client's functioning. This may include instances where the client is discharged from 
34.2 	the hospital. There must be a determination that the client requires nursing facility level 
34.3 	of care as defined in section 256B.0911, subdivision ~~4a, paragraph (d)~~ 4e, at initial and 
34.4 	subsequent assessments to initiate and maintain participation in the waiver program.
34.5 	(b) Regardless of other assessments identified in section 144.0724, subdivision 
34.6 	4, as appropriate to determine nursing facility level of care for purposes of medical 
34.7 	assistance payment for nursing facility services, only face-to-face assessments conducted 
34.8 	according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility 
34.9 	level of care determination will be accepted for purposes of initial and ongoing access to 
34.10 	waiver service payment.

34.11 	Sec. 28. Minnesota Statutes 2012, section 256B.0917, is amended by adding a 
34.12 	subdivision to read:
34.13 		Subd. 1a.Home and community-based services for older adults. (a) The purpose 
34.14 	of projects selected by the commissioner of human services under this section is to 
34.15 	make strategic changes in the long-term services and supports system for older adults 
34.16 	including statewide capacity for local service development and technical assistance, and 
34.17 	statewide availability of home and community-based services for older adult services, 
34.18 	caregiver support and respite care services, and other supports in the state of Minnesota. 
34.19 	These projects are intended to create incentives for new and expanded home and 
34.20 	community-based services in Minnesota in order to:
34.21 	(1) reach older adults early in the progression of their need for long-term services 
34.22 	and supports, providing them with low-cost, high-impact services that will prevent or 
34.23 	delay the use of more costly services;
34.24 	(2) support older adults to live in the most integrated, least restrictive community 
34.25 	setting;
34.26 	(3) support the informal caregivers of older adults;
34.27 	(4) develop and implement strategies to integrate long-term services and supports 
34.28 	with health care services, in order to improve the quality of care and enhance the quality 
34.29 	of life of older adults and their informal caregivers;
34.30 	(5) ensure cost-effective use of financial and human resources;
34.31 	(6) build community-based approaches and community commitment to delivering 
34.32 	long-term services and supports for older adults in their own homes;
34.33 	(7) achieve a broad awareness and use of lower-cost in-home services as an 
34.34 	alternative to nursing homes and other residential services;
35.1 	(8) strengthen and develop additional home and community-based services and 
35.2 	alternatives to nursing homes and other residential services; and
35.3 	(9) strengthen programs that use volunteers.
35.4 	(b) The services provided by these projects are available to older adults who are 
35.5 	eligible for medical assistance and the elderly waiver under section 256B.0915, the 
35.6 	alternative care program under section 256B.0913, or essential community supports grant 
35.7 	under subdivision 14, paragraph (b), and to persons who have their own funds to pay for 
35.8 	services.

35.9 	Sec. 29. Minnesota Statutes 2012, section 256B.0917, is amended by adding a 
35.10 	subdivision to read:
35.11 		Subd. 1b.Definitions. (a) For purposes of this section, the following terms have 
35.12 	the meanings given.
35.13 	(b) "Community" means a town; township; city; or targeted neighborhood within a 
35.14 	city; or a consortium of towns, townships, cities, or specific neighborhoods within a city.
35.15 	(c) "Core home and community-based services provider" means a Faith in Action, 
35.16 	Living at Home Block Nurse, Congregational Nurse, or similar community-based program 
35.17 	that organizes and uses volunteers and paid staff to deliver nonmedical services intended 
35.18 	to assist older adults to identify and manage risks and to maintain their community living 
35.19 	and integration in the community.
35.20 	(d) "Eldercare development partnership" means a team of representatives of county 
35.21 	social service and public health agencies, the area agency on aging, local nursing home 
35.22 	providers, local home care providers, and other appropriate home and community-based 
35.23 	providers in the area agency's planning and service area.
35.24 	(e) "Long-term services and supports" means any service available under the 
35.25 	elderly waiver program or alternative care grant programs; nursing facility services; 
35.26 	transportation services; caregiver support and respite care services; and other home and 
35.27 	community-based services identified as necessary either to maintain lifestyle choices for 
35.28 	older adults or to support them to remain in their own home.
35.29 	(f) "Older adult" refers to an individual who is 65 years of age or older.

35.30 	Sec. 30. Minnesota Statutes 2012, section 256B.0917, is amended by adding a 
35.31 	subdivision to read:
35.32 		Subd. 1c.Eldercare development partnerships. The commissioner of human 
35.33 	services shall select and contract with eldercare development partnerships sufficient to 
36.1 	provide statewide availability of service development and technical assistance using a 
36.2 	request for proposals process. Eldercare development partnerships shall:
36.3 	(1) develop a local long-term services and supports strategy consistent with state 
36.4 	goals and objectives;
36.5 	(2) identify and use existing local skills, knowledge and relationships, and build 
36.6 	on these assets;
36.7 	(3) coordinate planning for funds to provide services to older adults, including funds 
36.8 	received under Title III of the Older Americans Act, Title XX of the Social Security Act, 
36.9 	and the Local Public Health Act;
36.10 	(4) target service development and technical assistance where nursing facility 
36.11 	closures have occurred or are occurring or in areas where service needs have been 
36.12 	identified through activities under section 144A.351;
36.13 	(5) provide sufficient staff for development and technical support in its designated 
36.14 	area; and
36.15 	(6) designate a single public or nonprofit member of the eldercare development 
36.16 	partnerships to apply grant funding and manage the project.

36.17 	Sec. 31. Minnesota Statutes 2012, section 256B.0917, subdivision 6, is amended to read:
36.18 		Subd. 6.Caregiver support and respite care projects. (a) The commissioner 
36.19 	shall establish ~~up to 36~~ projects to expand the ~~respite care network in the state and to~~ 
36.20 	~~support caregivers in their responsibilities for care. The purpose of each project shall~~ 
36.21 	~~be to~~ availability of caregiver support and respite care services for family and other 
36.22 	caregivers. The commissioner shall use a request for proposals to select nonprofit entities 
36.23 	to administer the projects. Projects shall:
36.24 	(1) establish a local coordinated network of volunteer and paid respite workers;
36.25 	(2) coordinate assignment of respite ~~workers~~ care services to ~~clients and care~~ 
36.26 	~~receivers and assure the health and safety of the client; and~~ caregivers of older adults;
36.27 	~~(3) provide training for caregivers and ensure that support groups are available~~ 
36.28 	~~in the community.~~
36.29 	(3) assure the health and safety of the older adults;
36.30 	(4) identify at-risk caregivers;
36.31 	(5) provide information, education, and training for caregivers in the designated 
36.32 	community; and
36.33 	(6) demonstrate the need in the proposed service area particularly where nursing 
36.34 	facility closures have occurred or are occurring or areas with service needs identified 
37.1 	by section 144A.351. Preference must be given for projects that reach underserved 
37.2 	populations.
37.3 	~~(b) The caregiver support and respite care funds shall be available to the four to six~~ 
37.4 	~~local long-term care strategy projects designated in subdivisions 1 to 5.~~
37.5 	~~(c) The commissioner shall publish a notice in the State Register to solicit proposals~~ 
37.6 	~~from public or private nonprofit agencies for the projects not included in the four to six~~ 
37.7 	~~local long-term care strategy projects defined in subdivision 2. A county agency may,~~ 
37.8 	~~alone or in combination with other county agencies, apply for caregiver support and~~ 
37.9 	~~respite care project funds. A public or nonprofit agency within a designated SAIL project~~ 
37.10 	~~area may apply for project funds if the agency has a letter of agreement with the county~~ 
37.11 	~~or counties in which services will be developed, stating the intention of the county or~~ 
37.12 	~~counties to coordinate their activities with the agency requesting a grant.~~
37.13 	~~(d) The commissioner shall select grantees based on the following criteria~~ (b) 
37.14 	Projects must clearly describe:
37.15 	~~(1) the ability of the proposal to demonstrate need in the area served, as evidenced~~ 
37.16 	~~by a community needs assessment or other demographic data;~~
37.17 	~~(2) the ability of the proposal to clearly describe how the project~~ (1) how they will 
37.18 	achieve ~~the~~ their purpose ~~defined in paragraph (b)~~;
37.19 	~~(3) the ability of the proposal to reach underserved populations;~~
37.20 	~~(4) the ability of the proposal to demonstrate community commitment to the project,~~ 
37.21 	~~as evidenced by letters of support and cooperation as well as formation of a community~~ 
37.22 	~~task force;~~
37.23 	~~(5) the ability of the proposal to clearly describe~~ (2) the process for recruiting, 
37.24 	training, and retraining volunteers; and
37.25 	~~(6) the inclusion in the proposal of the~~ (3) their plan to promote the project in the 
37.26 	designated community, including outreach to persons needing the services.
37.27 	~~(e)~~ (c) Funds for all projects under this subdivision may be used to:
37.28 	(1) hire a coordinator to develop a coordinated network of volunteer and paid respite 
37.29 	care services and assign workers to clients;
37.30 	(2) recruit and train volunteer providers;
37.31 	(3) ~~train~~ provide information, training, and education to caregivers;
37.32 	~~(4) ensure the development of support groups for caregivers;~~
37.33 	~~(5)~~ (4) advertise the availability of the caregiver support and respite care project; and
37.34 	~~(6)~~ (5) purchase equipment to maintain a system of assigning workers to clients.
37.35 	~~(f)~~ (d) Project funds may not be used to supplant existing funding sources.

38.1 	Sec. 32. Minnesota Statutes 2012, section 256B.0917, is amended by adding a 
38.2 	subdivision to read:
38.3 		Subd. 7a.Core home and community-based services. The commissioner shall 
38.4 	select and contract with core home and community-based services providers for projects 
38.5 	to provide services and supports to older adults both with and without family and other 
38.6 	informal caregivers using a request for proposals process. Projects must:
38.7 	(1) have a credible, public, or private nonprofit sponsor providing ongoing financial 
38.8 	support;
38.9 	(2) have a specific, clearly defined geographic service area;
38.10 	(3) use a practice framework designed to identify high-risk older adults and help them 
38.11 	take action to better manage their chronic conditions and maintain their community living;
38.12 	(4) have a team approach to coordination and care, ensuring that the older adult 
38.13 	participants, their families, and the formal and informal providers are all part of planning 
38.14 	and providing services;
38.15 	(5) provide information, support services, homemaking services, counseling, and 
38.16 	training for the older adults and family caregivers;
38.17 	(6) encourage service area or neighborhood residents and local organizations to 
38.18 	collaborate in meeting the needs of older adults in their geographic service areas;
38.19 	(7) recruit, train, and direct the use of volunteers to provide informal services and 
38.20 	other appropriate support to older adults and their caregivers; and
38.21 	(8) provide coordination and management of formal and informal services to older 
38.22 	adults and their families using less expensive alternatives.

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

39.1 	Sec. 34. Minnesota Statutes 2012, section 256B.092, is amended by adding a 
39.2 	subdivision to read:
39.3 		Subd. 14.Reduce avoidable behavioral crisis emergency room, psychiatric 
39.4 	inpatient hospitalizations, and commitments to institutions. (a) Persons receiving 
39.5 	home and community-based services authorized under this section who have had two 
39.6 	or more admissions within a calendar year to an emergency room, psychiatric unit, 
39.7 	or institution must receive consultation from a mental health professional as defined in 
39.8 	section 245.462, subdivision 18, or a behavioral professional as defined in the home and 
39.9 	community-based services state plan within 30 days of discharge. The mental health 
39.10 	professional or behavioral professional must:
39.11 	(1) conduct a functional assessment of the crisis incident as defined in section 
39.12 	245D.02, subdivision 11, which led to the hospitalization with the goal of developing 
39.13 	proactive strategies as well as necessary reactive strategies to reduce the likelihood of 
39.14 	future avoidable hospitalizations due to a behavioral crisis;
39.15 	(2) use the results of the functional assessment to amend the coordinated service and 
39.16 	support plan set forth in section 245D.02, subdivision 4b, to address the potential need 
39.17 	for additional staff training, increased staffing, access to crisis mobility services, mental 
39.18 	health services, use of technology, and crisis stabilization services in section 256B.0624, 
39.19 	subdivision 7; and 
39.20 	(3) identify the need for additional consultation, testing, and mental health crisis 
39.21 	intervention team services as defined in section 245D.02, subdivision 20, psychotropic 
39.22 	medication use and monitoring under section 245D.051, as well as the frequency and 
39.23 	duration of ongoing consultation. 
39.24 	(b) For the purposes of this subdivision, "institution" includes, but is not limited to, 
39.25 	the Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.

39.26 	Sec. 35. Minnesota Statutes 2012, section 256B.439, subdivision 1, is amended to read:
39.27 		Subdivision 1.Development and implementation of quality profiles. (a) The 
39.28 	commissioner of human services, in cooperation with the commissioner of health, 
39.29 	shall develop and implement ~~a~~ quality ~~profile system~~ profiles for nursing facilities and, 
39.30 	beginning not later than July 1, ~~2004~~ 2014, other providers of long-term care services, 
39.31 	except when the quality profile system would duplicate requirements under section 
39.32 	256B.5011, 256B.5012, or 256B.5013. The ~~system~~ quality profiles  must be developed 
39.33 	~~and implemented to the extent possible without the collection of significant amounts of~~ 
39.34 	~~new data. To the extent possible, the system~~ using existing data sets maintained by the 
39.35 	commissioners of health and human services to the extent possible. The profiles  must 
40.1 	incorporate or be coordinated with information on quality maintained by area agencies on 
40.2 	aging, long-term care trade associations, the ombudsman offices, counties, tribes, health 
40.3 	plans, and other entities and the long-term care database maintained under section 256.975, 
40.4 	subdivision 7. The ~~system~~ profiles must be designed to provide information on quality to:
40.5 	(1) consumers and their families to facilitate informed choices of service providers;
40.6 	(2) providers to enable them to measure the results of their quality improvement 
40.7 	efforts and compare quality achievements with other service providers; and
40.8 	(3) public and private purchasers of long-term care services to enable them to 
40.9 	purchase high-quality care.
40.10 	(b) The ~~system~~ profiles must be developed in consultation with the long-term care 
40.11 	task force, area agencies on aging, and representatives of consumers, providers, and labor 
40.12 	unions. Within the limits of available appropriations, the commissioners may employ 
40.13 	consultants to assist with this project.

40.14 	Sec. 36. Minnesota Statutes 2012, section 256B.439, subdivision 2, is amended to read:
40.15 		Subd. 2.Quality measurement tools. The commissioners shall identify and apply 
40.16 	existing quality measurement tools to:
40.17 	(1) emphasize quality of care and its relationship to quality of life; and
40.18 	(2) address the needs of various users of long-term care services, including, but not 
40.19 	limited to, short-stay residents, persons with behavioral problems, persons with dementia, 
40.20 	and persons who are members of minority groups.
40.21 	The tools must be identified and applied, to the extent possible, without requiring 
40.22 	providers to supply information beyond ~~current~~ state and federal requirements.

40.23 	Sec. 37. Minnesota Statutes 2012, section 256B.439, subdivision 3, is amended to read:
40.24 		Subd. 3.Consumer surveys of nursing facilities residents. Following 
40.25 	identification of the quality measurement tool, the commissioners shall conduct surveys 
40.26 	of long-term care service consumers of nursing facilities to develop quality profiles 
40.27 	of providers. To the extent possible, surveys must be conducted face-to-face by state 
40.28 	employees or contractors. At the discretion of the commissioners, surveys may be 
40.29 	conducted by telephone or by provider staff. Surveys must be conducted periodically to 
40.30 	update quality profiles of individual ~~service~~ nursing facilities providers.

40.31 	Sec. 38. Minnesota Statutes 2012, section 256B.439, is amended by adding a 
40.32 	subdivision to read:
41.1 		Subd. 3a.Home and community-based services report card in cooperation with 
41.2 	the commissioner of health. The profiles developed for home and community-based 
41.3 	services providers under this section shall be incorporated into a report card and 
41.4 	maintained by the Minnesota Board on Aging pursuant to section 256.975, subdivision 
41.5 	7, paragraph (b), clause (2), as data becomes available. The commissioner, in 
41.6 	cooperation with the commissioner of health, shall use consumer choice, quality of life, 
41.7 	care approaches, and cost or flexible purchasing categories to organize the consumer 
41.8 	information in the profiles. The final categories used shall include consumer input and 
41.9 	survey data to the extent that is available through the state agencies. The commissioner 
41.10 	shall develop and disseminate the qualify profiles for a limited number of provider types 
41.11 	initially, and develop quality profiles for additional provider types as measurement tools 
41.12 	are developed and data becomes available. This includes providers of services to older 
41.13 	adults and people with disabilities, regardless of payor source.

41.14 	Sec. 39. Minnesota Statutes 2012, section 256B.439, subdivision 4, is amended to read:
41.15 		Subd. 4.Dissemination of quality profiles. By July 1, ~~2003~~ 2014, the 
41.16 	commissioners shall implement a ~~system~~ public awareness effort to disseminate the quality 
41.17 	profiles ~~developed from consumer surveys using the quality measurement tool~~. Profiles 
41.18 	may be disseminated ~~to~~ through the Senior LinkAge Line and Disability Linkage Line and 
41.19 	to consumers, providers, and purchasers of long-term care services ~~through all feasible~~ 
41.20 	~~printed and electronic outlets. The commissioners may conduct a public awareness~~ 
41.21 	~~campaign to inform potential users regarding profile contents and potential uses~~.

41.22 	Sec. 40. Minnesota Statutes 2012, section 256B.49, subdivision 12, is amended to read:
41.23 		Subd. 12.Informed choice. Persons who are determined likely to require the level 
41.24 	of care provided in a nursing facility as determined under section 256B.0911, subdivision 
41.25 	4e, or a hospital shall be informed of the home and community-based support alternatives 
41.26 	to the provision of inpatient hospital services or nursing facility services. Each person 
41.27 	must be given the choice of either institutional or home and community-based services 
41.28 	using the provisions described in section 256B.77, subdivision 2, paragraph (p).

41.29 	Sec. 41. Minnesota Statutes 2012, section 256B.49, subdivision 14, is amended to read:
41.30 		Subd. 14.Assessment and reassessment. (a) Assessments and reassessments 
41.31 	shall be conducted by certified assessors according to section 256B.0911, subdivision 2b. 
41.32 	With the permission of the recipient or the recipient's designated legal representative, 
41.33 	the recipient's current provider of services may submit a written report outlining their 
42.1 	recommendations regarding the recipient's care needs prepared by a direct service 
42.2 	employee with at least 20 hours of service to that client. The person conducting the 
42.3 	assessment or reassessment must notify the provider of the date by which this information 
42.4 	is to be submitted. This information shall be provided to the person conducting the 
42.5 	assessment and the person or the person's legal representative and must be considered 
42.6 	prior to the finalization of the assessment or reassessment.
42.7 	(b) There must be a determination that the client requires a hospital level of care or a 
42.8 	nursing facility level of care as defined in section 256B.0911, subdivision ~~4a, paragraph~~ 
42.9 	~~(d)~~ 4e, at initial and subsequent assessments to initiate and maintain participation in the 
42.10 	waiver program.
42.11 	(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as 
42.12 	appropriate to determine nursing facility level of care for purposes of medical assistance 
42.13 	payment for nursing facility services, only face-to-face assessments conducted according 
42.14 	to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care 
42.15 	determination or a nursing facility level of care determination must be accepted for 
42.16 	purposes of initial and ongoing access to waiver services payment.
42.17 	(d) Recipients who are found eligible for home and community-based services under 
42.18 	this section before their 65th birthday may remain eligible for these services after their 
42.19 	65th birthday if they continue to meet all other eligibility factors.
42.20 	(e) The commissioner shall develop criteria to identify recipients whose level of 
42.21 	functioning is reasonably expected to improve and reassess these recipients to establish 
42.22 	a baseline assessment. Recipients who meet these criteria must have a comprehensive 
42.23 	transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be 
42.24 	reassessed every six months until there has been no significant change in the recipient's 
42.25 	functioning for at least 12 months. After there has been no significant change in the 
42.26 	recipient's functioning for at least 12 months, reassessments of the recipient's strengths, 
42.27 	informal support systems, and need for services shall be conducted at least every 12 
42.28 	months and at other times when there has been a significant change in the recipient's 
42.29 	functioning. Counties, case managers, and service providers are responsible for 
42.30 	conducting these reassessments and shall complete the reassessments out of existing funds.

42.31 	Sec. 42. Minnesota Statutes 2012, section 256B.49, is amended by adding a 
42.32 	subdivision to read:
42.33 		Subd. 25.Reduce avoidable behavioral crisis emergency room, psychiatric 
42.34 	inpatient hospitalizations, and commitments to institutions. (a) Persons receiving 
42.35 	home and community-based services authorized under this section who have two or more 
43.1 	admissions within a calendar year to an emergency room, psychiatric unit, or institution 
43.2 	must receive consultation from a mental health professional as defined in section 245.462, 
43.3 	subdivision 18, or a behavioral professional as defined in the home and community-based 
43.4 	services state plan within 30 days of discharge. The mental health professional or 
43.5 	behavioral professional must:
43.6 	(1) conduct a functional assessment of the crisis incident as defined in section 
43.7 	245D.02, subdivision 11, which led to the hospitalization with the goal of developing 
43.8 	proactive strategies as well as necessary reactive strategies to reduce the likelihood of 
43.9 	future avoidable hospitalizations due to a behavioral crisis;
43.10 	(2) use the results of the functional assessment to amend the coordinated service and 
43.11 	support plan in section 245D.02, subdivision 4b, to address the potential need for additional 
43.12 	staff training, increased staffing, access to crisis mobility services, mental health services, 
43.13 	use of technology, and crisis stabilization services in section 256B.0624, subdivision 7; and
43.14 	(3) identify the need for additional consultation, testing, mental health crisis 
43.15 	intervention team services as defined in section 245D.02, subdivision 20, psychotropic 
43.16 	medication use and monitoring under section 245D.051, as well as the frequency and 
43.17 	duration of ongoing consultation. 
43.18 	(b) For the purposes of this subdivision, "institution" includes, but is not limited to, 
43.19 	the Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.

43.20 	Sec. 43. [256B.85] COMMUNITY FIRST SERVICES AND SUPPORTS.
43.21 		Subdivision 1.Basis and scope. (a) Upon federal approval, the commissioner 
43.22 	shall establish a medical assistance state plan option for the provision of home and 
43.23 	community-based personal assistance service and supports called "community first 
43.24 	services and supports (CFSS)."
43.25 	(b) CFSS is a participant-controlled method of selecting and providing services 
43.26 	and supports that allows the participant maximum control of the services and supports. 
43.27 	Participants may choose the degree to which they direct and manage their supports 
43.28 	by choosing to have a significant and meaningful role in the management of services 
43.29 	and supports including acting as the employer of record with the necessary supports 
43.30 	to perform that function.
43.31 	(c) CFSS is available statewide to eligible individuals to assist with accomplishing 
43.32 	activities of daily living (ADLs), instrumental activities of daily living (IADLs), and 
43.33 	health-related procedures and tasks through hands-on assistance to complete the task or 
43.34 	supervision and cueing to complete the task; and to assist with acquiring, maintaining, and 
43.35 	enhancing the skills necessary to accomplish ADLs, IADLs, and health-related procedures 
44.1 	and tasks. CFSS allows payment for certain supports and goods such as environmental 
44.2 	modifications and technology that are intended to replace or decrease the need for human 
44.3 	assistance.
44.4 	(d) Upon federal approval, CFSS will replace the personal care assistance program 
44.5 	under sections 256.476, 256B.0625, subdivisions 19a and 19c, and 256B.0659.
44.6 		Subd. 2.Definitions. (a) For the purposes of this section, the terms defined in 
44.7 	this subdivision have the meanings given.
44.8 	(b) "Activities of daily living" or "ADLs" means eating, toileting, grooming, 
44.9 	dressing, bathing, mobility, positioning, and transferring.
44.10 	(c) "Agency-provider model" means a method of CFSS under which a qualified 
44.11 	agency provides services and supports through the agency's own employees and policies. 
44.12 	The agency must allow the participant to have a significant role in the selection and 
44.13 	dismissal of support workers of their choice for the delivery of their specific services and 
44.14 	supports including employing workers specifically selected by the participant.
44.15 	(d) "Behavior" means a category to determine the home care rating and is based on the 
44.16 	criteria in section 256B.0659. "Level I behavior" means physical aggression towards self, 
44.17 	others, or destruction of property that requires the immediate response of another person.
44.18 	(e) "Complex health-related needs" means a category to determine the home care 
44.19 	rating and is based on the criteria in section 256B.0659.
44.20 	(f) "Community first services and supports" or "CFSS" means the assistance and 
44.21 	supports program under this section needed for accomplishing activities of daily living, 
44.22 	instrumental activities of daily living, and health-related tasks through hands-on assistance 
44.23 	to complete the task or supervision and cueing to complete the task, or the purchase of 
44.24 	goods as defined in subdivision 7, paragraph (a), clause (2), that replace the need for 
44.25 	human assistance.
44.26 	(g) "Community first services and supports service delivery plan" or "service delivery 
44.27 	plan" means a written summary of the services and supports, that is based on the community 
44.28 	support plan identified in section 256B.0911 and coordinated services and support plan 
44.29 	and budget identified in section 256B.0915, subdivision 6, if applicable, that is determined 
44.30 	by the participant to meet the assessed needs, using a person-centered planning process.
44.31 	(h) "Critical activities of daily living" means transferring, mobility, eating, and 
44.32 	toileting.
44.33 	(i) "Dependency" in activities of daily living means a person requires assistance to 
44.34 	begin and complete one or more of the activities of daily living.
44.35 	(j) "Financial management services contractor or vendor" means a qualified 
44.36 	organization having a written contract with the department to provide services necessary 
45.1 	to use the flexible spending model under subdivision 13, that include but are not limited 
45.2 	to: participant education and technical assistance; CFSS service delivery planning and 
45.3 	budgeting; billing, making payments, and monitoring of spending; and assisting the 
45.4 	participant in fulfilling regulatory requirements when acting as an employer of record for 
45.5 	support workers or employer agent, that are in accordance with Section 3504 of the IRS 
45.6 	code and the IRS Revenue Procedure 70-6.
45.7 	(k) "Flexible spending model" means a service delivery method of CFSS that uses 
45.8 	an individualized CFSS service delivery plan and service budget and assistance from the 
45.9 	financial management services contractor for the employment of support workers and the 
45.10 	acquisition of supports and goods.
45.11 	(l) "Health-related procedures and tasks" means procedures and tasks related to 
45.12 	the specific needs of an individual that can be delegated or assigned by a state-licensed 
45.13 	healthcare or behavioral health professional and performed by a support worker.
45.14 	(m) "Instrumental activities of daily living" means activities related to living 
45.15 	independently in the community, including but not limited to: meal planning, preparation, 
45.16 	and cooking; shopping for food, clothing, or other essential items; laundry; housecleaning; 
45.17 	assistance with medications; managing money; communicating needs, preferences, and 
45.18 	activities; arranging supports; and assistance with traveling around and participating 
45.19 	in the community.
45.20 	(n) "Legal representative" means parent of a minor, a court-appointed guardian, or 
45.21 	another representative with legal authority to make decisions about services and supports 
45.22 	for the participant. Other representatives with legal authority to make decisions include 
45.23 	but are not limited to a health care agent or an attorney-in-fact authorized through a health 
45.24 	care directive or power of attorney.
45.25 	(o) "Medication assistance" means providing verbal or visual reminders to take 
45.26 	regularly scheduled medication and includes any of the following supports:
45.27 	(1) under the direction of the participant or the participant's representative, bringing 
45.28 	medications to the participant including medications given through a nebulizer, opening a 
45.29 	container of previously set up medications, emptying the container into the participant's 
45.30 	hand, opening and giving the medication in the original container to the participant, or 
45.31 	bringing to the participant liquids or food to accompany the medication;
45.32 	(2) organizing medications as directed by the participant or the participant's 
45.33 	representative; and
45.34 	(3) providing verbal or visual reminders to perform regularly scheduled medications.
45.35 	(p) "Participant's representative" means a parent, family member, advocate, or 
45.36 	other adult authorized by the participant to serve as a representative in connection with 
46.1 	the provision of CFSS. This authorization must be in writing or by another method 
46.2 	that clearly indicates the participant's free choice. The participant's representative must 
46.3 	have no financial interest in the provision of any services included in the participant's 
46.4 	service delivery plan and must be capable of providing the support necessary to assist 
46.5 	the participant in the use of CFSS. If through the assessment process described in 
46.6 	subdivision 5 a participant is determined to be in need of a participant's representative, one 
46.7 	must be selected. If the participant is unable to assist in the selection of a participant's 
46.8 	representative, the legal representative shall appoint one. Two persons may be designated 
46.9 	as a participant's representative for reasons such as divided households and court-ordered 
46.10 	custodies. Duties of a participant's representatives may include:
46.11 	(1) being available while care is provided in a method agreed upon by the participant 
46.12 	or the participant's legal representative and documented in the participant's CFSS service 
46.13 	delivery plan;
46.14 	(2) monitoring CFSS services to ensure the participant's CFSS service delivery 
46.15 	plan is being followed; and
46.16 	(3) reviewing and signing CFSS time sheets after services are provided to provide 
46.17 	verification of the CFSS services.
46.18 	(q) "Person-centered planning process" means a process that is driven by the 
46.19 	participant for discovering and planning services and supports that ensures the participant 
46.20 	makes informed choices and decisions. The person-centered planning process must:
46.21 	(1) include people chosen by the participant;
46.22 	(2) provide necessary information and support to ensure that the participant directs 
46.23 	the process to the maximum extent possible, and is enabled to make informed choices 
46.24 	and decisions;
46.25 	(3) be timely and occur at time and locations of convenience to the participant;
46.26 	(4) reflect cultural considerations of the participant;
46.27 	(5) include strategies for solving conflict or disagreement within the process, 
46.28 	including clear conflict-of-interest guidelines for all planning;
46.29 	(6) offers choices to the participant regarding the services and supports they receive 
46.30 	and from whom;
46.31 	(7) include a method for the participant to request updates to the plan; and
46.32 	(8) record the alternative home and community-based settings that were considered 
46.33 	by the participant.
46.34 	(r) "Shared services" means the provision of CFSS services by the same CFSS 
46.35 	support worker to two or three participants who voluntarily enter into an agreement to 
46.36 	receive services at the same time and in the same setting by the same provider.
47.1 	(s) "Support specialist" means a professional with the skills and ability to assist the 
47.2 	participant using either the agency provider model under subdivision 11 or the flexible 
47.3 	spending model under subdivision 13, in services including, but not limited to:
47.4 	(1) the development, implementation, and evaluation of the CFSS service delivery 
47.5 	plan under subdivision 6;
47.6 	(2) recruitment, training, or supervision, including supervision of health-related 
47.7 	tasks or behavioral supports appropriately delegated by a health care professional, and 
47.8 	evaluation of support workers; and
47.9 	(3) facilitating the use of informal and community supports, goods, or resources.
47.10 	(t) "Support worker" means a regular or temporary employee of the agency-provider, 
47.11 	the financial management services contractor, or the participant who has direct contact 
47.12 	with the participant and provides services as specified within the participant's service 
47.13 	delivery plan.
47.14 	(u) "Wages and benefits" means the hourly wages and salaries, the employer's 
47.15 	share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' 
47.16 	compensation, mileage reimbursement, health and dental insurance, life insurance, 
47.17 	disability insurance, long-term care insurance, uniform allowance, and contributions to 
47.18 	employee retirement accounts.
47.19 		Subd. 3.Eligibility. CFSS is available to a person who meets one of the following:
47.20 	(1) is a recipient of medical assistance as determined under section 256B.055, 
47.21 	256B.056, or 256B.057, subdivisions 5 and 9;
47.22 	(2) is a recipient of the alternative care program under section 256B.0913;
47.23 	(3) is a waiver recipient as defined under section 256B.0915, 256B.092, 256B.093, 
47.24 	or 256B.49; or
47.25 	(4) has medical services identified in a participant's individualized education 
47.26 	program and is eligible for services as determined in section 256B.0625, subdivision 26.
47.27 	(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also 
47.28 	meet all of the following:
47.29 	(1) is determined eligible based on assessment under section 256B.0911;
47.30 	(2) is not a recipient under the family support grant under section 252.32;
47.31 	(3) lives in the person's own apartment or home including a family foster care setting 
47.32 	licensed under chapter 245A, but not in corporate foster care under chapter 245A; or a 
47.33 	noncertified boarding care or boarding and lodging establishments under chapter 157; 
47.34 	unless transitioning into the community from an institution; and
47.35 	(4) has not been excluded or disenrolled from the flexible spending model. 
48.1 	(c) The commissioner shall disenroll or exclude participants from the flexible 
48.2 	spending model and transfer them to the agency-provider model under the following 
48.3 	circumstances that include but are not limited to:
48.4 	(1) when a participant has been restricted by the Minnesota restricted recipient 
48.5 	program, the participant may be excluded for a specified time period;
48.6 	(2) when a participant exits the flexible spending service delivery model during the 
48.7 	participant's service plan year. Upon transfer, the participant shall not access the flexible 
48.8 	spending model for the remainder of that service plan year; or
48.9 	(3) when the department determines that the participant or participant's representative 
48.10 	or legal representative cannot manage participant responsibilities under the service 
48.11 	delivery model. The commissioner must develop policies for determining if a participant 
48.12 	is unable to manage responsibilities under a service model.
48.13 	(d) A participant may appeal in writing to the department to contest the department's 
48.14 	decision under paragraph (c), clause (3), to remove or exclude the participant from the 
48.15 	flexible spending model.
48.16 		Subd. 4.Eligibility for other services. Selection of CFSS by a participant must not 
48.17 	restrict access to other medically necessary care and services furnished under the state 
48.18 	plan medical assistance benefit or other services available through alternative care.
48.19 		Subd. 5.Assessment requirements. (a) The assessment of functional need must:
48.20 	(1) be conducted by a certified assessor according to the criteria established in 
48.21 	section 256B.0911;
48.22 	(2) be conducted face-to-face, initially and at least annually thereafter, or when there 
48.23 	is a significant change in the participant's condition or a change in the need for services 
48.24 	and supports; and
48.25 	(3) be completed using the format established by the commissioner.
48.26 	(b) A participant who is residing in a facility may be assessed and choose CFSS for 
48.27 	the purpose of using CFSS to return to the community as described in subdivisions 3 
48.28 	and 7, paragraph (a), clause (5).
48.29 	(c) The results of the assessment and any recommendations and authorizations for 
48.30 	CFSS must be determined and communicated in writing by the lead agency's certified 
48.31 	assessor as defined in section 256B.0911 to the participant and the agency-provider or 
48.32 	financial management services provider chosen by the participant within 40 calendar days 
48.33 	and must include the participant's right to appeal under section 256.045.
48.34 		Subd. 6.Community first services and support service delivery plan. (a) The 
48.35 	CFSS service delivery plan must be developed, implemented, and evaluated through a 
48.36 	person-centered planning process by the participant, or the participant's representative 
49.1 	or legal representative who may be assisted by a support specialist. The CFSS service 
49.2 	delivery plan must reflect the services and supports that are important to the participant 
49.3 	and for the participant to meet the needs assessed by the certified assessor and identified 
49.4 	in the community support plan under section 256B.0911 or the coordinated services and 
49.5 	support plan identified in section 256B.0915, subdivision 6, if applicable. The CFSS 
49.6 	service delivery plan must be reviewed by the participant and the agency-provider or 
49.7 	financial management services contractor at least annually upon reassessment, or when 
49.8 	there is a significant change in the participant's condition, or a change in the need for 
49.9 	services and supports.
49.10 	(b) The commissioner shall establish the format and criteria for the CFSS service 
49.11 	delivery plan.
49.12 	(c) The CFSS service delivery plan must be person-centered and:
49.13 	(1) specify the agency-provider or financial management services contractor selected 
49.14 	by the participant;
49.15 	(2) reflect the setting in which the participant resides that is chosen by the participant;
49.16 	(3) reflect the participant's strengths and preferences;
49.17 	(4) include the means to address the clinical and support needs as identified through 
49.18 	an assessment of functional needs;
49.19 	(5) include individually identified goals and desired outcomes;
49.20 	(6) reflect the services and supports, paid and unpaid, that will assist the participant 
49.21 	to achieve identified goals, and the providers of those services and supports, including 
49.22 	natural supports;
49.23 	(7) identify the amount and frequency of face-to-face supports and amount and 
49.24 	frequency of remote supports and technology that will be used;
49.25 	(8) identify risk factors and measures in place to minimize them, including 
49.26 	individualized backup plans;
49.27 	(9) be understandable to the participant and the individuals providing support;
49.28 	(10) identify the individual or entity responsible for monitoring the plan;
49.29 	(11) be finalized and agreed to in writing by the participant and signed by all 
49.30 	individuals and providers responsible for its implementation;
49.31 	(12) be distributed to the participant and other people involved in the plan; and
49.32 	(13) prevent the provision of unnecessary or inappropriate care.
49.33 	(d) The total units of agency-provider services or the budget allocation amount for 
49.34 	the flexible spending model include both annual totals and a monthly average amount 
49.35 	that cover the number of months of the service authorization. The amount used each 
49.36 	month may vary, but additional funds must not be provided above the annual service 
50.1 	authorization amount unless a change in condition is assessed and authorized by the 
50.2 	certified assessor and documented in the community support plan, coordinated services 
50.3 	and supports plan, and service delivery plan.
50.4 		Subd. 7.Community first services and supports; covered services. (a) Services 
50.5 	and supports covered under CFSS include:
50.6 	(1) assistance to accomplish activities of daily living (ADLs), instrumental activities 
50.7 	of daily living (IADLs), and health-related procedures and tasks through hands-on 
50.8 	assistance to complete the task or supervision and cueing to complete the task;
50.9 	(2) assistance to acquire, maintain, or enhance the skills necessary for the participant 
50.10 	to accomplish activities of daily living, instrumental activities of daily living, or 
50.11 	health-related tasks;
50.12 	(3) expenditures for items, services, supports, environmental modifications, or 
50.13 	goods, including assistive technology. These expenditures must:
50.14 	(i) relate to a need identified in a participant's CFSS service delivery plan; and
50.15 	(ii) increase independence or substitute for human assistance to the extent that 
50.16 	expenditures would otherwise be made for human assistance for the participant's assessed 
50.17 	needs;
50.18 	(4) observation and redirection for episodes where there is a need for redirection 
50.19 	due to participant behaviors. An assessment of behaviors must meet the criteria in this 
50.20 	clause. A recipient qualifies as having a need for assistance due to behaviors if the 
50.21 	recipient's behavior requires assistance at least four times per week and shows one or 
50.22 	more of the following behaviors:
50.23 	(i) physical aggression towards self or others, or destruction of property that requires 
50.24 	the immediate response of another person;
50.25 	(ii) increased vulnerability due to cognitive deficits or socially inappropriate 
50.26 	behavior; or
50.27 	(iii) increased need for assistance for recipients who are verbally aggressive or 
50.28 	resistive to care so that time needed to perform activities of daily living is increased;
50.29 	(5) back-up systems or mechanisms, such as the use of pagers or other electronic 
50.30 	devices, to ensure continuity of the participant's services and supports;
50.31 	(6) transition costs, including:
50.32 	(i) deposits for rent and utilities;
50.33 	(ii) first month's rent and utilities;
50.34 	(iii) bedding;
50.35 	(iv) basic kitchen supplies;
51.1 	(v) other necessities, to the extent that these necessities are not otherwise covered 
51.2 	under any other funding that the participant is eligible to receive; and
51.3 	(vi) other required necessities for an individual to make the transition from a nursing 
51.4 	facility, institution for mental diseases, or intermediate care facility for persons with 
51.5 	developmental disabilities to a community-based home setting where the participant 
51.6 	resides; and
51.7 	(7) services by a support specialist defined under subdivision 2 that are chosen 
51.8 	by the participant.
51.9 	(b) Services and supports received under this section are not home care services for 
51.10 	the purposes of section 144A.43.
51.11 		Subd. 8.Determination of CFSS service methodology. (a) All community first 
51.12 	services and supports must be authorized by the commissioner or the commissioner's 
51.13 	designee before services begin except for the assessments established in section 
51.14 	256B.0911. The authorization for CFSS must be completed within 30 days after receiving 
51.15 	a complete request.
51.16 	(b) The amount of CFSS authorized must be based on the recipient's home 
51.17 	care rating. The home care rating shall be determined by the commissioner or the 
51.18 	commissioner's designee based on information submitted to the commissioner identifying 
51.19 	the following for a recipient:
51.20 	(1) the total number of dependencies of activities of daily living as defined in 
51.21 	subdivision 2;
51.22 	(2) the presence of complex health-related needs as defined in subdivision 2; and
51.23 	(3) the presence of Level I behavior as defined in subdivision 2.
51.24 	(c) For purposes meeting the criteria in paragraph (b), the methodology to determine 
51.25 	the total minutes for CFSS for each home care rating is based on the median paid units per 
51.26 	day for each home care rating from fiscal year 2007 data for the CFSS program. Each 
51.27 	home care rating has a base number of minutes assigned. Additional minutes are added 
51.28 	through the assessment and identification of the following:
51.29 	(1) 30 additional minutes per day for a dependency in each critical activity of daily 
51.30 	living as defined in subdivision 2;
51.31 	(2) 30 additional minutes per day for each complex health-related function as 
51.32 	defined in subdivision 2; and
51.33 	(3) 30 additional minutes per day for each behavior issue as defined in subdivision 2.
51.34 		Subd. 9.Noncovered services. (a) Services or supports that are not eligible for 
51.35 	payment under this section include those that:
52.1 	(1) are not authorized by the certified assessor or included in the written service 
52.2 	delivery plan;
52.3 	(2) are provided prior to the authorization of services and the approval of the written 
52.4 	CFSS service delivery plan;
52.5 	(3) are duplicative of other paid services in the written service delivery plan;
52.6 	(4) supplant natural unpaid supports that are provided voluntarily to the participant 
52.7 	and are selected by the participant in lieu of a support worker and appropriately meeting 
52.8 	the participant's needs;
52.9 	(5) are not effective means to meet the participant's needs; and
52.10 	(6) are available through other funding sources, including, but not limited to, funding 
52.11 	through Title IV-E of the Social Security Act.
52.12 	(b) Additional services, goods, or supports that are not covered include:
52.13 	(1) those that are not for the direct benefit of the participant;
52.14 	(2) any fees incurred by the participant, such as Minnesota health care programs fees 
52.15 	and co-pays, legal fees, or costs related to advocate agencies;
52.16 	(3) insurance, except for insurance costs related to employee coverage;
52.17 	(4) room and board costs for the participant with the exception of allowable 
52.18 	transition costs in subdivision 7, clause (6);
52.19 	(5) services, supports, or goods that are not related to the assessed needs;
52.20 	(6) special education and related services provided under the Individuals with 
52.21 	Disabilities Education Act and vocational rehabilitation services provided under the 
52.22 	Rehabilitation Act of 1973;
52.23 	(7) assistive technology devices and assistive technology services other than those 
52.24 	for back-up systems or mechanisms to ensure continuity of service and supports listed in 
52.25 	subdivision 7;
52.26 	(8) medical supplies and equipment;
52.27 	(9) environmental modifications, except as specified in subdivision 7;
52.28 	(10) expenses for travel, lodging, or meals related to training the participant, the 
52.29 	participant's representative, legal representative, or paid or unpaid caregivers that exceed 
52.30 	$500 in a 12-month period;
52.31 	(11) experimental treatments;
52.32 	(12) any service or good covered by other medical assistance state plan services, 
52.33 	including prescription and over-the-counter medications, compounds, and solutions and 
52.34 	related fees, including premiums and co-payments;
52.35 	(13) membership dues or costs, except when the service is necessary and appropriate 
52.36 	to treat a physical condition or to improve or maintain the participant's physical condition. 
53.1 	The condition must be identified in the participant's CFSS plan and monitored by a 
53.2 	physician enrolled in a Minnesota health care program;
53.3 	(14) vacation expenses other than the cost of direct services;
53.4 	(15) vehicle maintenance or modifications not related to the disability, health 
53.5 	condition, or physical need; and
53.6 	(16) tickets and related costs to attend sporting or other recreational or entertainment 
53.7 	events.
53.8 		Subd. 10.Provider qualifications and general requirements. (a) 
53.9 	Agency-providers delivering services under the agency-provider model under subdivision 
53.10 	11 or financial management service (FMS) contractors under subdivision 13 shall:
53.11 	(1) enroll as a medical assistance Minnesota health care programs provider and meet 
53.12 	all applicable provider standards;
53.13 	(2) comply with medical assistance provider enrollment requirements;
53.14 	(3) demonstrate compliance with law and policies of CFSS as determined by the 
53.15 	commissioner;
53.16 	(4) comply with background study requirements under chapter 245C;
53.17 	(5) verify and maintain records of all services and expenditures by the participant, 
53.18 	including hours worked by support workers and support specialists;
53.19 	(6) not engage in any agency-initiated direct contact or marketing in person, by 
53.20 	telephone, or other electronic means to potential participants, guardians, family member 
53.21 	or participants' representatives;
53.22 	(7) pay support workers and support specialists based upon actual hours of services 
53.23 	provided;
53.24 	(8) withhold and pay all applicable federal and state payroll taxes;
53.25 	(9) make arrangements and pay unemployment insurance, taxes, workers' 
53.26 	compensation, liability insurance, and other benefits, if any;
53.27 	(10) enter into a written agreement with the participant, participant's representative, 
53.28 	or legal representative that assigns roles and responsibilities to be performed before 
53.29 	services, supports, or goods are provided using a format established by the commissioner;
53.30 	(11) report suspected neglect and abuse to the common entry point according to 
53.31 	sections 256B.0651 and 626.557; and
53.32 	(12) provide the participant with a copy of the service-related rights under 
53.33 	subdivision 19 at the start of services and supports.
53.34 	(b) The commissioner shall develop policies and procedures designed to ensure 
53.35 	program integrity and fiscal accountability for goods and services provided in this section.
54.1 		Subd. 11.Agency-provider model. (a) The agency-provider model is limited to 
54.2 	the services provided by support workers and support specialists who are employed by 
54.3 	an agency-provider that is licensed according to chapter 245A or meets other criteria 
54.4 	established by the commissioner, including required training.
54.5 	(b) The agency-provider shall allow the participant to retain the ability to have a 
54.6 	significant role in the selection and dismissal of the support workers for the delivery of the 
54.7 	services and supports specified in the service delivery plan.
54.8 	(c) A participant may use authorized units of CFSS services as needed within 
54.9 	a service authorization that is not greater than 12 months. Using authorized units 
54.10 	agency-provider services or the budget allocation amount for the flexible spending model 
54.11 	flexibly does not increase the total amount of services and supports authorized for a 
54.12 	participant or included in the participant's service delivery plan.
54.13 	(d) A participant may share CFSS services. Two or three CFSS participants may 
54.14 	share services at the same time provided by the same support worker.
54.15 	(e) The agency-provider must use a minimum of 72.5 percent of the revenue 
54.16 	generated by the medical assistance payment for CFSS for support worker wages and 
54.17 	benefits. The agency-provider must document how this requirement is being met. The 
54.18 	revenue generated by the support specialist and the reasonable costs associated with the 
54.19 	support specialist must not be used in making this calculation.
54.20 	(f) The agency-provider model must be used by individuals who have been restricted 
54.21 	by the Minnesota restricted recipient program.
54.22 		Subd. 12.Requirements for initial enrollment of CFSS provider agencies. (a) 
54.23 	All CFSS provider agencies must provide, at the time of enrollment as a CFSS provider 
54.24 	agency in a format determined by the commissioner, information and documentation that 
54.25 	includes, but is not limited to, the following:
54.26 	(1) the CFSS provider agency's current contact information including address, 
54.27 	telephone number, and e-mail address;
54.28 	(2) proof of surety bond coverage in the amount of $50,000 or ten percent of the 
54.29 	provider's payments from Medicaid in the previous year, whichever is less;
54.30 	(3) proof of fidelity bond coverage in the amount of $20,000;
54.31 	(4) proof of workers' compensation insurance coverage;
54.32 	(5) proof of liability insurance;
54.33 	(6) a description of the CFSS provider agency's organization identifying the names 
54.34 	or all owners, managing employees, staff, board of directors, and the affiliations of the 
54.35 	directors, owners, or staff to other service providers;
55.1 	(7) a copy of the CFSS provider agency's written policies and procedures including: 
55.2 	hiring of employees; training requirements; service delivery; and employee and consumer 
55.3 	safety including process for notification and resolution of consumer grievances, 
55.4 	identification and prevention of communicable diseases, and employee misconduct;
55.5 	(8) copies of all other forms the CFSS provider agency uses in the course of daily 
55.6 	business including, but not limited to:
55.7 	(i) a copy of the CFSS provider agency's time sheet if the time sheet varies from 
55.8 	the standard time sheet for CFSS services approved by the commissioner, and a letter 
55.9 	requesting approval of the CFSS provider agency's nonstandard time sheet;
55.10 	(ii) the CFSS provider agency's template for the CFSS care plan; and
55.11 	(iii) the CFSS provider agency's template for the written agreement in subdivision 
55.12 	21 for recipients using the CFSS choice option, if applicable;
55.13 	(9) a list of all training and classes that the CFSS provider agency requires of its 
55.14 	staff providing CFSS services;
55.15 	(10) documentation that the CFSS provider agency and staff have successfully 
55.16 	completed all the training required by this section;
55.17 	(11) documentation of the agency's marketing practices;
55.18 	(12) disclosure of ownership, leasing, or management of all residential properties 
55.19 	that is used or could be used for providing home care services;
55.20 	(13) documentation that the agency will use the following percentages of revenue 
55.21 	generated from the medical assistance rate paid for CFSS services for employee personal 
55.22 	care assistant wages and benefits: 72.5 percent of revenue from CFSS providers. The 
55.23 	revenue generated by the support specialist and the reasonable costs associated with the 
55.24 	support specialist shall not be used in making this calculation; and
55.25 	(14) documentation that the agency does not burden recipients' free exercise of their 
55.26 	right to choose service providers by requiring personal care assistants to sign an agreement 
55.27 	not to work with any particular CFSS recipient or for another CFSS provider agency after 
55.28 	leaving the agency and that the agency is not taking action on any such agreements or 
55.29 	requirements regardless of the date signed.
55.30 	(b) CFSS provider agencies shall provide the information specified in paragraph 
55.31 	(a) to the commissioner.
55.32 	(c) All CFSS provider agencies shall require all employees in management and 
55.33 	supervisory positions and owners of the agency who are active in the day-to-day 
55.34 	management and operations of the agency to complete mandatory training as determined 
55.35 	by the commissioner. Employees in management and supervisory positions and owners 
55.36 	who are active in the day-to-day operations of an agency who have completed the required 
56.1 	training as an employee with a CFSS provider agency do not need to repeat the required 
56.2 	training if they are hired by another agency, if they have completed the training within 
56.3 	the past three years. CFSS provider agency billing staff shall complete training about 
56.4 	CFSS program financial management. Any new owners or employees in management 
56.5 	and supervisory positions involved in the day-to-day operations are required to complete 
56.6 	mandatory training as a requisite of working for the agency. CFSS provider agencies 
56.7 	certified for participation in Medicare as home health agencies are exempt from the 
56.8 	training required in this subdivision.
56.9 		Subd. 13.Flexible spending model. (a) Under the flexible spending model 
56.10 	participants accept more responsibility and control over the services and supports 
56.11 	described and budgeted within the CFSS service delivery plan. Under this model:
56.12 	(1) using a budget allocation, participants may directly employ and pay support 
56.13 	workers and obtain other supports and goods as defined in subdivision 7; and
56.14 	(2) from the financial management services (FMS) contractor the participant may 
56.15 	choose a range of support assistance for:
56.16 	(i) planning, budgeting, and management of services and support;
56.17 	(ii) the employment, training, supervision, and evaluation of workers;
56.18 	(iii) acquisition and payment and supports and goods; and
56.19 	(iv) evaluation of individual service outcomes as needed for the scope of the 
56.20 	participant's degree of control and responsibility.
56.21 	(b) Participants who are unable to fulfill any of the functions listed in paragraph (a) 
56.22 	may authorize a legal representative or participant's representative to do so on their behalf.
56.23 	(c) The FMS contractor shall not provide CFSS services and supports under the 
56.24 	agency-provider service model. The FMS contractor shall provide service functions as 
56.25 	determined by the commissioner that include but are not limited to:
56.26 	(1) information and consultation about CFSS;
56.27 	(2) assistance with the development of the service delivery plan and flexible 
56.28 	spending model as requested by the participant;
56.29 	(3) billing and making payments for flexible spending model expenditures;
56.30 	(4) employer and employer agent functions according to Internal Revenue Code 
56.31 	Procedure 70-6, section 3504, Agency Employer Tax Liability, regulation 137036-08, 
56.32 	which includes assistance with filing and paying payroll taxes, and obtaining worker 
56.33 	compensation coverage;
56.34 	(5) data recording and reporting of participant spending; and
56.35 	(6) other duties established in the contract with the department.
57.1 	(d) A participant who requests to purchase goods and supports along with support 
57.2 	worker services under the agency-provider model must use flexible spending model 
57.3 	with a service delivery plan that specifies the amount of services to be authorized to the 
57.4 	agency-provider and the expenditures to be paid by the FMS contractor.
57.5 	(e) The FMS contractor shall:
57.6 	(1) not limit or restrict the participant's choice of service or support providers, 
57.7 	including the use of any available employment models;
57.8 	(2) provide the participant and the targeted case manager, if applicable, with a 
57.9 	monthly written summary of the spending for services and supports that were billed 
57.10 	against the spending budget;
57.11 	(3) be knowledgeable of state and federal employment regulations under the Fair 
57.12 	Labor Standards Act of 1938, and comply with the requirements under the Internal 
57.13 	Revenue Service Revenue Code Procedure 70-6, Section 35-4, Agency Employer Tax 
57.14 	Liability for vendor or fiscal employer agent, and any requirements necessary to process 
57.15 	employer and employee deductions, provide appropriate and timely submission of 
57.16 	employer tax liabilities, and maintain documentation to support medical assistance claims;
57.17 	(4) have current and adequate liability insurance and bonding and sufficient cash 
57.18 	flow as determined by the commission and have on staff or under contract a certified 
57.19 	public accountant or an individual with a baccalaureate degree in accounting;
57.20 	(5) assume fiscal accountability for state funds designated for the program; and
57.21 	(6) maintain documentation of receipts, invoices, and bills to track all services and 
57.22 	supports expenditures for any goods purchased and maintain time records of support 
57.23 	workers. The documentation and time records must be maintained for a minimum of 
57.24 	five years from the claim date and be available for audit or review upon request by the 
57.25 	commissioner. Claims submitted by the FMS contractor to the commissioner for payment 
57.26 	must correspond with services, amounts, and time periods as authorized in the participant's 
57.27 	spending budget and service plan.
57.28 	(f) The commissioner of human services shall:
57.29 	(1) establish rates and payment methodology for the FMS contractor;
57.30 	(2) identify a process to ensure quality and performance standards for the FMS 
57.31 	contractor and ensure statewide access to FMS contractors; and
57.32 	(3) establish a uniform protocol for delivering and administering CFSS services 
57.33 	to be used by eligible FMS contractors.
57.34 	(g) Participants who are disenrolled from the model shall be transferred to the 
57.35 	agency-provider model.
58.1 		Subd. 14.Participant's responsibilities under flexible spending model. (a) A 
58.2 	participant using the flexible spending model must use a FMS contractor or vendor that is 
58.3 	under contract with the department. Upon a determination of eligibility and completion of 
58.4 	the assessment and community support plan, the participant shall choose a FMS contractor 
58.5 	from a list of eligible vendors maintained by the department.
58.6 	(b) When the participant, participant's representative, or legal representative chooses 
58.7 	to be the employer of record for the support worker, they are responsible for recruiting, 
58.8 	interviewing, hiring, training, scheduling, supervising, and discharging direct support 
58.9 	workers.
58.10 	(c) In addition to the employer responsibilities in paragraph (b), the participant, 
58.11 	participant's representative, or legal representative is responsible for:
58.12 	(1) tracking the services provided and all expenditures for goods or other supports;
58.13 	(2) preparing and submitting time sheets, signed by both the participant and support 
58.14 	worker, to the FMS contractor on a regular basis and in a timely manner according to 
58.15 	the FMS contractor's procedures;
58.16 	(3) notifying the FMS contractor within ten days of any changes in circumstances 
58.17 	affecting the CFSS service plan or in the participant's place of residence including, but 
58.18 	not limited to, any hospitalization of the participant or change in the participant's address, 
58.19 	telephone number, or employment;
58.20 	(4) notifying the FMS contractor of any changes in the employment status of each 
58.21 	participant support worker; and
58.22 	(5) reporting any problems resulting from the quality of services rendered by the 
58.23 	support worker to the FMS contractor. If the participant is unable to resolve any problems 
58.24 	resulting from the quality of service rendered by the support worker with the FMS 
58.25 	contractor, the participant shall report the situation to the department.
58.26 		Subd. 15.Documentation of support services provided. (a) Support services 
58.27 	provided to a participant by a support worker employed by either an agency-provider 
58.28 	or the participant acting as the employer must be documented daily by each support 
58.29 	worker, on a time sheet form approved by the commissioner. All documentation may be 
58.30 	Web-based, electronic, or paper documentation. The completed form must be submitted 
58.31 	on a monthly basis to the provider or the participant and the FMS contractor selected by 
58.32 	the participant to provide assistance with meeting the participant's employer obligations 
58.33 	and kept in the recipient's health record.
58.34 	(b) The activity documentation must correspond to the written service delivery plan 
58.35 	and be reviewed by the agency provider or the participant and the FMS contractor when 
58.36 	the participant is acting as the employer of the support worker.
59.1 	(c) The time sheet must be on a form approved by the commissioner documenting 
59.2 	time the support worker provides services in the home. The following criteria must be 
59.3 	included in the time sheet:
59.4 	(1) full name of the support worker and individual provider number;
59.5 	(2) provider name and telephone numbers, if an agency-provider is responsible for 
59.6 	delivery services under the written service plan;
59.7 	(3) full name of the participant;
59.8 	(4) consecutive dates, including month, day, and year, and arrival and departure 
59.9 	times with a.m. or p.m. notations;
59.10 	(5) signatures of the participant or the participant's representative;
59.11 	(6) personal signature of the support worker;
59.12 	(7) any shared care provided, if applicable;
59.13 	(8) a statement that it is a federal crime to provide false information on CFSS 
59.14 	billings for medical assistance payments; and
59.15 	(9) dates and location of recipient stays in a hospital, care facility, or incarceration.
59.16 		Subd. 16.Support workers requirements. (a) Support workers shall:
59.17 	(1) enroll with the department as a support worker after a background study under 
59.18 	chapter 245C has been completed and the support worker has received a notice from the 
59.19 	commissioner that:
59.20 	(i) the support worker is not disqualified under section 245C.14; or
59.21 	(ii) is disqualified, but the support worker has received a set-aside of the 
59.22 	disqualification under section 245C.22;
59.23 	(2) have the ability to effectively communicate with the participant or the 
59.24 	participant's representative;
59.25 	(3) have the skills and ability to provide the services and supports according to the 
59.26 	person's CFSS service delivery plan and respond appropriately to the participant's needs;
59.27 	(4) not be a participant of CFSS;
59.28 	(5) complete the basic standardized training as determined by the commissioner 
59.29 	before completing enrollment. The training must be available in languages other than 
59.30 	English and to those who need accommodations due to disabilities. Support worker 
59.31 	training must include successful completion of the following training components: 
59.32 	basic first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic 
59.33 	roles and responsibilities of support workers including information about basic body 
59.34 	mechanics, emergency preparedness, orientation to positive behavioral practices, fraud 
59.35 	issues, time cards and documentation, and an overview of person-centered planning and 
60.1 	self-direction. Upon completion of the training components, the support worker must pass 
60.2 	the certification test to provide assistance to participants;
60.3 	(6) complete training and orientation on the participant's individual needs; and
60.4 	(7) maintain the privacy and confidentiality of the participant, and not independently 
60.5 	determine the medication dose or time for medications for the participant.
60.6 	(b) The commissioner may deny or terminate a support worker's provider enrollment 
60.7 	and provider number if the support worker:
60.8 	(1) lacks the skills, knowledge, or ability to adequately or safely perform the 
60.9 	required work;
60.10 	(2) fails to provide the authorized services required by the participant employer;
60.11 	(3) has been intoxicated by alcohol or drugs while providing authorized services to 
60.12 	the participant or while in the participant's home;
60.13 	(4) has manufactured or distributed drugs while providing authorized services to the 
60.14 	participant or while in the participant's home; or
60.15 	(5) has been excluded as a provider by the commissioner of human services, or the 
60.16 	United States Department of Health and Human Services, Office of Inspector General, 
60.17 	from participation in Medicaid, Medicare, or any other federal health care program.
60.18 	(c) A support worker may appeal in writing to the commissioner to contest the 
60.19 	decision to terminate the support worker's provider enrollment and provider number.
60.20 		Subd. 17.Support specialist requirements and payments. The commissioner 
60.21 	shall develop qualifications, scope of functions, and payment rates and service limits for a 
60.22 	support specialist that may provide additional or specialized assistance necessary to plan, 
60.23 	implement, arrange, augment, or evaluate services and supports.
60.24 		Subd. 18.Service unit and budget allocation requirements. (a) For the 
60.25 	agency-provider model, services will be authorized in units of service. The total service 
60.26 	unit amount must be established based upon the assessed need for CFSS services, and 
60.27 	must not exceed the maximum number of units available as determined by section 
60.28 	256B.0652, subdivision 6. The unit rate established by the commissioner is used with 
60.29 	assessed units to determine the maximum available CFSS allocation.
60.30 	(b) For the flexible spending model, services and supports are authorized under 
60.31 	a budget limit.
60.32 	(c) The maximum available CFSS participant budget allocation shall be established 
60.33 	by multiplying the number of units authorized under subdivision 8 by the payment rate 
60.34 	established by the commissioner.
60.35 		Subd. 19.Support system. (a) The commissioner shall provide information, 
60.36 	consultation, training, and assistance to ensure the participant is able to manage the 
61.1 	services and supports and budgets, if applicable. This support shall include individual 
61.2 	consultation on how to select and employ workers, manage responsibilities under CFSS, 
61.3 	and evaluate personal outcomes.
61.4 	(b) The commissioner shall provide assistance with the development of risk 
61.5 	management agreements.
61.6 		Subd. 20.Service-related rights. Participants must be provided with adequate 
61.7 	information, counseling, training, and assistance, as needed, to ensure that the participant 
61.8 	is able to choose and manage services, models, and budgets. This support shall include 
61.9 	information regarding: (1) person-centered planning; (2) the range and scope of individual 
61.10 	choices; (3) the process for changing plans, services and budgets; (4) the grievance 
61.11 	process; (5) individual rights; (6) identifying and assessing appropriate services; (7) risks 
61.12 	and responsibilities; and (8) risk management. A participant who appeals a reduction in 
61.13 	previously authorized CFSS services may continue previously authorized services pending 
61.14 	an appeal under section 256.045. The commissioner must ensure that the participant 
61.15 	has a copy of the most recent service delivery plan that contains a detailed explanation 
61.16 	of which areas of covered CFSS are reduced, and provide notice of the amount of the 
61.17 	budget reduction, and the reasons for the reduction in the participant's notice of denial, 
61.18 	termination, or reduction.
61.19 		Subd. 21.Development and Implementation Council. The commissioner 
61.20 	shall establish a Development and Implementation Council of which the majority of 
61.21 	members are individuals with disabilities, elderly individuals, and their representatives. 
61.22 	The commissioner shall consult and collaborate with the council when developing and 
61.23 	implementing this section.
61.24 		Subd. 22.Quality assurance and risk management system. (a) The commissioner 
61.25 	shall establish quality assurance and risk management measures for use in developing and 
61.26 	implementing CFSS including those that (1) recognize the roles and responsibilities of those 
61.27 	involved in obtaining CFSS, and (2) ensure the appropriateness of such plans and budgets 
61.28 	based upon a recipient's resources and capabilities. Risk management measures must 
61.29 	include background studies, and backup and emergency plans, including disaster planning.
61.30 	(b) The commissioner shall provide ongoing technical assistance and resource and 
61.31 	educational materials for CFSS participants.
61.32 	(c) Performance assessment measures, such as a participant's satisfaction with the 
61.33 	services and supports, and ongoing monitoring of health and well-being shall be identified 
61.34 	in consultation with the council established in subdivision 21.
61.35 		Subd. 23.Commissioner's access. When the commissioner is investigating a 
61.36 	possible overpayment of Medicaid funds, the commissioner must be given immediate 
62.1 	access without prior notice to the agency provider or FMS contractor's office during 
62.2 	regular business hours and to documentation and records related to services provided and 
62.3 	submission of claims for services provided. Denying the commissioner access to records 
62.4 	is cause for immediate suspension of payment and terminating the agency provider's 
62.5 	enrollment according to section 256B.064 or terminating the FMS contract.
62.6 		Subd. 24.CFSS agency-providers; background studies. CFSS agency-providers 
62.7 	enrolled to provide personal care assistance services under the medical assistance program 
62.8 	shall comply with the following:
62.9 	(1) owners who have a five percent interest or more and all managing employees 
62.10 	are subject to a background study as provided in chapter 245C. This applies to currently 
62.11 	enrolled CFSS agency-providers and those agencies seeking enrollment as a CFSS 
62.12 	agency-provider. "Managing employee" has the same meaning as Code of Federal 
62.13 	Regulations, title 42, section 455. An organization is barred from enrollment if:
62.14 	(i) the organization has not initiated background studies on owners managing 
62.15 	employees; or
62.16 	(ii) the organization has initiated background studies on owners and managing 
62.17 	employees, but the commissioner has sent the organization a notice that an owner or 
62.18 	managing employee of the organization has been disqualified under section 245C.14, and 
62.19 	the owner or managing employee has not received a set-aside of the disqualification 
62.20 	under section 245C.22;
62.21 	(2) a background study must be initiated and completed for all support specialists; and
62.22 	(3) a background study must be initiated and completed for all support workers.

62.23 	EFFECTIVE DATE. This section is effective upon federal approval. The 
62.24 	commissioner of human services shall notify the revisor of statutes when this occurs.

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

62.34 	Sec. 45. Minnesota Statutes 2012, section 626.557, subdivision 4, is amended to read:
63.1 		Subd. 4.Reporting. (a) Except as provided in paragraph (b), a mandated reporter 
63.2 	shall immediately make an oral report to the common entry point. The common entry 
63.3 	point may accept electronic reports submitted through a Web-based reporting system 
63.4 	established by the commissioner. Use of a telecommunications device for the deaf or other 
63.5 	similar device shall be considered an oral report. The common entry point may not require 
63.6 	written reports. To the extent possible, the report must be of sufficient content to identify 
63.7 	the vulnerable adult, the caregiver, the nature and extent of the suspected maltreatment, 
63.8 	any evidence of previous maltreatment, the name and address of the reporter, the time, 
63.9 	date, and location of the incident, and any other information that the reporter believes 
63.10 	might be helpful in investigating the suspected maltreatment. A mandated reporter may 
63.11 	disclose not public data, as defined in section 13.02, and medical records under sections 
63.12 	144.291 to 144.298, to the extent necessary to comply with this subdivision.
63.13 	(b) A boarding care home that is licensed under sections 144.50 to 144.58 and 
63.14 	certified under Title 19 of the Social Security Act, a nursing home that is licensed under 
63.15 	section 144A.02 and certified under Title 18 or Title 19 of the Social Security Act, or a 
63.16 	hospital that is licensed under sections 144.50 to 144.58 and has swing beds certified under 
63.17 	Code of Federal Regulations, title 42, section 482.66, may submit a report electronically 
63.18 	to the common entry point instead of submitting an oral report. The report may be a 
63.19 	duplicate of the initial report the facility submits electronically to the commissioner of 
63.20 	health to comply with the reporting requirements under Code of Federal Regulations, title 
63.21 	42, section 483.13. The commissioner of health may modify these reporting requirements 
63.22 	to include items required under paragraph (a) that are not currently included in the 
63.23 	electronic reporting form.

63.24 	EFFECTIVE DATE. This section is effective July 1, 2014.

63.25 	Sec. 46. Minnesota Statutes 2012, section 626.557, subdivision 9, is amended to read:
63.26 		Subd. 9.Common entry point designation. (a) ~~Each county board shall designate~~ 
63.27 	~~a common entry point for reports of suspected maltreatment. Two or more county boards~~ 
63.28 	~~may jointly designate a single~~ The commissioner of human services shall establish a
63.29 	 common entry point effective July 1, 2014. The common entry point is the unit responsible 
63.30 	for receiving the report of suspected maltreatment under this section.
63.31 	(b) The common entry point must be available 24 hours per day to take calls from 
63.32 	reporters of suspected maltreatment. The common entry point shall use a standard intake 
63.33 	form that includes:
63.34 	(1) the time and date of the report;
63.35 	(2) the name, address, and telephone number of the person reporting;
64.1 	(3) the time, date, and location of the incident;
64.2 	(4) the names of the persons involved, including but not limited to, perpetrators, 
64.3 	alleged victims, and witnesses;
64.4 	(5) whether there was a risk of imminent danger to the alleged victim;
64.5 	(6) a description of the suspected maltreatment;
64.6 	(7) the disability, if any, of the alleged victim;
64.7 	(8) the relationship of the alleged perpetrator to the alleged victim;
64.8 	(9) whether a facility was involved and, if so, which agency licenses the facility;
64.9 	(10) any action taken by the common entry point;
64.10 	(11) whether law enforcement has been notified;
64.11 	(12) whether the reporter wishes to receive notification of the initial and final 
64.12 	reports; and
64.13 	(13) if the report is from a facility with an internal reporting procedure, the name, 
64.14 	mailing address, and telephone number of the person who initiated the report internally.
64.15 	(c) The common entry point is not required to complete each item on the form prior 
64.16 	to dispatching the report to the appropriate lead investigative agency.
64.17 	(d) The common entry point shall immediately report to a law enforcement agency 
64.18 	any incident in which there is reason to believe a crime has been committed.
64.19 	(e) If a report is initially made to a law enforcement agency or a lead investigative 
64.20 	agency, those agencies shall take the report on the appropriate common entry point intake 
64.21 	forms and immediately forward a copy to the common entry point.
64.22 	(f) The common entry point staff must receive training on how to screen and 
64.23 	dispatch reports efficiently and in accordance with this section.
64.24 	(g) The commissioner of human services shall maintain a centralized database 
64.25 	for the collection of common entry point data, lead investigative agency data including 
64.26 	maltreatment report disposition, and appeals data. The common entry point shall 
64.27 	have access to the centralized database and must log the reports into the database and 
64.28 	immediately identify and locate prior reports of abuse, neglect, or exploitation.
64.29 	(h) When appropriate, the common entry point staff must refer calls that do not 
64.30 	allege the abuse, neglect, or exploitation of a vulnerable adult to other organizations 
64.31 	that might resolve the reporter's concerns.
64.32 	(i) a common entry point must be operated in a manner that enables the 
64.33 	commissioner of human services to:
64.34 	(1) track critical steps in the reporting, evaluation, referral, response, disposition, 
64.35 	and investigative process to ensure compliance with all requirements for all reports;
65.1 	(2) maintain data to facilitate the production of aggregate statistical reports for 
65.2 	monitoring patterns of abuse, neglect, or exploitation;
65.3 	(3) serve as a resource for the evaluation, management, and planning of preventative 
65.4 	and remedial services for vulnerable adults who have been subject to abuse, neglect, 
65.5 	or exploitation;
65.6 	(4) set standards, priorities, and policies to maximize the efficiency and effectiveness 
65.7 	of the common entry point; and
65.8 	(5) track and manage consumer complaints related to the common entry point.
65.9 	(j) The commissioners of human services and health shall collaborate on the creation 
65.10 	of a triage system for investigations. This system shall enable the commissioner of human 
65.11 	services to track critical steps in the reporting, evaluation, referral, response, disposition, 
65.12 	investigation, notification, determination, and appeal processes.

65.13 	Sec. 47. Minnesota Statutes 2012, section 626.557, subdivision 9e, is amended to read:
65.14 		Subd. 9e.Education requirements. (a) The commissioners of health, human 
65.15 	services, and public safety shall cooperate in the development of a joint program for 
65.16 	education of lead investigative agency investigators in the appropriate techniques for 
65.17 	investigation of complaints of maltreatment. This program must be developed by July 
65.18 	1, 1996. The program must include but need not be limited to the following areas: (1) 
65.19 	information collection and preservation; (2) analysis of facts; (3) levels of evidence; (4) 
65.20 	conclusions based on evidence; (5) interviewing skills, including specialized training to 
65.21 	interview people with unique needs; (6) report writing; (7) coordination and referral 
65.22 	to other necessary agencies such as law enforcement and judicial agencies; (8) human 
65.23 	relations and cultural diversity; (9) the dynamics of adult abuse and neglect within family 
65.24 	systems and the appropriate methods for interviewing relatives in the course of the 
65.25 	assessment or investigation; (10) the protective social services that are available to protect 
65.26 	alleged victims from further abuse, neglect, or financial exploitation; (11) the methods by 
65.27 	which lead investigative agency investigators and law enforcement workers cooperate in 
65.28 	conducting assessments and investigations in order to avoid duplication of efforts; and 
65.29 	(12) data practices laws and procedures, including provisions for sharing data.
65.30 	(b) The commissioner of human services shall conduct an outreach campaign to 
65.31 	promote the common entry point for reporting vulnerable adult maltreatment. This 
65.32 	campaign shall assist potential reporters, mandated reporters, and vulnerable adults in 
65.33 	finding information on reporting to the common entry point. This campaign shall use the 
65.34 	Internet and other means of communication.
66.1 	~~(b)~~ (c) The commissioners of health, human services, and public safety shall offer at 
66.2 	least annual education to others on the requirements of this section, on how this section is 
66.3 	implemented, and investigation techniques.
66.4 	~~(c)~~ (d) The commissioner of human services, in coordination with the commissioner 
66.5 	of public safety shall provide training for the common entry point staff as required in this 
66.6 	subdivision and the program courses described in this subdivision, at least four times 
66.7 	per year. At a minimum, the training shall be held twice annually in the seven-county 
66.8 	metropolitan area and twice annually outside the seven-county metropolitan area. The 
66.9 	commissioners shall give priority in the program areas cited in paragraph (a) to persons 
66.10 	currently performing assessments and investigations pursuant to this section.
66.11 	~~(d)~~ (e) The commissioner of public safety shall notify in writing law enforcement 
66.12 	personnel of any new requirements under this section. The commissioner of public 
66.13 	safety shall conduct regional training for law enforcement personnel regarding their 
66.14 	responsibility under this section.
66.15 	~~(e)~~ (f) Each lead investigative agency investigator must complete the education 
66.16 	program specified by this subdivision within the first 12 months of work as a lead 
66.17 	investigative agency investigator.
66.18 	A lead investigative agency investigator employed when these requirements take 
66.19 	effect must complete the program within the first year after training is available or as soon 
66.20 	as training is available.
66.21 	All lead investigative agency investigators having responsibility for investigation 
66.22 	duties under this section must receive a minimum of eight hours of continuing education 
66.23 	or in-service training each year specific to their duties under this section.

66.24 	Sec. 48.  REPEALER.
 66.25 	Minnesota Statutes 2012, sections 245A.655; 256B.0911, subdivisions 4a, 4b, and 
66.26 	4c; and 256B.0917, subdivisions 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, and 14, are repealed.