1.1 	A bill for an act
1.2 	relating to state government; establishing the health and human services budget; 
1.3 	modifying provisions governing community supports, housing, continuing care, 
1.4 	health care, health insurance, direct care and treatment, children and families, 
1.5 	chemical and mental health services, Department of Human Services operations, 
1.6 	Health Department, health licensing boards, opiate abuse prevention, managed 
1.7 	care organizations, and child care development block grant compliance; making 
1.8 	technical changes; modifying terminology and definitions; establishing licensing 
1.9 	fix-it tickets; requiring reports; establishing moratorium on conversion transactions; 
1.10 	modifying fees; making forecast adjustments; appropriating money;amending 
1.11 	Minnesota Statutes 2016, sections 3.972, by adding subdivisions; 13.32, by adding 
1.12 	a subdivision; 13.46, subdivisions 1, 2; 13.84, subdivision 5; 62A.04, subdivision 
1.13 	1; 62A.21, subdivision 2a; 62A.3075; 62D.105; 62E.04, subdivision 11; 62E.05, 
1.14 	subdivision 1; 62E.06, by adding a subdivision; 62K.15; 62U.02; 103I.005, 
1.15 	subdivisions 2, 2a, 12, 20a, 21, by adding subdivisions; 103I.101, subdivisions 2, 
1.16 	5, 6; 103I.105; 103I.111, subdivisions 6, 8; 103I.205, subdivisions 1, 2, 3, 4, 5, 6; 
1.17 	103I.208, subdivisions 1, 2; 103I.235, by adding a subdivision; 103I.301, 
1.18 	subdivisions 1, 2; 103I.315, subdivision 1; 103I.501; 103I.505, subdivisions 1, 2; 
1.19 	103I.515; 103I.525, subdivisions 1, 2, 5, 6, 8; 103I.531, subdivisions 2, 5; 103I.535, 
1.20 	subdivisions 2, 6; 103I.541, subdivisions 1, 2, 2a, 2b, 2c, 2e, 3, 4, 5; 103I.545; 
1.21 	103I.601, subdivisions 2, 4; 103I.711, subdivision 1; 103I.715, subdivision 2; 
1.22 	119B.011, subdivisions 20, 20a; 119B.025, subdivision 1, by adding subdivisions; 
1.23 	119B.03, subdivision 3; 119B.05, subdivision 1; 119B.09, subdivisions 1, 4; 
1.24 	119B.10, subdivision 1, by adding a subdivision; 119B.12, subdivision 2; 119B.13, 
1.25 	subdivisions 1, 6; 144.0722, subdivision 1, as amended; 144.0724, subdivisions 
1.26 	4, 6; 144.122; 144.1501, subdivision 2; 144.4961, subdivisions 3, 4, 5; 144.551, 
1.27 	subdivision 1; 144.562, subdivision 2; 144.99, subdivision 1; 144A.071, 
1.28 	subdivisions 3, as amended, 4a, as amended, 4c, as amended, 4d, as amended; 
1.29 	144A.10, subdivision 4, as amended; 144A.351, subdivision 1; 144A.472, 
1.30 	subdivision 7; 144A.4799, subdivision 3; 144A.70, subdivision 6, by adding a 
1.31 	subdivision; 144A.74; 144D.04, subdivision 2, by adding a subdivision; 144D.06; 
1.32 	145.4131, subdivision 1; 145.4716, subdivision 2; 145.928, subdivision 13; 145.986, 
1.33 	subdivision 1a; 146B.02, subdivisions 2, 3, 5, 8, by adding subdivisions; 146B.03, 
1.34 	subdivisions 6, 7, as amended; 146B.07, subdivision 2; 146B.10, subdivisions 1, 
1.35 	2, by adding a subdivision; 147.01, subdivision 7; 147.02, subdivision 1; 147.03, 
1.36 	subdivision 1; 147B.08, by adding a subdivision; 147C.40, by adding a subdivision; 
1.37 	148.514, subdivision 1; 148.519, subdivisions 1, 2; 148.5194, subdivisions 2, 3, 
1.38 	4, 7, by adding a subdivision; 148.5195, subdivision 2; 148.6402, subdivision 4; 
1.39 	148.6405; 148.6408, subdivision 2; 148.6410, subdivision 2; 148.6412, subdivision 
2.1 	2; 148.6415; 148.6418, subdivisions 1, 2, 4, 5; 148.6420, subdivisions 1, 3, 5; 
2.2 	148.6423; 148.6425, subdivisions 2, 3; 148.6428; 148.6443, subdivisions 5, 6, 7, 
2.3 	8; 148.6445, subdivisions 1, 10; 148.6448; 148.881; 148.89; 148.90, subdivisions 
2.4 	1, 2; 148.905, subdivision 1; 148.907, subdivisions 1, 2; 148.9105, subdivisions 
2.5 	1, 4, 5; 148.916, subdivisions 1, 1a; 148.925; 148.96, subdivision 3; 148.997, 
2.6 	subdivision 1; 148B.53, subdivision 1; 150A.06, subdivisions 3, 8; 150A.10, 
2.7 	subdivision 4; 151.212, subdivision 2; 152.11, by adding a subdivision; 152.25, 
2.8 	subdivision 1, by adding subdivisions; 152.28, by adding a subdivision; 152.33, 
2.9 	by adding a subdivision; 153A.14, subdivisions 1, 2; 153A.17; 157.16, subdivisions 
2.10 	1, 3, 3a; 214.01, subdivision 2; 245.462, subdivision 9; 245.467, subdivision 2; 
2.11 	245.4871, by adding subdivisions; 245.4876, subdivision 2; 245.4889, subdivision 
2.12 	1; 245.814, by adding a subdivision; 245.91, subdivisions 4, 6; 245.94, subdivision 
2.13 	1; 245.97, subdivision 6; 245A.02, subdivisions 2b, 5a, by adding subdivisions; 
2.14 	245A.03, subdivisions 2, 7; 245A.04, subdivisions 4, 14; 245A.06, subdivisions 
2.15 	2, 8, by adding a subdivision; 245A.07, subdivision 3; 245A.09, subdivision 7; 
2.16 	245A.10, subdivision 2; 245A.11, by adding subdivisions; 245A.14, by adding a 
2.17 	subdivision; 245A.16, subdivision 1, by adding a subdivision; 245A.191; 245A.40, 
2.18 	by adding a subdivision; 245A.50, subdivision 5; 245C.02, by adding a subdivision; 
2.19 	245C.03, subdivision 1, by adding a subdivision; 245C.04, subdivisions 1, 8; 
2.20 	245C.05, subdivisions 2b, 4, 5, 7; 245C.08, subdivisions 1, 2, 4; 245C.09, by 
2.21 	adding a subdivision; 245C.10, subdivision 9, by adding subdivisions; 245C.11, 
2.22 	subdivision 3; 245C.15; 245C.16, subdivision 1; 245C.17, subdivision 6; 245C.21, 
2.23 	subdivision 1; 245C.22, subdivisions 5, 7; 245C.23; 245C.24, subdivision 3; 
2.24 	245C.25; 245C.30, subdivision 2; 245D.03, subdivision 1; 245D.04, subdivision 
2.25 	3; 246.18, subdivision 4, by adding a subdivision; 252.27, subdivision 2a; 252.41, 
2.26 	subdivision 3; 252.50, subdivision 5; 253B.10, subdivision 1; 254A.01; 254A.02, 
2.27 	subdivisions 2, 3, 5, 6, 8, 10, by adding subdivisions; 254A.03; 254A.035, 
2.28 	subdivision 1; 254A.04; 254A.08; 254A.09; 254A.19, subdivision 3; 254B.01, 
2.29 	subdivision 3, by adding a subdivision; 254B.03, subdivision 2; 254B.04, 
2.30 	subdivisions 1, 2b; 254B.05, subdivisions 1, 1a, 5; 254B.051; 254B.07; 254B.08; 
2.31 	254B.09; 254B.12, subdivision 2, by adding a subdivision; 254B.13, subdivision 
2.32 	2a; 256.01, by adding a subdivision; 256.045, subdivisions 3, 3a; 256.9657, 
2.33 	subdivision 1; 256.9685, subdivisions 1, 1a; 256.9686, subdivision 8; 256.969, 
2.34 	subdivisions 1, 2b, 3a, 8, 8c, 9, 12; 256.9695, subdivision 1; 256.975, subdivision 
2.35 	7, by adding a subdivision; 256B.04, subdivisions 12, 24; 256B.056, subdivisions 
2.36 	3b, 3c, 5c; 256B.0561, subdivisions 2, 4; 256B.057, subdivision 9, as amended; 
2.37 	256B.059, subdivision 6, as amended; 256B.0621, subdivision 10; 256B.0625, 
2.38 	subdivisions 1, 3b, 6a, 7, 17, 17b, 18h, 20, 31, 45a, 64, by adding subdivisions; 
2.39 	256B.0644; 256B.0653, subdivisions 2, 3, 4, as amended, 5, 6, by adding a 
2.40 	subdivision; 256B.072; 256B.0755, subdivisions 1, 3, 4, by adding a subdivision; 
2.41 	256B.0911, subdivisions 1a, 2b, 3a, 4d, as amended, 5, 6, as amended, by adding 
2.42 	a subdivision; 256B.0915, subdivisions 1, 3a, 3e, 3h, 5, by adding subdivisions; 
2.43 	256B.092, subdivision 4; 256B.0921; 256B.0924, by adding a subdivision; 
2.44 	256B.0943, subdivision 13; 256B.0945, subdivisions 2, 4; 256B.196, subdivisions 
2.45 	2, 3, 4; 256B.35, subdivision 4, as amended; 256B.431, subdivisions 10, 16, 30; 
2.46 	256B.434, subdivisions 4, 4f; 256B.49, subdivisions 11, 15; 256B.4913, subdivision 
2.47 	4a, by adding a subdivision; 256B.4914, subdivisions 2, 3, 5, 6, 7, 8, 9, 10, 16, by 
2.48 	adding a subdivision; 256B.493, subdivisions 1, 2, by adding a subdivision; 
2.49 	256B.50, subdivision 1b; 256B.5012, by adding subdivisions; 256B.69, subdivision 
2.50 	9e, by adding subdivisions; 256B.75; 256B.76, subdivisions 1, as amended, 2; 
2.51 	256B.761; 256B.763; 256B.766; 256C.21; 256C.23, subdivisions 1, 2, by adding 
2.52 	subdivisions; 256C.233, subdivisions 1, 2, 4; 256C.24; 256C.25, subdivision 1; 
2.53 	256C.261; 256C.30; 256D.44, subdivisions 4, as amended, 5, as amended; 256E.30, 
2.54 	subdivision 2; 256I.03, subdivision 8; 256I.04, subdivisions 1, 2d, 2g, 3; 256I.05, 
2.55 	subdivisions 1a, 1c, 1e, 1j, 1m, by adding subdivisions; 256I.06, subdivisions 2, 
2.56 	8; 256J.45, subdivision 2; 256L.03, subdivisions 1, 1a, 5; 256L.11, subdivision 7, 
2.57 	by adding a subdivision; 256L.15, subdivision 2; 256P.06, subdivision 2; 256P.07, 
2.58 	subdivisions 3, 6; 256R.02, subdivisions 4, 17, 18, 19, 22, 42, 52, by adding 
3.1 	subdivisions; 256R.06, subdivision 5; 256R.07, by adding a subdivision; 256R.10, 
3.2 	by adding a subdivision; 256R.37; 256R.40, subdivisions 1, 5; 256R.41; 256R.47; 
3.3 	256R.49, subdivision 1; 260C.451, subdivision 6; 327.15, subdivision 3; 364.09; 
3.4 	609.5315, subdivision 5c; 626.556, subdivisions 2, 3, 3c, 4, 10d, 10e, 10f, 10i; 
3.5 	Laws 2009, chapter 101, article 1, section 12; Laws 2012, chapter 247, article 4, 
3.6 	section 47, as amended; article 6, section 2, subdivision 2; Laws 2013, chapter 
3.7 	108, article 15, section 2, subdivision 2; Laws 2015, chapter 71, article 14, section 
3.8 	3, subdivision 2, as amended; Laws 2017, chapter 2, article 1, sections 2, 
3.9 	subdivision 3; 5; 7; Laws 2017, chapter 13, article 1, section 15; proposing coding 
3.10 	for new law in Minnesota Statutes, chapters 103I; 119B; 137; 144; 147A; 148; 
3.11 	245; 245A; 256; 256B; 256I; 256N; 256R; proposing coding for new law as 
3.12 	Minnesota Statutes, chapters 144H; 245G; repealing Minnesota Statutes 2016, 
3.13 	sections 13.468; 103I.005, subdivisions 8, 14, 15; 103I.451; 119B.07; 144.0571; 
3.14 	144A.351, subdivision 2; 147A.21; 147B.08, subdivisions 1, 2, 3; 147C.40, 
3.15 	subdivisions 1, 2, 3, 4; 148.6402, subdivision 2; 148.6450; 148.906; 148.907, 
3.16 	subdivision 5; 148.908; 148.909, subdivision 7; 148.96, subdivisions 4, 5; 
3.17 	245A.1915; 245A.192; 254A.02, subdivision 4; 256B.19, subdivision 1c; 
3.18 	256B.4914, subdivision 16; 256B.64; 256B.7631; Laws 2012, chapter 247, article 
3.19 	4, section 47, as amended; Laws 2015, chapter 71, article 7, section 54; Minnesota 
3.20 	Rules, parts 5600.2500; 9500.1140, subparts 3, 4, 5, 6; 9530.6405, subparts 1, 1a, 
3.21 	2, 3, 4, 5, 6, 7, 7a, 8, 9, 10, 11, 12, 13, 14, 14a, 15, 15a, 16, 17, 17a, 17b, 17c, 18, 
3.22 	20, 21; 9530.6410; 9530.6415; 9530.6420; 9530.6422; 9530.6425; 9530.6430; 
3.23 	9530.6435; 9530.6440; 9530.6445; 9530.6450; 9530.6455; 9530.6460; 9530.6465; 
3.24 	9530.6470; 9530.6475; 9530.6480; 9530.6485; 9530.6490; 9530.6495; 9530.6500; 
3.25 	9530.6505.
3.26 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

3.27 	ARTICLE 1
3.28 	COMMUNITY SUPPORTS

3.29 	Section 1. Minnesota Statutes 2016, section 144A.351, subdivision 1, is amended to read:
3.30 		Subdivision 1.Report requirements. The commissioners of health and human services, 
3.31 	with the cooperation of counties and in consultation with stakeholders, including persons 
3.32 	who need or are using long-term care services and supports, lead agencies, regional entities, 
3.33 	senior, disability, and mental health organization representatives, service providers, and 
3.34 	community members shall prepare a report to the legislature by August 15, 2013, and 
3.35 	biennially thereafter, regarding the status of the full range of long-term care services and 
3.36 	supports for the elderly and children and adults with disabilities and mental illnesses in 
3.37 	Minnesota. Any amounts appropriated for this report are available in either year of the 
3.38 	biennium. The report shall address:
3.39 	(1) demographics and need for long-term care services and supports in Minnesota;
3.40 	(2) summary of county and regional reports on long-term care gaps, surpluses, imbalances, 
3.41 	and corrective action plans;
3.42 	(3) status of long-term care services and related mental health services, housing options, 
3.43 	and supports by county and region including:
4.1 	(i) changes in availability of the range of long-term care services and housing options;
4.2 	(ii) access problems, including access to the least restrictive and most integrated services 
4.3 	and settings, regarding long-term care services; and
4.4 	(iii) comparative measures of long-term care services availability, including serving 
4.5 	people in their home areas near family, and changes over time; and
4.6 	(4) recommendations regarding goals for the future of long-term care services and 
4.7 	supports, policy and fiscal changes, and resource development and transition needs.

4.8 	Sec. 2. Minnesota Statutes 2016, section 245D.03, subdivision 1, is amended to read:
4.9 		Subdivision 1.Applicability.  (a) The commissioner shall regulate the provision of home 
4.10 	and community-based services to persons with disabilities and persons age 65 and older 
4.11 	pursuant to this chapter. The licensing standards in this chapter govern the provision of 
4.12 	basic support services and intensive support services.
4.13 	(b) Basic support services provide the level of assistance, supervision, and care that is 
4.14 	necessary to ensure the health and welfare of the person and do not include services that 
4.15 	are specifically directed toward the training, treatment, habilitation, or rehabilitation of the 
4.16 	person. Basic support services include:
4.17 	(1) in-home and out-of-home respite care services as defined in section 245A.02, 
4.18 	subdivision 15, and under the brain injury, community alternative care, community access 
4.19 	for disability inclusion, developmental disability, and elderly waiver plans, excluding 
4.20 	out-of-home respite care provided to children in a family child foster care home licensed 
4.21 	under Minnesota Rules, parts 2960.3000 to 2960.3100, when the child foster care license 
4.22 	holder complies with the requirements under section 245D.06, subdivisions 5, 6, 7, and 8, 
4.23 	or successor provisions; and section 245D.061 or successor provisions, which must be 
4.24 	stipulated in the statement of intended use required under Minnesota Rules, part 2960.3000, 
4.25 	subpart 4;
4.26 	(2) adult companion services as defined under the brain injury, community access for 
4.27 	disability inclusion, and elderly waiver plans, excluding adult companion services provided 
4.28 	under the Corporation for National and Community Services Senior Companion Program 
4.29 	established under the Domestic Volunteer Service Act of 1973, Public Law 98-288;
4.30 	(3) personal support as defined under the developmental disability waiver plan;
4.31 	(4) 24-hour emergency assistance, personal emergency response as defined under the 
4.32 	community access for disability inclusion and developmental disability waiver plans;
5.1 	(5) night supervision services as defined under the brain injury waiver plan; and
5.2 	(6) homemaker services as defined under the community access for disability inclusion, 
5.3 	brain injury, community alternative care, developmental disability, and elderly waiver plans, 
5.4 	excluding providers licensed by the Department of Health under chapter 144A and those 
5.5 	providers providing cleaning services only; and
5.6 	(7) individual community living support under section 256B.0915, subdivision 3j.
5.7 	(c) Intensive support services provide assistance, supervision, and care that is necessary 
5.8 	to ensure the health and welfare of the person and services specifically directed toward the 
5.9 	training, habilitation, or rehabilitation of the person. Intensive support services include:
5.10 	(1) intervention services, including:
5.11 	(i) behavioral support services as defined under the brain injury and community access 
5.12 	for disability inclusion waiver plans;
5.13 	(ii) in-home or out-of-home crisis respite services as defined under the developmental 
5.14 	disability waiver plan; and
5.15 	(iii) specialist services as defined under the current developmental disability waiver 
5.16 	plan;
5.17 	(2) in-home support services, including:
5.18 	(i) in-home family support and supported living services as defined under the 
5.19 	developmental disability waiver plan;
5.20 	(ii) independent living services training as defined under the brain injury and community 
5.21 	access for disability inclusion waiver plans; and
5.22 	(iii) semi-independent living services; and
5.23 	(iv) individualized home supports services as defined under the brain injury, community 
5.24 	alternative care, and community access for disability inclusion waiver plans;
5.25 	(3) residential supports and services, including:
5.26 	(i) supported living services as defined under the developmental disability waiver plan 
5.27 	provided in a family or corporate child foster care residence, a family adult foster care 
5.28 	residence, a community residential setting, or a supervised living facility;
5.29 	(ii) foster care services as defined in the brain injury, community alternative care, and 
5.30 	community access for disability inclusion waiver plans provided in a family or corporate 
6.1 	child foster care residence, a family adult foster care residence, or a community residential 
6.2 	setting; and
6.3 	(iii) residential services provided to more than four persons with developmental 
6.4 	disabilities in a supervised living facility, including ICFs/DD;
6.5 	(4) day services, including:
6.6 	(i) structured day services as defined under the brain injury waiver plan;
6.7 	(ii) day training and habilitation services under sections 252.41 to 252.46, and as defined 
6.8 	under the developmental disability waiver plan; and
6.9 	(iii) prevocational services as defined under the brain injury and community access for 
6.10 	disability inclusion waiver plans; and
6.11 	(5) supported employment as defined under the brain injury, developmental disability, 
6.12 	and community access for disability inclusion waiver plans employment exploration services 
6.13 	as defined under the brain injury, community alternative care, community access for disability 
6.14 	inclusion, and developmental disability waiver plans;
6.15 	(6) employment development services as defined under the brain injury, community 
6.16 	alternative care, community access for disability inclusion, and developmental disability 
6.17 	waiver plans; and
6.18 	(7) employment support services as defined under the brain injury, community alternative 
6.19 	care, community access for disability inclusion, and developmental disability waiver plans.

6.20 	EFFECTIVE DATE. (a) The amendment to paragraphs (b) and (c), clause (2), is 
6.21 	effective the day following final enactment.
6.22 	(b) The amendments to paragraph (c), clauses (5) to (7), are effective upon federal 
6.23 	approval. The commissioner of human services shall notify the revisor of statutes when 
6.24 	federal approval is obtained.

6.25 	Sec. 3. Minnesota Statutes 2016, section 252.41, subdivision 3, is amended to read:
6.26 		Subd. 3.Day training and habilitation services for adults with developmental 
6.27 	disabilities. (a) "Day training and habilitation services for adults with developmental 
6.28 	disabilities" means services that:
6.29 	(1) include supervision, training, assistance, and supported employment, center-based
6.30 	work-related activities, or other community-integrated activities designed and implemented 
6.31 	in accordance with the individual service and individual habilitation plans required under 
7.1 	Minnesota Rules, parts 9525.0004 to 9525.0036, to help an adult reach and maintain the 
7.2 	highest possible level of independence, productivity, and integration into the community; 
7.3 	and
7.4 	(2) are provided by a vendor licensed under sections 245A.01 to 245A.16 and 252.28, 
7.5 	subdivision 2, to provide day training and habilitation services.
7.6 	(b) Day training and habilitation services reimbursable under this section do not include 
7.7 	special education and related services as defined in the Education of the Individuals with 
7.8 	Disabilities Act, United States Code, title 20, chapter 33, section 1401, clauses (6) and (17), 
7.9 	or vocational services funded under section 110 of the Rehabilitation Act of 1973, United 
7.10 	States Code, title 29, section 720, as amended.
7.11 	(c) Day training and habilitation services do not include employment exploration, 
7.12 	employment development, or employment support services as defined in the home and 
7.13 	community-based services waivers for people with disabilities authorized under sections 
7.14 	256B.092 and 256B.49.

7.15 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
7.16 	of human services shall notify the revisor of statutes when federal approval is obtained.

7.17 	Sec. 4. [256.477] SELF-ADVOCACY GRANTS.
7.18 	(a) The commissioner shall make available a grant for the purposes of establishing and 
7.19 	maintaining a statewide self-advocacy network for persons with intellectual and 
7.20 	developmental disabilities. The self-advocacy network shall:
7.21 	(1) ensure that persons with intellectual and developmental disabilities are informed of 
7.22 	their rights in employment, housing, transportation, voting, government policy, and other 
7.23 	issues pertinent to the intellectual and developmental disability community;
7.24 	(2) provide public education and awareness of the civil and human rights issues persons 
7.25 	with intellectual and developmental disabilities face;
7.26 	(3) provide funds, technical assistance, and other resources for self-advocacy groups 
7.27 	across the state; and
7.28 	(4) organize systems of communications to facilitate an exchange of information between 
7.29 	self-advocacy groups.
7.30 	(b) An organization receiving a grant under paragraph (a) must be an organization 
7.31 	governed by people with intellectual and developmental disabilities that administers a 
7.32 	statewide network of disability groups in order to maintain and promote self-advocacy 
8.1 	services and supports for persons with intellectual and developmental disabilities throughout 
8.2 	the state.

8.3 	Sec. 5. Minnesota Statutes 2016, section 256B.0625, subdivision 6a, is amended to read:
8.4 		Subd. 6a.Home health services. Home health services are those services specified in 
8.5 	Minnesota Rules, part 9505.0295 and sections 256B.0651 and 256B.0653. Medical assistance 
8.6 	covers home health services at a recipient's home residence or in the community where 
8.7 	normal life activities take the recipient. Medical assistance does not cover home health 
8.8 	services for residents of a hospital, nursing facility, or intermediate care facility, unless the 
8.9 	commissioner of human services has authorized skilled nurse visits for less than 90 days 
8.10 	for a resident at an intermediate care facility for persons with developmental disabilities, 
8.11 	to prevent an admission to a hospital or nursing facility or unless a resident who is otherwise 
8.12 	eligible is on leave from the facility and the facility either pays for the home health services 
8.13 	or forgoes the facility per diem for the leave days that home health services are used. Home 
8.14 	health services must be provided by a Medicare certified home health agency. All nursing 
8.15 	and home health aide services must be provided according to sections 256B.0651 to 
8.16 	256B.0653.

8.17 	Sec. 6. Minnesota Statutes 2016, section 256B.0625, subdivision 31, is amended to read:
8.18 		Subd. 31.Medical supplies and equipment. (a) Medical assistance covers medical 
8.19 	supplies and equipment. Separate payment outside of the facility's payment rate shall be 
8.20 	made for wheelchairs and wheelchair accessories for recipients who are residents of 
8.21 	intermediate care facilities for the developmentally disabled. Reimbursement for wheelchairs 
8.22 	and wheelchair accessories for ICF/DD recipients shall be subject to the same conditions 
8.23 	and limitations as coverage for recipients who do not reside in institutions. A wheelchair 
8.24 	purchased outside of the facility's payment rate is the property of the recipient.
8.25 	(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies 
8.26 	must enroll as a Medicare provider.
8.27 	(c) When necessary to ensure access to durable medical equipment, prosthetics, orthotics, 
8.28 	or medical supplies, the commissioner may exempt a vendor from the Medicare enrollment 
8.29 	requirement if:
8.30 	(1) the vendor supplies only one type of durable medical equipment, prosthetic, orthotic, 
8.31 	or medical supply;
8.32 	(2) the vendor serves ten or fewer medical assistance recipients per year;
9.1 	(3) the commissioner finds that other vendors are not available to provide same or similar 
9.2 	durable medical equipment, prosthetics, orthotics, or medical supplies; and
9.3 	(4) the vendor complies with all screening requirements in this chapter and Code of 
9.4 	Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from 
9.5 	the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare 
9.6 	and Medicaid Services approved national accreditation organization as complying with the 
9.7 	Medicare program's supplier and quality standards and the vendor serves primarily pediatric 
9.8 	patients.
9.9 	(d) Durable medical equipment means a device or equipment that:
9.10 	(1) can withstand repeated use;
9.11 	(2) is generally not useful in the absence of an illness, injury, or disability; and
9.12 	(3) is provided to correct or accommodate a physiological disorder or physical condition 
9.13 	or is generally used primarily for a medical purpose.
9.14 	(e) Electronic tablets may be considered durable medical equipment if the electronic 
9.15 	tablet will be used as an augmentative and alternative communication system as defined 
9.16 	under subdivision 31a, paragraph (a). To be covered by medical assistance, the device must 
9.17 	be locked in order to prevent use not related to communication.
9.18 	(f) Notwithstanding the requirement in paragraph (e) that an electronic tablet must be 
9.19 	locked to prevent use not as an augmentative communication device, a recipient of waiver 
9.20 	services may use an electronic tablet for a use not related to communication when the 
9.21 	recipient has been authorized under the waiver to receive one or more additional applications 
9.22 	that can be loaded onto the electronic tablet, such that allowing the additional use prevents 
9.23 	the purchase of a separate electronic tablet with waiver funds.
9.24 	(g) An order or prescription for medical supplies, equipment, or appliances must meet 
9.25 	the requirements in Code of Federal Regulations, title 42, part 440.70.

9.26 	Sec. 7. Minnesota Statutes 2016, section 256B.0653, subdivision 2, is amended to read:
9.27 		Subd. 2.Definitions. For the purposes of this section, the following terms have the 
9.28 	meanings given.
9.29 	(a) "Assessment" means an evaluation of the recipient's medical need for home health 
9.30 	agency services by a registered nurse or appropriate therapist that is conducted within 30 
9.31 	days of a request.
10.1 	(b) "Home care therapies" means occupational, physical, and respiratory therapy and 
10.2 	speech-language pathology services provided in the home by a Medicare certified home 
10.3 	health agency.
10.4 	(c) "Home health agency services" means services delivered in the recipient's home 
10.5 	residence, except as specified in section 256B.0625, by a home health agency to a recipient 
10.6 	with medical needs due to illness, disability, or physical conditions in settings permitted 
10.7 	under section 256B.0625, subdivision 6a.
10.8 	(d) "Home health aide" means an employee of a home health agency who completes 
10.9 	medically oriented tasks written in the plan of care for a recipient.
10.10 	(e) "Home health agency" means a home care provider agency that is Medicare-certified.
10.11 	(f) "Occupational therapy services" mean the services defined in Minnesota Rules, part 
10.12 	9505.0390.
10.13 	(g) "Physical therapy services" mean the services defined in Minnesota Rules, part 
10.14 	9505.0390.
10.15 	(h) "Respiratory therapy services" mean the services defined in chapter 147C.
10.16 	(i) "Speech-language pathology services" mean the services defined in Minnesota Rules, 
10.17 	part 9505.0390.
10.18 	(j) "Skilled nurse visit" means a professional nursing visit to complete nursing tasks 
10.19 	required due to a recipient's medical condition that can only be safely provided by a 
10.20 	professional nurse to restore and maintain optimal health.
10.21 	(k) "Store-and-forward technology" means telehomecare services that do not occur in 
10.22 	real time via synchronous transmissions such as diabetic and vital sign monitoring.
10.23 	(l) "Telehomecare" means the use of telecommunications technology via live, two-way 
10.24 	interactive audiovisual technology which may be augmented by store-and-forward 
10.25 	technology.
10.26 	(m) "Telehomecare skilled nurse visit" means a visit by a professional nurse to deliver 
10.27 	a skilled nurse visit to a recipient located at a site other than the site where the nurse is 
10.28 	located and is used in combination with face-to-face skilled nurse visits to adequately meet 
10.29 	the recipient's needs.

11.1 	Sec. 8. Minnesota Statutes 2016, section 256B.0653, subdivision 3, is amended to read:
11.2 		Subd. 3.Home health aide visits. (a) Home health aide visits must be provided by a 
11.3 	certified home health aide using a written plan of care that is updated in compliance with 
11.4 	Medicare regulations. A home health aide shall provide hands-on personal care, perform 
11.5 	simple procedures as an extension of therapy or nursing services, and assist in instrumental 
11.6 	activities of daily living as defined in section 256B.0659, including assuring that the person 
11.7 	gets to medical appointments if identified in the written plan of care. Home health aide 
11.8 	visits must may be provided in the recipient's home or in the community where normal life 
11.9 	activities take the recipient.
11.10 	(b) All home health aide visits must have authorization under section 256B.0652. The 
11.11 	commissioner shall limit home health aide visits to no more than one visit per day per 
11.12 	recipient.
11.13 	(c) Home health aides must be supervised by a registered nurse or an appropriate therapist 
11.14 	when providing services that are an extension of therapy.

11.15 	Sec. 9. Minnesota Statutes 2016, section 256B.0653, subdivision 4, as amended by Laws 
11.16 	2017, chapter 59, section 10, is amended to read:
11.17 		Subd. 4.Skilled nurse visit services. (a) Skilled nurse visit services must be provided 
11.18 	by a registered nurse or a licensed practical nurse under the supervision of a registered nurse, 
11.19 	according to the written plan of care and accepted standards of medical and nursing practice 
11.20 	according to chapter 148. Skilled nurse visit services must be ordered by a physician, 
11.21 	advanced practice registered nurse, or physician assistant and documented in a plan of care 
11.22 	that is reviewed and approved by the ordering physician, advanced practice registered nurse, 
11.23 	or physician assistant at least once every 60 days. All skilled nurse visits must be medically 
11.24 	necessary and provided in the recipient's home residence or in the community where normal 
11.25 	life activities take the recipient,except as allowed under section 256B.0625, subdivision 
11.26 	6a.
11.27 	(b) Skilled nurse visits include face-to-face and telehomecare visits with a limit of up 
11.28 	to two visits per day per recipient. All visits must be based on assessed needs.
11.29 	(c) Telehomecare skilled nurse visits are allowed when the recipient's health status can 
11.30 	be accurately measured and assessed without a need for a face-to-face, hands-on encounter. 
11.31 	All telehomecare skilled nurse visits must have authorization and are paid at the same 
11.32 	allowable rates as face-to-face skilled nurse visits.
12.1 	(d) The provision of telehomecare must be made via live, two-way interactive audiovisual 
12.2 	technology and may be augmented by utilizing store-and-forward technologies. Individually 
12.3 	identifiable patient data obtained through real-time or store-and-forward technology must 
12.4 	be maintained as health records according to sections 144.291 to 144.298. If the video is 
12.5 	used for research, training, or other purposes unrelated to the care of the patient, the identity 
12.6 	of the patient must be concealed.
12.7 	(e) Authorization for skilled nurse visits must be completed under section 256B.0652. 
12.8 	A total of nine face-to-face skilled nurse visits per calendar year do not require authorization. 
12.9 	All telehomecare skilled nurse visits require authorization.

12.10 	Sec. 10. Minnesota Statutes 2016, section 256B.0653, subdivision 5, is amended to read:
12.11 		Subd. 5.Home care therapies. (a) Home care therapies include the following: physical 
12.12 	therapy, occupational therapy, respiratory therapy, and speech and language pathology 
12.13 	therapy services.
12.14 	(b) Home care therapies must be:
12.15 	(1) provided in the recipient's residence or in the community where normal life activities 
12.16 	take the recipient after it has been determined the recipient is unable to access outpatient 
12.17 	therapy;
12.18 	(2) prescribed, ordered, or referred by a physician and documented in a plan of care and 
12.19 	reviewed, according to Minnesota Rules, part 9505.0390;
12.20 	(3) assessed by an appropriate therapist; and
12.21 	(4) provided by a Medicare-certified home health agency enrolled as a Medicaid provider 
12.22 	agency.
12.23 	(c) Restorative and specialized maintenance therapies must be provided according to 
12.24 	Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be used 
12.25 	as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.
12.26 	(d) For both physical and occupational therapies, the therapist and the therapist's assistant 
12.27 	may not both bill for services provided to a recipient on the same day.

12.28 	Sec. 11. Minnesota Statutes 2016, section 256B.0653, subdivision 6, is amended to read:
12.29 		Subd. 6.Noncovered home health agency services. The following are not eligible for 
12.30 	payment under medical assistance as a home health agency service:
13.1 	(1) telehomecare skilled nurses services that is communication between the home care 
13.2 	nurse and recipient that consists solely of a telephone conversation, facsimile, electronic 
13.3 	mail, or a consultation between two health care practitioners;
13.4 	(2) the following skilled nurse visits:
13.5 	(i) for the purpose of monitoring medication compliance with an established medication 
13.6 	program for a recipient;
13.7 	(ii) administering or assisting with medication administration, including injections, 
13.8 	prefilling syringes for injections, or oral medication setup of an adult recipient, when, as 
13.9 	determined and documented by the registered nurse, the need can be met by an available 
13.10 	pharmacy or the recipient or a family member is physically and mentally able to 
13.11 	self-administer or prefill a medication;
13.12 	(iii) services done for the sole purpose of supervision of the home health aide or personal 
13.13 	care assistant;
13.14 	(iv) services done for the sole purpose to train other home health agency workers;
13.15 	(v) services done for the sole purpose of blood samples or lab draw when the recipient 
13.16 	is able to access these services outside the home; and
13.17 	(vi) Medicare evaluation or administrative nursing visits required by Medicare;
13.18 	(3) home health aide visits when the following activities are the sole purpose for the 
13.19 	visit: companionship, socialization, household tasks, transportation, and education; and
13.20 	(4) home care therapies provided in other settings such as a clinic, day program, or as 
13.21 	an inpatient or when the recipient can access therapy outside of the recipient's residence; 
13.22 	and
13.23 	(5) home health agency services without qualifying documentation of a face-to-face 
13.24 	encounter as specified in subdivision 7.

13.25 	Sec. 12. Minnesota Statutes 2016, section 256B.0653, is amended by adding a subdivision 
13.26 	to read:
13.27 		Subd. 7.Face-to-face encounter. (a) A face-to-face encounter by a qualifying provider 
13.28 	must be completed for all home health services regardless of the need for prior authorization, 
13.29 	except when providing a onetime perinatal visit by skilled nursing. The face-to-face encounter 
13.30 	may occur through telemedicine as defined in section 256B.0625, subdivision 3b. The 
13.31 	encounter must be related to the primary reason the recipient requires home health services 
13.32 	and must occur within the 90 days before or the 30 days after the start of services. The 
14.1 	face-to-face encounter may be conducted by one of the following practitioners, licensed in 
14.2 	Minnesota:
14.3 	(1) a physician;
14.4 	(2) a nurse practitioner or clinical nurse specialist;
14.5 	(3) a certified nurse midwife; or
14.6 	(4) a physician assistant.
14.7 	(b) The allowed nonphysician practitioner, as described in this subdivision, performing 
14.8 	the face-to-face encounter must communicate the clinical findings of that face-to-face 
14.9 	encounter to the ordering physician. Those clinical findings must be incorporated into a 
14.10 	written or electronic document included in the recipient's medical record. To assure clinical 
14.11 	correlation between the face-to-face encounter and the associated home health services, the 
14.12 	physician responsible for ordering the services must:
14.13 	(1) document that the face-to-face encounter, which is related to the primary reason the 
14.14 	recipient requires home health services, occurred within the required time period; and
14.15 	(2) indicate the practitioner who conducted the encounter and the date of the encounter.
14.16 	(c) For home health services requiring authorization, including prior authorization, home 
14.17 	health agencies must retain the qualifying documentation of a face-to-face encounter as part 
14.18 	of the recipient health service record, and submit the qualifying documentation to the 
14.19 	commissioner or the commissioner's designee upon request.

14.20 	Sec. 13. Minnesota Statutes 2016, section 256B.0911, subdivision 1a, is amended to read:
14.21 		Subd. 1a.Definitions. For purposes of this section, the following definitions apply:
14.22 	(a) Until additional requirements apply under paragraph (b), "long-term care consultation 
14.23 	services" means:
14.24 	(1) intake for and access to assistance in identifying services needed to maintain an 
14.25 	individual in the most inclusive environment;
14.26 	(2) providing recommendations for and referrals to cost-effective community services 
14.27 	that are available to the individual;
14.28 	(3) development of an individual's person-centered community support plan;
14.29 	(4) providing information regarding eligibility for Minnesota health care programs;
15.1 	(5) face-to-face long-term care consultation assessments, which may be completed in a 
15.2 	hospital, nursing facility, intermediate care facility for persons with developmental disabilities 
15.3 	(ICF/DDs), regional treatment centers, or the person's current or planned residence;
15.4 	(6) determination of home and community-based waiver and other service eligibility as 
15.5 	required under sections 256B.0913, 256B.0915, and 256B.49, including level of care 
15.6 	determination for individuals who need an institutional level of care as determined under 
15.7 	subdivision 4e, based on assessment and community support plan development, appropriate 
15.8 	referrals to obtain necessary diagnostic information, and including an eligibility determination 
15.9 	for consumer-directed community supports;
15.10 	(7) providing recommendations for institutional placement when there are no 
15.11 	cost-effective community services available;
15.12 	(8) providing access to assistance to transition people back to community settings after 
15.13 	institutional admission; and
15.14 	(9) providing information about competitive employment, with or without supports, for 
15.15 	school-age youth and working-age adults and referrals to the Disability Linkage Line and 
15.16 	Disability Benefits 101 to ensure that an informed choice about competitive employment 
15.17 	can be made. For the purposes of this subdivision, "competitive employment" means work 
15.18 	in the competitive labor market that is performed on a full-time or part-time basis in an 
15.19 	integrated setting, and for which an individual is compensated at or above the minimum 
15.20 	wage, but not less than the customary wage and level of benefits paid by the employer for 
15.21 	the same or similar work performed by individuals without disabilities.
15.22 	(b) Upon statewide implementation of lead agency requirements in subdivisions 2b, 2c, 
15.23 	and 3a, "long-term care consultation services" also means:
15.24 	(1) service eligibility determination for state plan home care services identified in:
15.25 	(i) section 256B.0625, subdivisions 7, 19a, and 19c;
15.26 	(ii) consumer support grants under section 256.476; or
15.27 	(iii) section 256B.85;
15.28 	(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024, 
15.29 	determination of eligibility for case management services available under sections 256B.0621, 
15.30 	subdivision 2, paragraph (4), and 256B.0924 and Minnesota Rules, part 9525.0016;
15.31 	(3) determination of institutional level of care, home and community-based service 
15.32 	waiver, and other service eligibility as required under section 256B.092, determination of 
16.1 	eligibility for family support grants under section 252.32, semi-independent living services 
16.2 	under section 252.275, and day training and habilitation services under section 256B.092; 
16.3 	and
16.4 	(4) obtaining necessary diagnostic information to determine eligibility under clauses (2) 
16.5 	and (3).
16.6 	(c) "Long-term care options counseling" means the services provided by the linkage 
16.7 	lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and also 
16.8 	includes telephone assistance and follow up once a long-term care consultation assessment 
16.9 	has been completed.
16.10 	(d) "Minnesota health care programs" means the medical assistance program under this 
16.11 	chapter and the alternative care program under section 256B.0913.
16.12 	(e) "Lead agencies" means counties administering or tribes and health plans under 
16.13 	contract with the commissioner to administer long-term care consultation assessment and 
16.14 	support planning services.
16.15 	(f) "Person-centered planning" is a process that includes the active participation of a 
16.16 	person in the planning of the person's services, including in making meaningful and informed 
16.17 	choices about the person's own goals, talents, and objectives, as well as making meaningful 
16.18 	and informed choices about the services the person receives. For the purposes of this section, 
16.19 	"informed choice" means a voluntary choice of services by a person from all available 
16.20 	service options based on accurate and complete information concerning all available service 
16.21 	options and concerning the person's own preferences, abilities, goals, and objectives. In 
16.22 	order for a person to make an informed choice, all available options must be developed and 
16.23 	presented to the person to empower the person to make decisions.

16.24 	Sec. 14. Minnesota Statutes 2016, section 256B.0911, subdivision 2b, is amended to read:
16.25 		Subd. 2b.MnCHOICES certified assessors. (a) Each lead agency shall use certified 
16.26 	assessors who have completed MnCHOICES training and the certification processes 
16.27 	determined by the commissioner in subdivision 2c. Certified assessors shall demonstrate 
16.28 	best practices in assessment and support planning including person-centered planning 
16.29 	principals principles and have a common set of skills that must ensure consistency and 
16.30 	equitable access to services statewide. A lead agency may choose, according to departmental 
16.31 	policies, to contract with a qualified, certified assessor to conduct assessments and 
16.32 	reassessments on behalf of the lead agency. Certified assessors must use person-centered 
16.33 	planning principles to conduct an interview that identifies what is important to the person, 
17.1 	the person's needs for supports, health and safety concerns, and the person's abilities, interests, 
17.2 	and goals.
17.3 	Certified assessors are responsible for:
17.4 	(1) ensuring persons are offered objective, unbiased access to resources;
17.5 	(2) ensuring persons have the needed information to support informed choice, including 
17.6 	where and how they choose to live and the opportunity to pursue desired employment;
17.7 	(3) determining level of care and eligibility for long-term services and supports;
17.8 	(4) using the information gathered from the interview to develop a person-centered 
17.9 	community support plan that reflects identified needs and support options within the context 
17.10 	of values, interests, and goals important to the person; and
17.11 	(5) providing the person with a community support plan that summarizes the person's 
17.12 	assessment findings, support options, and agreed-upon next steps.
17.13 	(b) MnCHOICES certified assessors are persons with a minimum of a bachelor's degree 
17.14 	in social work, nursing with a public health nursing certificate, or other closely related field 
17.15 	with at least one year of home and community-based experience, or a registered nurse with 
17.16 	at least two years of home and community-based experience who has received training and 
17.17 	certification specific to assessment and consultation for long-term care services in the state.

17.18 	Sec. 15. Minnesota Statutes 2016, section 256B.0911, is amended by adding a subdivision 
17.19 	to read:
17.20 		Subd. 3f.Long-term care reassessments and community support plan updates.
 17.21 	Reassessments must be tailored using the professional judgment of the assessor to the 
17.22 	person's known needs, strengths, preferences, and circumstances. Reassessments provide 
17.23 	information to support the person's informed choice and opportunities to express choice 
17.24 	regarding activities that contribute to quality of life, as well as information and opportunity 
17.25 	to identify goals related to desired employment, community activities, and preferred living 
17.26 	environment. Reassessments allow for a review of the current support plan's effectiveness, 
17.27 	monitoring of services, and the development of an updated person-centered community 
17.28 	support plan. Reassessments verify continued eligibility or offer alternatives as warranted 
17.29 	and provide an opportunity for quality assurance of service delivery. Face-to-face assessments 
17.30 	must be conducted annually or as required by federal and state laws and rules.

18.1 	Sec. 16. Minnesota Statutes 2016, section 256B.0911, subdivision 4d, as amended by 
18.2 	Laws 2017, chapter 40, article 1, section 69, is amended to read:
18.3 		Subd. 4d.Preadmission screening of individuals under 65 years of age. (a) It is the 
18.4 	policy of the state of Minnesota to ensure that individuals with disabilities or chronic illness 
18.5 	are served in the most integrated setting appropriate to their needs and have the necessary 
18.6 	information to make informed choices about home and community-based service options.
18.7 	(b) Individuals under 65 years of age who are admitted to a Medicaid-certified nursing 
18.8 	facility must be screened prior to admission according to the requirements outlined in section 
18.9 	256.975, subdivisions 7a to 7c. This shall be provided by the Senior LinkAge Line as 
18.10 	required under section 256.975, subdivision 7.
18.11 	(c) Individuals under 65 years of age who are admitted to nursing facilities with only a 
18.12 	telephone screening must receive a face-to-face assessment from the long-term care 
18.13 	consultation team member of the county in which the facility is located or from the recipient's 
18.14 	county case manager within 40 calendar days of admission the timeline established by the 
18.15 	commissioner, based on review of data.
18.16 	(d) At the face-to-face assessment, the long-term care consultation team member or 
18.17 	county case manager must perform the activities required under subdivision 3b.
18.18 	(e) For individuals under 21 years of age, a screening interview which recommends 
18.19 	nursing facility admission must be face-to-face and approved by the commissioner before 
18.20 	the individual is admitted to the nursing facility.
18.21 	(f) In the event that an individual under 65 years of age is admitted to a nursing facility 
18.22 	on an emergency basis, the Senior LinkAge Line must be notified of the admission on the 
18.23 	next working day, and a face-to-face assessment as described in paragraph (c) must be 
18.24 	conducted within 40 calendar days of admission the timeline established by the commissioner, 
18.25 	based on review of data.
18.26 	(g) At the face-to-face assessment, the long-term care consultation team member or the 
18.27 	case manager must present information about home and community-based options, including 
18.28 	consumer-directed options, so the individual can make informed choices. If the individual 
18.29 	chooses home and community-based services, the long-term care consultation team member 
18.30 	or case manager must complete a written relocation plan within 20 working days of the 
18.31 	visit. The plan shall describe the services needed to move out of the facility and a time line 
18.32 	for the move which is designed to ensure a smooth transition to the individual's home and 
18.33 	community.
19.1 	(h) An individual under 65 years of age residing in a nursing facility shall receive a 
19.2 	face-to-face assessment at least every 12 months to review the person's service choices and 
19.3 	available alternatives unless the individual indicates, in writing, that annual visits are not 
19.4 	desired. In this case, the individual must receive a face-to-face assessment at least once 
19.5 	every 36 months for the same purposes.
19.6 	(i) Notwithstanding the provisions of subdivision 6, the commissioner may pay county 
19.7 	agencies directly for face-to-face assessments for individuals under 65 years of age who 
19.8 	are being considered for placement or residing in a nursing facility.
19.9 	(j) Funding for preadmission screening follow-up shall be provided to the Disability 
19.10 	Linkage Line for the under-60 population by the Department of Human Services to cover 
19.11 	options counseling salaries and expenses to provide the services described in subdivisions 
19.12 	7a to 7c. The Disability Linkage Line shall employ, or contract with other agencies to 
19.13 	employ, within the limits of available funding, sufficient personnel to provide preadmission 
19.14 	screening follow-up services and shall seek to maximize federal funding for the service as 
19.15 	provided under section 256.01, subdivision 2, paragraph (aa).

19.16 	Sec. 17. Minnesota Statutes 2016, section 256B.0911, subdivision 5, is amended to read:
19.17 		Subd. 5.Administrative activity. (a) The commissioner shall streamline the processes, 
19.18 	including timelines for when assessments need to be completed, required to provide the 
19.19 	services in this section and shall implement integrated solutions to automate the business 
19.20 	processes to the extent necessary for community support plan approval, reimbursement, 
19.21 	program planning, evaluation, and policy development.
19.22 	(b) The commissioner of human services shall work with lead agencies responsible for 
19.23 	conducting long-term consultation services to modify the MnCHOICES application and 
19.24 	assessment policies to create efficiencies while ensuring federal compliance with medical 
19.25 	assistance and long-term services and supports eligibility criteria.

19.26 	Sec. 18. Minnesota Statutes 2016, section 256B.0911, subdivision 6, as amended by Laws 
19.27 	2017, chapter 40, article 1, section 70, is amended to read:
19.28 		Subd. 6.Payment for long-term care consultation services. (a) Until September 30, 
19.29 	2013, payment for long-term care consultation face-to-face assessment shall be made as 
19.30 	described in this subdivision.
19.31 	(b) The total payment for each county must be paid monthly by certified nursing facilities 
19.32 	in the county. The monthly amount to be paid by each nursing facility for each fiscal year 
20.1 	must be determined by dividing the county's annual allocation for long-term care consultation 
20.2 	services by 12 to determine the monthly payment and allocating the monthly payment to 
20.3 	each nursing facility based on the number of licensed beds in the nursing facility. Payments 
20.4 	to counties in which there is no certified nursing facility must be made by increasing the 
20.5 	payment rate of the two facilities located nearest to the county seat.
20.6 	(c) The commissioner shall include the total annual payment determined under paragraph 
20.7 	(b) for each nursing facility reimbursed under section 256B.431, 256B.434, or chapter 256R.
20.8 	(d) In the event of the layaway, delicensure and decertification, or removal from layaway 
20.9 	of 25 percent or more of the beds in a facility, the commissioner may adjust the per diem 
20.10 	payment amount in paragraph (c) and may adjust the monthly payment amount in paragraph 
20.11 	(b). The effective date of an adjustment made under this paragraph shall be on or after the 
20.12 	first day of the month following the effective date of the layaway, delicensure and 
20.13 	decertification, or removal from layaway.
20.14 	(e) Payments for long-term care consultation services are available to the county or 
20.15 	counties to cover staff salaries and expenses to provide the services described in subdivision 
20.16 	1a. The county shall employ, or contract with other agencies to employ, within the limits 
20.17 	of available funding, sufficient personnel to provide long-term care consultation services 
20.18 	while meeting the state's long-term care outcomes and objectives as defined in subdivision 
20.19 	1. The county shall be accountable for meeting local objectives as approved by the 
20.20 	commissioner in the biennial home and community-based services quality assurance plan 
20.21 	on a form provided by the commissioner.
20.22 	(f) Notwithstanding section 256B.0641, overpayments attributable to payment of the 
20.23 	screening costs under the medical assistance program may not be recovered from a facility.
20.24 	(g) The commissioner of human services shall amend the Minnesota medical assistance 
20.25 	plan to include reimbursement for the local consultation teams.
20.26 	(h) Until the alternative payment methodology in paragraph (i) is implemented, the 
20.27 	county may bill, as case management services, assessments, support planning, and 
20.28 	follow-along provided to persons determined to be eligible for case management under 
20.29 	Minnesota health care programs. No individual or family member shall be charged for an 
20.30 	initial assessment or initial support plan development provided under subdivision 3a or 3b.
20.31 	(i) The commissioner shall develop an alternative payment methodology, effective on 
20.32 	October 1, 2013, for long-term care consultation services that includes the funding available 
20.33 	under this subdivision, and for assessments authorized under sections 256B.092 and 
20.34 	256B.0659. In developing the new payment methodology, the commissioner shall consider 
21.1 	the maximization of other funding sources, including federal administrative reimbursement 
21.2 	through federal financial participation funding, for all long-term care consultation activity. 
21.3 	The alternative payment methodology shall include the use of the appropriate time studies 
21.4 	and the state financing of nonfederal share as part of the state's medical assistance program.
21.5 	Between July 1, 2017, and June 30, 2019, the state shall pay 84.3 percent of the nonfederal 
21.6 	share as reimbursement to the counties. Beginning July 1, 2019, the state shall pay 81.9 
21.7 	percent of the nonfederal share as reimbursement to the counties.

21.8 	Sec. 19. Minnesota Statutes 2016, section 256B.0921, is amended to read:
21.9 	256B.0921 HOME AND COMMUNITY-BASED SERVICES INCENTIVE POOL.
21.10 	The commissioner of human services shall develop an initiative to provide incentives 
21.11 	for innovation in: (1) achieving integrated competitive employment,; (2) achieving integrated 
21.12 	competitive employment for youth under age 25 upon their graduation from school; (3)
21.13 	living in the most integrated setting,; and (4) other outcomes determined by the commissioner. 
21.14 	The commissioner shall seek requests for proposals and shall contract with one or more 
21.15 	entities to provide incentive payments for meeting identified outcomes. The initial requests 
21.16 	for proposals must be issued by October 1, 2016.

21.17 	Sec. 20. Minnesota Statutes 2016, section 256B.4913, subdivision 4a, is amended to read:
21.18 		Subd. 4a.Rate stabilization adjustment. (a) For purposes of this subdivision, 
21.19 	"implementation period" means the period beginning January 1, 2014, and ending on the 
21.20 	last day of the month in which the rate management system is populated with the data 
21.21 	necessary to calculate rates for substantially all individuals receiving home and 
21.22 	community-based waiver services under sections 256B.092 and 256B.49. "Banding period" 
21.23 	means the time period beginning on January 1, 2014, and ending upon the expiration of the 
21.24 	12-month period defined in paragraph (c), clause (5).
21.25 	(b) For purposes of this subdivision, the historical rate for all service recipients means 
21.26 	the individual reimbursement rate for a recipient in effect on December 1, 2013, except 
21.27 	that:
21.28 	(1) for a day service recipient who was not authorized to receive these waiver services 
21.29 	prior to January 1, 2014; added a new service or services on or after January 1, 2014; or 
21.30 	changed providers on or after January 1, 2014, the historical rate must be the weighted 
21.31 	average authorized rate for the provider number in the county of service, effective December 
21.32 	1, 2013; or
22.1 	(2) for a unit-based service with programming or a unit-based service without 
22.2 	programming recipient who was not authorized to receive these waiver services prior to 
22.3 	January 1, 2014; added a new service or services on or after January 1, 2014; or changed 
22.4 	providers on or after January 1, 2014, the historical rate must be the weighted average 
22.5 	authorized rate for each provider number in the county of service, effective December 1, 
22.6 	2013; or
22.7 	(3) for residential service recipients who change providers on or after January 1, 2014, 
22.8 	the historical rate must be set by each lead agency within their county aggregate budget 
22.9 	using their respective methodology for residential services effective December 1, 2013, for 
22.10 	determining the provider rate for a similarly situated recipient being served by that provider.
22.11 	(c) The commissioner shall adjust individual reimbursement rates determined under this 
22.12 	section so that the unit rate is no higher or lower than:
22.13 	(1) 0.5 percent from the historical rate for the implementation period;
22.14 	(2) 0.5 percent from the rate in effect in clause (1), for the 12-month period immediately 
22.15 	following the time period of clause (1);
22.16 	(3) 0.5 percent from the rate in effect in clause (2), for the 12-month period immediately 
22.17 	following the time period of clause (2);
22.18 	(4) 1.0 percent from the rate in effect in clause (3), for the 12-month period immediately 
22.19 	following the time period of clause (3);
22.20 	(5) 1.0 percent from the rate in effect in clause (4), for the 12-month period immediately 
22.21 	following the time period of clause (4); and
22.22 	(6) no adjustment to the rate in effect in clause (5) for the 12-month period immediately 
22.23 	following the time period of clause (5). During this banding rate period, the commissioner 
22.24 	shall not enforce any rate decrease or increase that would otherwise result from the end of 
22.25 	the banding period. The commissioner shall, upon enactment, seek federal approval for the 
22.26 	addition of this banding period; and
22.27 	(7) one percent from the rate in effect in clause (6) for the 12-month period immediately 
22.28 	following the time period of clause (6).
22.29 	(d) The commissioner shall review all changes to rates that were in effect on December 
22.30 	1, 2013, to verify that the rates in effect produce the equivalent level of spending and service 
22.31 	unit utilization on an annual basis as those in effect on October 31, 2013.
23.1 	(e) By December 31, 2014, the commissioner shall complete the review in paragraph 
23.2 	(d), adjust rates to provide equivalent annual spending, and make appropriate adjustments.
23.3 	(f) During the banding period, the Medicaid Management Information System (MMIS) 
23.4 	service agreement rate must be adjusted to account for change in an individual's need. The 
23.5 	commissioner shall adjust the Medicaid Management Information System (MMIS) service 
23.6 	agreement rate by:
23.7 	(1) calculating a service rate under section 256B.4914, subdivision 6, 7, 8, or 9, for the 
23.8 	individual with variables reflecting the level of service in effect on December 1, 2013;
23.9 	(2) calculating a service rate under section 256B.4914, subdivision 6, 7, 8, or 9, for the 
23.10 	individual with variables reflecting the updated level of service at the time of application; 
23.11 	and
23.12 	(3) adding to or subtracting from the Medicaid Management Information System (MMIS) 
23.13 	service agreement rate, the difference between the values in clauses (1) and (2).
23.14 	(g) This subdivision must not apply to rates for recipients served by providers new to a 
23.15 	given county after January 1, 2014. Providers of personal supports services who also acted 
23.16 	as fiscal support entities must be treated as new providers as of January 1, 2014.

23.17 	EFFECTIVE DATE. (a) The amendment to paragraph (b) is effective the day following 
23.18 	final enactment.
23.19 	(b) The amendment to paragraph (c) is effective upon federal approval. The commissioner 
23.20 	of human services shall notify the revisor of statutes when federal approval is obtained.

23.21 	Sec. 21. Minnesota Statutes 2016, section 256B.4913, is amended by adding a subdivision 
23.22 	to read:
23.23 		Subd. 7.New services.  A service added to section 256B.4914 after January 1, 2014, is 
23.24 	not subject to rate stabilization adjustment in this section.

23.25 	EFFECTIVE DATE. This section is effective the day following final enactment.

23.26 	Sec. 22. Minnesota Statutes 2016, section 256B.4914, subdivision 2, is amended to read:
23.27 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
23.28 	meanings given them, unless the context clearly indicates otherwise.
23.29 	(b) "Commissioner" means the commissioner of human services.
24.1 	(c) "Component value" means underlying factors that are part of the cost of providing 
24.2 	services that are built into the waiver rates methodology to calculate service rates.
24.3 	(d) "Customized living tool" means a methodology for setting service rates that delineates 
24.4 	and documents the amount of each component service included in a recipient's customized 
24.5 	living service plan.
24.6 	(e) "Disability waiver rates system" means a statewide system that establishes rates that 
24.7 	are based on uniform processes and captures the individualized nature of waiver services 
24.8 	and recipient needs.
24.9 	(f) "Individual staffing" means the time spent as a one-to-one interaction specific to an 
24.10 	individual recipient by staff to provide direct support and assistance with activities of daily 
24.11 	living, instrumental activities of daily living, and training to participants, and is based on 
24.12 	the requirements in each individual's coordinated service and support plan under section 
24.13 	245D.02, subdivision 4b; any coordinated service and support plan addendum under section 
24.14 	245D.02, subdivision 4c; and an assessment tool. Provider observation of an individual's 
24.15 	needs must also be considered.
24.16 	(g) "Lead agency" means a county, partnership of counties, or tribal agency charged 
24.17 	with administering waivered services under sections 256B.092 and 256B.49.
24.18 	(h) "Median" means the amount that divides distribution into two equal groups, one-half 
24.19 	above the median and one-half below the median.
24.20 	(i) "Payment or rate" means reimbursement to an eligible provider for services provided 
24.21 	to a qualified individual based on an approved service authorization.
24.22 	(j) "Rates management system" means a Web-based software application that uses a 
24.23 	framework and component values, as determined by the commissioner, to establish service 
24.24 	rates.
24.25 	(k) "Recipient" means a person receiving home and community-based services funded 
24.26 	under any of the disability waivers.
24.27 	(l) "Shared staffing" means time spent by employees, not defined under paragraph (f), 
24.28 	providing or available to provide more than one individual with direct support and assistance 
24.29 	with activities of daily living as defined under section 256B.0659, subdivision 1, paragraph 
24.30 	(b); instrumental activities of daily living as defined under section 256B.0659, subdivision 
24.31 	1, paragraph (i); ancillary activities needed to support individual services; and training to 
24.32 	participants, and is based on the requirements in each individual's coordinated service and 
24.33 	support plan under section 245D.02, subdivision 4b; any coordinated service and support 
25.1 	plan addendum under section 245D.02, subdivision 4c; an assessment tool; and provider 
25.2 	observation of an individual's service need. Total shared staffing hours are divided 
25.3 	proportionally by the number of individuals who receive the shared service provisions.
25.4 	(m) "Staffing ratio" means the number of recipients a service provider employee supports 
25.5 	during a unit of service based on a uniform assessment tool, provider observation, case 
25.6 	history, and the recipient's services of choice, and not based on the staffing ratios under 
25.7 	section 245D.31.
25.8 	(n) "Unit of service" means the following:
25.9 	(1) for residential support services under subdivision 6, a unit of service is a day. Any 
25.10 	portion of any calendar day, within allowable Medicaid rules, where an individual spends 
25.11 	time in a residential setting is billable as a day;
25.12 	(2) for day services under subdivision 7:
25.13 	(i) for day training and habilitation services, a unit of service is either:
25.14 	(A) a day unit of service is defined as six or more hours of time spent providing direct 
25.15 	services and transportation; or
25.16 	(B) a partial day unit of service is defined as fewer than six hours of time spent providing 
25.17 	direct services and transportation; and
25.18 	(C) for new day service recipients after January 1, 2014, 15 minute units of service must 
25.19 	be used for fewer than six hours of time spent providing direct services and transportation;
25.20 	(ii) for adult day and structured day services, a unit of service is a day or 15 minutes. A 
25.21 	day unit of service is six or more hours of time spent providing direct services;
25.22 	(iii) for prevocational services, a unit of service is a day or an hour. A day unit of service 
25.23 	is six or more hours of time spent providing direct service;
25.24 	(3) for unit-based services with programming under subdivision 8:
25.25 	(i) for supported living services, a unit of service is a day or 15 minutes. When a day 
25.26 	rate is authorized, any portion of a calendar day where an individual receives services is 
25.27 	billable as a day; and
25.28 	(ii) for all other services, a unit of service is 15 minutes; and
25.29 	(4) for unit-based services without programming under subdivision 9:
26.1 	(i) for respite services, a unit of service is a day or 15 minutes. When a day rate is 
26.2 	authorized, any portion of a calendar day when an individual receives services is billable 
26.3 	as a day; and
26.4 	(ii) for all other services, a unit of service is 15 minutes.

26.5 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
26.6 	of human services shall notify the revisor of statutes when federal approval is obtained.

26.7 	Sec. 23. Minnesota Statutes 2016, section 256B.4914, subdivision 3, is amended to read:
26.8 		Subd. 3.Applicable services. Applicable services are those authorized under the state's 
26.9 	home and community-based services waivers under sections 256B.092 and 256B.49, 
26.10 	including the following, as defined in the federally approved home and community-based 
26.11 	services plan:
26.12 	(1) 24-hour customized living;
26.13 	(2) adult day care;
26.14 	(3) adult day care bath;
26.15 	(4) behavioral programming;
26.16 	(5) companion services;
26.17 	(6) customized living;
26.18 	(7) day training and habilitation;
26.19 	(8) housing access coordination;
26.20 	(9) independent living skills;
26.21 	(10) in-home family support;
26.22 	(11) night supervision;
26.23 	(12) personal support;
26.24 	(13) prevocational services;
26.25 	(14) residential care services;
26.26 	(15) residential support services;
26.27 	(16) respite services;
26.28 	(17) structured day services;
27.1 	(18) supported employment services;
27.2 	(19) supported living services;
27.3 	(20) transportation services; and
27.4 	(21) individualized home supports;
27.5 	(22) independent living skills specialist services;
27.6 	(23) employment exploration services;
27.7 	(24) employment development services;
27.8 	(25) employment support services; and
27.9 	(21) (26) other services as approved by the federal government in the state home and 
27.10 	community-based services plan.

27.11 	EFFECTIVE DATE. (a) Clause (21) is effective the day following final enactment.
27.12 	(b) Clauses (22) to (25) are effective upon federal approval. The commissioner of human 
27.13 	services shall notify the revisor of statutes when federal approval is obtained.
27.14 	(c) Clause (18) expires upon federal approval. The commissioner of human services 
27.15 	shall notify the revisor of statutes when federal approval is obtained.

27.16 	Sec. 24. Minnesota Statutes 2016, section 256B.4914, subdivision 5, is amended to read:
27.17 		Subd. 5.Base wage index and standard component values. (a) The base wage index 
27.18 	is established to determine staffing costs associated with providing services to individuals 
27.19 	receiving home and community-based services. For purposes of developing and calculating 
27.20 	the proposed base wage, Minnesota-specific wages taken from job descriptions and standard 
27.21 	occupational classification (SOC) codes from the Bureau of Labor Statistics as defined in 
27.22 	the most recent edition of the Occupational Handbook must be used. The base wage index 
27.23 	must be calculated as follows:
27.24 	(1) for residential direct care staff, the sum of:
27.25 	(i) 15 percent of the subtotal of 50 percent of the median wage for personal and home 
27.26 	health aide (SOC code 39-9021); 30 percent of the median wage for nursing aide assistant
27.27 	(SOC code 31-1012 31-1014); and 20 percent of the median wage for social and human 
27.28 	services aide (SOC code 21-1093); and
27.29 	(ii) 85 percent of the subtotal of 20 percent of the median wage for home health aide 
27.30 	(SOC code 31-1011); 20 percent of the median wage for personal and home health aide 
28.1 	(SOC code 39-9021); 20 percent of the median wage for nursing aide assistant (SOC code 
28.2 	31-1012 31-1014); 20 percent of the median wage for psychiatric technician (SOC code 
28.3 	29-2053); and 20 percent of the median wage for social and human services aide (SOC code 
28.4 	21-1093);
28.5 	(2) for day services, 20 percent of the median wage for nursing aide assistant (SOC code 
28.6 	31-1012 31-1014); 20 percent of the median wage for psychiatric technician (SOC code 
28.7 	29-2053); and 60 percent of the median wage for social and human services aide (SOC code 
28.8 	21-1093);
28.9 	(3) for residential asleep-overnight staff, the wage will be $7.66 per hour is the minimum 
28.10 	wage in Minnesota for large employers, except in a family foster care setting, the wage is 
28.11 	$2.80 per hour 36 percent of the minimum wage in Minnesota for large employers;
28.12 	(4) for behavior program analyst staff, 100 percent of the median wage for mental health 
28.13 	counselors (SOC code 21-1014);
28.14 	(5) for behavior program professional staff, 100 percent of the median wage for clinical 
28.15 	counseling and school psychologist (SOC code 19-3031);
28.16 	(6) for behavior program specialist staff, 100 percent of the median wage for psychiatric 
28.17 	technicians (SOC code 29-2053);
28.18 	(7) for supportive living services staff, 20 percent of the median wage for nursing aide
28.19 	assistant (SOC code 31-1012 31-1014); 20 percent of the median wage for psychiatric 
28.20 	technician (SOC code 29-2053); and 60 percent of the median wage for social and human 
28.21 	services aide (SOC code 21-1093);
28.22 	(8) for housing access coordination staff, 50 100 percent of the median wage for 
28.23 	community and social services specialist (SOC code 21-1099); and 50 percent of the median 
28.24 	wage for social and human services aide (SOC code 21-1093);
28.25 	(9) for in-home family support staff, 20 percent of the median wage for nursing aide 
28.26 	(SOC code 31-1012); 30 percent of the median wage for community social service specialist 
28.27 	(SOC code 21-1099); 40 percent of the median wage for social and human services aide 
28.28 	(SOC code 21-1093); and ten percent of the median wage for psychiatric technician (SOC 
28.29 	code 29-2053);
28.30 	(10) for individualized home supports services staff, 40 percent of the median wage for 
28.31 	community social service specialist (SOC code 21-1099); 50 percent of the median wage 
28.32 	for social and human services aide (SOC code 21-1093); and ten percent of the median 
28.33 	wage for psychiatric technician (SOC code 29-2053);
29.1 	(11) for independent living skills staff, 40 percent of the median wage for community 
29.2 	social service specialist (SOC code 21-1099); 50 percent of the median wage for social and 
29.3 	human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric 
29.4 	technician (SOC code 29-2053);
29.5 	(12) for independent living skills specialist staff, 100 percent of mental health and 
29.6 	substance abuse social worker (SOC code 21-1023);
29.7 	(11) (13)  for supported employment staff, 20 percent of the median wage for nursing 
29.8 	aide assistant (SOC code 31-1012 31-1014); 20 percent of the median wage for psychiatric 
29.9 	technician (SOC code 29-2053); and 60 percent of the median wage for social and human 
29.10 	services aide (SOC code 21-1093);
29.11 	(14) for employment support services staff, 50 percent of the median wage for 
29.12 	rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for 
29.13 	community and social services specialist (SOC code 21-1099);
29.14 	(15) for employment exploration services staff, 50 percent of the median wage for 
29.15 	rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for 
29.16 	community and social services specialist (SOC code 21-1099);
29.17 	(16) for employment development services staff, 50 percent of the median wage for 
29.18 	education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 percent 
29.19 	of the median wage for community and social services specialist (SOC code 21-1099);
29.20 	(12) (17) for adult companion staff, 50 percent of the median wage for personal and 
29.21 	home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides, 
29.22 	orderlies, and attendants assistant (SOC code 31-1012 31-1014);
29.23 	(13) (18) for night supervision staff, 20 percent of the median wage for home health 
29.24 	aide (SOC code 31-1011); 20 percent of the median wage for personal and home health 
29.25 	aide (SOC code 39-9021); 20 percent of the median wage for nursing aide assistant (SOC 
29.26 	code 31-1012 31-1014); 20 percent of the median wage for psychiatric technician (SOC 
29.27 	code 29-2053); and 20 percent of the median wage for social and human services aide (SOC 
29.28 	code 21-1093);
29.29 	(14) (19) for respite staff, 50 percent of the median wage for personal and home care 
29.30 	aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides, orderlies, 
29.31 	and attendants assistant (SOC code 31-1012 31-1014);
30.1 	(15) (20) for personal support staff, 50 percent of the median wage for personal and 
30.2 	home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides, 
30.3 	orderlies, and attendants assistant (SOC code 31-1012 31-1014);
30.4 	(16) (21) for supervisory staff, the basic wage is $17.43 per hour, 100 percent of the 
30.5 	median wage for community and social services specialist (SOC code 21-1099), with the 
30.6 	exception of the supervisor of behavior professional, behavior analyst, and behavior 
30.7 	specialists, which must be $30.75 per hour is 100 percent of the median wage for clinical 
30.8 	counseling and school psychologist (SOC code 19-3031);
30.9 	(17) (22) for registered nurse staff, the basic wage is $30.82 per hour, 100 percent of 
30.10 	the median wage for registered nurses (SOC code 29-1141); and
30.11 	(18) (23) for licensed practical nurse staff, the basic wage is $18.64 per hour 100 percent 
30.12 	of the median wage for licensed practical nurses (SOC code 29-2061).
30.13 	(b) Component values for residential support services are:
30.14 	(1) supervisory span of control ratio: 11 percent;
30.15 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
30.16 	(3) employee-related cost ratio: 23.6 percent;
30.17 	(4) general administrative support ratio: 13.25 percent;
30.18 	(5) program-related expense ratio: 1.3 percent; and
30.19 	(6) absence and utilization factor ratio: 3.9 percent.
30.20 	(c) Component values for family foster care are:
30.21 	(1) supervisory span of control ratio: 11 percent;
30.22 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
30.23 	(3) employee-related cost ratio: 23.6 percent;
30.24 	(4) general administrative support ratio: 3.3 percent;
30.25 	(5) program-related expense ratio: 1.3 percent; and
30.26 	(6) absence factor: 1.7 percent.
30.27 	(d) Component values for day services for all services are:
30.28 	(1) supervisory span of control ratio: 11 percent;
30.29 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
31.1 	(3) employee-related cost ratio: 23.6 percent;
31.2 	(4) program plan support ratio: 5.6 percent;
31.3 	(5) client programming and support ratio: ten percent;
31.4 	(6) general administrative support ratio: 13.25 percent;
31.5 	(7) program-related expense ratio: 1.8 percent; and
31.6 	(8) absence and utilization factor ratio: 3.99.4 percent.
31.7 	(e) Component values for unit-based services with programming are:
31.8 	(1) supervisory span of control ratio: 11 percent;
31.9 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
31.10 	(3) employee-related cost ratio: 23.6 percent;
31.11 	(4) program plan supports ratio: 3.1 15.5 percent;
31.12 	(5) client programming and supports ratio: 8.6 4.7 percent;
31.13 	(6) general administrative support ratio: 13.25 percent;
31.14 	(7) program-related expense ratio: 6.1 percent; and
31.15 	(8) absence and utilization factor ratio: 3.9 percent.
31.16 	(f) Component values for unit-based services without programming except respite are:
31.17 	(1) supervisory span of control ratio: 11 percent;
31.18 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
31.19 	(3) employee-related cost ratio: 23.6 percent;
31.20 	(4) program plan support ratio: 3.1 7.0 percent;
31.21 	(5) client programming and support ratio: 8.6 2.3 percent;
31.22 	(6) general administrative support ratio: 13.25 percent;
31.23 	(7) program-related expense ratio: 6.1 2.9 percent; and
31.24 	(8) absence and utilization factor ratio: 3.9 percent.
31.25 	(g) Component values for unit-based services without programming for respite are:
31.26 	(1) supervisory span of control ratio: 11 percent;
31.27 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
32.1 	(3) employee-related cost ratio: 23.6 percent;
32.2 	(4) general administrative support ratio: 13.25 percent;
32.3 	(5) program-related expense ratio: 6.1 2.9 percent; and
32.4 	(6) absence and utilization factor ratio: 3.9 percent.
32.5 	(h) On July 1, 2017, the commissioner shall update the base wage index in paragraph 
32.6 	(a) based on the wage data by standard occupational code (SOC) from the Bureau of Labor 
32.7 	Statistics available on December 31, 2016. The commissioner shall publish these updated 
32.8 	values and load them into the rate management system. This adjustment occurs every five 
32.9 	years. For adjustments in 2021 and beyond, the commissioner shall use the data available 
32.10 	on December 31 of the calendar year five years prior.On July 1, 2022, and every five years 
32.11 	thereafter, the commissioner shall update the base wage index in paragraph (a) based on 
32.12 	the most recently available wage data by SOC from the Bureau of Labor Statistics. The 
32.13 	commissioner shall publish these updated values and load them into the rate management 
32.14 	system.
32.15 	(i) On July 1, 2017, the commissioner shall update the framework components in 
32.16 	paragraphs (b) to (g) paragraph (d), clause (5); paragraph (e), clause (5); and paragraph (f), 
32.17 	clause (5); subdivision 6, clauses (8) and (9); and subdivision 7, clauses (10), (16), and (17), 
32.18 	for changes in the Consumer Price Index. The commissioner will adjust these values higher 
32.19 	or lower by the percentage change in the Consumer Price Index-All Items, United States 
32.20 	city average (CPI-U) from January 1, 2014, to January 1, 2017. The commissioner shall 
32.21 	publish these updated values and load them into the rate management system. This adjustment 
32.22 	occurs every five years. For adjustments in 2021 and beyond, the commissioner shall use 
32.23 	the data available on January 1 of the calendar year four years prior and January 1 of the 
32.24 	current calendar year. On July 1, 2022, and every five years thereafter, the commissioner 
32.25 	shall update the framework components in paragraph (d), clause (5); paragraph (e), clause 
32.26 	(5); and paragraph (f), clause (5); subdivision 6, clauses (8) and (9); and subdivision 7, 
32.27 	clauses (10), (16), and (17), for changes in the Consumer Price Index. The commissioner 
32.28 	shall adjust these values higher or lower by the percentage change in the CPI-U from the 
32.29 	date of the previous update to the date of the data most recently available prior to the 
32.30 	scheduled update. The commissioner shall publish these updated values and load them into 
32.31 	the rate management system.
32.32 	(j) In this subdivision, if Bureau of Labor Statistics occupational codes or Consumer 
32.33 	Price Index items are unavailable in the future, the commissioner shall recommend to the 
32.34 	legislature codes or items to update and replace missing component values.

33.1 	EFFECTIVE DATE. (a) The amendments to paragraphs (a) to (g) are effective January 
33.2 	1, 2018, except the amendment to paragraph (a), clauses (3), (21), and (22), and paragraph 
33.3 	(d), clause (8), which are effective January 1, 2019, and the amendment to paragraph (a), 
33.4 	clause (10), which is effective the day following final enactment.
33.5 	(b) The amendments to paragraphs (h) to (j) are effective the day following final 
33.6 	enactment.
33.7 	(c) Paragraph (a), clause (13), expires upon federal approval. The commissioner of 
33.8 	human services shall notify the revisor of statutes when federal approval is obtained.

33.9 	Sec. 25. Minnesota Statutes 2016, section 256B.4914, subdivision 6, is amended to read:
33.10 		Subd. 6.Payments for residential support services. (a) Payments for residential support 
33.11 	services, as defined in sections 256B.092, subdivision 11, and 256B.49, subdivision 22, 
33.12 	must be calculated as follows:
33.13 	(1) determine the number of shared staffing and individual direct staff hours to meet a 
33.14 	recipient's needs provided on site or through monitoring technology;
33.15 	(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics 
33.16 	Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 
33.17 	5. This is defined as the direct-care rate;
33.18 	(3) for a recipient requiring customization for deaf and hard-of-hearing language 
33.19 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
33.20 	to the result of clause (2). This is defined as the customized direct-care rate;
33.21 	(4) multiply the number of shared and individual direct staff hours provided on site or 
33.22 	through monitoring technology and nursing hours by the appropriate staff wages in 
33.23 	subdivision 5, paragraph (a), or the customized direct-care rate;
33.24 	(5) multiply the number of shared and individual direct staff hours provided on site or 
33.25 	through monitoring technology and nursing hours by the product of the supervision span 
33.26 	of control ratio in subdivision 5, paragraph (b), clause (1), and the appropriate supervision 
33.27 	wage in subdivision 5, paragraph (a), clause (16) (21);
33.28 	(6) combine the results of clauses (4) and (5), excluding any shared and individual direct 
33.29 	staff hours provided through monitoring technology, and multiply the result by one plus 
33.30 	the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (b), 
33.31 	clause (2). This is defined as the direct staffing cost;
34.1 	(7) for employee-related expenses, multiply the direct staffing cost, excluding any shared 
34.2 	and individual direct staff hours provided through monitoring technology, by one plus the 
34.3 	employee-related cost ratio in subdivision 5, paragraph (b), clause (3);
34.4 	(8) for client programming and supports, the commissioner shall add $2,179; and
34.5 	(9) for transportation, if provided, the commissioner shall add $1,680, or $3,000 if 
34.6 	customized for adapted transport, based on the resident with the highest assessed need.
34.7 	(b) The total rate must be calculated using the following steps:
34.8 	(1) subtotal paragraph (a), clauses (7) to (9), and the direct staffing cost of any shared 
34.9 	and individual direct staff hours provided through monitoring technology that was excluded 
34.10 	in clause (7);
34.11 	(2) sum the standard general and administrative rate, the program-related expense ratio, 
34.12 	and the absence and utilization ratio;
34.13 	(3) divide the result of clause (1) by one minus the result of clause (2). This is the total 
34.14 	payment amount; and
34.15 	(4) adjust the result of clause (3) by a factor to be determined by the commissioner to 
34.16 	adjust for regional differences in the cost of providing services.
34.17 	(c) The payment methodology for customized living, 24-hour customized living, and 
34.18 	residential care services must be the customized living tool. Revisions to the customized 
34.19 	living tool must be made to reflect the services and activities unique to disability-related 
34.20 	recipient needs.
34.21 	(d) For individuals enrolled prior to January 1, 2014, the days of service authorized must 
34.22 	meet or exceed the days of service used to convert service agreements in effect on December 
34.23 	1, 2013, and must not result in a reduction in spending or service utilization due to conversion 
34.24 	during the implementation period under section 256B.4913, subdivision 4a. If during the 
34.25 	implementation period, an individual's historical rate, including adjustments required under 
34.26 	section 256B.4913, subdivision 4a, paragraph (c), is equal to or greater than the rate 
34.27 	determined in this subdivision, the number of days authorized for the individual is 365.
34.28 	(e) The number of days authorized for all individuals enrolling after January 1, 2014, 
34.29 	in residential services must include every day that services start and end.

35.1 	Sec. 26. Minnesota Statutes 2016, section 256B.4914, subdivision 7, is amended to read:
35.2 		Subd. 7.Payments for day programs. Payments for services with day programs 
35.3 	including adult day care, day treatment and habilitation, prevocational services, and structured 
35.4 	day services must be calculated as follows:
35.5 	(1) determine the number of units of service and staffing ratio to meet a recipient's needs:
35.6 	(i) the staffing ratios for the units of service provided to a recipient in a typical week 
35.7 	must be averaged to determine an individual's staffing ratio; and
35.8 	(ii) the commissioner, in consultation with service providers, shall develop a uniform 
35.9 	staffing ratio worksheet to be used to determine staffing ratios under this subdivision;
35.10 	(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics 
35.11 	Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 
35.12 	5;
35.13 	(3) for a recipient requiring customization for deaf and hard-of-hearing language 
35.14 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
35.15 	to the result of clause (2). This is defined as the customized direct-care rate;
35.16 	(4) multiply the number of day program direct staff hours and nursing hours by the 
35.17 	appropriate staff wage in subdivision 5, paragraph (a), or the customized direct-care rate;
35.18 	(5) multiply the number of day direct staff hours by the product of the supervision span 
35.19 	of control ratio in subdivision 5, paragraph (d), clause (1), and the appropriate supervision 
35.20 	wage in subdivision 5, paragraph (a), clause (16) (21);
35.21 	(6) combine the results of clauses (4) and (5), and multiply the result by one plus the 
35.22 	employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (d), clause 
35.23 	(2). This is defined as the direct staffing rate;
35.24 	(7) for program plan support, multiply the result of clause (6) by one plus the program 
35.25 	plan support ratio in subdivision 5, paragraph (d), clause (4);
35.26 	(8) for employee-related expenses, multiply the result of clause (7) by one plus the 
35.27 	employee-related cost ratio in subdivision 5, paragraph (d), clause (3);
35.28 	(9) for client programming and supports, multiply the result of clause (8) by one plus 
35.29 	the client programming and support ratio in subdivision 5, paragraph (d), clause (5);
35.30 	(10) for program facility costs, add $19.30 per week with consideration of staffing ratios 
35.31 	to meet individual needs;
36.1 	(11) for adult day bath services, add $7.01 per 15 minute unit;
36.2 	(12) this is the subtotal rate;
36.3 	(13) sum the standard general and administrative rate, the program-related expense ratio, 
36.4 	and the absence and utilization factor ratio;
36.5 	(14) divide the result of clause (12) by one minus the result of clause (13). This is the 
36.6 	total payment amount;
36.7 	(15) adjust the result of clause (14) by a factor to be determined by the commissioner 
36.8 	to adjust for regional differences in the cost of providing services;
36.9 	(16) for transportation provided as part of day training and habilitation for an individual 
36.10 	who does not require a lift, add:
36.11 	(i) $10.50 for a trip between zero and ten miles for a nonshared ride in a vehicle without 
36.12 	a lift, $8.83 for a shared ride in a vehicle without a lift, and $9.25 for a shared ride in a 
36.13 	vehicle with a lift;
36.14 	(ii) $15.75 for a trip between 11 and 20 miles for a nonshared ride in a vehicle without 
36.15 	a lift, $10.58 for a shared ride in a vehicle without a lift, and $11.88 for a shared ride in a 
36.16 	vehicle with a lift;
36.17 	(iii) $25.75 for a trip between 21 and 50 miles for a nonshared ride in a vehicle without 
36.18 	a lift, $13.92 for a shared ride in a vehicle without a lift, and $16.88 for a shared ride in a 
36.19 	vehicle with a lift; or
36.20 	(iv) $33.50 for a trip of 51 miles or more for a nonshared ride in a vehicle without a lift, 
36.21 	$16.50 for a shared ride in a vehicle without a lift, and $20.75 for a shared ride in a vehicle 
36.22 	with a lift;
36.23 	(17) for transportation provided as part of day training and habilitation for an individual 
36.24 	who does require a lift, add:
36.25 	(i) $19.05 for a trip between zero and ten miles for a nonshared ride in a vehicle with a 
36.26 	lift, and $15.05 for a shared ride in a vehicle with a lift;
36.27 	(ii) $32.16 for a trip between 11 and 20 miles for a nonshared ride in a vehicle with a 
36.28 	lift, and $28.16 for a shared ride in a vehicle with a lift;
36.29 	(iii) $58.76 for a trip between 21 and 50 miles for a nonshared ride in a vehicle with a 
36.30 	lift, and $58.76 for a shared ride in a vehicle with a lift; or
37.1 	(iv) $80.93 for a trip of 51 miles or more for a nonshared ride in a vehicle with a lift, 
37.2 	and $80.93 for a shared ride in a vehicle with a lift.

37.3 	Sec. 27. Minnesota Statutes 2016, section 256B.4914, subdivision 8, is amended to read:
37.4 		Subd. 8.Payments for unit-based services with programming. Payments for unit-based 
37.5 	services with programming, including behavior programming, housing access coordination, 
37.6 	in-home family support, independent living skills training, independent living skills specialist 
37.7 	services, individualized home supports, hourly supported living services, employment 
37.8 	exploration services, employment development services, supported employment, and 
37.9 	supported employment support services provided to an individual outside of any day or 
37.10 	residential service plan must be calculated as follows, unless the services are authorized 
37.11 	separately under subdivision 6 or 7:
37.12 	(1) determine the number of units of service to meet a recipient's needs;
37.13 	(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics 
37.14 	Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 
37.15 	5;
37.16 	(3) for a recipient requiring customization for deaf and hard-of-hearing language 
37.17 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
37.18 	to the result of clause (2). This is defined as the customized direct-care rate;
37.19 	(4) multiply the number of direct staff hours by the appropriate staff wage in subdivision 
37.20 	5, paragraph (a), or the customized direct-care rate;
37.21 	(5) multiply the number of direct staff hours by the product of the supervision span of 
37.22 	control ratio in subdivision 5, paragraph (e), clause (1), and the appropriate supervision 
37.23 	wage in subdivision 5, paragraph (a), clause (16) (21);
37.24 	(6) combine the results of clauses (4) and (5), and multiply the result by one plus the 
37.25 	employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (e), clause 
37.26 	(2). This is defined as the direct staffing rate;
37.27 	(7) for program plan support, multiply the result of clause (6) by one plus the program 
37.28 	plan supports ratio in subdivision 5, paragraph (e), clause (4);
37.29 	(8) for employee-related expenses, multiply the result of clause (7) by one plus the 
37.30 	employee-related cost ratio in subdivision 5, paragraph (e), clause (3);
37.31 	(9) for client programming and supports, multiply the result of clause (8) by one plus 
37.32 	the client programming and supports ratio in subdivision 5, paragraph (e), clause (5);
38.1 	(10) this is the subtotal rate;
38.2 	(11) sum the standard general and administrative rate, the program-related expense ratio, 
38.3 	and the absence and utilization factor ratio;
38.4 	(12) divide the result of clause (10) by one minus the result of clause (11). This is the 
38.5 	total payment amount;
38.6 	(13) for supported employment provided in a shared manner, divide the total payment 
38.7 	amount in clause (12) by the number of service recipients, not to exceed three. For 
38.8 	employment support services provided in a shared manner, divide the total payment amount 
38.9 	in clause (12) by the number of service recipients, not to exceed six. For independent living 
38.10 	skills training and individualized home supports provided in a shared manner, divide the 
38.11 	total payment amount in clause (12) by the number of service recipients, not to exceed two; 
38.12 	and
38.13 	(14) adjust the result of clause (13) by a factor to be determined by the commissioner 
38.14 	to adjust for regional differences in the cost of providing services.

38.15 	EFFECTIVE DATE.  This section is effective the day following final enactment. 
38.16 	Supported employment services in this subdivision expire upon federal approval. The 
38.17 	commissioner of human services shall notify the revisor of statutes when federal approval 
38.18 	is obtained.

38.19 	Sec. 28. Minnesota Statutes 2016, section 256B.4914, subdivision 9, is amended to read:
38.20 		Subd. 9.Payments for unit-based services without programming. Payments for 
38.21 	unit-based services without programming, including night supervision, personal support, 
38.22 	respite, and companion care provided to an individual outside of any day or residential 
38.23 	service plan must be calculated as follows unless the services are authorized separately 
38.24 	under subdivision 6 or 7:
38.25 	(1) for all services except respite, determine the number of units of service to meet a 
38.26 	recipient's needs;
38.27 	(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics 
38.28 	Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;
38.29 	(3) for a recipient requiring customization for deaf and hard-of-hearing language 
38.30 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
38.31 	to the result of clause (2). This is defined as the customized direct care rate;
39.1 	(4) multiply the number of direct staff hours by the appropriate staff wage in subdivision 
39.2 	5 or the customized direct care rate;
39.3 	(5) multiply the number of direct staff hours by the product of the supervision span of 
39.4 	control ratio in subdivision 5, paragraph (f), clause (1), and the appropriate supervision 
39.5 	wage in subdivision 5, paragraph (a), clause (16) (21);
39.6 	(6) combine the results of clauses (4) and (5), and multiply the result by one plus the 
39.7 	employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (f), clause 
39.8 	(2). This is defined as the direct staffing rate;
39.9 	(7) for program plan support, multiply the result of clause (6) by one plus the program 
39.10 	plan support ratio in subdivision 5, paragraph (f), clause (4);
39.11 	(8) for employee-related expenses, multiply the result of clause (7) by one plus the 
39.12 	employee-related cost ratio in subdivision 5, paragraph (f), clause (3);
39.13 	(9) for client programming and supports, multiply the result of clause (8) by one plus 
39.14 	the client programming and support ratio in subdivision 5, paragraph (f), clause (5);
39.15 	(10) this is the subtotal rate;
39.16 	(11) sum the standard general and administrative rate, the program-related expense ratio, 
39.17 	and the absence and utilization factor ratio;
39.18 	(12) divide the result of clause (10) by one minus the result of clause (11). This is the 
39.19 	total payment amount;
39.20 	(13) for respite services, determine the number of day units of service to meet an 
39.21 	individual's needs;
39.22 	(14) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics 
39.23 	Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;
39.24 	(15) for a recipient requiring deaf and hard-of-hearing customization under subdivision 
39.25 	12, add the customization rate provided in subdivision 12 to the result of clause (14). This 
39.26 	is defined as the customized direct care rate;
39.27 	(16) multiply the number of direct staff hours by the appropriate staff wage in subdivision 
39.28 	5, paragraph (a);
39.29 	(17) multiply the number of direct staff hours by the product of the supervisory span of 
39.30 	control ratio in subdivision 5, paragraph (g), clause (1), and the appropriate supervision 
39.31 	wage in subdivision 5, paragraph (a), clause (16) (21);
40.1 	(18) combine the results of clauses (16) and (17), and multiply the result by one plus 
40.2 	the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (g), 
40.3 	clause (2). This is defined as the direct staffing rate;
40.4 	(19) for employee-related expenses, multiply the result of clause (18) by one plus the 
40.5 	employee-related cost ratio in subdivision 5, paragraph (g), clause (3);
40.6 	(20) this is the subtotal rate;
40.7 	(21) sum the standard general and administrative rate, the program-related expense ratio, 
40.8 	and the absence and utilization factor ratio;
40.9 	(22) divide the result of clause (20) by one minus the result of clause (21). This is the 
40.10 	total payment amount; and
40.11 	(23) adjust the result of clauses (12) and (22) by a factor to be determined by the 
40.12 	commissioner to adjust for regional differences in the cost of providing services.

40.13 	Sec. 29. Minnesota Statutes 2016, section 256B.4914, subdivision 10, is amended to read:
40.14 		Subd. 10.Updating payment values and additional information. (a) From January 
40.15 	1, 2014, through December 31, 2017, the commissioner shall develop and implement uniform 
40.16 	procedures to refine terms and adjust values used to calculate payment rates in this section.
40.17 	(b) No later than July 1, 2014, the commissioner shall, within available resources, begin 
40.18 	to conduct research and gather data and information from existing state systems or other 
40.19 	outside sources on the following items:
40.20 	(1) differences in the underlying cost to provide services and care across the state; and
40.21 	(2) mileage, vehicle type, lift requirements, incidents of individual and shared rides, and 
40.22 	units of transportation for all day services, which must be collected from providers using 
40.23 	the rate management worksheet and entered into the rates management system; and
40.24 	(3) the distinct underlying costs for services provided by a license holder under sections 
40.25 	245D.05, 245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services provided 
40.26 	by a license holder certified under section 245D.33.
40.27 	(c) Beginning January 1, 2014, through December 31, 2018, using a statistically valid 
40.28 	set of rates management system data, the commissioner, in consultation with stakeholders, 
40.29 	shall analyze for each service the average difference in the rate on December 31, 2013, and 
40.30 	the framework rate at the individual, provider, lead agency, and state levels. The 
40.31 	commissioner shall issue semiannual reports to the stakeholders on the difference in rates 
40.32 	by service and by county during the banding period under section 256B.4913, subdivision 
41.1 	4a. The commissioner shall issue the first report by October 1, 2014, and the final report 
41.2 	shall be issued by December 31, 2018.
41.3 	(d) No later than July 1, 2014, the commissioner, in consultation with stakeholders, shall 
41.4 	begin the review and evaluation of the following values already in subdivisions 6 to 9, or 
41.5 	issues that impact all services, including, but not limited to:
41.6 	(1) values for transportation rates for day services;
41.7 	(2) values for transportation rates in residential services;
41.8 	(3) (2) values for services where monitoring technology replaces staff time;
41.9 	(4) (3) values for indirect services;
41.10 	(5) (4) values for nursing;
41.11 	(6) component values for independent living skills;
41.12 	(7) component values for family foster care that reflect licensing requirements;
41.13 	(8) adjustments to other components to replace the budget neutrality factor;
41.14 	(9) remote monitoring technology for nonresidential services;
41.15 	(10) values for basic and intensive services in residential services;
41.16 	(11) (5) values for the facility use rate in day services, and the weightings used in the 
41.17 	day service ratios and adjustments to those weightings;
41.18 	(12) (6) values for workers' compensation as part of employee-related expenses;
41.19 	(13) (7) values for unemployment insurance as part of employee-related expenses;
41.20 	(14) a component value to reflect costs for individuals with rates previously adjusted 
41.21 	for the inclusion of group residential housing rate 3 costs, only for any individual enrolled 
41.22 	as of December 31, 2013; and
41.23 	(15) (8) any changes in state or federal law with an a direct impact on the underlying 
41.24 	cost of providing home and community-based services.; and
41.25 	(9) outcome measures, determined by the commissioner, for home and community-based 
41.26 	services rates determined under this section.
41.27 	(e) The commissioner shall report to the chairs and the ranking minority members of 
41.28 	the legislative committees and divisions with jurisdiction over health and human services 
41.29 	policy and finance with the information and data gathered under paragraphs (b) to (d) on 
41.30 	the following dates:
42.1 	(1) January 15, 2015, with preliminary results and data;
42.2 	(2) January 15, 2016, with a status implementation update, and additional data and 
42.3 	summary information;
42.4 	(3) January 15, 2017, with the full report; and
42.5 	(4) January 15, 2019 2020, with another full report, and a full report once every four 
42.6 	years thereafter.
42.7 	(f) Based on the commissioner's evaluation of the information and data collected in 
42.8 	paragraphs (b) to (d), the commissioner shall make recommendations to the legislature by 
42.9 	January 15, 2015, to address any issues identified during the first year of implementation. 
42.10 	After January 15, 2015, the commissioner may make recommendations to the legislature 
42.11 	to address potential issues.
42.12 	(g) (f) The commissioner shall implement a regional adjustment factor to all rate 
42.13 	calculations in subdivisions 6 to 9, effective no later than January 1, 2015. Beginning July 
42.14 	1, 2017, the commissioner shall renew analysis and implement changes to the regional 
42.15 	adjustment factors when adjustments required under subdivision 5, paragraph (h), occur. 
42.16 	Prior to implementation, the commissioner shall consult with stakeholders on the 
42.17 	methodology to calculate the adjustment.
42.18 	(h) (g) The commissioner shall provide a public notice via LISTSERV in October of 
42.19 	each year beginning October 1, 2014, containing information detailing legislatively approved 
42.20 	changes in:
42.21 	(1) calculation values including derived wage rates and related employee and 
42.22 	administrative factors;
42.23 	(2) service utilization;
42.24 	(3) county and tribal allocation changes; and
42.25 	(4) information on adjustments made to calculation values and the timing of those 
42.26 	adjustments.
42.27 	The information in this notice must be effective January 1 of the following year.
42.28 	(i) No later than July 1, 2016, the commissioner shall develop and implement, in 
42.29 	consultation with stakeholders, a methodology sufficient to determine the shared staffing 
42.30 	levels necessary to meet, at a minimum, health and welfare needs of individuals who will 
42.31 	be living together in shared residential settings, and the required shared staffing activities 
42.32 	described in subdivision 2, paragraph (l). This determination methodology must ensure 
43.1 	staffing levels are adaptable to meet the needs and desired outcomes for current and 
43.2 	prospective residents in shared residential settings.
43.3 	(j) (h) When the available shared staffing hours in a residential setting are insufficient 
43.4 	to meet the needs of an individual who enrolled in residential services after January 1, 2014, 
43.5 	or insufficient to meet the needs of an individual with a service agreement adjustment 
43.6 	described in section 256B.4913, subdivision 4a, paragraph (f), then individual staffing hours 
43.7 	shall be used.
43.8 	(i) The commissioner shall study the underlying cost of absence and utilization for day 
43.9 	services. Based on the commissioner's evaluation of the data collected under this paragraph, 
43.10 	the commissioner shall make recommendations to the legislature by January 15, 2018, for 
43.11 	changes, if any, to the absence and utilization factor ratio component value for day services.
43.12 	(j) Beginning July 1, 2017, the commissioner shall collect transportation and trip 
43.13 	information for all day services through the rates management system.

43.14 	EFFECTIVE DATE. This section is effective the day following final enactment.

43.15 	Sec. 30. Minnesota Statutes 2016, section 256B.4914, is amended by adding a subdivision 
43.16 	to read:
43.17 		Subd. 10a.Reporting and analysis of cost data. (a) The commissioner must ensure 
43.18 	that wage values and component values in subdivisions 5 to 9 reflect the cost to provide the 
43.19 	service. As determined by the commissioner, in consultation with stakeholders identified 
43.20 	in section 256B.4913, subdivision 5, a provider enrolled to provide services with rates 
43.21 	determined under this section must submit requested cost data to the commissioner to support 
43.22 	research on the cost of providing services that have rates determined by the disability waiver 
43.23 	rates system. Requested cost data may include, but is not limited to:
43.24 	(1) worker wage costs;
43.25 	(2) benefits paid;
43.26 	(3) supervisor wage costs;
43.27 	(4) executive wage costs;
43.28 	(5) vacation, sick, and training time paid;
43.29 	(6) taxes, workers' compensation, and unemployment insurance costs paid;
43.30 	(7) administrative costs paid;
43.31 	(8) program costs paid;
44.1 	(9) transportation costs paid;
44.2 	(10) vacancy rates; and
44.3 	(11) other data relating to costs required to provide services requested by the 
44.4 	commissioner.
44.5 	(b) At least once in any five-year period, a provider must submit cost data for a fiscal 
44.6 	year that ended not more than 18 months prior to the submission date. The commissioner 
44.7 	shall provide each provider a 90-day notice prior to its submission due date. If a provider 
44.8 	fails to submit required reporting data, the commissioner shall provide notice to providers 
44.9 	that have not provided required data 30 days after the required submission date, and a second 
44.10 	notice for providers who have not provided required data 60 days after the required 
44.11 	submission date. The commissioner shall temporarily suspend payments to the provider if 
44.12 	cost data is not received 90 days after the required submission date. Withheld payments 
44.13 	shall be made once data is received by the commissioner.
44.14 	(c) The commissioner shall conduct a random validation of data submitted under 
44.15 	paragraph (a) to ensure data accuracy. The commissioner shall analyze cost documentation 
44.16 	in paragraph (a) and provide recommendations for adjustments to cost components.
44.17 	(d) The commissioner shall analyze cost documentation in paragraph (a) and, in 
44.18 	consultation with stakeholders identified in section 256B.4913, subdivision 5, may submit 
44.19 	recommendations on component values and inflationary factor adjustments to the chairs 
44.20 	and ranking minority members of the legislative committees with jurisdiction over human 
44.21 	services every four years beginning January 1, 2020. The commissioner shall make 
44.22 	recommendations in conjunction with reports submitted to the legislature according to 
44.23 	subdivision 10, paragraph (e). The commissioner shall release cost data in an aggregate 
44.24 	form, and cost data from individual providers shall not be released except as provided for 
44.25 	in current law.
44.26 	(e) The commissioner, in consultation with stakeholders identified in section 256B.4913, 
44.27 	subdivision 5, shall develop and implement a process for providing training and technical 
44.28 	assistance necessary to support provider submission of cost documentation required under 
44.29 	paragraph (a).

44.30 	EFFECTIVE DATE. This section is effective the day following final enactment.

44.31 	Sec. 31. Minnesota Statutes 2016, section 256B.4914, subdivision 16, is amended to read:
44.32 		Subd. 16.Budget neutrality adjustments. (a) The commissioner shall use the following 
44.33 	adjustments to the rate generated by the framework to assure budget neutrality until the rate 
45.1 	information is available to implement paragraph (b). The rate generated by the framework 
45.2 	shall be multiplied by the appropriate factor, as designated below:
45.3 	(1) for residential services: 1.003;
45.4 	(2) for day services: 1.000;
45.5 	(3) for unit-based services with programming: 0.941; and
45.6 	(4) for unit-based services without programming: 0.796.
45.7 	(b) Within 12 months of January 1, 2014, the commissioner shall compare estimated 
45.8 	spending for all home and community-based waiver services under the new payment rates 
45.9 	defined in subdivisions 6 to 9 with estimated spending for the same recipients and services 
45.10 	under the rates in effect on July 1, 2013. This comparison must distinguish spending under 
45.11 	each of subdivisions 6, 7, 8, and 9. The comparison must be based on actual recipients and 
45.12 	services for one or more service months after the new rates have gone into effect. The 
45.13 	commissioner shall consult with the commissioner of management and budget on this 
45.14 	analysis to ensure budget neutrality. If estimated spending under the new rates for services 
45.15 	under one or more subdivisions differs in this comparison by 0.3 percent or more, the 
45.16 	commissioner shall assure aggregate budget neutrality across all service areas by adjusting 
45.17 	the budget neutrality factor in paragraph (a) in each subdivision so that total estimated 
45.18 	spending for each subdivision under the new rates matches estimated spending under the 
45.19 	rates in effect on July 1, 2013.
45.20 	(c) A service rate developed using values in subdivision 5, paragraph (a), clause (10), 
45.21 	is not subject to budget neutrality adjustments.

45.22 	EFFECTIVE DATE. This section is effective the day following final enactment.

45.23 	Sec. 32. Minnesota Statutes 2016, section 256C.23, is amended by adding a subdivision 
45.24 	to read:
45.25 		Subd. 1a.Culturally affirmative. "Culturally affirmative" describes services that are 
45.26 	designed and delivered within the context of the culture, language, and life experiences of 
45.27 	a person who is deaf, a person who is deafblind, and a person who is hard-of-hearing.

45.28 	Sec. 33. Minnesota Statutes 2016, section 256C.23, subdivision 2, is amended to read:
45.29 		Subd. 2.Deaf. "Deaf" means a hearing loss of such severity that the individual must 
45.30 	depend primarily on visual communication such as American Sign Language or other signed 
46.1 	language, visual and manual means of communication such as signing systems in English 
46.2 	or Cued Speech, writing, lip speech reading, manual communication, and gestures.

46.3 	Sec. 34. Minnesota Statutes 2016, section 256C.23, is amended by adding a subdivision 
46.4 	to read:
46.5 		Subd. 2c.Interpreting services. "Interpreting services" means services that include:
46.6 	(1) interpreting between a spoken language, such as English, and a visual language, such 
46.7 	as American Sign Language;
46.8 	(2) interpreting between a spoken language and a visual representation of a spoken 
46.9 	language, such as Cued Speech and signing systems in English;
46.10 	(3) interpreting within one language where the interpreter uses natural gestures and 
46.11 	silently repeats the spoken message, replacing some words or phrases to give higher visibility 
46.12 	on the lips;
46.13 	(4) interpreting using low vision or tactile methods for persons who have a combined 
46.14 	hearing and vision loss or are deafblind; and
46.15 	(5) interpreting from one communication mode or language into another communication 
46.16 	mode or language that is linguistically and culturally appropriate for the participants in the 
46.17 	communication exchange.

46.18 	Sec. 35. Minnesota Statutes 2016, section 256C.23, is amended by adding a subdivision 
46.19 	to read:
46.20 		Subd. 6.Real-time captioning. "Real-time captioning" means a method of captioning 
46.21 	in which a caption is simultaneously prepared and displayed or transmitted at the time of 
46.22 	origination by specially trained real-time captioners.

46.23 	Sec. 36. Minnesota Statutes 2016, section 256C.233, subdivision 1, is amended to read:
46.24 		Subdivision 1.Deaf and Hard-of-Hearing Services Division. The commissioners of 
46.25 	human services, education, employment and economic development, and health shall create 
46.26 	a distinct and separate organizational unit to be known as advise the commissioner of human 
46.27 	services on the activities of the Deaf and Hard-of-Hearing Services Division to address. 
46.28 	This division addresses the developmental, social, educational, and occupationaland 
46.29 	social-emotional needs of persons who are deaf, persons who are deafblind, and persons 
46.30 	who are hard-of-hearing persons through a statewide network of collaborative services and 
46.31 	by coordinating the promulgation of public policies, regulations, legislation, and programs 
47.1 	affecting advocates on behalf of and provides information and training about how to best 
47.2 	serve persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing 
47.3 	persons. An interdepartmental management team shall advise the activities of the Deaf and 
47.4 	Hard-of-Hearing Services Division. The commissioner of human services shall coordinate 
47.5 	the work of the interagency management team advisers and receive legislative appropriations 
47.6 	for the division.

47.7 	Sec. 37. Minnesota Statutes 2016, section 256C.233, subdivision 2, is amended to read:
47.8 		Subd. 2.Responsibilities. The Deaf and Hard-of-Hearing Services Division shall:
47.9 	(1) establish and maintain a statewide network of regional service centersculturally 
47.10 	affirmative services for Minnesotans who are deaf, Minnesotans who are deafblind, and
47.11 	Minnesotans who are hard-of-hearing Minnesotans;
47.12 	(2) assist work across divisions within the Departments Department of Human Services, 
47.13 	Education, and Employment and Economic Development to coordinate the promulgation 
47.14 	and implementation of public policies, regulations, legislation, programs, and services 
47.15 	affecting as well as with other agencies and counties, to ensure that there is an understanding 
47.16 	of:
47.17 	(i) the communication challenges faced by persons who are deaf, persons who are
47.18 	deafblind, and persons who are hard-of-hearing persons;
47.19 	(ii) the best practices for accommodating and mitigating communication challenges; 
47.20 	and
47.21 	(iii) the legal requirements for providing access to and effective communication with 
47.22 	persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing; and
47.23 	(3) provide a coordinated system of assess the supply and demand statewide interpreting 
47.24 	or for interpreter referral services. and real-time captioning services, implement strategies 
47.25 	to provide greater access to these services in areas without sufficient supply, and build the 
47.26 	base of service providers across the state;
47.27 	(4) maintain a statewide information resource that includes contact information and 
47.28 	professional certification credentials of interpreting service providers and real-time captioning 
47.29 	service providers;
47.30 	(5) provide culturally affirmative mental health services to persons who are deaf, persons 
47.31 	who are deafblind, and persons who are hard-of-hearing who:
48.1 	(i) use a visual language such as American Sign Language or a tactile form of a language; 
48.2 	or
48.3 	(ii) otherwise need culturally affirmative therapeutic services;
48.4 	(6) research and develop best practices and recommendations for emerging issues;
48.5 	(7) provide as much information as practicable on the division's stand-alone Web site 
48.6 	in American Sign Language; and
48.7 	(8) report to the chairs and ranking minority members of the legislative committees with 
48.8 	jurisdiction over human services biennially, beginning on January 1, 2019, on the following:
48.9 	(i) the number of regional service center staff, the location of the office of each staff 
48.10 	person, other service providers with which they are colocated, the number of people served 
48.11 	by each staff person and a breakdown of whether each person was served on-site or off-site, 
48.12 	and for those served off-site, a list of locations where services were delivered and the number 
48.13 	who were served in-person and the number who were served via technology;
48.14 	(ii) the amount and percentage of the division budget spent on reasonable 
48.15 	accommodations for staff;
48.16 	(iii) the number of people who use demonstration equipment and consumer evaluations 
48.17 	of the experience;
48.18 	(iv) the number of training sessions provided by division staff, the topics covered, the 
48.19 	number of participants, and consumer evaluations, including a breakdown by delivery 
48.20 	method such as in-person or via technology;
48.21 	(v) the number of training sessions hosted at a division location provided by another 
48.22 	service provider, the topics covered, the number of participants, and consumer evaluations, 
48.23 	including a breakdown by delivery method such as in-person or via technology;
48.24 	(vi) for each grant awarded, the amount awarded to the grantee and a summary of the 
48.25 	grantee's results, including consumer evaluations of the services or products provided;
48.26 	(vii) the number of people on waiting lists for any services provided by division staff 
48.27 	or for services or equipment funded through grants awarded by the division;
48.28 	(viii) the amount of time staff spent driving to appointments to deliver direct one-to-one 
48.29 	client services in locations outside of the regional service centers; and
48.30 	(ix) the regional needs and feedback on addressing service gaps identified by the advisory 
48.31 	committees.

49.1 	Sec. 38. Minnesota Statutes 2016, section 256C.24, subdivision 1, is amended to read:
49.2 		Subdivision 1.Location. The Deaf and Hard-of-Hearing Services Division shall establish 
49.3 	up to eight at least six regional service centers for persons who are deaf and persons who 
49.4 	are hard-of-hearing persons. The centers shall be distributed regionally to provide access 
49.5 	for persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing 
49.6 	persons in all parts of the state.

49.7 	Sec. 39. Minnesota Statutes 2016, section 256C.24, subdivision 2, is amended to read:
49.8 		Subd. 2.Responsibilities. Each regional service center shall:
49.9 	(1) serve as a central entry point for establish connections and collaborations and explore 
49.10 	co-locating with other public and private entities providing services to persons who are
49.11 	deaf, persons who are deafblind, and persons who are hard-of-hearing persons in need of 
49.12 	services and make referrals to the services needed in the region;
49.13 	(2) for those in need of services, assist in coordinating services between service providers 
49.14 	and persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing, 
49.15 	and the persons' families, and make referrals to the services needed;
49.16 	(2) (3) employ staff trained to work with persons who are deaf, persons who are deafblind, 
49.17 	and persons who are hard-of-hearing persons;
49.18 	(3) (4) if adequate services are not available from another public or private service 
49.19 	provider in the region, provide to all individual assistance to persons who are deaf, persons 
49.20 	who are deafblind, and persons who are hard-of-hearing persons access to interpreter services 
49.21 	which are necessary to help them obtain services, and the persons' families. Individual 
49.22 	culturally affirmative assistance may be provided using technology only in areas of the state 
49.23 	where a person has access to sufficient quality telecommunications or broadband services 
49.24 	to allow effective communication. When a person who is deaf, a person who is deafblind, 
49.25 	or a person who is hard-of-hearing does not have access to sufficient telecommunications 
49.26 	or broadband service, individual assistance shall be available in person;
49.27 	(5) identify regional training needs, work with deaf and hard-of-hearing services training 
49.28 	staff, and collaborate with others to deliver training for persons who are deaf, persons who 
49.29 	are deafblind, and persons who are hard-of-hearing, and the persons' families, and other 
49.30 	service providers about subjects including the persons' rights under the law, American Sign 
49.31 	Language, and the impact of hearing loss and options for accommodating it;
49.32 	(4) implement a plan to provide loaned equipment and resource materials to deaf, 
49.33 	deafblind, and hard-of-hearing(6) have a mobile or permanent lab where persons who are 
50.1 	deaf, persons who are deafblind, and persons who are hard-of-hearing can try a selection 
50.2 	of modern assistive technology and equipment to determine what would best meet the 
50.3 	persons' needs;
50.4 	(5) cooperate with responsible departments and administrative authorities to provide 
50.5 	access for deaf, deafblind, and hard-of-hearing persons to services provided by state, county, 
50.6 	and regional agencies;
50.7 	(6) (7) collaborate with the Resource Center for the Deaf and Hard-of-Hearing Persons, 
50.8 	other divisions of the Department of Education, and local school districts to develop and 
50.9 	deliver programs and services for families with children who are deaf, children who are 
50.10 	deafblind, or children who are hard-of-hearing children and to support school personnel 
50.11 	serving these children;
50.12 	(7) when possible, (8) provide training to the social service or income maintenance staff 
50.13 	employed by counties or by organizations with whom counties contract for services to 
50.14 	ensure that communication barriers which prevent persons who are deaf, persons who are 
50.15 	deafblind, and persons who are hard-of-hearing persons from using services are removed;
50.16 	(8) when possible, (9) provide training to state and regional human service agencies in 
50.17 	the region regarding program access for persons who are deaf, persons who are deafblind, 
50.18 	and persons who are hard-of-hearing persons; and
50.19 	(9) (10) assess the ongoing need and supply of services for persons who are deaf, persons 
50.20 	who are deafblind, and persons who are hard-of-hearing persons in all parts of the state, 
50.21 	annually consult with the division's advisory committees to identify regional needs and 
50.22 	solicit feedback on addressing service gaps, and cooperate with public and private service 
50.23 	providers to develop these services.;
50.24 	(11) provide culturally affirmative mental health services to persons who are deaf, 
50.25 	persons who are deafblind, and persons who are hard-of-hearing who:
50.26 	(i) use a visual language such as American Sign Language or a tactile form of a language; 
50.27 	or
50.28 	(ii) otherwise need culturally affirmative therapeutic services; and
50.29 	(12) establish partnerships with state and regional entities statewide that have the 
50.30 	technological capacity to provide Minnesotans with virtual access to the division's services 
50.31 	and division-sponsored training via technology.

51.1 	Sec. 40. Minnesota Statutes 2016, section 256C.24, subdivision 3, is amended to read:
51.2 		Subd. 3.Advisory committee. The director of the Deaf and Hard-of-Hearing Services 
51.3 	Division shall appoint an advisory committee eight advisory committees of up to nine 
51.4 	persons for each regional service area per advisory committee. Each committee shall represent 
51.5 	a specific region of the state. The director shall determine the boundaries of each advisory 
51.6 	committee region. The committees shall advise the director on the needs of persons who 
51.7 	are deaf, persons who are deafblind, and persons who are hard-of-hearing and service gaps 
51.8 	in the region of the state the committee represents. Members shall include persons who are 
51.9 	deaf, persons who are deafblind, and persons who are hard-of-hearing, persons who have 
51.10 	communication disabilities, parents of children who are deaf and parents of children who 
51.11 	are hard-of-hearing, parents of children who have communication disabilities, and 
51.12 	representatives of county and regional human services, including representatives of private 
51.13 	service providers. At least 50 percent of the members must be deaf or deafblind or 
51.14 	hard-of-hearing or have a communication disability. Committee members shall serve for a 
51.15 	three-year term and shall serve no more than two consecutive terms, and may be appointed 
51.16 	to consecutive terms. Each advisory committee shall elect a chair. The director of the Deaf 
51.17 	and Hard-of-Hearing Services Division shall assign staff to serve as nonvoting members of 
51.18 	the committee. Members shall not receive a per diem. Otherwise, the compensation, removal 
51.19 	of members, and filling of vacancies on the committee shall be as provided in section 
51.20 	15.0575.

51.21 	Sec. 41. Minnesota Statutes 2016, section 256C.261, is amended to read:
51.22 	256C.261 SERVICES FOR PERSONS WHO ARE DEAFBLIND PERSONS.
51.23 	(a) The commissioner of human services shall combine the existing biennial base level 
51.24 	funding for deafblind services into a single grant program. At least 35 percent of the total 
51.25 	funding is awarded for services and other supports to deafblind children and their families 
51.26 	and at least 25 percent is awarded for services and other supports to deafblind adults. use 
51.27 	at least 35 percent of the deafblind services biennial base level grant funding for services 
51.28 	and other supports for a child who is deafblind and the child's family. The commissioner 
51.29 	shall use at least 25 percent of the deafblind services biennial base level grant funding for 
51.30 	services and other supports for an adult who is deafblind.
51.31 	The commissioner shall award grants for the purposes of:
51.32 	(1) providing services and supports to individuals persons who are deafblind; and
52.1 	(2) developing and providing training to counties and the network of senior citizen 
52.2 	service providers. The purpose of the training grants is to teach counties how to use existing 
52.3 	programs that capture federal financial participation to meet the needs of eligible persons 
52.4 	who are deafblind persons and to build capacity of senior service programs to meet the 
52.5 	needs of seniors with a dual sensory hearing and vision loss.
52.6 	(b) The commissioner may make grants:
52.7 	(1) for services and training provided by organizations; and
52.8 	(2) to develop and administer consumer-directed services.
52.9 	(c) Consumer-directed services shall be provided in whole by grant-funded providers. 
52.10 	The deaf and hard-of-hearing regional service centers shall not provide any aspect of a 
52.11 	grant-funded consumer-directed services program.
52.12 	(c) (d) Any entity that is able to satisfy the grant criteria is eligible to receive a grant 
52.13 	under paragraph (a).
52.14 	(d) (e) Deafblind service providers may, but are not required to, provide intervenor 
52.15 	services as part of the service package provided with grant funds under this section.

52.16 	Sec. 42. Minnesota Statutes 2016, section 256C.30, is amended to read:
52.17 	256C.30 DUTIES OF HUMAN SERVICES COMMISSIONER.
52.18 	(a) As described in this section, the commissioner of human services must enter into 
52.19 	grant agreements with television stations to make live local news programming accessible 
52.20 	to persons who are deaf, persons who are hard-of-hearing, and persons who are deafblind 
52.21 	persons as defined in section 256C.23.
52.22 	(b) The grant agreements must provide for:
52.23 	(1) real-time captioning services for broadcasting that is not emergency broadcasting 
52.24 	subject to Code of Federal Regulations, title 47, section 79.2;
52.25 	(2) real-time captioning services for commercial broadcasters in areas of Minnesota 
52.26 	where commercial broadcasters are not subject to the live programming closed-captioning 
52.27 	requirements of Code of Federal Regulations, title 47, section 79.1(d); and
52.28 	(3) real-time captioning for large-market noncommercial broadcasters who produce live 
52.29 	news programming.
53.1 	(c) For the purposes of this section, "real-time captioning" means a method of captioning 
53.2 	in which captions are simultaneously prepared and transmitted at the time of origination by 
53.3 	specially trained real-time captioners.

53.4 	EFFECTIVE DATE. This section is effective the day following final enactment.

53.5 	Sec. 43. Laws 2012, chapter 247, article 4, section 47, as amended by Laws 2014, chapter 
53.6 	312, article 27, section 72, and Laws 2016, chapter 144, section 1, the effective date, is 
53.7 	amended to read:

53.8 	EFFECTIVE DATE. The amendments to this section are effective on June 1, 2016, 
53.9 	and expire on the date Laws 2015, chapter 71, article 7, section 54, becomes effective. The 
53.10 	commissioner of human services shall notify the revisor of statutes when Laws 2015, chapter 
53.11 	71, article 7, section 54, becomes effective. Notwithstanding any other law to the contrary, 
53.12 	the exception in this section is effective until the exception under section 44 or under Laws 
53.13 	2015, chapter 71, article 7, section 54, becomes effective, whichever occurs first. The 
53.14 	commissioner of human services shall notify the revisor of statutes when section 44 or Laws 
53.15 	2015, chapter 71, article 7, section 54, is effective.

53.16 	Sec. 44. EXPANSION OF CONSUMER-DIRECTED COMMUNITY SUPPORTS 
53.17 	BUDGET METHODOLOGY EXCEPTION.
 53.18 	(a) No later than September 30, 2017, if necessary, the commissioner of human services 
53.19 	shall submit an amendment to the Centers for Medicare and Medicaid Services for the home 
53.20 	and community-based services waivers authorized under Minnesota Statutes, sections 
53.21 	256B.092 and 256B.49, to expand the exception to the consumer-directed community 
53.22 	supports budget methodology under Laws 2015, chapter 71, article 7, section 54, to provide 
53.23 	up to 30 percent more funds for either:
53.24 	(1) consumer-directed community supports participants who have a coordinated service 
53.25 	and support plan which identifies the need for an increased amount of services or supports 
53.26 	under consumer-directed community supports than the amount they are currently receiving 
53.27 	under the consumer-directed community supports budget methodology:
53.28 	(i) to increase the amount of time a person works or otherwise improves employment 
53.29 	opportunities;
53.30 	(ii) to plan a transition to, move to, or live in a setting described in Minnesota Statutes, 
53.31 	section 256D.44, subdivision 5, paragraph (f), clause (1), item (ii), or paragraph (g); or
53.32 	(iii) to develop and implement a positive behavior support plan; or
54.1 	(2) home and community-based waiver participants who are currently using licensed 
54.2 	providers for (i) employment supports or services during the day; or (ii) residential services, 
54.3 	either of which cost more annually than the person would spend under a consumer-directed 
54.4 	community supports plan for any or all of the supports needed to meet the goals identified 
54.5 	in paragraph (a), clause (1), items (i), (ii), and (iii).
54.6 	(b) The exception under paragraph (a), clause (1), is limited to those persons who can 
54.7 	demonstrate that they will have to discontinue using consumer-directed community supports 
54.8 	and accept other non-self-directed waiver services because their supports needed for the 
54.9 	goals described in paragraph (a), clause (1), items (i), (ii), and (iii), cannot be met within 
54.10 	the consumer-directed community supports budget limits.
54.11 	(c) The exception under paragraph (a), clause (2), is limited to those persons who can 
54.12 	demonstrate that, upon choosing to become a consumer-directed community supports 
54.13 	participant, the total cost of services, including the exception, will be less than the cost of 
54.14 	current waiver services.

54.15 	EFFECTIVE DATE. The exception under this section is effective October 1, 2017, or 
54.16 	upon federal approval, whichever is later. Notwithstanding any other law to the contrary, 
54.17 	the exception in Laws 2016, chapter 144, section 1, remains in effect until the exception 
54.18 	under Laws 2015, chapter 71, article 7, section 54, or under this section becomes effective, 
54.19 	whichever occurs first. The commissioner of human services shall notify the revisor of 
54.20 	statutes when federal approval is obtained.

54.21 	Sec. 45. CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET 
54.22 	METHODOLOGY EXCEPTION FOR PERSONS LEAVING INSTITUTIONS AND 
54.23 	CRISIS RESIDENTIAL SETTINGS.
54.24 	(a) By September 30, 2017, the commissioner shall establish an institutional and crisis 
54.25 	bed consumer-directed community supports budget exception process in the home and 
54.26 	community-based services waivers under Minnesota Statutes, sections 256B.092 and 
54.27 	256B.49. This budget exception process shall be available for any individual who:
54.28 	(1) is not offered available and appropriate services within 60 days since approval for 
54.29 	discharge from the individual's current institutional setting; and
54.30 	(2) requires services that are more expensive than appropriate services provided in a 
54.31 	noninstitutional setting using the consumer-directed community supports option.
54.32 	(b) Institutional settings for purposes of this exception include intermediate care facilities 
54.33 	for persons with developmental disabilities; nursing facilities; acute care hospitals; Anoka 
55.1 	Metro Regional Treatment Center; Minnesota Security Hospital; and crisis beds. The budget 
55.2 	exception shall be limited to no more than the amount of appropriate services provided in 
55.3 	a noninstitutional setting as determined by the lead agency managing the individual's home 
55.4 	and community-based services waiver. The lead agency shall notify the Department of 
55.5 	Human Services of the budget exception.

55.6 	EFFECTIVE DATE. This section is effective the day following final enactment.

55.7 	Sec. 46. CONSUMER-DIRECTED COMMUNITY SUPPORTS REVISED BUDGET 
55.8 	METHODOLOGY REPORT.
 55.9 	(a) The commissioner of human services, in consultation with stakeholders and others 
55.10 	including representatives of lead agencies, home and community-based services waiver 
55.11 	participants using consumer-directed community supports, advocacy groups, state agencies, 
55.12 	the Institute on Community Integration at the University of Minnesota, and service and 
55.13 	financial management providers, shall develop a revised consumer-directed community 
55.14 	supports budget methodology. The new methodology shall be based on (1) the costs of 
55.15 	providing services as reflected by the wage and other relevant components incorporated in 
55.16 	the disability waiver rate formulas under Minnesota Statutes, chapter 256B, and (2) 
55.17 	state-to-county waiver-funding methodologies. The new methodology should develop 
55.18 	individual consumer-directed community supports budgets comparable to those provided 
55.19 	for similar needs individuals if paying for non-consumer-directed community supports 
55.20 	waiver services.
55.21 	(b) By December 15, 2018, the commissioner shall report a revised consumer-directed 
55.22 	community supports budget methodology, including proposed legislation and funding 
55.23 	necessary to implement the new methodology, to the chairs and ranking minority members 
55.24 	of the house of representatives and senate committees with jurisdiction over health and 
55.25 	human services.

55.26 	EFFECTIVE DATE. This section is effective the day following final enactment.

55.27 	Sec. 47. FEDERAL WAIVER AMENDMENTS.
 55.28 	The commissioner of human services shall submit necessary waiver amendments to the 
55.29 	Centers for Medicare and Medicaid Services to add employment exploration services, 
55.30 	employment development services, and employment support services to the home and 
55.31 	community-based services waivers authorized under Minnesota Statutes, sections 256B.092 
55.32 	and 256B.49. The commissioner shall also submit necessary waiver amendments to remove 
55.33 	community-based employment services from day training and habilitation and prevocational 
56.1 	services. The commissioner shall submit all necessary waiver amendments by October 1, 
56.2 	2017.

56.3 	EFFECTIVE DATE. This section is effective the day following final enactment.

56.4 	Sec. 48. TRANSPORTATION STUDY.
 56.5 	The commissioner of human services, with cooperation from lead agencies and in 
56.6 	consultation with stakeholders, shall conduct a study to identify opportunities to increase 
56.7 	access to transportation services for an individual who receives home and community-based 
56.8 	services. The commissioner shall submit a report with recommendations to the chairs and 
56.9 	ranking minority members of the legislative committees with jurisdiction over human 
56.10 	services by January 15, 2019. The report shall:
56.11 	(1) study all aspects of the current transportation service network, including the fleet 
56.12 	available, the different rate-setting methods currently used, methods that an individual uses 
56.13 	to access transportation, and the diversity of available provider agencies;
56.14 	(2) identify current barriers for an individual accessing transportation and for a provider 
56.15 	providing waiver services transportation in the marketplace;
56.16 	(3) identify efficiencies and collaboration opportunities to increase available 
56.17 	transportation, including transportation funded by medical assistance, and available regional 
56.18 	transportation and transit options;
56.19 	(4) study transportation solutions in other states for delivering home and community-based 
56.20 	services;
56.21 	(5) study provider costs required to administer transportation services;
56.22 	(6) make recommendations for coordinating and increasing transportation accessibility 
56.23 	across the state; and
56.24 	(7) make recommendations for the rate setting of waivered transportation.

56.25 	EFFECTIVE DATE. This section is effective the day following final enactment.

56.26 	Sec. 49. DIRECTION TO COMMISSIONER; TELECOMMUNICATION 
56.27 	EQUIPMENT PROGRAM.
 56.28 	The commissioner of human services shall work in consultation with the Commission 
56.29 	of Deaf, Deafblind, and Hard-of-Hearing Minnesotans to provide recommendations by 
56.30 	January 15, 2018, to the chairs and ranking minority members of the house of representatives 
57.1 	and senate committees with jurisdiction over human services to modernize the 
57.2 	telecommunication equipment program. The recommendations must address:
57.3 	(1) types of equipment and supports the program should provide to ensure people with 
57.4 	communication difficulties have equitable access to telecommunications services;
57.5 	(2) additional services the program should provide, such as education about technology 
57.6 	options that can improve a person's access to telecommunications services; and
57.7 	(3) how the current program's service delivery structure might be improved to better 
57.8 	meet the needs of people with communication disabilities.
57.9 	The commissioner shall also provide draft legislative language to accomplish the 
57.10 	recommendations. Final recommendations, the final report, and draft legislative language 
57.11 	must be approved by both the commissioner and the chair of the Commission of Deaf, 
57.12 	Deafblind, and Hard-of-Hearing Minnesotans.

57.13 	Sec. 50. DIRECTION TO COMMISSIONER; BILLING FOR MENTAL HEALTH 
57.14 	SERVICES.
 57.15 	By January 1, 2018, the commissioner of human services shall report to the chairs and 
57.16 	ranking minority members of the house of representatives and senate committees with 
57.17 	jurisdiction over deaf and hard-of-hearing services on the potential costs and benefits of the 
57.18 	Deaf and Hard-of-Hearing Services Division billing for the cost of providing mental health 
57.19 	services.

57.20 	Sec. 51. DIRECTION TO COMMISSIONER; MnCHOICES ASSESSMENT TOOL.
 57.21 	The commissioner of human services shall work with lead agencies responsible for 
57.22 	conducting long-term consultation services under Minnesota Statutes, section 256B.0911, 
57.23 	to modify the MnCHOICES assessment tool and related policies to:
57.24 	(1) reduce assessment times;
57.25 	(2) create efficiencies within the tool and within practice and policy for conducting 
57.26 	assessments and support planning;
57.27 	(3) implement policy changes reducing the frequency and depth of assessment and 
57.28 	reassessment, while ensuring federal compliance with medical assistance and disability 
57.29 	waiver eligibility requirements; and
57.30 	(4) evaluate alternative payment methods.

58.1 	Sec. 52. RANDOM MOMENT TIME STUDY EVALUATION REQUIRED.
 58.2 	The commissioner of human services shall implement administrative efficiencies and 
58.3 	evaluate the random moment time study methodology for reimbursement of costs associated 
58.4 	with county duties required under Minnesota Statutes, section 256B.0911. The evaluation 
58.5 	must determine whether random moment is efficient and effective in supporting functions 
58.6 	of assessment and support planning and the purpose under Minnesota Statutes, section 
58.7 	256B.0911, subdivision 1. The commissioner shall submit a report to the chairs and ranking 
58.8 	minority members of the house of representatives and senate committees with jurisdiction 
58.9 	over health and human services by January 15, 2019.

58.10 	Sec. 53. RATE INCREASE FOR SELF-DIRECTED WORKFORCE 
58.11 	NEGOTIATIONS.
 58.12 	(a) Notwithstanding any other law or rule to the contrary, effective July 1, 2017, and 
58.13 	within available appropriations, the commissioner of human services shall have the authority 
58.14 	to implement rate adjustments to comply with wages and benefits negotiated in the labor 
58.15 	agreement between the state of Minnesota and the Service Employees International Union 
58.16 	(SEIU) Healthcare Minnesota for the period between July 1, 2017, and June 30, 2019.
58.17 	(b) The rate changes described in this section apply to direct support services provided 
58.18 	through a covered program, as defined by Minnesota Statutes, section 256B.0711, subdivision 
58.19 	1, paragraph (b).

58.20 	Sec. 54.  REPEALER.
 58.21 	(a) Minnesota Statutes 2016, section 144A.351, subdivision 2, is repealed.
58.22 	(b) Minnesota Statutes 2016, section 256B.4914, subdivision 16, is repealed effective 
58.23 	January 1, 2018.
58.24 	(c) Laws 2012, chapter 247, article 4, section 47, as amended by Laws 2014, chapter 
58.25 	312, article 27, section 72, Laws 2015, chapter 71, article 7, section 58, Laws 2016, chapter 
58.26 	144, section 1; and Laws 2015, chapter 71, article 7, section 54, are repealed upon the 
58.27 	effective date of section 44.
58.28 	(d) Minnesota Statutes 2016, sections 256C.23, subdivision 3; 256C.233, subdivision 
58.29 	4; and 256C.25, subdivisions 1 and 2, are repealed.

59.1 	ARTICLE 2
59.2 	HOUSING

59.3 	Section 1. Minnesota Statutes 2016, section 144D.04, subdivision 2, is amended to read:
59.4 		Subd. 2.Contents of contract.  A housing with services contract, which need not be 
59.5 	entitled as such to comply with this section, shall include at least the following elements in 
59.6 	itself or through supporting documents or attachments:
59.7 	(1) the name, street address, and mailing address of the establishment;
59.8 	(2) the name and mailing address of the owner or owners of the establishment and, if 
59.9 	the owner or owners is not a natural person, identification of the type of business entity of 
59.10 	the owner or owners;
59.11 	(3) the name and mailing address of the managing agent, through management agreement 
59.12 	or lease agreement, of the establishment, if different from the owner or owners;
59.13 	(4) the name and address of at least one natural person who is authorized to accept service 
59.14 	of process on behalf of the owner or owners and managing agent;
59.15 	(5) a statement describing the registration and licensure status of the establishment and 
59.16 	any provider providing health-related or supportive services under an arrangement with the 
59.17 	establishment;
59.18 	(6) the term of the contract;
59.19 	(7) a description of the services to be provided to the resident in the base rate to be paid 
59.20 	by resident, including a delineation of the portion of the base rate that constitutes rent and 
59.21 	a delineation of charges for each service included in the base rate;
59.22 	(8) a description of any additional services, including home care services, available for 
59.23 	an additional fee from the establishment directly or through arrangements with the 
59.24 	establishment, and a schedule of fees charged for these services;
59.25 	(9) a description of the process through which the contract may be modified, amended, 
59.26 	or terminated, including whether a move to a different room or sharing a room would be 
59.27 	required in the event that the tenant can no longer pay the current rent;
59.28 	(10) a description of the establishment's complaint resolution process available to residents 
59.29 	including the toll-free complaint line for the Office of Ombudsman for Long-Term Care;
59.30 	(11) the resident's designated representative, if any;
59.31 	(12) the establishment's referral procedures if the contract is terminated;
60.1 	(13) requirements of residency used by the establishment to determine who may reside 
60.2 	or continue to reside in the housing with services establishment;
60.3 	(14) billing and payment procedures and requirements;
60.4 	(15) a statement regarding the ability of residents a resident to receive services from 
60.5 	service providers with whom the establishment does not have an arrangement;
60.6 	(16) a statement regarding the availability of public funds for payment for residence or 
60.7 	services in the establishment; and
60.8 	(17) a statement regarding the availability of and contact information for long-term care 
60.9 	consultation services under section 256B.0911 in the county in which the establishment is 
60.10 	located.

60.11 	EFFECTIVE DATE. This section is effective the day following final enactment.

60.12 	Sec. 2. Minnesota Statutes 2016, section 144D.04, is amended by adding a subdivision to 
60.13 	read:
60.14 		Subd. 2a.Additional contract requirements. (a) For a resident receiving one or more 
60.15 	health-related services from the establishment's arranged home care provider, as defined in 
60.16 	section 144D.01, subdivision 6, the contract must include the requirements in paragraph 
60.17 	(b). A restriction of a resident's rights under this subdivision is allowed only if determined 
60.18 	necessary for health and safety reasons identified by the home care provider's registered 
60.19 	nurse in an initial assessment or reassessment, as defined under section 144A.4791, 
60.20 	subdivision 8, and documented in the written service plan under section 144A.4791, 
60.21 	subdivision 9. Any restrictions of those rights for people served under sections 256B.0915 
60.22 	and 256B.49 must be documented in the resident's coordinated service and support plan 
60.23 	(CSSP), as defined under sections 256B.0915, subdivision 6 and 256B.49, subdivision 15.
60.24 	(b) The contract must include a statement:
60.25 	(1) regarding the ability of a resident to furnish and decorate the resident's unit within 
60.26 	the terms of the lease;
60.27 	(2) regarding the resident's right to access food at any time;
60.28 	(3) regarding a resident's right to choose the resident's visitors and times of visits;
60.29 	(4) regarding the resident's right to choose a roommate if sharing a unit; and
60.30 	(5) notifying the resident of the resident's right to have and use a lockable door to the 
60.31 	resident's unit. The landlord shall provide the locks on the unit. Only a staff member with 
61.1 	a specific need to enter the unit shall have keys, and advance notice must be given to the 
61.2 	resident before entrance, when possible.

61.3 	EFFECTIVE DATE. This section is effective the day following final enactment.

61.4 	Sec. 3. Minnesota Statutes 2016, section 245A.03, subdivision 7, is amended to read:
61.5 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an initial license 
61.6 	for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult 
61.7 	foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter 
61.8 	for a physical location that will not be the primary residence of the license holder for the 
61.9 	entire period of licensure. If a license is issued during this moratorium, and the license 
61.10 	holder changes the license holder's primary residence away from the physical location of 
61.11 	the foster care license, the commissioner shall revoke the license according to section 
61.12 	245A.07. The commissioner shall not issue an initial license for a community residential 
61.13 	setting licensed under chapter 245D. When approving an exception under this paragraph, 
61.14 	the commissioner shall consider the resource need determination process in paragraph (h), 
61.15 	the availability of foster care licensed beds in the geographic area in which the licensee 
61.16 	seeks to operate, the results of a person's choices during their annual assessment and service 
61.17 	plan review, and the recommendation of the local county board. The determination by the 
61.18 	commissioner is final and not subject to appeal. Exceptions to the moratorium include:
61.19 	(1) foster care settings that are required to be registered under chapter 144D;
61.20 	(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or 
61.21 	community residential setting licenses replacing adult foster care licenses in existence on 
61.22 	December 31, 2013, and determined to be needed by the commissioner under paragraph 
61.23 	(b);
61.24 	(3) new foster care licenses or community residential setting licenses determined to be 
61.25 	needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD, 
61.26 	or regional treatment center; restructuring of state-operated services that limits the capacity 
61.27 	of state-operated facilities; or allowing movement to the community for people who no 
61.28 	longer require the level of care provided in state-operated facilities as provided under section 
61.29 	256B.092, subdivision 13, or 256B.49, subdivision 24;
61.30 	(4) new foster care licenses or community residential setting licenses determined to be 
61.31 	needed by the commissioner under paragraph (b) for persons requiring hospital level care; 
61.32 	or
62.1 	(5) new foster care licenses or community residential setting licenses determined to be 
62.2 	needed by the commissioner for the transition of people from personal care assistance to 
62.3 	the home and community-based services;
62.4 	(6) new foster care licenses or community residential setting licenses determined to be 
62.5 	needed by the commissioner for the transition of people from the residential care waiver 
62.6 	services to foster care services. This exception applies only when:
62.7 	(i) the person's case manager provided the person with information about the choice of 
62.8 	service, service provider, and location of service to help the person make an informed choice; 
62.9 	and
62.10 	(ii) the person's foster care services are less than or equal to the cost of the person's 
62.11 	services delivered in the residential care waiver service setting as determined by the lead 
62.12 	agency; or
62.13 	(7) new foster care licenses or community residential setting licenses for people receiving 
62.14 	services under chapter 245D and residing in an unlicensed setting before May 1, 2017, and 
62.15 	for which a license is required. This exception does not apply to people living in their own 
62.16 	home. For purposes of this clause, there is a presumption that a foster care or community 
62.17 	residential setting license is required for services provided to three or more people in a 
62.18 	dwelling unit when the setting is controlled by the provider. A license holder subject to this 
62.19 	exception may rebut the presumption that a license is required by seeking a reconsideration 
62.20 	of the commissioner's determination. The commissioner's disposition of a request for 
62.21 	reconsideration is final and not subject to appeal under chapter 14. The exception is available 
62.22 	until June 30, 2018. This exception is available when:
62.23 	(i) the person's case manager provided the person with information about the choice of 
62.24 	service, service provider, and location of service, including in the person's home, to help 
62.25 	the person make an informed choice; and
62.26 	(ii) the person's services provided in the licensed foster care or community residential 
62.27 	setting are less than or equal to the cost of the person's services delivered in the unlicensed 
62.28 	setting as determined by the lead agency.
62.29 	(b) The commissioner shall determine the need for newly licensed foster care homes or 
62.30 	community residential settings as defined under this subdivision. As part of the determination, 
62.31 	the commissioner shall consider the availability of foster care capacity in the area in which 
62.32 	the licensee seeks to operate, and the recommendation of the local county board. The 
62.33 	determination by the commissioner must be final. A determination of need is not required 
62.34 	for a change in ownership at the same address.
63.1 	(c) When an adult resident served by the program moves out of a foster home that is not 
63.2 	the primary residence of the license holder according to section 256B.49, subdivision 15, 
63.3 	paragraph (f), or the adult community residential setting, the county shall immediately 
63.4 	inform the Department of Human Services Licensing Division. The department shallmay 
63.5 	decrease the statewide licensed capacity for adult foster care settings where the physical 
63.6 	location is not the primary residence of the license holder, or for adult community residential 
63.7 	settings, if the voluntary changes described in paragraph (e) are not sufficient to meet the 
63.8 	savings required by reductions in licensed bed capacity under Laws 2011, First Special 
63.9 	Session chapter 9, article 7, sections 1 and 40, paragraph (f), and maintain statewide long-term 
63.10 	care residential services capacity within budgetary limits. Implementation of the statewide 
63.11 	licensed capacity reduction shall begin on July 1, 2013. The commissioner shall delicense 
63.12 	up to 128 beds by June 30, 2014, using the needs determination process. Prior to any 
63.13 	involuntary reduction of licensed capacity, the commissioner shall consult with lead agencies 
63.14 	and license holders to determine which adult foster care settings, where the physical location 
63.15 	is not the primary residence of the license holder, or community residential settings, are 
63.16 	licensed for up to five beds, but have operated at less than full capacity for 12 or more 
63.17 	months as of March 1, 2014. The settings that meet these criteria must be the first to be 
63.18 	considered for an involuntary decrease in statewide licensed capacity, up to a maximum of 
63.19 	35 beds. If more than 35 beds are identified that meet these criteria, the commissioner shall 
63.20 	prioritize the selection of those beds to be closed based on the length of time the beds have 
63.21 	been vacant. The longer a bed has been vacant, the higher priority it must be given for 
63.22 	closure. Under this paragraph, the commissioner has the authority to reduce unused licensed 
63.23 	capacity of a current foster care program, or the community residential settings, to accomplish 
63.24 	the consolidation or closure of settings. Under this paragraph, the commissioner has the 
63.25 	authority to manage statewide capacity, including adjusting the capacity available to each 
63.26 	county and adjusting statewide available capacity, to meet the statewide needs identified 
63.27 	through the process in paragraph (e). A decreased licensed capacity according to this 
63.28 	paragraph is not subject to appeal under this chapter.
63.29 	(d) Residential settings that would otherwise be subject to the decreased license capacity 
63.30 	established in paragraph (c) shall be exempt if the license holder's beds are occupied by 
63.31 	residents whose primary diagnosis is mental illness and the license holder is certified under 
63.32 	the requirements in subdivision 6a or section 245D.33.
63.33 	(e) A resource need determination process, managed at the state level, using the available 
63.34 	reports required by section 144A.351, and other data and information shall be used to 
63.35 	determine where the reduced capacity requireddetermined under paragraph (c) section 
64.1 	256B.493 will be implemented. The commissioner shall consult with the stakeholders 
64.2 	described in section 144A.351, and employ a variety of methods to improve the state's 
64.3 	capacity to meet the informed decisions of those people who want to move out of corporate 
64.4 	foster care or community residential settings, long-term care service needs within budgetary 
64.5 	limits, including seeking proposals from service providers or lead agencies to change service 
64.6 	type, capacity, or location to improve services, increase the independence of residents, and 
64.7 	better meet needs identified by the long-term care services and supports reports and statewide 
64.8 	data and information. By February 1, 2013, and August 1, 2014, and each following year, 
64.9 	the commissioner shall provide information and data on the overall capacity of licensed 
64.10 	long-term care services, actions taken under this subdivision to manage statewide long-term 
64.11 	care services and supports resources, and any recommendations for change to the legislative 
64.12 	committees with jurisdiction over health and human services budget.
64.13 	(f) At the time of application and reapplication for licensure, the applicant and the license 
64.14 	holder that are subject to the moratorium or an exclusion established in paragraph (a) are 
64.15 	required to inform the commissioner whether the physical location where the foster care 
64.16 	will be provided is or will be the primary residence of the license holder for the entire period 
64.17 	of licensure. If the primary residence of the applicant or license holder changes, the applicant 
64.18 	or license holder must notify the commissioner immediately. The commissioner shall print 
64.19 	on the foster care license certificate whether or not the physical location is the primary 
64.20 	residence of the license holder.
64.21 	(g) License holders of foster care homes identified under paragraph (f) that are not the 
64.22 	primary residence of the license holder and that also provide services in the foster care home 
64.23 	that are covered by a federally approved home and community-based services waiver, as 
64.24 	authorized under section 256B.0915, 256B.092, or 256B.49, must inform the human services 
64.25 	licensing division that the license holder provides or intends to provide these waiver-funded 
64.26 	services.
64.27 	(h) The commissioner may adjust capacity to address needs identified in section 
64.28 	144A.351. Under this authority, the commissioner may approve new licensed settings or 
64.29 	delicense existing settings. Delicensing of settings will be accomplished through a process 
64.30 	identified in section 256B.493. Annually, by August 1, the commissioner shall provide 
64.31 	information and data on capacity of licensed long-term services and supports, actions taken 
64.32 	under the subdivision to manage statewide long-term services and supports resources, and 
64.33 	any recommendations for change to the legislative committees with jurisdiction over the 
64.34 	health and human services budget.
65.1 	(i) The commissioner must notify a license holder when its corporate foster care or 
65.2 	community residential setting licensed beds are reduced under this section. The notice of 
65.3 	reduction of licensed beds must be in writing and delivered to the license holder by certified 
65.4 	mail or personal service. The notice must state why the licensed beds are reduced and must 
65.5 	inform the license holder of its right to request reconsideration by the commissioner. The 
65.6 	license holder's request for reconsideration must be in writing. If mailed, the request for 
65.7 	reconsideration must be postmarked and sent to the commissioner within 20 calendar days 
65.8 	after the license holder's receipt of the notice of reduction of licensed beds. If a request for 
65.9 	reconsideration is made by personal service, it must be received by the commissioner within 
65.10 	20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.
65.11 	(j) The commissioner shall not issue an initial license for children's residential treatment 
65.12 	services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter 
65.13 	for a program that Centers for Medicare and Medicaid Services would consider an institution 
65.14 	for mental diseases. Facilities that serve only private pay clients are exempt from the 
65.15 	moratorium described in this paragraph. The commissioner has the authority to manage 
65.16 	existing statewide capacity for children's residential treatment services subject to the 
65.17 	moratorium under this paragraph and may issue an initial license for such facilities if the 
65.18 	initial license would not increase the statewide capacity for children's residential treatment 
65.19 	services subject to the moratorium under this paragraph.

65.20 	Sec. 4. Minnesota Statutes 2016, section 245A.04, subdivision 14, is amended to read:
65.21 		Subd. 14.Policies and procedures for program administration required and 
65.22 	enforceable. (a) The license holder shall develop program policies and procedures necessary 
65.23 	to maintain compliance with licensing requirements under Minnesota Statutes and Minnesota 
65.24 	Rules.
65.25 	(b) The license holder shall:
65.26 	(1) provide training to program staff related to their duties in implementing the program's 
65.27 	policies and procedures developed under paragraph (a);
65.28 	(2) document the provision of this training; and
65.29 	(3) monitor implementation of policies and procedures by program staff.
65.30 	(c) The license holder shall keep program policies and procedures readily accessible to 
65.31 	staff and index the policies and procedures with a table of contents or another method 
65.32 	approved by the commissioner.
66.1 	(d) An adult foster care license holder that provides foster care services to a resident 
66.2 	under section 256B.0915 must annually provide a copy of the resident termination policy 
66.3 	under section 245A.11, subdivision 11, to a resident covered by the policy.

66.4 	Sec. 5. Minnesota Statutes 2016, section 245A.11, is amended by adding a subdivision to 
66.5 	read:
66.6 		Subd. 9.Adult foster care bedrooms. (a) A resident receiving services must have a 
66.7 	choice of roommate. Each roommate must consent in writing to sharing a bedroom with 
66.8 	one another. The license holder is responsible for notifying a resident of the resident's right 
66.9 	to request a change of roommate.
66.10 	(b) The license holder must provide a lock for each resident's bedroom door, unless 
66.11 	otherwise indicated for the resident's health, safety, or well-being. A restriction on the use 
66.12 	of the lock must be documented and justified in the resident's individual abuse prevention 
66.13 	plan required by sections 245A.65, subdivision 2, paragraph (b), and 626.557, subdivision 
66.14 	14.For a resident served under section 256B.0915, the case manager must be part of the 
66.15 	interdisciplinary team under section 245A.65, subdivision 2, paragraph (b).

66.16 	EFFECTIVE DATE. This section is effective the day following final enactment.

66.17 	Sec. 6. Minnesota Statutes 2016, section 245A.11, is amended by adding a subdivision to 
66.18 	read:
66.19 		Subd. 10.Adult foster care resident rights. (a) The license holder shall ensure that a 
66.20 	resident and a resident's legal representative are given, at admission:
66.21 	(1) an explanation and copy of the resident's rights specified in paragraph (b);
66.22 	(2) a written summary of the Vulnerable Adults Protection Act prepared by the 
66.23 	department; and
66.24 	(3) the name, address, and telephone number of the local agency to which a resident or 
66.25 	a resident's legal representative may submit an oral or written complaint.
66.26 	(b) Adult foster care resident rights include the right to:
66.27 	(1) have daily, private access to and use of a non-coin-operated telephone for local and 
66.28 	long-distance telephone calls made collect or paid for by the resident;
66.29 	(2) receive and send, without interference, uncensored, unopened mail or electronic 
66.30 	correspondence or communication;
67.1 	(3) have use of and free access to common areas in the residence and the freedom to 
67.2 	come and go from the residence at will;
67.3 	(4) have privacy for visits with the resident's spouse, next of kin, legal counsel, religious 
67.4 	adviser, or others, according to section 363A.09 of the Human Rights Act, including privacy 
67.5 	in the resident's bedroom;
67.6 	(5) keep, use, and access the resident's personal clothing and possessions as space permits, 
67.7 	unless this right infringes on the health, safety, or rights of another resident or household 
67.8 	member, including the right to access the resident's personal possessions at any time;
67.9 	(6) choose the resident's visitors and time of visits and participate in activities of 
67.10 	commercial, religious, political, and community groups without interference if the activities 
67.11 	do not infringe on the rights of another resident or household member;
67.12 	(7) if married, privacy for visits by the resident's spouse, and, if both spouses are residents 
67.13 	of the adult foster home, the residents have the right to share a bedroom and bed;
67.14 	(8) privacy, including use of the lock on the resident's bedroom door or unit door. A 
67.15 	resident's privacy must be respected by license holders, caregivers, household members, 
67.16 	and volunteers by knocking on the door of a resident's bedroom or bathroom and seeking 
67.17 	consent before entering, except in an emergency;
67.18 	(9) furnish and decorate the resident's bedroom or living unit;
67.19 	(10) engage in chosen activities and have an individual schedule supported by the license 
67.20 	holder that meets the resident's preferences;
67.21 	(11) freedom and support to access food at any time;
67.22 	(12) have personal, financial, service, health, and medical information kept private, and 
67.23 	be advised of disclosure of this information by the license holder;
67.24 	(13) access records and recorded information about the resident according to applicable 
67.25 	state and federal law, regulation, or rule;
67.26 	(14) be free from maltreatment;
67.27 	(15) be treated with courtesy and respect and receive respectful treatment of the resident's 
67.28 	property;
67.29 	(16) reasonable observance of cultural and ethnic practice and religion;
67.30 	(17) be free from bias and harassment regarding race, gender, age, disability, spirituality, 
67.31 	and sexual orientation;
68.1 	(18) be informed of and use the license holder's grievance policy and procedures, 
68.2 	including how to contact the highest level of authority in the program;
68.3 	(19) assert the resident's rights personally, or have the rights asserted by the resident's 
68.4 	family, authorized representative, or legal representative, without retaliation; and
68.5 	(20) give or withhold written informed consent to participate in any research or 
68.6 	experimental treatment.
68.7 	(c) A restriction of a resident's rights under paragraph (b), clauses (1) to (4), (6), (8), 
68.8 	(10), and (11), is allowed only if determined necessary to ensure the health, safety, and 
68.9 	well-being of the resident. Any restriction of a resident's right must be documented and 
68.10 	justified in the resident's individual abuse prevention plan required by sections 245A.65, 
68.11 	subdivision 2, paragraph (b) and 626.557, subdivision 14. For a resident served under section 
68.12 	256B.0915, the case manager must be part of the interdisciplinary team under section 
68.13 	245A.65, subdivision 2, paragraph (b). The restriction must be implemented in the least 
68.14 	restrictive manner necessary to protect the resident and provide support to reduce or eliminate 
68.15 	the need for the restriction.

68.16 	EFFECTIVE DATE. This section is effective the day following final enactment.

68.17 	Sec. 7. Minnesota Statutes 2016, section 245A.11, is amended by adding a subdivision to 
68.18 	read:
68.19 		Subd. 11.Adult foster care service termination for elderly waiver participants. (a) 
68.20 	This subdivision applies to foster care services for a resident served under section 256B.0915.
68.21 	(b) The foster care license holder must establish policies and procedures for service 
68.22 	termination that promote continuity of care and service coordination with the resident and 
68.23 	the case manager and with another licensed caregiver, if any, who also provides support to 
68.24 	the resident. The policy must include the requirements specified in paragraphs (c) to (h).
68.25 	(c) The license holder must allow a resident to remain in the program and cannot terminate 
68.26 	services unless:
68.27 	(1) the termination is necessary for the resident's health, safety, and well-being and the 
68.28 	resident's needs cannot be met in the facility;
68.29 	(2) the safety of the resident or another resident in the program is endangered and positive 
68.30 	support strategies were attempted and have not achieved and effectively maintained safety 
68.31 	for the resident or another resident in the program;
69.1 	(3) the health, safety, and well-being of the resident or another resident in the program 
69.2 	would otherwise be endangered;
69.3 	(4) the program was not paid for services;
69.4 	(5) the program ceases to operate; or
69.5 	(6) the resident was terminated by the lead agency from waiver eligibility.
69.6 	(d) Before giving notice of service termination, the license holder must document the 
69.7 	action taken to minimize or eliminate the need for termination. The action taken by the 
69.8 	license holder must include, at a minimum:
69.9 	(1) consultation with the resident's interdisciplinary team to identify and resolve issues 
69.10 	leading to a notice of service termination; and
69.11 	(2) a request to the case manager or other professional consultation or intervention 
69.12 	services to support the resident in the program. This requirement does not apply to a notice 
69.13 	of service termination issued under paragraph (c), clause (4) or (5).
69.14 	(e) If, based on the best interests of the resident, the circumstances at the time of notice 
69.15 	were such that the license holder was unable to take the action specified in paragraph (d), 
69.16 	the license holder must document the specific circumstances and the reason the license 
69.17 	holder was unable to take the action.
69.18 	(f) The license holder must notify the resident or the resident's legal representative and 
69.19 	the case manager in writing of the intended service termination. The notice must include:
69.20 	(1) the reason for the action;
69.21 	(2) except for service termination under paragraph (c), clause (4) or (5), a summary of 
69.22 	the action taken to minimize or eliminate the need for termination and the reason the action 
69.23 	failed to prevent the termination;
69.24 	(3) the resident's right to appeal the service termination under section 256.045, subdivision 
69.25 	3, paragraph (a); and
69.26 	(4) the resident's right to seek a temporary order staying the service termination according 
69.27 	to the procedures in section 256.045, subdivision 4a, or subdivision 6, paragraph (c).
69.28 	(g) Notice of the proposed service termination must be given at least 30 days before 
69.29 	terminating a resident's service.
69.30 	(h) After the resident receives the notice of service termination and before the services 
69.31 	are terminated, the license holder must:
70.1 	(1) work with the support team or expanded support team to develop reasonable 
70.2 	alternatives to support continuity of care and to protect the resident;
70.3 	(2) provide information requested by the resident or case manager; and
70.4 	(3) maintain information about the service termination, including the written notice of 
70.5 	service termination, in the resident's record.

70.6 	EFFECTIVE DATE. This section is effective the day following final enactment.

70.7 	Sec. 8. Minnesota Statutes 2016, section 245D.04, subdivision 3, is amended to read:
70.8 		Subd. 3.Protection-related rights. (a) A person's protection-related rights include the 
70.9 	right to:
70.10 	(1) have personal, financial, service, health, and medical information kept private, and 
70.11 	be advised of disclosure of this information by the license holder;
70.12 	(2) access records and recorded information about the person in accordance with 
70.13 	applicable state and federal law, regulation, or rule;
70.14 	(3) be free from maltreatment;
70.15 	(4) be free from restraint, time out, seclusion, restrictive intervention, or other prohibited 
70.16 	procedure identified in section 245D.06, subdivision 5, or successor provisions, except for: 
70.17 	(i) emergency use of manual restraint to protect the person from imminent danger to self 
70.18 	or others according to the requirements in section 245D.061 or successor provisions; or (ii) 
70.19 	the use of safety interventions as part of a positive support transition plan under section 
70.20 	245D.06, subdivision 8, or successor provisions;
70.21 	(5) receive services in a clean and safe environment when the license holder is the owner, 
70.22 	lessor, or tenant of the service site;
70.23 	(6) be treated with courtesy and respect and receive respectful treatment of the person's 
70.24 	property;
70.25 	(7) reasonable observance of cultural and ethnic practice and religion;
70.26 	(8) be free from bias and harassment regarding race, gender, age, disability, spirituality, 
70.27 	and sexual orientation;
70.28 	(9) be informed of and use the license holder's grievance policy and procedures, including 
70.29 	knowing how to contact persons responsible for addressing problems and to appeal under 
70.30 	section 256.045;
71.1 	(10) know the name, telephone number, and the Web site, e-mail, and street addresses 
71.2 	of protection and advocacy services, including the appropriate state-appointed ombudsman, 
71.3 	and a brief description of how to file a complaint with these offices;
71.4 	(11) assert these rights personally, or have them asserted by the person's family, 
71.5 	authorized representative, or legal representative, without retaliation;
71.6 	(12) give or withhold written informed consent to participate in any research or 
71.7 	experimental treatment;
71.8 	(13) associate with other persons of the person's choice;
71.9 	(14) personal privacy; and
71.10 	(15) engage in chosen activities.
71.11 	(b) For a person residing in a residential site licensed according to chapter 245A, or 
71.12 	where the license holder is the owner, lessor, or tenant of the residential service site, 
71.13 	protection-related rights also include the right to:
71.14 	(1) have daily, private access to and use of a non-coin-operated telephone for local calls 
71.15 	and long-distance calls made collect or paid for by the person;
71.16 	(2) receive and send, without interference, uncensored, unopened mail or electronic 
71.17 	correspondence or communication;
71.18 	(3) have use of and free access to common areas in the residence; and
71.19 	(4) privacy for visits with the person's spouse, next of kin, legal counsel, religious advisor
71.20 	adviser, or others, in accordance with section 363A.09 of the Human Rights Act, including 
71.21 	privacy in the person's bedroom.; and
71.22 	(5) have access to three nutritionally balanced meals and nutritious snacks between 
71.23 	meals each day.
71.24 	(c) Restriction of a person's rights under paragraph (a), clauses (13) to (15), or paragraph 
71.25 	(b) is allowed only if determined necessary to ensure the health, safety, and well-being of 
71.26 	the person. Any restriction of those rights must be documented in the person's coordinated 
71.27 	service and support plan or coordinated service and support plan addendum. The restriction 
71.28 	must be implemented in the least restrictive alternative manner necessary to protect the 
71.29 	person and provide support to reduce or eliminate the need for the restriction in the most 
71.30 	integrated setting and inclusive manner. The documentation must include the following 
71.31 	information:
72.1 	(1) the justification for the restriction based on an assessment of the person's vulnerability 
72.2 	related to exercising the right without restriction;
72.3 	(2) the objective measures set as conditions for ending the restriction;
72.4 	(3) a schedule for reviewing the need for the restriction based on the conditions for 
72.5 	ending the restriction to occur semiannually from the date of initial approval, at a minimum, 
72.6 	or more frequently if requested by the person, the person's legal representative, if any, and 
72.7 	case manager; and
72.8 	(4) signed and dated approval for the restriction from the person, or the person's legal 
72.9 	representative, if any. A restriction may be implemented only when the required approval 
72.10 	has been obtained. Approval may be withdrawn at any time. If approval is withdrawn, the 
72.11 	right must be immediately and fully restored.

72.12 	EFFECTIVE DATE. This section is effective the day following final enactment.

72.13 	Sec. 9. Minnesota Statutes 2016, section 256.045, subdivision 3, is amended to read:
72.14 		Subd. 3.State agency hearings. (a) State agency hearings are available for the following:
72.15 	(1) any person applying for, receiving or having received public assistance, medical 
72.16 	care, or a program of social services granted by the state agency or a county agency or the 
72.17 	federal Food Stamp Act whose application for assistance is denied, not acted upon with 
72.18 	reasonable promptness, or whose assistance is suspended, reduced, terminated, or claimed 
72.19 	to have been incorrectly paid;
72.20 	(2) any patient or relative aggrieved by an order of the commissioner under section 
72.21 	252.27;
72.22 	(3) a party aggrieved by a ruling of a prepaid health plan;
72.23 	(4) except as provided under chapter 245C, any individual or facility determined by a 
72.24 	lead investigative agency to have maltreated a vulnerable adult under section 626.557 after 
72.25 	they have exercised their right to administrative reconsideration under section 626.557;
72.26 	(5) any person whose claim for foster care payment according to a placement of the 
72.27 	child resulting from a child protection assessment under section 626.556 is denied or not 
72.28 	acted upon with reasonable promptness, regardless of funding source;
72.29 	(6) any person to whom a right of appeal according to this section is given by other 
72.30 	provision of law;
73.1 	(7) an applicant aggrieved by an adverse decision to an application for a hardship waiver 
73.2 	under section 256B.15;
73.3 	(8) an applicant aggrieved by an adverse decision to an application or redetermination 
73.4 	for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;
73.5 	(9) except as provided under chapter 245A, an individual or facility determined to have 
73.6 	maltreated a minor under section 626.556, after the individual or facility has exercised the 
73.7 	right to administrative reconsideration under section 626.556;
73.8 	(10) except as provided under chapter 245C, an individual disqualified under sections 
73.9 	245C.14 and 245C.15, following a reconsideration decision issued under section 245C.23, 
73.10 	on the basis of serious or recurring maltreatment; a preponderance of the evidence that the 
73.11 	individual has committed an act or acts that meet the definition of any of the crimes listed 
73.12 	in section 245C.15, subdivisions 1 to 4; or for failing to make reports required under section 
73.13 	626.556, subdivision 3, or 626.557, subdivision 3. Hearings regarding a maltreatment 
73.14 	determination under clause (4) or (9) and a disqualification under this clause in which the 
73.15 	basis for a disqualification is serious or recurring maltreatment, shall be consolidated into 
73.16 	a single fair hearing. In such cases, the scope of review by the human services judge shall 
73.17 	include both the maltreatment determination and the disqualification. The failure to exercise 
73.18 	the right to an administrative reconsideration shall not be a bar to a hearing under this section 
73.19 	if federal law provides an individual the right to a hearing to dispute a finding of 
73.20 	maltreatment;
73.21 	(11) any person with an outstanding debt resulting from receipt of public assistance, 
73.22 	medical care, or the federal Food Stamp Act who is contesting a setoff claim by the 
73.23 	Department of Human Services or a county agency. The scope of the appeal is the validity 
73.24 	of the claimant agency's intention to request a setoff of a refund under chapter 270A against 
73.25 	the debt;
73.26 	(12) a person issued a notice of service termination under section 245D.10, subdivision 
73.27 	3a, from residential supports and services as defined in section 245D.03, subdivision 1, 
73.28 	paragraph (c), clause (3), that is not otherwise subject to appeal under subdivision 4a; or
73.29 	(13) an individual disability waiver recipient based on a denial of a request for a rate 
73.30 	exception under section 256B.4914.; or
73.31 	(14) a person issued a notice of service termination under section 245A.11, subdivision 
73.32 	11, that is not otherwise subject to appeal under subdivision 4a.
74.1 	(b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or (10), 
74.2 	is the only administrative appeal to the final agency determination specifically, including 
74.3 	a challenge to the accuracy and completeness of data under section 13.04. Hearings requested 
74.4 	under paragraph (a), clause (4), apply only to incidents of maltreatment that occur on or 
74.5 	after October 1, 1995. Hearings requested by nursing assistants in nursing homes alleged 
74.6 	to have maltreated a resident prior to October 1, 1995, shall be held as a contested case 
74.7 	proceeding under the provisions of chapter 14. Hearings requested under paragraph (a), 
74.8 	clause (9), apply only to incidents of maltreatment that occur on or after July 1, 1997. A 
74.9 	hearing for an individual or facility under paragraph (a), clauses (4), (9), and (10), is only 
74.10 	available when there is no district court action pending. If such action is filed in district 
74.11 	court while an administrative review is pending that arises out of some or all of the events 
74.12 	or circumstances on which the appeal is based, the administrative review must be suspended 
74.13 	until the judicial actions are completed. If the district court proceedings are completed, 
74.14 	dismissed, or overturned, the matter may be considered in an administrative hearing.
74.15 	(c) For purposes of this section, bargaining unit grievance procedures are not an 
74.16 	administrative appeal.
74.17 	(d) The scope of hearings involving claims to foster care payments under paragraph (a), 
74.18 	clause (5), shall be limited to the issue of whether the county is legally responsible for a 
74.19 	child's placement under court order or voluntary placement agreement and, if so, the correct 
74.20 	amount of foster care payment to be made on the child's behalf and shall not include review 
74.21 	of the propriety of the county's child protection determination or child placement decision.
74.22 	(e) The scope of hearings under paragraph (a), clause clauses (12) and (14), shall be 
74.23 	limited to whether the proposed termination of services is authorized under section 245D.10, 
74.24 	subdivision 3a, paragraph (b), or 245A.11, subdivision 11, and whether the requirements 
74.25 	of section 245D.10, subdivision 3a, paragraph paragraphs (c) to (e), or 245A.11, subdivision 
74.26 	2a, paragraphs (d) to (f), were met. If the appeal includes a request for a temporary stay of 
74.27 	termination of services, the scope of the hearing shall also include whether the case 
74.28 	management provider has finalized arrangements for a residential facility, a program, or 
74.29 	services that will meet the assessed needs of the recipient by the effective date of the service 
74.30 	termination.
74.31 	(f) A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor 
74.32 	under contract with a county agency to provide social services is not a party and may not 
74.33 	request a hearing under this section, except if assisting a recipient as provided in subdivision 
74.34 	4.
75.1 	(g) An applicant or recipient is not entitled to receive social services beyond the services 
75.2 	prescribed under chapter 256M or other social services the person is eligible for under state 
75.3 	law.
75.4 	(h) The commissioner may summarily affirm the county or state agency's proposed 
75.5 	action without a hearing when the sole issue is an automatic change due to a change in state 
75.6 	or federal law.
75.7 	(i) Unless federal or Minnesota law specifies a different time frame in which to file an 
75.8 	appeal, an individual or organization specified in this section may contest the specified 
75.9 	action, decision, or final disposition before the state agency by submitting a written request 
75.10 	for a hearing to the state agency within 30 days after receiving written notice of the action, 
75.11 	decision, or final disposition, or within 90 days of such written notice if the applicant, 
75.12 	recipient, patient, or relative shows good cause, as defined in section 256.0451, subdivision 
75.13 	13, why the request was not submitted within the 30-day time limit. The individual filing 
75.14 	the appeal has the burden of proving good cause by a preponderance of the evidence.

75.15 	EFFECTIVE DATE. This section is effective the day following final enactment.

75.16 	Sec. 10. [256B.051] HOUSING SUPPORT SERVICES.
75.17 		Subdivision 1.Purpose. Housing support services are established to provide housing 
75.18 	support services to an individual with a disability that limits the individual's ability to obtain 
75.19 	or maintain stable housing. The services support an individual's transition to housing in the 
75.20 	community and increase long-term stability in housing, to avoid future periods of being at 
75.21 	risk of homelessness or institutionalization.
75.22 		Subd. 2.Definitions. (a) For the purposes of this section, the terms defined in this 
75.23 	subdivision have the meanings given.
75.24 	(b) "At-risk of homelessness" means (1) an individual that is faced with a  set of 
75.25 	circumstances likely to cause the individual to become homeless, or (2) an individual 
75.26 	previously homeless, who will be discharged from a correctional, medical, mental health, 
75.27 	or treatment center, who lacks sufficient resources to pay for housing and does not have a 
75.28 	permanent place to live.
75.29 	(c) "Commissioner" means the commissioner of human services.
75.30 	(d) "Homeless" means an individual or family lacking a fixed, adequate nighttime 
75.31 	residence.
75.32 	(e) "Individual with a disability" means:
76.1 	(1) an individual who is aged, blind, or disabled as determined by the criteria used by 
76.2 	the title 11 program of the Social Security Act, United States Code, title 42, section 416, 
76.3 	paragraph (i), item (1); or
76.4 	(2) an individual who meets a category of eligibility under section 256D.05, subdivision 
76.5 	1, paragraph (a), clauses (1), (3), (5) to (9), or (14).
76.6 	(f) "Institution" means a setting as defined in section 256B.0621, subdivision 2, clause 
76.7 	(3), and the Minnesota Security Hospital as defined in section 253.20.
76.8 		Subd. 3.Eligibility. An individual with a disability is eligible for housing support services 
76.9 	if the individual:
76.10 	(1) is 18 years of age or older;
76.11 	(2) is enrolled in medical assistance;
76.12 	(3) has an assessment of functional need that determines a need for services due to 
76.13 	limitations caused by the individual's disability;
76.14 	(4) resides in or plans to transition to a community-based setting as defined in Code of 
76.15 	Federal Regulations, title 42, section 441.301(c); and
76.16 	(5) has housing instability evidenced by:
76.17 	(i) being homeless or at-risk of homelessness;
76.18 	(ii) being in the process of transitioning from, or having transitioned in the past six 
76.19 	months from, an institution or licensed or registered setting;
76.20 	(iii) being eligible for waiver services under section 256B.0915, 256B.092, or 256B.49; 
76.21 	or
76.22 	(iv) having been identified by a long-term care consultation under section 256B.0911 
76.23 	as at risk of institutionalization.
76.24 		Subd. 4.Assessment requirements. (a) An individual's assessment of functional need 
76.25 	must be conducted by one of the following methods:
76.26 	(1) an assessor according to the criteria established in section 256B.0911, subdivision 
76.27 	3a, using a format established by the commissioner;
76.28 	(2) documented need for services as verified by a professional statement of need as 
76.29 	defined in section 256I.03, subdivision 12; or
77.1 	(3) according to the continuum of care coordinated assessment system established in 
77.2 	Code of Federal Regulations, title 24, section 578.3, using a format established by the 
77.3 	commissioner.
77.4 	(b) An individual must be reassessed within one year of initial assessment, and annually 
77.5 	thereafter.
77.6 		Subd. 5.Housing support services. (a) Housing support services include housing 
77.7 	transition services and housing and tenancy sustaining services.
77.8 	(b) Housing transition services are defined as:
77.9 	(1) tenant screening and housing assessment;
77.10 	(2) assistance with the housing search and application process;
77.11 	(3) identifying resources to cover onetime moving expenses;
77.12 	(4) ensuring a new living arrangement is safe and ready for move-in;
77.13 	(5) assisting in arranging for and supporting details of a move; and
77.14 	(6) developing a housing support crisis plan.
77.15 	(c) Housing and tenancy sustaining services include:
77.16 	(1) prevention and early identification of behaviors that may jeopardize continued stable 
77.17 	housing;
77.18 	(2) education and training on roles, rights, and responsibilities of the tenant and the 
77.19 	property manager;
77.20 	(3) coaching to develop and maintain key relationships with property managers and 
77.21 	neighbors;
77.22 	(4) advocacy and referral to community resources to prevent eviction when housing is 
77.23 	at risk;
77.24 	(5) assistance with housing recertification process;
77.25 	(6) coordination with the tenant to regularly review, update, and modify housing support 
77.26 	and crisis plan; and
77.27 	(7) continuing training on being a good tenant, lease compliance, and household 
77.28 	management.
77.29 	(d) A housing support service may include person-centered planning for people who are 
77.30 	not eligible to receive person-centered planning through any other service, if the 
78.1 	person-centered planning is provided by a consultation service provider that is under contract 
78.2 	with the department and enrolled as a Minnesota health care program.
78.3 		Subd. 6.Provider qualifications and duties. A provider eligible for reimbursement 
78.4 	under this section shall:
78.5 	(1) enroll as a medical assistance Minnesota health care program provider and meet all 
78.6 	applicable provider standards and requirements;
78.7 	(2) demonstrate compliance with federal and state laws and policies for housing support 
78.8 	services as determined by the commissioner;
78.9 	(3) comply with background study requirements under chapter 245C and maintain 
78.10 	documentation of background study requests and results; and
78.11 	(4) directly provide housing support services and not use a subcontractor or reporting 
78.12 	agent.
78.13 		Subd. 7.Housing support supplemental service rates. Supplemental service rates for 
78.14 	individuals in settings according to sections 144D.025, 256I.04, subdivision 3, paragraph 
78.15 	(a), clause (3), and 256I.05, subdivision 1g, shall be reduced by one-half over a two-year 
78.16 	period. This reduction only applies to supplemental service rates for individuals eligible for 
78.17 	housing support services under this section.

78.18 	EFFECTIVE DATE. (a) Subdivisions 1 to 6 are contingent upon federal approval. The 
78.19 	commissioner of human services shall notify the revisor of statutes when federal approval 
78.20 	is obtained.
78.21 	(b) Subdivision 7 is contingent upon federal approval of subdivisions 1 to 6. The 
78.22 	commissioner of human services shall notify the revisor of statutes when federal approval 
78.23 	is obtained.

78.24 	Sec. 11. Minnesota Statutes 2016, section 256B.0911, subdivision 3a, is amended to read:
78.25 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, services 
78.26 	planning, or other assistance intended to support community-based living, including persons 
78.27 	who need assessment in order to determine waiver or alternative care program eligibility, 
78.28 	must be visited by a long-term care consultation team within 20 calendar days after the date 
78.29 	on which an assessment was requested or recommended. Upon statewide implementation 
78.30 	of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person 
78.31 	requesting personal care assistance services and home care nursing. The commissioner shall 
79.1 	provide at least a 90-day notice to lead agencies prior to the effective date of this requirement. 
79.2 	Face-to-face assessments must be conducted according to paragraphs (b) to (i).
79.3 	(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified 
79.4 	assessors to conduct the assessment. For a person with complex health care needs, a public 
79.5 	health or registered nurse from the team must be consulted.
79.6 	(c) The MnCHOICES assessment provided by the commissioner to lead agencies must 
79.7 	be used to complete a comprehensive, person-centered assessment. The assessment must 
79.8 	include the health, psychological, functional, environmental, and social needs of the 
79.9 	individual necessary to develop a community support plan that meets the individual's needs 
79.10 	and preferences.
79.11 	(d) The assessment must be conducted in a face-to-face interview with the person being 
79.12 	assessed and the person's legal representative. At the request of the person, other individuals 
79.13 	may participate in the assessment to provide information on the needs, strengths, and 
79.14 	preferences of the person necessary to develop a community support plan that ensures the 
79.15 	person's health and safety. Except for legal representatives or family members invited by 
79.16 	the person, persons participating in the assessment may not be a provider of service or have 
79.17 	any financial interest in the provision of services. For persons who are to be assessed for 
79.18 	elderly waiver customized living services under section 256B.0915, with the permission of 
79.19 	the person being assessed or the person's designated or legal representative, the client's 
79.20 	current or proposed provider of services may submit a copy of the provider's nursing 
79.21 	assessment or written report outlining its recommendations regarding the client's care needs. 
79.22 	The person conducting the assessment must notify the provider of the date by which this 
79.23 	information is to be submitted. This information shall be provided to the person conducting 
79.24 	the assessment prior to the assessment. For a person who is to be assessed for waiver services 
79.25 	under section 256B.092 or 256B.49, with the permission of the person being assessed or 
79.26 	the person's designated legal representative, the person's current provider of services may 
79.27 	submit a written report outlining recommendations regarding the person's care needs prepared 
79.28 	by a direct service employee with at least 20 hours of service to that client. The person 
79.29 	conducting the assessment or reassessment must notify the provider of the date by which 
79.30 	this information is to be submitted. This information shall be provided to the person 
79.31 	conducting the assessment and the person or the person's legal representative, and must be 
79.32 	considered prior to the finalization of the assessment or reassessment.
79.33 	(e) The person or the person's legal representative must be provided with a written 
79.34 	community support plan within 40 calendar days of the assessment visit, regardless of 
80.1 	whether the individual is eligible for Minnesota health care programs. The written community 
80.2 	support plan must include:
80.3 	(1) a summary of assessed needs as defined in paragraphs (c) and (d);
80.4 	(2) the individual's options and choices to meet identified needs, including all available 
80.5 	options for case management services and providers;
80.6 	(3) identification of health and safety risks and how those risks will be addressed, 
80.7 	including personal risk management strategies;
80.8 	(4) referral information; and
80.9 	(5) informal caregiver supports, if applicable.
80.10 	For a person determined eligible for state plan home care under subdivision 1a, paragraph 
80.11 	(b), clause (1), the person or person's representative must also receive a copy of the home 
80.12 	care service plan developed by the certified assessor.
80.13 	(f) A person may request assistance in identifying community supports without 
80.14 	participating in a complete assessment. Upon a request for assistance identifying community 
80.15 	support, the person must be transferred or referred to long-term care options counseling 
80.16 	services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for 
80.17 	telephone assistance and follow up.
80.18 	(g) The person has the right to make the final decision between institutional placement 
80.19 	and community placement after the recommendations have been provided, except as provided 
80.20 	in section 256.975, subdivision 7a, paragraph (d).
80.21 	(h) The lead agency must give the person receiving assessment or support planning, or 
80.22 	the person's legal representative, materials, and forms supplied by the commissioner 
80.23 	containing the following information:
80.24 	(1) written recommendations for community-based services and consumer-directed 
80.25 	options;
80.26 	(2) documentation that the most cost-effective alternatives available were offered to the 
80.27 	individual. For purposes of this clause, "cost-effective" means community services and 
80.28 	living arrangements that cost the same as or less than institutional care. For an individual 
80.29 	found to meet eligibility criteria for home and community-based service programs under 
80.30 	section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally 
80.31 	approved waiver plan for each program;
81.1 	(3) the need for and purpose of preadmission screening conducted by long-term care 
81.2 	options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects 
81.3 	nursing facility placement. If the individual selects nursing facility placement, the lead 
81.4 	agency shall forward information needed to complete the level of care determinations and 
81.5 	screening for developmental disability and mental illness collected during the assessment 
81.6 	to the long-term care options counselor using forms provided by the commissioner;
81.7 	(4) the role of long-term care consultation assessment and support planning in eligibility 
81.8 	determination for waiver and alternative care programs, and state plan home care, case 
81.9 	management, and other services as defined in subdivision 1a, paragraphs (a), clause (6), 
81.10 	and (b);
81.11 	(5) information about Minnesota health care programs;
81.12 	(6) the person's freedom to accept or reject the recommendations of the team;
81.13 	(7) the person's right to confidentiality under the Minnesota Government Data Practices 
81.14 	Act, chapter 13;
81.15 	(8) the certified assessor's decision regarding the person's need for institutional level of 
81.16 	care as determined under criteria established in subdivision 4e and the certified assessor's 
81.17 	decision regarding eligibility for all services and programs as defined in subdivision 1a, 
81.18 	paragraphs (a), clause (6), and (b); and
81.19 	(9) the person's right to appeal the certified assessor's decision regarding eligibility for 
81.20 	all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and 
81.21 	(8), and (b), and incorporating the decision regarding the need for institutional level of care 
81.22 	or the lead agency's final decisions regarding public programs eligibility according to section 
81.23 	256.045, subdivision 3.
81.24 	(i) Face-to-face assessment completed as part of eligibility determination for the 
81.25 	alternative care, elderly waiver, community access for disability inclusion, community 
81.26 	alternative care, and brain injury waiver programs under sections 256B.0913, 256B.0915, 
81.27 	and 256B.49 is valid to establish service eligibility for no more than 60 calendar days after 
81.28 	the date of assessment.
81.29 	(j) The effective eligibility start date for programs in paragraph (i) can never be prior to 
81.30 	the date of assessment. If an assessment was completed more than 60 days before the 
81.31 	effective waiver or alternative care program eligibility start date, assessment and support 
81.32 	plan information must be updated and documented in the department's Medicaid Management 
81.33 	Information System (MMIS). Notwithstanding retroactive medical assistance coverage of 
82.1 	state plan services, the effective date of eligibility for programs included in paragraph (i) 
82.2 	cannot be prior to the date the most recent updated assessment is completed.
82.3 	(k) At the time of reassessment, the certified assessor shall assess each person receiving 
82.4 	waiver services currently residing in a community residential setting, or licensed adult foster 
82.5 	care home that is not the primary residence of the license holder, or in which the license 
82.6 	holder is not the primary caregiver, to determine if that person would prefer to be served in 
82.7 	a community-living settings as defined in section 256B.49, subdivision 23. The certified 
82.8 	assessor shall offer the person, through a person-centered planning process, the option to 
82.9 	receive alternative housing and service options.

82.10 	Sec. 12. Minnesota Statutes 2016, section 256B.0915, subdivision 1, is amended to read:
82.11 		Subdivision 1.Authority. (a) The commissioner is authorized to apply for a home and 
82.12 	community-based services waiver for the elderly, authorized under section 1915(c) of the 
82.13 	Social Security Act, in order to obtain federal financial participation to expand the availability 
82.14 	of services for persons who are eligible for medical assistance. The commissioner may 
82.15 	apply for additional waivers or pursue other federal financial participation which is 
82.16 	advantageous to the state for funding home care services for the frail elderly who are eligible 
82.17 	for medical assistance. The provision of waivered services to elderly and disabled medical 
82.18 	assistance recipients must comply with the criteria for service definitions and provider 
82.19 	standards approved in the waiver.
82.20 	(b) The commissioner shall comply with the requirements in the federally approved 
82.21 	transition plan for the home and community-based services waivers authorized under this 
82.22 	section.

82.23 	EFFECTIVE DATE. This section is effective the day following final enactment.

82.24 	Sec. 13. Minnesota Statutes 2016, section 256B.092, subdivision 4, is amended to read:
82.25 		Subd. 4.Home and community-based services for developmental disabilities. (a) 
82.26 	The commissioner shall make payments to approved vendors participating in the medical 
82.27 	assistance program to pay costs of providing home and community-based services, including 
82.28 	case management service activities provided as an approved home and community-based 
82.29 	service, to medical assistance eligible persons with developmental disabilities who have 
82.30 	been screened under subdivision 7 and according to federal requirements. Federal 
82.31 	requirements include those services and limitations included in the federally approved 
82.32 	application for home and community-based services for persons with developmental 
82.33 	disabilities and subsequent amendments.
83.1 	(b) Effective July 1, 1995, contingent upon federal approval and state appropriations 
83.2 	made available for this purpose, and in conjunction with Laws 1995, chapter 207, article 8, 
83.3 	section 40, the commissioner of human services shall allocate resources to county agencies 
83.4 	for home and community-based waivered services for persons with developmental disabilities 
83.5 	authorized but not receiving those services as of June 30, 1995, based upon the average 
83.6 	resource need of persons with similar functional characteristics. To ensure service continuity 
83.7 	for service recipients receiving home and community-based waivered services for persons 
83.8 	with developmental disabilities prior to July 1, 1995, the commissioner shall make available 
83.9 	to the county of financial responsibility home and community-based waivered services 
83.10 	resources based upon fiscal year 1995 authorized levels.
83.11 	(c) Home and community-based resources for all recipients shall be managed by the 
83.12 	county of financial responsibility within an allowable reimbursement average established 
83.13 	for each county. Payments for home and community-based services provided to individual 
83.14 	recipients shall not exceed amounts authorized by the county of financial responsibility. 
83.15 	For specifically identified former residents of nursing facilities, the commissioner shall be 
83.16 	responsible for authorizing payments and payment limits under the appropriate home and 
83.17 	community-based service program. Payment is available under this subdivision only for 
83.18 	persons who, if not provided these services, would require the level of care provided in an 
83.19 	intermediate care facility for persons with developmental disabilities.
83.20 	(d) The commissioner shall comply with the requirements in the federally approved 
83.21 	transition plan for the home and community-based services waivers for the elderly authorized 
83.22 	under this section.

83.23 	EFFECTIVE DATE. This section is effective the day following final enactment.

83.24 	Sec. 14. Minnesota Statutes 2016, section 256B.49, subdivision 11, is amended to read:
83.25 		Subd. 11.Authority. (a) The commissioner is authorized to apply for home and 
83.26 	community-based service waivers, as authorized under section 1915(c) of the Social Security 
83.27 	Act to serve persons under the age of 65 who are determined to require the level of care 
83.28 	provided in a nursing home and persons who require the level of care provided in a hospital. 
83.29 	The commissioner shall apply for the home and community-based waivers in order to:
83.30 	(1) promote the support of persons with disabilities in the most integrated settings;
83.31 	(2) expand the availability of services for persons who are eligible for medical assistance;
83.32 	(3) promote cost-effective options to institutional care; and
83.33 	(4) obtain federal financial participation.
84.1 	(b) The provision of waivered services to medical assistance recipients with disabilities 
84.2 	shall comply with the requirements outlined in the federally approved applications for home 
84.3 	and community-based services and subsequent amendments, including provision of services 
84.4 	according to a service plan designed to meet the needs of the individual. For purposes of 
84.5 	this section, the approved home and community-based application is considered the necessary 
84.6 	federal requirement.
84.7 	(c) The commissioner shall provide interested persons serving on agency advisory 
84.8 	committees, task forces, the Centers for Independent Living, and others who request to be 
84.9 	on a list to receive, notice of, and an opportunity to comment on, at least 30 days before 
84.10 	any effective dates, (1) any substantive changes to the state's disability services program 
84.11 	manual, or (2) changes or amendments to the federally approved applications for home and 
84.12 	community-based waivers, prior to their submission to the federal Centers for Medicare 
84.13 	and Medicaid Services.
84.14 	(d) The commissioner shall seek approval, as authorized under section 1915(c) of the 
84.15 	Social Security Act, to allow medical assistance eligibility under this section for children 
84.16 	under age 21 without deeming of parental income or assets.
84.17 	(e) The commissioner shall seek approval, as authorized under section 1915(c) of the 
84.18 	Social Act, to allow medical assistance eligibility under this section for individuals under 
84.19 	age 65 without deeming the spouse's income or assets.
84.20 	(f) The commissioner shall comply with the requirements in the federally approved 
84.21 	transition plan for the home and community-based services waivers authorized under this 
84.22 	section.

84.23 	EFFECTIVE DATE. This section is effective the day following final enactment.

84.24 	Sec. 15. Minnesota Statutes 2016, section 256B.49, subdivision 15, is amended to read:
84.25 		Subd. 15.Coordinated service and support plan; comprehensive transitional service 
84.26 	plan; maintenance service plan. (a) Each recipient of home and community-based waivered 
84.27 	services shall be provided a copy of the written coordinated service and support plan which 
84.28 	meets the requirements in section 256B.092, subdivision 1b.
84.29 	(b) In developing the comprehensive transitional service plan, the individual receiving 
84.30 	services, the case manager, and the guardian, if applicable, will identify the transitional 
84.31 	service plan fundamental service outcome and anticipated timeline to achieve this outcome. 
84.32 	Within the first 20 days following a recipient's request for an assessment or reassessment, 
84.33 	the transitional service planning team must be identified. A team leader must be identified 
85.1 	who will be responsible for assigning responsibility and communicating with team members 
85.2 	to ensure implementation of the transition plan and ongoing assessment and communication 
85.3 	process. The team leader should be an individual, such as the case manager or guardian, 
85.4 	who has the opportunity to follow the recipient to the next level of service.
85.5 	Within ten days following an assessment, a comprehensive transitional service plan must 
85.6 	be developed incorporating elements of a comprehensive functional assessment and including 
85.7 	short-term measurable outcomes and timelines for achievement of and reporting on these 
85.8 	outcomes. Functional milestones must also be identified and reported according to the 
85.9 	timelines agreed upon by the transitional service planning team. In addition, the 
85.10 	comprehensive transitional service plan must identify additional supports that may assist 
85.11 	in the achievement of the fundamental service outcome such as the development of greater 
85.12 	natural community support, increased collaboration among agencies, and technological 
85.13 	supports.
85.14 	The timelines for reporting on functional milestones will prompt a reassessment of 
85.15 	services provided, the units of services, rates, and appropriate service providers. It is the 
85.16 	responsibility of the transitional service planning team leader to review functional milestone 
85.17 	reporting to determine if the milestones are consistent with observable skills and that 
85.18 	milestone achievement prompts any needed changes to the comprehensive transitional 
85.19 	service plan.
85.20 	For those whose fundamental transitional service outcome involves the need to procure 
85.21 	housing, a plan for the recipient to seek the resources necessary to secure the least restrictive 
85.22 	housing possible should be incorporated into the plan, including employment and public 
85.23 	supports such as housing access and shelter needy funding.
85.24 	(c) Counties and other agencies responsible for funding community placement and 
85.25 	ongoing community supportive services are responsible for the implementation of the 
85.26 	comprehensive transitional service plans. Oversight responsibilities include both ensuring 
85.27 	effective transitional service delivery and efficient utilization of funding resources.
85.28 	(d) Following one year of transitional services, the transitional services planning team 
85.29 	will make a determination as to whether or not the individual receiving services requires 
85.30 	the current level of continuous and consistent support in order to maintain the recipient's 
85.31 	current level of functioning. Recipients who are determined to have not had a significant 
85.32 	change in functioning for 12 months must move from a transitional to a maintenance service 
85.33 	plan. Recipients on a maintenance service plan must be reassessed to determine if the 
85.34 	recipient would benefit from a transitional service plan at least every 12 months and at other 
86.1 	times when there has been a significant change in the recipient's functioning. This assessment 
86.2 	should consider any changes to technological or natural community supports.
86.3 	(e) When a county is evaluating denials, reductions, or terminations of home and 
86.4 	community-based services under this section for an individual, the case manager shall offer 
86.5 	to meet with the individual or the individual's guardian in order to discuss the prioritization 
86.6 	of service needs within the coordinated service and support plan, comprehensive transitional 
86.7 	service plan, or maintenance service plan. The reduction in the authorized services for an 
86.8 	individual due to changes in funding for waivered services may not exceed the amount 
86.9 	needed to ensure medically necessary services to meet the individual's health, safety, and 
86.10 	welfare.
86.11 	(f) At the time of reassessment, local agency case managers shall assess each recipient 
86.12 	of community access for disability inclusion or brain injury waivered services currently 
86.13 	residing in a licensed adult foster home that is not the primary residence of the license 
86.14 	holder, or in which the license holder is not the primary caregiver, to determine if that 
86.15 	recipient could appropriately be served in a community-living setting. If appropriate for the 
86.16 	recipient, the case manager shall offer the recipient, through a person-centered planning 
86.17 	process, the option to receive alternative housing and service options. In the event that the 
86.18 	recipient chooses to transfer from the adult foster home, the vacated bed shall not be filled 
86.19 	with another recipient of waiver services and group residential housing and the licensed 
86.20 	capacity shall be reduced accordingly, unless the savings required by the licensed bed closure 
86.21 	reductions under Laws 2011, First Special Session chapter 9, article 7, sections 1 and 40, 
86.22 	paragraph (f), for foster care settings where the physical location is not the primary residence 
86.23 	of the license holder are met through voluntary changes described in section 245A.03, 
86.24 	subdivision 7, paragraph (e), or as provided under paragraph (a), clauses (3) and (4). If the 
86.25 	adult foster home becomes no longer viable due to these transfers, the county agency, with 
86.26 	the assistance of the department, shall facilitate a consolidation of settings or closure. This 
86.27 	reassessment process shall be completed by July 1, 2013.

86.28 	Sec. 16. Minnesota Statutes 2016, section 256B.493, subdivision 1, is amended to read:
86.29 		Subdivision 1.Commissioner's duties; report. The commissioner of human services 
86.30 	shall solicit proposals for the conversion of services provided for persons with disabilities 
86.31 	in settings licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, or community 
86.32 	residential settings licensed under chapter 245D, to other types of community settings in 
86.33 	conjunction with the closure of identified licensed adult foster care settings has the authority 
86.34 	to manage statewide licensed corporate foster care or community residential settings capacity, 
87.1 	including the reduction and realignment of licensed capacity of a current foster care or 
87.2 	community residential settings to accomplish the consolidation or closure of settings. The 
87.3 	commissioner shall implement a program for planned closure of licensed corporate adult 
87.4 	foster care or community residential settings, necessary as a preferred method to: (1) respond 
87.5 	to the informed decisions of those individuals who want to move out of these settings into 
87.6 	other types of community settings; and (2) achieve necessary budgetary savings required 
87.7 	in section 245A.03, subdivision 7, paragraphs (c) and (d).

87.8 	Sec. 17. Minnesota Statutes 2016, section 256B.493, subdivision 2, is amended to read:
87.9 		Subd. 2.Planned closure process needs determination. The commissioner shall 
87.10 	announce and implement a program for planned closure of adult foster care homes. Planned 
87.11 	closure shall be the preferred method for achieving necessary budgetary savings required 
87.12 	by the licensed bed closure budget reduction in section 245A.03, subdivision 7, paragraph 
87.13 	(c). If additional closures are required to achieve the necessary savings, the commissioner 
87.14 	shall use the process and priorities in section 245A.03, subdivision 7, paragraph (c) A 
87.15 	resource need determination process, managed at the state level, using available reports 
87.16 	required by section 144A.351 and other data and information shall be used by the 
87.17 	commissioner to align capacity where needed.

87.18 	Sec. 18. Minnesota Statutes 2016, section 256B.493, is amended by adding a subdivision 
87.19 	to read:
87.20 		Subd. 2a.Closure process. (a) The commissioner shall work with stakeholders to 
87.21 	establish a process for the application, review, approval, and implementation of setting 
87.22 	closures. Voluntary proposals from license holders for consolidation and closure of adult 
87.23 	foster care or community residential settings are encouraged. Whether voluntary or 
87.24 	involuntary, all closure plans must include:
87.25 	(1) a description of the proposed closure plan, identifying the home or homes and 
87.26 	occupied beds;
87.27 	(2) the proposed timetable for the proposed closure, including the proposed dates for 
87.28 	notification to people living there and the affected lead agencies, commencement of closure, 
87.29 	and completion of closure;
87.30 	(3) the proposed relocation plan jointly developed by the counties of financial 
87.31 	responsibility, the people living there and their legal representatives, if any, who wish to 
87.32 	continue to receive services from the provider, and the providers for current residents of 
87.33 	any adult foster care home designated for closure; and
88.1 	(4) documentation from the provider in a format approved by the commissioner that all 
88.2 	the adult foster care homes or community residential settings receiving a planned closure 
88.3 	rate adjustment under the plan have accepted joint and severable for recovery of 
88.4 	overpayments under section 256B.0641, subdivision 2, for the facilities designated for 
88.5 	closure under this plan.
88.6 	(b) The commissioner shall give first priority to closure plans which:
88.7 	(1) target counties and geographic areas which have:
88.8 	(i) need for other types of services;
88.9 	(ii) need for specialized services;
88.10 	(iii) higher than average per capita use of licensed corporate foster care or community 
88.11 	residential settings; or
88.12 	(iv) residents not living in the geographic area of their choice;
88.13 	(2) demonstrate savings of medical assistance expenditures; and
88.14 	(3) demonstrate that alternative services are based on the recipient's choice of provider 
88.15 	and are consistent with federal law, state law, and federally approved waiver plans.
88.16 	The commissioner shall also consider any information provided by people using services, 
88.17 	their legal representatives, family members, or the lead agency on the impact of the planned 
88.18 	closure on people and the services they need.
88.19 	(c) For each closure plan approved by the commissioner, a contract must be established 
88.20 	between the commissioner, the counties of financial responsibility, and the participating 
88.21 	license holder.

88.22 	Sec. 19. Minnesota Statutes 2016, section 256D.44, subdivision 4, as amended by Laws 
88.23 	2017, chapter 59, section 12, is amended to read:
88.24 		Subd. 4.Temporary absence due to illness. For the purposes of this subdivision, "home" 
88.25 	means a residence owned or rented by a recipient or the recipient's spouse. Home does not 
88.26 	include a group residential housing facility. Assistance payments for recipients who are 
88.27 	temporarily absent from their home due to hospitalization for illness must continue at the 
88.28 	same level of payment during their absence if the following criteria are met:
88.29 	(1) a physician, advanced practice registered nurse, or physician assistant certifies that 
88.30 	the absence is not expected to continue for more than three months;
89.1 	(2) a physician, advanced practice registered nurse, or physician assistant certifies that 
89.2 	the recipient will be able to return to independent living; and
89.3 	(3) the recipient has expenses associated with maintaining a residence in the community.

89.4 	Sec. 20. Minnesota Statutes 2016, section 256D.44, subdivision 5, as amended by Laws 
89.5 	2017, chapter 40, article 1, section 84, and Laws 2017, chapter 59, section 13, is amended 
89.6 	to read:
89.7 		Subd. 5.Special needs. (a) In addition to the state standards of assistance established 
89.8 	in subdivisions 1 to 4, payments are allowed for the following special needs of recipients 
89.9 	of Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 
89.10 	center, or a group residential setting authorized to receive housing facility support payments 
89.11 	under chapter 256I.
89.12 	(a) (b) The county agency shall pay a monthly allowance for medically prescribed diets 
89.13 	if the cost of those additional dietary needs cannot be met through some other maintenance 
89.14 	benefit. The need for special diets or dietary items must be prescribed by a licensed physician, 
89.15 	advanced practice registered nurse, or physician assistant. Costs for special diets shall be 
89.16 	determined as percentages of the allotment for a one-person household under the thrifty 
89.17 	food plan as defined by the United States Department of Agriculture. The types of diets and 
89.18 	the percentages of the thrifty food plan that are covered are as follows:
89.19 	(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
89.20 	(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent of 
89.21 	thrifty food plan;
89.22 	(3) controlled protein diet, less than 40 grams and requires special products, 125 percent 
89.23 	of thrifty food plan;
89.24 	(4) low cholesterol diet, 25 percent of thrifty food plan;
89.25 	(5) high residue diet, 20 percent of thrifty food plan;
89.26 	(6) pregnancy and lactation diet, 35 percent of thrifty food plan;
89.27 	(7) gluten-free diet, 25 percent of thrifty food plan;
89.28 	(8) lactose-free diet, 25 percent of thrifty food plan;
89.29 	(9) antidumping diet, 15 percent of thrifty food plan;
89.30 	(10) hypoglycemic diet, 15 percent of thrifty food plan; or
89.31 	(11) ketogenic diet, 25 percent of thrifty food plan.
90.1 	(b) (c) Payment for nonrecurring special needs must be allowed for necessary home 
90.2 	repairs or necessary repairs or replacement of household furniture and appliances using the 
90.3 	payment standard of the AFDC program in effect on July 16, 1996, for these expenses, as 
90.4 	long as other funding sources are not available.
90.5 	(c) (d) A fee for guardian or conservator service is allowed at a reasonable rate negotiated 
90.6 	by the county or approved by the court. This rate shall not exceed five percent of the 
90.7 	assistance unit's gross monthly income up to a maximum of $100 per month. If the guardian 
90.8 	or conservator is a member of the county agency staff, no fee is allowed.
90.9 	(d) (e) The county agency shall continue to pay a monthly allowance of $68 for restaurant 
90.10 	meals for a person who was receiving a restaurant meal allowance on June 1, 1990, and 
90.11 	who eats two or more meals in a restaurant daily. The allowance must continue until the 
90.12 	person has not received Minnesota supplemental aid for one full calendar month or until 
90.13 	the person's living arrangement changes and the person no longer meets the criteria for the 
90.14 	restaurant meal allowance, whichever occurs first.
90.15 	(e) (f) A fee of ten percent of the recipient's gross income or $25, whichever is less, is 
90.16 	allowed for representative payee services provided by an agency that meets the requirements 
90.17 	under SSI regulations to charge a fee for representative payee services. This special need 
90.18 	is available to all recipients of Minnesota supplemental aid regardless of their living 
90.19 	arrangement.
90.20 	(f) (g)(1) Notwithstanding the language in this subdivision, an amount equal to one-half 
90.21 	of the maximum allotment authorized by the federal Food Stamp Program for a federal 
90.22 	Supplemental Security Income payment amount for a single individual which is in effect 
90.23 	on the first day of July of each year will be added to the standards of assistance established 
90.24 	in subdivisions 1 to 4 for adults under the age of 65 who qualify as shelter needy in need 
90.25 	of housing assistance and are:
90.26 	(i) relocating from an institution, a setting authorized to receive housing support under 
90.27 	chapter 256I, or an adult mental health residential treatment program under section 
90.28 	256B.0622; or
90.29 	(ii) eligible for personal care assistance under section 256B.0659; or
90.30 	(iii) home and community-based waiver recipients living in their own home or rented 
90.31 	or leased apartment.
90.32 	(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the shelter 
90.33 	needy benefit under this paragraph is considered a household of one. An eligible individual 
91.1 	who receives this benefit prior to age 65 may continue to receive the benefit after the age 
91.2 	of 65.
91.3 	(3) "Shelter needy Housing assistance" means that the assistance unit incurs monthly 
91.4 	shelter costs that exceed 40 percent of the assistance unit's gross income before the application 
91.5 	of this special needs standard. "Gross income" for the purposes of this section is the 
91.6 	applicant's or recipient's income as defined in section 256D.35, subdivision 10, or the 
91.7 	standard specified in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient 
91.8 	of a federal or state housing subsidy, that limits shelter costs to a percentage of gross income, 
91.9 	shall not be considered shelter needy in need of housing assistance for purposes of this 
91.10 	paragraph.

91.11 	EFFECTIVE DATE. Paragraphs (a) to (f) are effective July 1, 2017. Paragraph (g), 
91.12 	clause (1), is effective July 1, 2020, except paragraph (g), clause (1), items (ii) and (iii), are 
91.13 	effective July 1, 2017.

91.14 	Sec. 21. Minnesota Statutes 2016, section 256I.03, subdivision 8, is amended to read:
91.15 		Subd. 8.Supplementary services. "Supplementary services" means housing support 
91.16 	services provided to residents of group residential housing providers individuals in addition 
91.17 	to room and board including, but not limited to, oversight and up to 24-hour supervision, 
91.18 	medication reminders, assistance with transportation, arranging for meetings and 
91.19 	appointments, and arranging for medical and social services.

91.20 	Sec. 22. Minnesota Statutes 2016, section 256I.04, subdivision 1, is amended to read:
91.21 		Subdivision 1.Individual eligibility requirements. An individual is eligible for and 
91.22 	entitled to a group residential housing support payment to be made on the individual's behalf 
91.23 	if the agency has approved the individual's residence in a group residentialsetting where 
91.24 	the individual will receive housing settingsupport and the individual meets the requirements 
91.25 	in paragraph (a) or, (b), or (c).
91.26 	(a) The individual is aged, blind, or is over 18 years of age and disabled as determined 
91.27 	under the criteria used by the title II program of the Social Security Act, and meets the 
91.28 	resource restrictions and standards of section 256P.02, and the individual's countable income 
91.29 	after deducting the (1) exclusions and disregards of the SSI program, (2) the medical 
91.30 	assistance personal needs allowance under section 256B.35, and (3) an amount equal to the 
91.31 	income actually made available to a community spouse by an elderly waiver participant 
91.32 	under the provisions of sections 256B.0575, paragraph (a), clause (4), and 256B.058, 
92.1 	subdivision 2, is less than the monthly rate specified in the agency's agreement with the 
92.2 	provider of group residential housing support in which the individual resides.
92.3 	(b) The individual meets a category of eligibility under section 256D.05, subdivision 1, 
92.4 	paragraph (a), clauses (1), (3), (5) to (9), and (14), and paragraph (b), if applicable, and the 
92.5 	individual's resources are less than the standards specified by section 256P.02, and the 
92.6 	individual's countable income as determined under section 256P.06, less the medical 
92.7 	assistance personal needs allowance under section 256B.35 is less than the monthly rate 
92.8 	specified in the agency's agreement with the provider of group residential housing support 
92.9 	in which the individual resides.
92.10 	(c) The individual receives licensed residential crisis stabilization services under section 
92.11 	256B.0624, subdivision 7, and is receiving medical assistance. The individual may receive 
92.12 	concurrent housing support payments if receiving licensed residential crisis stabilization 
92.13 	services under section 256B.0624, subdivision 7.

92.14 	EFFECTIVE DATE. Paragraph (c) is effective October 1, 2017.

92.15 	Sec. 23. Minnesota Statutes 2016, section 256I.04, subdivision 2d, is amended to read:
92.16 		Subd. 2d.Conditions of payment; commissioner's right to suspend or terminate 
92.17 	agreement. (a) Group residential Housing or supplementary services support must be 
92.18 	provided to the satisfaction of the commissioner, as determined at the sole discretion of the 
92.19 	commissioner's authorized representative, and in accordance with all applicable federal, 
92.20 	state, and local laws, ordinances, rules, and regulations, including business registration 
92.21 	requirements of the Office of the Secretary of State. A provider shall not receive payment 
92.22 	for room and board or supplementary services or housing found by the commissioner to be 
92.23 	performed or provided in violation of federal, state, or local law, ordinance, rule, or 
92.24 	regulation.
92.25 	(b) The commissioner has the right to suspend or terminate the agreement immediately 
92.26 	when the commissioner determines the health or welfare of the housing or service recipients 
92.27 	is endangered, or when the commissioner has reasonable cause to believe that the provider 
92.28 	has breached a material term of the agreement under subdivision 2b.
92.29 	(c) Notwithstanding paragraph (b), if the commissioner learns of a curable material 
92.30 	breach of the agreement by the provider, the commissioner shall provide the provider with 
92.31 	a written notice of the breach and allow ten days to cure the breach. If the provider does 
92.32 	not cure the breach within the time allowed, the provider shall be in default of the agreement 
92.33 	and the commissioner may terminate the agreement immediately thereafter. If the provider 
93.1 	has breached a material term of the agreement and cure is not possible, the commissioner 
93.2 	may immediately terminate the agreement.

93.3 	Sec. 24. Minnesota Statutes 2016, section 256I.04, subdivision 2g, is amended to read:
93.4 		Subd. 2g.Crisis shelters. Secure crisis shelters for battered women and their children 
93.5 	designated by the Minnesota Department of Corrections are not group residences eligible 
93.6 	for housing support under this chapter.

93.7 	Sec. 25. Minnesota Statutes 2016, section 256I.04, subdivision 3, is amended to read:
93.8 		Subd. 3.Moratorium on development of group residential housing support beds.
 93.9 	(a) Agencies shall not enter into agreements for new group residential housing support beds 
93.10 	with total rates in excess of the MSA equivalent rate except:
93.11 	(1) for group residential housing establishments licensed under chapter 245D provided 
93.12 	the facility is needed to meet the census reduction targets for persons with developmental 
93.13 	disabilities at regional treatment centers;
93.14 	(2) up to 80 beds in a single, specialized facility located in Hennepin County that will 
93.15 	provide housing for chronic inebriates who are repetitive users of detoxification centers and 
93.16 	are refused placement in emergency shelters because of their state of intoxication, and 
93.17 	planning for the specialized facility must have been initiated before July 1, 1991, in 
93.18 	anticipation of receiving a grant from the Housing Finance Agency under section 462A.05, 
93.19 	subdivision 20a, paragraph (b);
93.20 	(3) notwithstanding the provisions of subdivision 2a, for up to 190226 supportive 
93.21 	housing units in Anoka, Dakota, Hennepin, or Ramsey County for homeless adults with a 
93.22 	mental illness, a history of substance abuse, or human immunodeficiency virus or acquired 
93.23 	immunodeficiency syndrome. For purposes of this section, "homeless adult" means a person 
93.24 	who is living on the street or in a shelter or discharged from a regional treatment center, 
93.25 	community hospital, or residential treatment program and has no appropriate housing 
93.26 	available and lacks the resources and support necessary to access appropriate housing. At 
93.27 	least 70 percent of the supportive housing units must serve homeless adults with mental 
93.28 	illness, substance abuse problems, or human immunodeficiency virus or acquired 
93.29 	immunodeficiency syndrome who are about to be or, within the previous six months, has 
93.30 	been discharged from a regional treatment center, or a state-contracted psychiatric bed in 
93.31 	a community hospital, or a residential mental health or chemical dependency treatment 
93.32 	program. If a person meets the requirements of subdivision 1, paragraph (a), and receives 
93.33 	a federal or state housing subsidy, the group residential housing support rate for that person 
94.1 	is limited to the supplementary rate under section 256I.05, subdivision 1a, and is determined 
94.2 	by subtracting the amount of the person's countable income that exceeds the MSA equivalent 
94.3 	rate from the group residential housing support supplementary service rate. A resident in a 
94.4 	demonstration project site who no longer participates in the demonstration program shall 
94.5 	retain eligibility for a group residential housing support payment in an amount determined 
94.6 	under section 256I.06, subdivision 8, using the MSA equivalent rate. Service funding under 
94.7 	section 256I.05, subdivision 1a, will end June 30, 1997, if federal matching funds are 
94.8 	available and the services can be provided through a managed care entity. If federal matching 
94.9 	funds are not available, then service funding will continue under section 256I.05, subdivision 
94.10 	1a;
94.11 	(4) for an additional two beds, resulting in a total of 32 beds, for a facility located in 
94.12 	Hennepin County providing services for recovering and chemically dependent men that has 
94.13 	had a group residential housing support contract with the county and has been licensed as 
94.14 	a board and lodge facility with special services since 1980;
94.15 	(5) for a group residential housing support provider located in the city of St. Cloud, or 
94.16 	a county contiguous to the city of St. Cloud, that operates a 40-bed facility, that received 
94.17 	financing through the Minnesota Housing Finance Agency Ending Long-Term Homelessness 
94.18 	Initiative and serves chemically dependent clientele, providing 24-hour-a-day supervision;
94.19 	(6) for a new 65-bed facility in Crow Wing County that will serve chemically dependent 
94.20 	persons, operated by a group residential housing support provider that currently operates a 
94.21 	304-bed facility in Minneapolis, and a 44-bed facility in Duluth;
94.22 	(7) for a group residential housing support provider that operates two ten-bed facilities, 
94.23 	one located in Hennepin County and one located in Ramsey County, that provide community 
94.24 	support and 24-hour-a-day supervision to serve the mental health needs of individuals who 
94.25 	have chronically lived unsheltered; and
94.26 	(8) for a group residential facility authorized for recipients of housing support in Hennepin 
94.27 	County with a capacity of up to 48 beds that has been licensed since 1978 as a board and 
94.28 	lodging facility and that until August 1, 2007, operated as a licensed chemical dependency 
94.29 	treatment program.
94.30 	(b) An agency may enter into a group residential housing support agreement for beds 
94.31 	with rates in excess of the MSA equivalent rate in addition to those currently covered under 
94.32 	a group residential housing support agreement if the additional beds are only a replacement 
94.33 	of beds with rates in excess of the MSA equivalent rate which have been made available 
94.34 	due to closure of a setting, a change of licensure or certification which removes the beds 
95.1 	from group residential housing support payment, or as a result of the downsizing of a group 
95.2 	residential housing setting authorized for recipients of housing support. The transfer of 
95.3 	available beds from one agency to another can only occur by the agreement of both agencies.

95.4 	Sec. 26. Minnesota Statutes 2016, section 256I.05, subdivision 1a, is amended to read:
95.5 		Subd. 1a.Supplementary service rates. (a) Subject to the provisions of section 256I.04, 
95.6 	subdivision 3, the county agency may negotiate a payment not to exceed $426.37 for other 
95.7 	services necessary to provide room and board provided by the group residence if the residence 
95.8 	is licensed by or registered by the Department of Health, or licensed by the Department of 
95.9 	Human Services to provide services in addition to room and board, and if the provider of 
95.10 	services is not also concurrently receiving funding for services for a recipient under a home 
95.11 	and community-based waiver under title XIX of the Social Security Act; or funding from 
95.12 	the medical assistance program under section 256B.0659, for personal care services for 
95.13 	residents in the setting; or residing in a setting which receives funding under section 245.73. 
95.14 	If funding is available for other necessary services through a home and community-based 
95.15 	waiver, or personal care services under section 256B.0659, then the GRH housing support
95.16 	rate is limited to the rate set in subdivision 1. Unless otherwise provided in law, in no case 
95.17 	may the supplementary service rate exceed $426.37. The registration and licensure 
95.18 	requirement does not apply to establishments which are exempt from state licensure because 
95.19 	they are located on Indian reservations and for which the tribe has prescribed health and 
95.20 	safety requirements. Service payments under this section may be prohibited under rules to 
95.21 	prevent the supplanting of federal funds with state funds. The commissioner shall pursue 
95.22 	the feasibility of obtaining the approval of the Secretary of Health and Human Services to 
95.23 	provide home and community-based waiver services under title XIX of the Social Security 
95.24 	Act for residents who are not eligible for an existing home and community-based waiver 
95.25 	due to a primary diagnosis of mental illness or chemical dependency and shall apply for a 
95.26 	waiver if it is determined to be cost-effective.
95.27 	(b) The commissioner is authorized to make cost-neutral transfers from the GRH housing 
95.28 	support fund for beds under this section to other funding programs administered by the 
95.29 	department after consultation with the county or counties in which the affected beds are 
95.30 	located. The commissioner may also make cost-neutral transfers from the GRH housing 
95.31 	support fund to county human service agencies for beds permanently removed from the 
95.32 	GRH housing support census under a plan submitted by the county agency and approved 
95.33 	by the commissioner. The commissioner shall report the amount of any transfers under this 
95.34 	provision annually to the legislature.
96.1 	(c) Counties must not negotiate supplementary service rates with providers of group 
96.2 	residential housing support that are licensed as board and lodging with special services and 
96.3 	that do not encourage a policy of sobriety on their premises and make referrals to available 
96.4 	community services for volunteer and employment opportunities for residents.

96.5 	Sec. 27. Minnesota Statutes 2016, section 256I.05, subdivision 1c, is amended to read:
96.6 		Subd. 1c.Rate increases. An agency may not increase the rates negotiated for group 
96.7 	residential housing support above those in effect on June 30, 1993, except as provided in 
96.8 	paragraphs (a) to (f).
96.9 	(a) An agency may increase the rates for group residential housing settings room and 
96.10 	board to the MSA equivalent rate for those settings whose current rate is below the MSA 
96.11 	equivalent rate.
96.12 	(b) An agency may increase the rates for residents in adult foster care whose difficulty 
96.13 	of care has increased. The total group residential housing support rate for these residents 
96.14 	must not exceed the maximum rate specified in subdivisions 1 and 1a. Agencies must not 
96.15 	include nor increase group residential housing difficulty of care rates for adults in foster 
96.16 	care whose difficulty of care is eligible for funding by home and community-based waiver 
96.17 	programs under title XIX of the Social Security Act.
96.18 	(c) The room and board rates will be increased each year when the MSA equivalent rate 
96.19 	is adjusted for SSI cost-of-living increases by the amount of the annual SSI increase, less 
96.20 	the amount of the increase in the medical assistance personal needs allowance under section 
96.21 	256B.35.
96.22 	(d) When a group residential housing rate is used to pay support pays for an individual's 
96.23 	room and board, or other costs necessary to provide room and board, the rate payable to the 
96.24 	residence must continue for up to 18 calendar days per incident that the person is temporarily 
96.25 	absent from the residence, not to exceed 60 days in a calendar year, if the absence or absences 
96.26 	have received the prior approval of the county agency's social service staff. Prior approval 
96.27 	is not required for emergency absences due to crisis, illness, or injury.
96.28 	(e) For facilities meeting substantial change criteria within the prior year. Substantial 
96.29 	change criteria exists if the group residential housing establishment experiences a 25 percent 
96.30 	increase or decrease in the total number of its beds, if the net cost of capital additions or 
96.31 	improvements is in excess of 15 percent of the current market value of the residence, or if 
96.32 	the residence physically moves, or changes its licensure, and incurs a resulting increase in 
96.33 	operation and property costs.
97.1 	(f) Until June 30, 1994, an agency may increase by up to five percent the total rate paid 
97.2 	for recipients of assistance under sections 256D.01 to 256D.21 or 256D.33 to 256D.54 who 
97.3 	reside in residences that are licensed by the commissioner of health as a boarding care home, 
97.4 	but are not certified for the purposes of the medical assistance program. However, an increase 
97.5 	under this clause must not exceed an amount equivalent to 65 percent of the 1991 medical 
97.6 	assistance reimbursement rate for nursing home resident class A, in the geographic grouping 
97.7 	in which the facility is located, as established under Minnesota Rules, parts 9549.0051 to 
97.8 	9549.0058.

97.9 	Sec. 28. Minnesota Statutes 2016, section 256I.05, subdivision 1e, is amended to read:
97.10 		Subd. 1e.Supplementary rate for certain facilities. (a) Notwithstanding the provisions 
97.11 	of subdivisions 1a and 1c, beginning July 1, 2005, a county agency shall negotiate a 
97.12 	supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 per 
97.13 	month, including any legislatively authorized inflationary adjustments, for a group residential
97.14 	housing support provider that:
97.15 	(1) is located in Hennepin County and has had a group residential housing support 
97.16 	contract with the county since June 1996;
97.17 	(2) operates in three separate locations a 75-bed facility, a 50-bed facility, and a 26-bed 
97.18 	facility; and
97.19 	(3) serves a chemically dependent clientele, providing 24 hours per day supervision and 
97.20 	limiting a resident's maximum length of stay to 13 months out of a consecutive 24-month 
97.21 	period.
97.22 	(b) Notwithstanding subdivisions 1a and 1c, a county agency shall negotiate a 
97.23 	supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 per 
97.24 	month, including any legislatively authorized inflationary adjustments, of a group residential
97.25 	housing support provider that:
97.26 	(1) is located in St. Louis County and has had a group residential housing support contract 
97.27 	with the county since 2006;
97.28 	(2) operates a 62-bed facility; and
97.29 	(3) serves a chemically dependent adult male clientele, providing 24 hours per day 
97.30 	supervision and limiting a resident's maximum length of stay to 13 months out of a 
97.31 	consecutive 24-month period.
98.1 	(c) Notwithstanding subdivisions 1a and 1c, beginning July 1, 2013, a county agency 
98.2 	shall negotiate a supplementary rate in addition to the rate specified in subdivision 1, not 
98.3 	to exceed $700 per month, including any legislatively authorized inflationary adjustments, 
98.4 	for the group residential provider described under paragraphs (a) and (b), not to exceed an 
98.5 	additional 115 beds.

98.6 	Sec. 29. Minnesota Statutes 2016, section 256I.05, subdivision 1j, is amended to read:
98.7 		Subd. 1j.Supplementary rate for certain facilities; Crow Wing County.
 98.8 	Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, 2007, a county 
98.9 	agency shall negotiate a supplementary rate in addition to the rate specified in subdivision 
98.10 	1, not to exceed $700 per month, including any legislatively authorized inflationary 
98.11 	adjustments, for a new 65-bed facility in Crow Wing County that will serve chemically 
98.12 	dependent persons operated by a group residential housing support provider that currently 
98.13 	operates a 304-bed facility in Minneapolis and a 44-bed facility in Duluth which opened in 
98.14 	January of 2006.

98.15 	Sec. 30. Minnesota Statutes 2016, section 256I.05, subdivision 1m, is amended to read:
98.16 		Subd. 1m.Supplemental rate for certain facilities; Hennepin and Ramsey Counties.
 98.17 	(a) Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency 
98.18 	shall negotiate a supplemental service rate in addition to the rate specified in subdivision 
98.19 	1, not to exceed $700 per monththe maximum rate in subdivision 1a or the existing monthly 
98.20 	rate, whichever is higher, including any legislatively authorized inflationary adjustments, 
98.21 	for a group residential housing support provider that operates two ten-bed facilities, one 
98.22 	located in Hennepin County and one located in Ramsey County, which provide community 
98.23 	support and serve the mental health needs of individuals who have chronically lived 
98.24 	unsheltered, providing 24-hour-per-day supervision.
98.25 	(b) An individual who has lived in one of the facilities under paragraph (a), who is being 
98.26 	transitioned to independent living as part of the program plan continues to be eligible for 
98.27 	group residential housing and the supplemental service rate negotiated with the county under 
98.28 	paragraph (a).

98.29 	Sec. 31. Minnesota Statutes 2016, section 256I.05, is amended by adding a subdivision 
98.30 	to read:
98.31 		Subd. 1p.Supplementary rate; St. Louis County. Notwithstanding the provisions of 
98.32 	subdivisions 1a and 1c, beginning July 1, 2017, a county agency shall negotiate a 
99.1 	supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 per 
99.2 	month, including any legislatively authorized inflationary adjustments, for a housing support 
99.3 	provider that:
99.4 	(1) is located in St. Louis County and has had a housing support contract with the county 
99.5 	since July 2016;
99.6 	(2) operates a 35-bed facility;
99.7 	(3) serves women who are chemically dependent, mentally ill, or both;
99.8 	(4) provides 24-hour per day supervision;
99.9 	(5) provides on-site support with skilled professionals, including a licensed practical 
99.10 	nurse, registered nurses, peer specialists, and resident counselors; and
99.11 	(6) provides independent living skills training and assistance with family reunification.

99.12 	Sec. 32. Minnesota Statutes 2016, section 256I.05, is amended by adding a subdivision 
99.13 	to read:
99.14 		Subd. 1q.Supplemental rate; Olmsted County. Notwithstanding the provisions of 
99.15 	subdivisions 1a and 1c, beginning July 1, 2017, a county agency shall negotiate a 
99.16 	supplementary rate in addition to the rate specified in subdivision 1, not to exceed $750 per 
99.17 	month, including any legislatively authorized inflationary adjustments, for a housing support 
99.18 	provider located in Olmsted County that operates long-term residential facilities with a total 
99.19 	of 104 beds that serve chemically dependent men and women and provide 24-hour-a-day 
99.20 	supervision and other support services.

99.21 	Sec. 33. Minnesota Statutes 2016, section 256I.05, is amended by adding a subdivision 
99.22 	to read:
99.23 		Subd. 1r.Supplemental rate; Anoka County. Notwithstanding the provisions in this 
99.24 	section, a county agency shall negotiate a supplemental rate for 42 beds in addition to the 
99.25 	rate specified in subdivision 1, not to exceed the maximum rate allowed under subdivision 
99.26 	1a, including any legislatively authorized inflationary adjustments, for a housing support 
99.27 	provider that is located in Anoka County and provides emergency housing on the former 
99.28 	Anoka Regional Treatment Center campus.

100.1 	Sec. 34. Minnesota Statutes 2016, section 256I.05, is amended by adding a subdivision 
100.2 	to read:
100.3 		Subd. 11.Transfer of emergency shelter funds. (a) The commissioner shall make a 
100.4 	cost-neutral transfer of funding from the housing support fund to county human service 
100.5 	agencies for emergency shelter beds removed from the housing support census under a 
100.6 	biennial plan submitted by the county and approved by the commissioner. The plan must 
100.7 	describe: (1) anticipated and actual outcomes for persons experiencing homelessness in 
100.8 	emergency shelters; (2) improved efficiencies in administration; (3) requirements for 
100.9 	individual eligibility; and (4) plans for quality assurance monitoring and quality assurance 
100.10 	outcomes. The commissioner shall review the county plan to monitor implementation and 
100.11 	outcomes at least biennially, and more frequently if the commissioner deems necessary.
100.12 	(b) The funding under paragraph (a) may be used for the provision of room and board 
100.13 	or supplemental services according to section 256I.03, subdivisions 2 and 8. Providers must 
100.14 	meet the requirements of section 256I.04, subdivisions 2a to 2f. Funding must be allocated 
100.15 	annually, and the room and board portion of the allocation shall be adjusted according to 
100.16 	the percentage change in the housing support room and board rate. The room and board 
100.17 	portion of the allocation shall be determined at the time of transfer. The commissioner or 
100.18 	county may return beds to the housing support fund with 180 days' notice, including financial 
100.19 	reconciliation.

100.20 	EFFECTIVE DATE. This section is effective July 1, 2017.

100.21 	Sec. 35. Minnesota Statutes 2016, section 256I.06, subdivision 2, is amended to read:
100.22 		Subd. 2.Time of payment. A county agency may make payments to a group residence
100.23 	in advance for an individual whose stay in the group residence is expected to last beyond 
100.24 	the calendar month for which the payment is made. Group residential Housing support
100.25 	payments made by a county agency on behalf of an individual who is not expected to remain 
100.26 	in the group residence beyond the month for which payment is made must be made 
100.27 	subsequent to the individual's departure from the group residence.

100.28 	EFFECTIVE DATE. This section is effective July 1, 2017.

100.29 	Sec. 36. Minnesota Statutes 2016, section 256I.06, subdivision 8, is amended to read:
100.30 		Subd. 8.Amount of group residential housing support payment. (a) The amount of 
100.31 	a group residential housing room and board payment to be made on behalf of an eligible 
100.32 	individual is determined by subtracting the individual's countable income under section 
101.1 	256I.04, subdivision 1, for a whole calendar month from the group residential housing 
101.2 	charge room and board rate for that same month. The group residential housing charge
101.3 	support payment is determined by multiplying the group residential housing support rate 
101.4 	times the period of time the individual was a resident or temporarily absent under section 
101.5 	256I.05, subdivision 1c, paragraph (d).
101.6 	(b) For an individual with earned income under paragraph (a), prospective budgeting 
101.7 	must be used to determine the amount of the individual's payment for the following six-month 
101.8 	period. An increase in income shall not affect an individual's eligibility or payment amount 
101.9 	until the month following the reporting month. A decrease in income shall be effective the 
101.10 	first day of the month after the month in which the decrease is reported.
101.11 	(c) For an individual who receives licensed residential crisis stabilization services under 
101.12 	section 256B.0624, subdivision 7, the amount of housing support payment is determined 
101.13 	by multiplying the housing support rate times the period of time the individual was a resident.

101.14 	EFFECTIVE DATE. Paragraph (c) is effective October 1, 2017.

101.15 	Sec. 37. [256I.09] COMMUNITY LIVING INFRASTRUCTURE.
101.16 	The commissioner shall award grants to agencies through an annual competitive process. 
101.17 	Grants awarded under this section may be used for: (1) outreach to locate and engage people 
101.18 	who are homeless or residing in segregated settings to screen for basic needs and assist with 
101.19 	referral to community living resources; (2) building capacity to provide technical assistance 
101.20 	and consultation on housing and related support service resources for persons with both 
101.21 	disabilities and low income; or (3) streamlining the administration and monitoring activities 
101.22 	related to housing support funds. Agencies may collaborate and submit a joint application 
101.23 	for funding under this section.

101.24 	Sec. 38. GROUP RESIDENTIAL HOUSING; HOUSING SUPPORT SERVICES 
101.25 	PLAN TO REVIEW SUPPLEMENTAL SERVICE RATES.
 101.26 	(a) Since 1993, group residential housing supplementary service rates have been 
101.27 	established in statute without a standard rate setting methodology, nor information about 
101.28 	or an analysis of the actual cost the provider will sustain to provide the services. There are 
101.29 	approximately 200 providers that receive more than 65 different monthly supplemental rates 
101.30 	ranging from $44 to $5,000. Further, there are wide discrepancies between the services that 
101.31 	are provided for the supplemental rate payment.
102.1 	(b) The commissioner of human services shall develop: (1) a plan to review all 
102.2 	supplemental rates over a sufficient time period, to be determined by the commissioner; (2) 
102.3 	a process to modify the rate if it is either inadequate or excessive; and (3) a process to review 
102.4 	supplemental rates prospectively, so the legislature has the foundation necessary in which 
102.5 	to make a decision as to whether to approve the request for a supplemental rate. The 
102.6 	information must be provided in a report to the senate and house of representatives 
102.7 	committees with jurisdiction over group residential housing issues, along with proposed 
102.8 	legislation to effectuate the plan and processes and a fiscal estimate by December 1, 2018.

102.9 	Sec. 39. REVISOR'S INSTRUCTION.
 102.10 	In each section of Minnesota Statutes referred to in column A, the revisor of statutes 
102.11 	shall change the phrase in column B to the phrase in column C. The revisor may make 
102.12 	technical and other necessary changes to sentence structure to preserve the meaning of the 
102.13 	text. The revisor shall make other changes in chapter titles; section, subdivision, part, and 
102.14 	subpart headnotes; and in other terminology necessary as a result of the enactment of this 
102.15 	section.

102.16	Column A
	Column B
	Column C
	
102.17102.18	144A.071, subdivision 4d
	group residential housing
	housing support under chapter 
256I
	
102.19102.20	201.061, subdivision 3
	group residential housing
	setting authorized to provide 
housing support
	
102.21102.22102.23	244.052, subdivision 4c
	group residential housing 
facility
	licensed setting authorized to 
provide housing support 
under section 256I.04
	
102.24102.25	245.466, subdivision 7
	under group residential 
housing
	by housing support under 
chapter 256I
	
102.26	245.466, subdivision 7
	from group residential housing
	from housing support
	
102.27102.28	245.4661, subdivision 6
	group residential housing
	housing support under chapter 
256I
	
102.29102.30	245C.10, subdivision 11
	group residential housing or 
supplementary services
	housing support
	
102.31102.32	256.01, subdivision 18
	group residential housing
	housing support under chapter 
256I
	
102.33	256.017, subdivision 1
	group residential housing
	housing support
	
102.34102.35	256.98, subdivision 8
	group residential housing
	housing support under chapter 
256I
	
102.36102.37	256B.49, subdivision 15
	group residential housing
	housing support under chapter 
256I
	
102.38102.39	256B.4914, subdivision 10
	group residential housing rate 
3 costs
	housing support rate 3 costs 
under chapter 256I
	
103.1	256B.501, subdivision 4b
	group residential housing
	housing support
	
103.2103.3
103.4	256B.77, subdivision 12
	residential services covered 
under the group residential 
housing program
	housing support services 
under chapter 256I
	
103.5103.6	256D.44, subdivision 2
	group residential housing 
facility
	setting authorized to provide 
housing support
	
103.7103.8	256G.01, subdivision 3
	group residential housing
	housing support under chapter 
256I
	
103.9	256I.01
	Group Residential Housing
	Housing Support
	
103.10	256I.02
	Group Residential Housing
	Housing Support
	
103.11	256I.03, subdivision 2
	"Group residential housing"
	"Room and board"
	
103.12	256I.03, subdivision 2
	Group residential housing
	The room and board
	
103.13	256I.03, subdivision 3
	"Group residential housing"
	"Housing support"
	
103.14	256I.03, subdivision 6
	group residential housing
	room and board
	
103.15	256I.03, subdivisions 7 and 9
	group residential housing
	housing support
	
103.16
103.17	256I.04, subdivisions 1a, 1b, 
1c, and 2
	group residential housing
	housing support
	
103.18103.19	256I.04, subdivision 2a
	provide group residential 
housing
	provide housing support
	
103.20103.21	256I.04, subdivision 2a
	of group residential housing 
or supplementary services
	of housing support
	
103.22103.23	256I.04, subdivision 2a
	complete group residential 
housing
	complete housing support
	
103.24103.25	256I.04, subdivision 2b
	group residential housing or 
supplementary services
	housing support
	
103.26103.27	256I.04, subdivision 2b
	provision of group residential 
housing
	provision of housing support
	
103.28103.29	256I.04, subdivision 2c
	group residential housing or 
supplementary services
	housing support
	
103.30103.31	256I.04, subdivision 2e
	group residential housing or 
supplementary services
	housing support
	
103.32103.33	256I.04, subdivision 4
	group residential housing 
payment for room and board
	room and board rate
	
103.34103.35	256I.05, subdivision 1
	living in group residential 
housing
	receiving housing support
	
103.36
103.37	256I.05, subdivisions 1h, 1k, 
1l, 7b, and 7c
	group residential housing
	housing support
	
103.38	256I.05, subdivision 2
	group residential housing
	room and board
	
103.39	256I.05, subdivision 3
	group residential housing
	room and board
	
103.40103.41	256I.05, subdivision 6
	reside in group residential 
housing
	receive housing support
	
103.42
103.43	256I.06, subdivisions 1, 3, 4, 
and 6
	group residential housing
	housing support
	
103.44	256I.06, subdivision 7
	group residential housing
	the housing support
	
104.1	256I.08
	group residential housing
	housing support
	
104.2	256P.03, subdivision 1
	group residential housing
	housing support
	
104.3	256P.05, subdivision 1
	group residential housing
	housing support
	
104.4	256P.07, subdivision 1
	group residential housing
	housing support
	
104.5	256P.08, subdivision 1
	group residential housing
	housing support
	
104.6104.7	290A.03, subdivision 8
	accepts group residential 
housing
	accepts housing support
	
104.8104.9	290A.03, subdivision 8
	the group residential housing 
program
	the housing support program

104.10 	ARTICLE 3
104.11 	CONTINUING CARE

104.12 	Section 1. Minnesota Statutes 2016, section 144.0724, subdivision 4, is amended to read:
104.13 		Subd. 4.Resident assessment schedule. (a) A facility must conduct and electronically 
104.14 	submit to the commissioner of health MDS assessments that conform with the assessment 
104.15 	schedule defined by Code of Federal Regulations, title 42, section 483.20, and published 
104.16 	by the United States Department of Health and Human Services, Centers for Medicare and 
104.17 	Medicaid Services, in the Long Term Care Assessment Instrument User's Manual, version 
104.18 	3.0, and subsequent updates when issued by the Centers for Medicare and Medicaid Services. 
104.19 	The commissioner of health may substitute successor manuals or question and answer 
104.20 	documents published by the United States Department of Health and Human Services, 
104.21 	Centers for Medicare and Medicaid Services, to replace or supplement the current version 
104.22 	of the manual or document.
104.23 	(b) The assessments used to determine a case mix classification for reimbursement 
104.24 	include the following:
104.25 	(1) a new admission assessment;
104.26 	(2) an annual assessment which must have an assessment reference date (ARD) within 
104.27 	92 days of the previous assessment and the previous comprehensive assessment;
104.28 	(3) a significant change in status assessment must be completed within 14 days of the 
104.29 	identification of a significant change, whether improvement or decline, and regardless of 
104.30 	the amount of time since the last significant change in status assessment;
104.31 	(4) all quarterly assessments must have an assessment reference date (ARD) within 92 
104.32 	days of the ARD of the previous assessment;
105.1 	(5) any significant correction to a prior comprehensive assessment, if the assessment 
105.2 	being corrected is the current one being used for RUG classification; and
105.3 	(6) any significant correction to a prior quarterly assessment, if the assessment being 
105.4 	corrected is the current one being used for RUG classification.
105.5 	(c) In addition to the assessments listed in paragraph (b), the assessments used to 
105.6 	determine nursing facility level of care include the following:
105.7 	(1) preadmission screening completed under section 256.975, subdivisions 7a to 7c, by 
105.8 	the Senior LinkAge Line or other organization under contract with the Minnesota Board on 
105.9 	Aging; and
105.10 	(2) a nursing facility level of care determination as provided for under section 256B.0911, 
105.11 	subdivision 4e, as part of a face-to-face long-term care consultation assessment completed 
105.12 	under section 256B.0911, by a county, tribe, or managed care organization under contract 
105.13 	with the Department of Human Services.

105.14 	Sec. 2. Minnesota Statutes 2016, section 144.0724, subdivision 6, is amended to read:
105.15 		Subd. 6.Penalties for late or nonsubmission. (a) A facility that fails to complete or 
105.16 	submit an assessment according to subdivisions 4 and 5 for a RUG-IV classification within 
105.17 	seven days of the time requirements listed in the Long-Term Care Facility Resident 
105.18 	Assessment Instrument User's Manual is subject to a reduced rate for that resident. The 
105.19 	reduced rate shall be the lowest rate for that facility. The reduced rate is effective on the 
105.20 	day of admission for new admission assessments, on the ARD for significant change in 
105.21 	status assessments, or on the day that the assessment was due for all other assessments and 
105.22 	continues in effect until the first day of the month following the date of submission and 
105.23 	acceptance of the resident's assessment.
105.24 	(b) If loss of revenue due to penalties incurred by a facility for any period of 92 days 
105.25 	are equal to or greater than 1.0 0.1 percent of the total operating costs on the facility's most 
105.26 	recent annual statistical and cost report, a facility may apply to the commissioner of human 
105.27 	services for a reduction in the total penalty amount. The commissioner of human services, 
105.28 	in consultation with the commissioner of health, may, at the sole discretion of the 
105.29 	commissioner of human services, limit the penalty for residents covered by medical assistance 
105.30 	to 15 ten days.

105.31 	EFFECTIVE DATE. This section is effective the day following final enactment.

106.1 	Sec. 3. Minnesota Statutes 2016, section 144.562, subdivision 2, is amended to read:
106.2 		Subd. 2.Eligibility for license condition. (a) A hospital is not eligible to receive a 
106.3 	license condition for swing beds unless (1) it either has a licensed bed capacity of less than 
106.4 	50 beds defined in the federal Medicare regulations, Code of Federal Regulations, title 42, 
106.5 	section 482.66, or it has a licensed bed capacity of 50 beds or more and has swing beds that 
106.6 	were approved for Medicare reimbursement before May 1, 1985, or it has a licensed bed 
106.7 	capacity of less than 65 beds and the available nursing homes within 50 miles have had, in 
106.8 	the aggregate, an average occupancy rate of 96 percent or higher in the most recent two 
106.9 	years as documented on the statistical reports to the Department of Health; and (2) it is 
106.10 	located in a rural area as defined in the federal Medicare regulations, Code of Federal 
106.11 	Regulations, title 42, section 482.66.
106.12 	(b) Except for those critical access hospitals established under section 144.1483, clause 
106.13 	(9), and section 1820 of the federal Social Security Act, United States Code, title 42, section 
106.14 	1395i-4, that have an attached nursing home or that owned a nursing home located in the 
106.15 	same municipality as of May 1, 2005, eligible hospitals are allowed a total of 2,000 days 
106.16 	of swing bed use per year. Critical access hospitals that have an attached nursing home or 
106.17 	that owned a nursing home located in the same municipality as of May 1, 2005, are allowed 
106.18 	swing bed use as provided in federal law.
106.19 	(c) Except for critical access hospitals that have an attached nursing home or that owned 
106.20 	a nursing home located in the same municipality as of May 1, 2005, the commissioner of 
106.21 	health may approve swing bed use beyond 2,000 days as long as there are no Medicare 
106.22 	certified skilled nursing facility beds available within 25 miles of that hospital that are 
106.23 	willing to admit the patient and the patient agrees to the referral being sent to the skilled 
106.24 	nursing facility. Critical access hospitals exceeding 2,000 swing bed days must maintain 
106.25 	documentation that they have contacted skilled nursing facilities within 25 miles to determine 
106.26 	if any skilled nursing facility beds are available that are willing to admit the patient and the 
106.27 	patient agrees to the referral being sent to the skilled nursing facility.
106.28 	(d) After reaching 2,000 days of swing bed use in a year, an eligible hospital to which 
106.29 	this limit applies may admit six additional patients to swing beds each year without seeking 
106.30 	approval from the commissioner or being in violation of this subdivision. These six swing 
106.31 	bed admissions are exempt from the limit of 2,000 annual swing bed days for hospitals 
106.32 	subject to this limit.
107.1 	(e) A health care system that is in full compliance with this subdivision may allocate its 
107.2 	total limit of swing bed days among the hospitals within the system, provided that no hospital 
107.3 	in the system without an attached nursing home may exceed 2,000 swing bed days per year.

107.4 	Sec. 4. Minnesota Statutes 2016, section 144A.071, subdivision 4d, as amended by Laws 
107.5 	2017, chapter 40, article 1, section 25, is amended to read:
107.6 		Subd. 4d.Consolidation of nursing facilities. (a) The commissioner of health, in 
107.7 	consultation with the commissioner of human services, may approve a request for 
107.8 	consolidation of nursing facilities which includes the closure of one or more facilities and 
107.9 	the upgrading of the physical plant of the remaining nursing facility or facilities, the costs 
107.10 	of which exceed the threshold project limit under subdivision 2, clause (a). The 
107.11 	commissioners shall consider the criteria in this section, section 144A.073, and section 
107.12 	256R.40, in approving or rejecting a consolidation proposal. In the event the commissioners 
107.13 	approve the request, the commissioner of human services shall calculate an external fixed 
107.14 	costs rate adjustment according to clauses (1) to (3):
107.15 	(1) the closure of beds shall not be eligible for a planned closure rate adjustment under 
107.16 	section 256R.40, subdivision 5;
107.17 	(2) the construction project permitted in this clause shall not be eligible for a threshold 
107.18 	project rate adjustment under section 256B.434, subdivision 4f, or a moratorium exception 
107.19 	adjustment under section 144A.073; and
107.20 	(3) the payment rate for external fixed costs for a remaining facility or facilities shall 
107.21 	be increased by an amount equal to 65 percent of the projected net cost savings to the state 
107.22 	calculated in paragraph (b), divided by the state's medical assistance percentage of medical 
107.23 	assistance dollars, and then divided by estimated medical assistance resident days, as 
107.24 	determined in paragraph (c), of the remaining nursing facility or facilities in the request in 
107.25 	this paragraph. The rate adjustment is effective on the later of the first day of the month 
107.26 	following first day of the month of January or July, whichever date occurs first following 
107.27 	both the completion of the construction upgrades in the consolidation plan or the first day 
107.28 	of the month following and the complete closure of a facility closure of the facility or 
107.29 	facilities designated for closure in the consolidation plan. If more than one facility is receiving 
107.30 	upgrades in the consolidation plan, each facility's date of construction completion must be 
107.31 	evaluated separately.
107.32 	(b) For purposes of calculating the net cost savings to the state, the commissioner shall 
107.33 	consider clauses (1) to (7):
108.1 	(1) the annual savings from estimated medical assistance payments from the net number 
108.2 	of beds closed taking into consideration only beds that are in active service on the date of 
108.3 	the request and that have been in active service for at least three years;
108.4 	(2) the estimated annual cost of increased case load of individuals receiving services 
108.5 	under the elderly waiver;
108.6 	(3) the estimated annual cost of elderly waiver recipients receiving support under group 
108.7 	residential housing;
108.8 	(4) the estimated annual cost of increased case load of individuals receiving services 
108.9 	under the alternative care program;
108.10 	(5) the annual loss of license surcharge payments on closed beds;
108.11 	(6) the savings from not paying planned closure rate adjustments that the facilities would 
108.12 	otherwise be eligible for under section 256R.40; and
108.13 	(7) the savings from not paying external fixed costs payment rate adjustments from 
108.14 	submission of renovation costs that would otherwise be eligible as threshold projects under 
108.15 	section 256B.434, subdivision 4f.
108.16 	(c) For purposes of the calculation in paragraph (a), clause (3), the estimated medical 
108.17 	assistance resident days of the remaining facility or facilities shall be computed assuming 
108.18 	95 percent occupancy multiplied by the historical percentage of medical assistance resident 
108.19 	days of the remaining facility or facilities, as reported on the facility's or facilities' most 
108.20 	recent nursing facility statistical and cost report filed before the plan of closure is submitted, 
108.21 	multiplied by 365.
108.22 	(d) For purposes of net cost of savings to the state in paragraph (b), the average occupancy 
108.23 	percentages will be those reported on the facility's or facilities' most recent nursing facility 
108.24 	statistical and cost report filed before the plan of closure is submitted, and the average 
108.25 	payment rates shall be calculated based on the approved payment rates in effect at the time 
108.26 	the consolidation request is submitted.
108.27 	(e) To qualify for the external fixed costs payment rate adjustment under this subdivision, 
108.28 	the closing facilities shall:
108.29 	(1) submit an application for closure according to section 256R.40, subdivision 2; and
108.30 	(2) follow the resident relocation provisions of section 144A.161.
108.31 	(f) The county or counties in which a facility or facilities are closed under this subdivision 
108.32 	shall not be eligible for designation as a hardship area under subdivision 3 for five years 
109.1 	from the date of the approval of the proposed consolidation. The applicant shall notify the 
109.2 	county of this limitation and the county shall acknowledge this in a letter of support.

109.3 	EFFECTIVE DATE. This section is effective for consolidations occurring after July 
109.4 	1, 2017.

109.5 	Sec. 5. Minnesota Statutes 2016, section 144A.74, is amended to read:
109.6 	144A.74 MAXIMUM CHARGES.
109.7 	A supplemental nursing services agency must not bill or receive payments from a nursing 
109.8 	home licensed under this chapter at a rate higher than 150 percent of the sum of the weighted 
109.9 	average wage rate, plus a factor determined by the commissioner to incorporate payroll 
109.10 	taxes as defined in Minnesota Rules, part 9549.0020, subpart 33 section 256R.02, subdivision 
109.11 	37, for the applicable employee classification for the geographic group to which the nursing
109.12 	home is assigned under Minnesota Rules, part 9549.0052 specified in section 256R.23, 
109.13 	subdivision 4. The weighted average wage rates must be determined by the commissioner 
109.14 	of human services and reported to the commissioner of health on an annual basis. Wages 
109.15 	are defined as hourly rate of pay and shift differential, including weekend shift differential 
109.16 	and overtime. Facilities shall provide information necessary to determine weighted average 
109.17 	wage rates to the commissioner of human services in a format requested by the commissioner. 
109.18 	The maximum rate must include all charges for administrative fees, contract fees, or other 
109.19 	special charges in addition to the hourly rates for the temporary nursing pool personnel 
109.20 	supplied to a nursing home. A nursing home that pays for the actual travel and housing costs 
109.21 	for supplemental nursing services agency staff working at the facility and that pays these 
109.22 	costs to the employee, the agency, or another vendor, is not violating the limitation on 
109.23 	charges described in this section.

109.24 	EFFECTIVE DATE. This section is effective January 1, 2018.

109.25 	Sec. 6. Minnesota Statutes 2016, section 256.975, subdivision 7, is amended to read:
109.26 		Subd. 7.Consumer information and assistance and long-term care options 
109.27 	counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a 
109.28 	statewide service to aid older Minnesotans and their families in making informed choices 
109.29 	about long-term care options and health care benefits. Language services to persons with 
109.30 	limited English language skills may be made available. The service, known as Senior 
109.31 	LinkAge Line, shall serve older adults as the designated Aging and Disability Resource 
109.32 	Center under United States Code, title 42, section 3001, the Older Americans Act 
109.33 	Amendments of 2006 in partnership with the Disability Linkage Line under section 256.01, 
110.1 	subdivision 24, and must be available during business hours through a statewide toll-free 
110.2 	number and the Internet. The Minnesota Board on Aging shall consult with, and when 
110.3 	appropriate work through, the area agencies on aging counties, and other entities that serve 
110.4 	aging and disabled populations of all ages, to provide and maintain the telephone 
110.5 	infrastructure and related support for the Aging and Disability Resource Center partners 
110.6 	which agree by memorandum to access the infrastructure, including the designated providers 
110.7 	of the Senior LinkAge Line and the Disability Linkage Line.
110.8 	(b) The service must provide long-term care options counseling by assisting older adults, 
110.9 	caregivers, and providers in accessing information and options counseling about choices in 
110.10 	long-term care services that are purchased through private providers or available through 
110.11 	public options. The service must:
110.12 	(1) develop and provide for regular updating of a comprehensive database that includes 
110.13 	detailed listings in both consumer- and provider-oriented formats that can provide search 
110.14 	results down to the neighborhood level;
110.15 	(2) make the database accessible on the Internet and through other telecommunication 
110.16 	and media-related tools;
110.17 	(3) link callers to interactive long-term care screening tools and make these tools available 
110.18 	through the Internet by integrating the tools with the database;
110.19 	(4) develop community education materials with a focus on planning for long-term care 
110.20 	and evaluating independent living, housing, and service options;
110.21 	(5) conduct an outreach campaign to assist older adults and their caregivers in finding 
110.22 	information on the Internet and through other means of communication;
110.23 	(6) implement a messaging system for overflow callers and respond to these callers by 
110.24 	the next business day;
110.25 	(7) link callers with county human services and other providers to receive more in-depth 
110.26 	assistance and consultation related to long-term care options;
110.27 	(8) link callers with quality profiles for nursing facilities and other home and 
110.28 	community-based services providers developed by the commissioners of health and human 
110.29 	services;
110.30 	(9) develop an outreach plan to seniors and their caregivers with a particular focus on 
110.31 	establishing a clear presence in places that seniors recognize and:
111.1 	(i) place a significant emphasis on improved outreach and service to seniors and their 
111.2 	caregivers by establishing annual plans by neighborhood, city, and county, as necessary, to 
111.3 	address the unique needs of geographic areas in the state where there are dense populations 
111.4 	of seniors;
111.5 	(ii) establish an efficient workforce management approach and assign community living 
111.6 	specialist staff and volunteers to geographic areas as well as aging and disability resource 
111.7 	center sites so that seniors and their caregivers and professionals recognize the Senior 
111.8 	LinkAge Line as the place to call for aging services and information;
111.9 	(iii) recognize the size and complexity of the metropolitan area service system by working 
111.10 	with metropolitan counties to establish a clear partnership with them, including seeking 
111.11 	county advice on the establishment of local aging and disabilities resource center sites; and
111.12 	(iv) maintain dashboards with metrics that demonstrate how the service is expanding 
111.13 	and extending or enhancing its outreach efforts in dispersed or hard to reach locations in 
111.14 	varied population centers;
111.15 	(10) incorporate information about the availability of housing options, as well as 
111.16 	registered housing with services and consumer rights within the MinnesotaHelp.info network 
111.17 	long-term care database to facilitate consumer comparison of services and costs among 
111.18 	housing with services establishments and with other in-home services and to support financial 
111.19 	self-sufficiency as long as possible. Housing with services establishments and their arranged 
111.20 	home care providers shall provide information that will facilitate price comparisons, including 
111.21 	delineation of charges for rent and for services available. The commissioners of health and 
111.22 	human services shall align the data elements required by section 144G.06, the Uniform 
111.23 	Consumer Information Guide, and this section to provide consumers standardized information 
111.24 	and ease of comparison of long-term care options. The commissioner of human services 
111.25 	shall provide the data to the Minnesota Board on Aging for inclusion in the 
111.26 	MinnesotaHelp.info network long-term care database;
111.27 	(11) provide long-term care options counseling. Long-term care options counselors shall:
111.28 	(i) for individuals not eligible for case management under a public program or public 
111.29 	funding source, provide interactive decision support under which consumers, family 
111.30 	members, or other helpers are supported in their deliberations to determine appropriate 
111.31 	long-term care choices in the context of the consumer's needs, preferences, values, and 
111.32 	individual circumstances, including implementing a community support plan;
112.1 	(ii) provide Web-based educational information and collateral written materials to 
112.2 	familiarize consumers, family members, or other helpers with the long-term care basics, 
112.3 	issues to be considered, and the range of options available in the community;
112.4 	(iii) provide long-term care futures planning, which means providing assistance to 
112.5 	individuals who anticipate having long-term care needs to develop a plan for the more 
112.6 	distant future; and
112.7 	(iv) provide expertise in benefits and financing options for long-term care, including 
112.8 	Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages, 
112.9 	private pay options, and ways to access low or no-cost services or benefits through 
112.10 	volunteer-based or charitable programs;
112.11 	(12) using risk management and support planning protocols, provide long-term care 
112.12 	options counseling under clause (13) to current residents of nursing homes deemed 
112.13 	appropriate for discharge by the commissioner, former residents of nursing homes who 
112.14 	were discharged to community settings, and older adults who request service after 
112.15 	consultation with the Senior LinkAge Line under clause (13). The Senior LinkAge Line 
112.16 	shall also receive referrals from the residents or staff of nursing homes. who meet a profile 
112.17 	that demonstrates that the consumer is either at risk of readmission to a nursing home or 
112.18 	hospital, or would benefit from long-term care options counseling to age in place. The Senior 
112.19 	LinkAge Line shall identify and contact residents or patients deemed appropriate for 
112.20 	discharge by developing targeting criteria and creating a profile in consultation with the 
112.21 	commissioner who. The commissioner shall provide designated Senior LinkAge Line contact 
112.22 	centers with a list of current or former nursing home residents or people discharged from a 
112.23 	hospital or for whom Medicare home care has ended, that meet the criteria as being 
112.24 	appropriate for discharge planning long-term care options counseling through a referral via 
112.25 	a secure Web portal. Senior LinkAge Line shall provide these residents, if they indicate a 
112.26 	preference to receive long-term care options counseling, with initial assessment and, if 
112.27 	appropriate, a referral to:
112.28 	(i) long-term care consultation services under section 256B.0911;
112.29 	(ii) designated care coordinators of contracted entities under section 256B.035 for persons 
112.30 	who are enrolled in a managed care plan; or
112.31 	(iii) the long-term care consultation team for those who are eligible for relocation service 
112.32 	coordination due to high-risk factors or psychological or physical disability; and
112.33 	(13) develop referral protocols and processes that will assist certified health care homes, 
112.34 	Medicare home care, and hospitals to identify at-risk older adults and determine when to 
113.1 	refer these individuals to the Senior LinkAge Line for long-term care options counseling 
113.2 	under this section. The commissioner is directed to work with the commissioner of health 
113.3 	to develop protocols that would comply with the health care home designation criteria and 
113.4 	protocols available at the time of hospital discharge or the end of Medicare home care. The 
113.5 	commissioner shall keep a record of the number of people who choose long-term care 
113.6 	options counseling as a result of this section.
113.7 	(c) Nursing homes shall provide contact information to the Senior LinkAge Line for 
113.8 	residents identified in paragraph (b), clause (12), to provide long-term care options counseling 
113.9 	pursuant to paragraph (b), clause (11). The contact information for residents shall include 
113.10 	all information reasonably necessary to contact residents, including first and last names, 
113.11 	permanent and temporary addresses, telephone numbers, and e-mail addresses.
113.12 	(d) The Senior LinkAge Line shall determine when it is appropriate to refer a consumer 
113.13 	who receives long-term care options counseling under paragraph (b), clause (12) or (13), 
113.14 	and who uses an unpaid caregiver to the self-directed caregiver service under subdivision 
113.15 	12.

113.16 	EFFECTIVE DATE. This section is effective July 1, 2017.

113.17 	Sec. 7. Minnesota Statutes 2016, section 256.975, is amended by adding a subdivision to 
113.18 	read:
113.19 		Subd. 12.Self-directed caregiver grants. Beginning on July 1, 2019, the Minnesota 
113.20 	Board on Aging shall administer self-directed caregiver grants to support at risk family 
113.21 	caregivers of older adults or others eligible under the Older Americans Act of 1965, United 
113.22 	States Code, title 42, chapter 35, sections 3001 to 3058ff, to sustain family caregivers in 
113.23 	the caregivers' roles so older adults can remain at home longer. The board shall give priority 
113.24 	to consumers referred under section 256.975, subdivision 7, paragraph (d).

113.25 	EFFECTIVE DATE. This section is effective July 1, 2017.

113.26 	Sec. 8. Minnesota Statutes 2016, section 256B.0911, subdivision 3a, is amended to read:
113.27 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, services 
113.28 	planning, or other assistance intended to support community-based living, including persons 
113.29 	who need assessment in order to determine waiver or alternative care program eligibility, 
113.30 	must be visited by a long-term care consultation team within 20 calendar days after the date 
113.31 	on which an assessment was requested or recommended. Upon statewide implementation 
113.32 	of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person 
114.1 	requesting personal care assistance services and home care nursing. The commissioner shall 
114.2 	provide at least a 90-day notice to lead agencies prior to the effective date of this requirement. 
114.3 	Face-to-face assessments must be conducted according to paragraphs (b) to (i).
114.4 	(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified 
114.5 	assessors to conduct the assessment. For a person with complex health care needs, a public 
114.6 	health or registered nurse from the team must be consulted.
114.7 	(c) The MnCHOICES assessment provided by the commissioner to lead agencies must 
114.8 	be used to complete a comprehensive, person-centered assessment. The assessment must 
114.9 	include the health, psychological, functional, environmental, and social needs of the 
114.10 	individual necessary to develop a community support plan that meets the individual's needs 
114.11 	and preferences.
114.12 	(d) The assessment must be conducted in a face-to-face interview with the person being 
114.13 	assessed and the person's legal representative. At the request of the person, other individuals 
114.14 	may participate in the assessment to provide information on the needs, strengths, and 
114.15 	preferences of the person necessary to develop a community support plan that ensures the 
114.16 	person's health and safety. Except for legal representatives or family members invited by 
114.17 	the person, persons participating in the assessment may not be a provider of service or have 
114.18 	any financial interest in the provision of services. For persons who are to be assessed for 
114.19 	elderly waiver customized living or adult day services under section 256B.0915, with the 
114.20 	permission of the person being assessed or the person's designated or legal representative, 
114.21 	the client's current or proposed provider of services may submit a copy of the provider's 
114.22 	nursing assessment or written report outlining its recommendations regarding the client's 
114.23 	care needs. The person conducting the assessment must notify the provider of the date by 
114.24 	which this information is to be submitted. This information shall be provided to the person 
114.25 	conducting the assessment prior to the assessment. For a person who is to be assessed for 
114.26 	waiver services under section 256B.092 or 256B.49, with the permission of the person being 
114.27 	assessed or the person's designated legal representative, the person's current provider of 
114.28 	services may submit a written report outlining recommendations regarding the person's care 
114.29 	needs prepared by a direct service employee with at least 20 hours of service to that client. 
114.30 	The person conducting the assessment or reassessment must notify the provider of the date 
114.31 	by which this information is to be submitted. This information shall be provided to the 
114.32 	person conducting the assessment and the person or the person's legal representative, and 
114.33 	must be considered prior to the finalization of the assessment or reassessment.
115.1 	(e) The person or the person's legal representative must be provided with a written 
115.2 	community support plan within 40 calendar days of the assessment visit, regardless of 
115.3 	whether the individual is eligible for Minnesota health care programs.
115.4 	(f) For a person being assessed for elderly waiver services under section 256B.0915, a 
115.5 	provider who submitted information under paragraph (d) shall receive the final written 
115.6 	community support plan when available and the Residential Services Workbook.
115.7 	(g) The written community support plan must include:
115.8 	(1) a summary of assessed needs as defined in paragraphs (c) and (d);
115.9 	(2) the individual's options and choices to meet identified needs, including all available 
115.10 	options for case management services and providers;
115.11 	(3) identification of health and safety risks and how those risks will be addressed, 
115.12 	including personal risk management strategies;
115.13 	(4) referral information; and
115.14 	(5) informal caregiver supports, if applicable.
115.15 	For a person determined eligible for state plan home care under subdivision 1a, paragraph 
115.16 	(b), clause (1), the person or person's representative must also receive a copy of the home 
115.17 	care service plan developed by the certified assessor.
115.18 	(f) (h) A person may request assistance in identifying community supports without 
115.19 	participating in a complete assessment. Upon a request for assistance identifying community 
115.20 	support, the person must be transferred or referred to long-term care options counseling 
115.21 	services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for 
115.22 	telephone assistance and follow up.
115.23 	(g) (i) The person has the right to make the final decision between institutional placement 
115.24 	and community placement after the recommendations have been provided, except as provided 
115.25 	in section 256.975, subdivision 7a, paragraph (d).
115.26 	(h) (j) The lead agency must give the person receiving assessment or support planning, 
115.27 	or the person's legal representative, materials, and forms supplied by the commissioner 
115.28 	containing the following information:
115.29 	(1) written recommendations for community-based services and consumer-directed 
115.30 	options;
115.31 	(2) documentation that the most cost-effective alternatives available were offered to the 
115.32 	individual. For purposes of this clause, "cost-effective" means community services and 
116.1 	living arrangements that cost the same as or less than institutional care. For an individual 
116.2 	found to meet eligibility criteria for home and community-based service programs under 
116.3 	section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally 
116.4 	approved waiver plan for each program;
116.5 	(3) the need for and purpose of preadmission screening conducted by long-term care 
116.6 	options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects 
116.7 	nursing facility placement. If the individual selects nursing facility placement, the lead 
116.8 	agency shall forward information needed to complete the level of care determinations and 
116.9 	screening for developmental disability and mental illness collected during the assessment 
116.10 	to the long-term care options counselor using forms provided by the commissioner;
116.11 	(4) the role of long-term care consultation assessment and support planning in eligibility 
116.12 	determination for waiver and alternative care programs, and state plan home care, case 
116.13 	management, and other services as defined in subdivision 1a, paragraphs (a), clause (6), 
116.14 	and (b);
116.15 	(5) information about Minnesota health care programs;
116.16 	(6) the person's freedom to accept or reject the recommendations of the team;
116.17 	(7) the person's right to confidentiality under the Minnesota Government Data Practices 
116.18 	Act, chapter 13;
116.19 	(8) the certified assessor's decision regarding the person's need for institutional level of 
116.20 	care as determined under criteria established in subdivision 4e and the certified assessor's 
116.21 	decision regarding eligibility for all services and programs as defined in subdivision 1a, 
116.22 	paragraphs (a), clause (6), and (b); and
116.23 	(9) the person's right to appeal the certified assessor's decision regarding eligibility for 
116.24 	all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and 
116.25 	(8), and (b), and incorporating the decision regarding the need for institutional level of care 
116.26 	or the lead agency's final decisions regarding public programs eligibility according to section 
116.27 	256.045, subdivision 3.
116.28 	(i) (k) Face-to-face assessment completed as part of eligibility determination for the 
116.29 	alternative care, elderly waiver, community access for disability inclusion, community 
116.30 	alternative care, and brain injury waiver programs under sections 256B.0913, 256B.0915, 
116.31 	and 256B.49 is valid to establish service eligibility for no more than 60 calendar days after 
116.32 	the date of assessment.
117.1 	(j) (l) The effective eligibility start date for programs in paragraph (i)(k) can never be 
117.2 	prior to the date of assessment. If an assessment was completed more than 60 days before 
117.3 	the effective waiver or alternative care program eligibility start date, assessment and support 
117.4 	plan information must be updated and documented in the department's Medicaid Management 
117.5 	Information System (MMIS). Notwithstanding retroactive medical assistance coverage of 
117.6 	state plan services, the effective date of eligibility for programs included in paragraph (i)
117.7 	(k) cannot be prior to the date the most recent updated assessment is completed.
117.8 	(m) If an eligibility update is completed within 90 days of the previous face-to-face 
117.9 	assessment and documented in the department's Medicaid Management Information System 
117.10 	(MMIS), the effective date of eligibility for programs included in paragraph (k) is the date 
117.11 	of the previous face-to-face assessment when all other eligibility requirements are met.

117.12 	Sec. 9. Minnesota Statutes 2016, section 256B.0915, subdivision 3a, is amended to read:
117.13 		Subd. 3a.Elderly waiver cost limits. (a) Effective on the first day of the state fiscal 
117.14 	year in which the resident assessment system as described in section 256B.438 256R.17 for 
117.15 	nursing home rate determination is implemented and the first day of each subsequent state 
117.16 	fiscal year, the monthly limit for the cost of waivered services to an individual elderly waiver 
117.17 	client shall be the monthly limit of the case mix resident class to which the waiver client 
117.18 	would be assigned under Minnesota Rules, parts 9549.0051 to 9549.0059, in effect on the 
117.19 	last day of the previous state fiscal year, adjusted by any legislatively adopted home and 
117.20 	community-based services percentage rate adjustment. If a legislatively authorized increase 
117.21 	is service-specific, the monthly cost limit shall be adjusted based on the overall average 
117.22 	increase to the elderly waiver program.
117.23 	(b) The monthly limit for the cost of waivered services under paragraph (a) to an 
117.24 	individual elderly waiver client assigned to a case mix classification A with:
117.25 	(1) no dependencies in activities of daily living; or
117.26 	(2) up to two dependencies in bathing, dressing, grooming, walking, and eating when 
117.27 	the dependency score in eating is three or greater as determined by an assessment performed 
117.28 	under section 256B.0911 shall be $1,750 per month effective on July 1, 2011, for all new 
117.29 	participants enrolled in the program on or after July 1, 2011. This monthly limit shall be 
117.30 	applied to all other participants who meet this criteria at reassessment. This monthly limit 
117.31 	shall be increased annually as described in paragraphs (a) and (e).
117.32 	(c) If extended medical supplies and equipment or environmental modifications are or 
117.33 	will be purchased for an elderly waiver client, the costs may be prorated for up to 12 
118.1 	consecutive months beginning with the month of purchase. If the monthly cost of a recipient's 
118.2 	waivered services exceeds the monthly limit established in paragraph (a), (b), (d), or (e), 
118.3 	the annual cost of all waivered services shall be determined. In this event, the annual cost 
118.4 	of all waivered services shall not exceed 12 times the monthly limit of waivered services 
118.5 	as described in paragraph (a), (b), (d), or (e).
118.6 	(d) Effective July 1, 2013, the monthly cost limit of waiver services, including any 
118.7 	necessary home care services described in section 256B.0651, subdivision 2, for individuals 
118.8 	who meet the criteria as ventilator-dependent given in section 256B.0651, subdivision 1, 
118.9 	paragraph (g), shall be the average of the monthly medical assistance amount established 
118.10 	for home care services as described in section 256B.0652, subdivision 7, and the annual 
118.11 	average contracted amount established by the commissioner for nursing facility services 
118.12 	for ventilator-dependent individuals. This monthly limit shall be increased annually as 
118.13 	described in paragraphs (a) and (e).
118.14 	(e) Effective July 1, 2016 January 1, 2018, and each July January 1 thereafter, the monthly 
118.15 	cost limits for elderly waiver services in effect on the previous June 30 December 31 shall 
118.16 	be increased by the difference between any legislatively adopted home and community-based 
118.17 	provider rate increases effective on July January 1 or since the previous July January 1 and 
118.18 	the average statewide percentage increase in nursing facility operating payment rates under 
118.19 	sections 256B.431, 256B.434, and 256B.441 chapter 256R, effective the previous January 
118.20 	1. This paragraph shall only apply if the average statewide percentage increase in nursing 
118.21 	facility operating payment rates is greater than any legislatively adopted home and 
118.22 	community-based provider rate increases effective on July January 1, or occurring since 
118.23 	the previous July January 1.

118.24 	Sec. 10. Minnesota Statutes 2016, section 256B.0915, subdivision 3e, is amended to read:
118.25 		Subd. 3e.Customized living service rate. (a) Payment for customized living services 
118.26 	shall be a monthly rate authorized by the lead agency within the parameters established by 
118.27 	the commissioner. The payment agreement must delineate the amount of each component 
118.28 	service included in the recipient's customized living service plan. The lead agency, with 
118.29 	input from the provider of customized living services, shall ensure that there is a documented 
118.30 	need within the parameters established by the commissioner for all component customized 
118.31 	living services authorized.
118.32 	(b) The payment rate must be based on the amount of component services to be provided 
118.33 	utilizing component rates established by the commissioner. Counties and tribes shall use 
119.1 	tools issued by the commissioner to develop and document customized living service plans 
119.2 	and rates.
119.3 	(c) Component service rates must not exceed payment rates for comparable elderly 
119.4 	waiver or medical assistance services and must reflect economies of scale. Customized 
119.5 	living services must not include rent or raw food costs.
119.6 	(d) With the exception of individuals described in subdivision 3a, paragraph (b), the 
119.7 	individualized monthly authorized payment for the customized living service plan shall not 
119.8 	exceed 50 percent of the greater of either the statewide or any of the geographic groups'
119.9 	weighted average monthly nursing facility rate of the case mix resident class to which the 
119.10 	elderly waiver eligible client would be assigned under Minnesota Rules, parts 9549.0051
119.11 	to 9549.0059, less the maintenance needs allowance as described in subdivision 1d, paragraph 
119.12 	(a). Effective On July 1 of the state fiscal each year in which the resident assessment system 
119.13 	as described in section 256B.438 for nursing home rate determination is implemented and 
119.14 	July 1 of each subsequent state fiscal year, the individualized monthly authorized payment 
119.15 	for the services described in this clause shall not exceed the limit which was in effect on 
119.16 	June 30 of the previous state fiscal year updated annually based on legislatively adopted 
119.17 	changes to all service rate maximums for home and community-based service providers.
119.18 	(e) Effective July 1, 2011, The individualized monthly payment for the customized living 
119.19 	service plan for individuals described in subdivision 3a, paragraph (b), must be the monthly 
119.20 	authorized payment limit for customized living for individuals classified as case mix A, 
119.21 	reduced by 25 percent. This rate limit must be applied to all new participants enrolled in 
119.22 	the program on or after July 1, 2011, who meet the criteria described in subdivision 3a, 
119.23 	paragraph (b). This monthly limit also applies to all other participants who meet the criteria 
119.24 	described in subdivision 3a, paragraph (b), at reassessment.
119.25 	(f) Customized living services are delivered by a provider licensed by the Department 
119.26 	of Health as a class A or class F home care provider and provided in a building that is 
119.27 	registered as a housing with services establishment under chapter 144D. Licensed home 
119.28 	care providers are subject to section 256B.0651, subdivision 14.
119.29 	(g) A provider may not bill or otherwise charge an elderly waiver participant or their 
119.30 	family for additional units of any allowable component service beyond those available under 
119.31 	the service rate limits described in paragraph (d) (e), nor for additional units of any allowable 
119.32 	component service beyond those approved in the service plan by the lead agency.
119.33 	(h) Effective July 1, 2016  January 1, 2018, and each July January 1 thereafter, 
119.34 	individualized service rate limits for customized living services under this subdivision shall 
120.1 	be increased by the difference between any legislatively adopted home and community-based 
120.2 	provider rate increases effective on July January 1 or since the previous July January 1 and 
120.3 	the average statewide percentage increase in nursing facility operating payment rates under 
120.4 	sections 256B.431, 256B.434, and 256B.441 chapter 256R, effective the previous January 
120.5 	1. This paragraph shall only apply if the average statewide percentage increase in nursing 
120.6 	facility operating payment rates is greater than any legislatively adopted home and 
120.7 	community-based provider rate increases effective on July January 1, or occurring since 
120.8 	the previous July January 1.

120.9 	EFFECTIVE DATE. This section prevails over any conflicting amendment regardless 
120.10 	of the order of enactment.

120.11 	Sec. 11. Minnesota Statutes 2016, section 256B.0915, subdivision 3h, is amended to read:
120.12 		Subd. 3h.Service rate limits; 24-hour customized living services. (a) The payment 
120.13 	rate for 24-hour customized living services is a monthly rate authorized by the lead agency 
120.14 	within the parameters established by the commissioner of human services. The payment 
120.15 	agreement must delineate the amount of each component service included in each recipient's 
120.16 	customized living service plan. The lead agency, with input from the provider of customized 
120.17 	living services, shall ensure that there is a documented need within the parameters established 
120.18 	by the commissioner for all component customized living services authorized. The lead 
120.19 	agency shall not authorize 24-hour customized living services unless there is a documented 
120.20 	need for 24-hour supervision.
120.21 	(b) For purposes of this section, "24-hour supervision" means that the recipient requires 
120.22 	assistance due to needs related to one or more of the following:
120.23 	(1) intermittent assistance with toileting, positioning, or transferring;
120.24 	(2) cognitive or behavioral issues;
120.25 	(3) a medical condition that requires clinical monitoring; or
120.26 	(4) for all new participants enrolled in the program on or after July 1, 2011, and all other 
120.27 	participants at their first reassessment after July 1, 2011, dependency in at least three of the 
120.28 	following activities of daily living as determined by assessment under section 256B.0911: 
120.29 	bathing; dressing; grooming; walking; or eating when the dependency score in eating is 
120.30 	three or greater; and needs medication management and at least 50 hours of service per 
120.31 	month. The lead agency shall ensure that the frequency and mode of supervision of the 
120.32 	recipient and the qualifications of staff providing supervision are described and meet the 
120.33 	needs of the recipient.
121.1 	(c) The payment rate for 24-hour customized living services must be based on the amount 
121.2 	of component services to be provided utilizing component rates established by the 
121.3 	commissioner. Counties and tribes will use tools issued by the commissioner to develop 
121.4 	and document customized living plans and authorize rates.
121.5 	(d) Component service rates must not exceed payment rates for comparable elderly 
121.6 	waiver or medical assistance services and must reflect economies of scale.
121.7 	(e) The individually authorized 24-hour customized living payments, in combination 
121.8 	with the payment for other elderly waiver services, including case management, must not 
121.9 	exceed the recipient's community budget cap specified in subdivision 3a. Customized living 
121.10 	services must not include rent or raw food costs.
121.11 	(f) The individually authorized 24-hour customized living payment rates shall not exceed 
121.12 	the 95 percentile of statewide monthly authorizations for 24-hour customized living services 
121.13 	in effect and in the Medicaid management information systems on March 31, 2009, for each 
121.14 	case mix resident class under Minnesota Rules, parts 9549.0051 to 9549.0059, to which 
121.15 	elderly waiver service clients are assigned. When there are fewer than 50 authorizations in 
121.16 	effect in the case mix resident class, the commissioner shall multiply the calculated service 
121.17 	payment rate maximum for the A classification by the standard weight for that classification 
121.18 	under Minnesota Rules, parts 9549.0051 to 9549.0059, to determine the applicable payment 
121.19 	rate maximum. Service payment rate maximums shall be updated annually based on 
121.20 	legislatively adopted changes to all service rates for home and community-based service 
121.21 	providers.
121.22 	(g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner may 
121.23 	establish alternative payment rate systems for 24-hour customized living services in housing 
121.24 	with services establishments which are freestanding buildings with a capacity of 16 or fewer, 
121.25 	by applying a single hourly rate for covered component services provided in either:
121.26 	(1) licensed corporate adult foster homes; or
121.27 	(2) specialized dementia care units which meet the requirements of section 144D.065 
121.28 	and in which:
121.29 	(i) each resident is offered the option of having their own apartment; or
121.30 	(ii) the units are licensed as board and lodge establishments with maximum capacity of 
121.31 	eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205, 
121.32 	subparts 1, 2, 3, and 4, item A.
122.1 	(h) Twenty-four-hour customized living services are delivered by a provider licensed 
122.2 	by the Department of Health as a class A or class F home care provider and provided in a 
122.3 	building that is registered as a housing with services establishment under chapter 144D. 
122.4 	Licensed home care providers are subject to section 256B.0651, subdivision 14.
122.5 	(i) A provider may not bill or otherwise charge an elderly waiver participant or their 
122.6 	family for additional units of any allowable component service beyond those available under 
122.7 	the service rate limits described in paragraph (e), nor for additional units of any allowable 
122.8 	component service beyond those approved in the service plan by the lead agency.
122.9 	(j) Effective July 1, 2016 January 1, 2018, and each July January 1 thereafter, 
122.10 	individualized service rate limits for 24-hour customized living services under this 
122.11 	subdivision shall be increased by the difference between any legislatively adopted home 
122.12 	and community-based provider rate increases effective on July January 1 or since the previous 
122.13 	July January 1 and the average statewide percentage increase in nursing facility operating 
122.14 	payment rates under sections 256B.431, 256B.434, and 256B.441 chapter 256R, effective 
122.15 	the previous January 1. This paragraph shall only apply if the average statewide percentage 
122.16 	increase in nursing facility operating payment rates is greater than any legislatively adopted 
122.17 	home and community-based provider rate increases effective on July January 1, or occurring 
122.18 	since the previous July January 1.

122.19 	Sec. 12. Minnesota Statutes 2016, section 256B.0915, subdivision 5, is amended to read:
122.20 		Subd. 5.Assessments and reassessments for waiver clients. (a) Each client shall 
122.21 	receive an initial assessment of strengths, informal supports, and need for services in 
122.22 	accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a client 
122.23 	served under the elderly waiver must be conducted at least every 12 months and at other 
122.24 	times when the case manager determines that there has been significant change in the client's 
122.25 	functioning. This may include instances where the client is discharged from the hospital. 
122.26 	There must be a determination that the client requires nursing facility level of care as defined 
122.27 	in section 256B.0911, subdivision 4e, at initial and subsequent assessments to initiate and 
122.28 	maintain participation in the waiver program.
122.29 	(b) Regardless of other assessments identified in section 144.0724, subdivision 4, as 
122.30 	appropriate to determine nursing facility level of care for purposes of medical assistance 
122.31 	payment for nursing facility services, only face-to-face assessments conducted according 
122.32 	to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility level of care 
122.33 	determination will be accepted for purposes of initial and ongoing access to waiver service 
122.34 	payment.
123.1 	(c) The lead agency shall conduct a change-in-condition reassessment before the annual 
123.2 	reassessment in cases where a client's condition changed due to a major health event, an 
123.3 	emerging need or risk, worsening health condition, or cases where the current services do 
123.4 	not meet the client's needs. A change-in-condition reassessment may be initiated by the lead 
123.5 	agency, or it may be requested by the client or requested on the client's behalf by another 
123.6 	party, such as a provider of services. The lead agency shall complete a change-in-condition 
123.7 	reassessment no later than 20 calendar days from the request. The lead agency shall conduct 
123.8 	these assessments in a timely manner and expedite urgent requests. The lead agency shall 
123.9 	evaluate urgent requests based on the client's needs and risk to the client if a reassessment 
123.10 	is not completed.

123.11 	Sec. 13. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision 
123.12 	to read:
123.13 		Subd. 11.Payment rates; application. The payment methodologies in subdivisions 12 
123.14 	to 16 apply to elderly waiver and elderly waiver customized living under this section, 
123.15 	alternative care under section 256B.0913, essential community supports under section 
123.16 	256B.0922, and community access for disability inclusion customized living, brain injury 
123.17 	customized living, and elderly waiver foster care and residential care.

123.18 	Sec. 14. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision 
123.19 	to read:
123.20 		Subd. 12.Payment rates; phase-in.  Effective January 1, 2019,  all rates and rate 
123.21 	components for services under subdivision 11 shall be the sum of ten percent of the rates 
123.22 	calculated under subdivisions 13 to 16 and 90 percent of the rates calculated using the rate 
123.23 	methodology in effect as of June 30, 2017.

123.24 	Sec. 15. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision 
123.25 	to read:
123.26 		Subd. 13.Payment rates; establishment. (a) When establishing the base wages 
123.27 	according to subdivision 14, the commissioner shall use standard occupational classification 
123.28 	(SOC) codes from the Bureau of Labor Statistics as defined in the edition of the Occupational 
123.29 	Handbook published immediately prior to January 1, 2019, using Minnesota-specific wages 
123.30 	taken from job descriptions.
124.1 	(b) Beginning January 1, 2019, and every January 1 thereafter, the commissioner shall 
124.2 	establish factors, component rates, and rates according to subdivisions 15 and 16, using 
124.3 	base wages established according to paragraph (a) and subdivision 14.

124.4 	Sec. 16. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision 
124.5 	to read:
124.6 		Subd. 14.Payment rates; base wage index. (a) Base wages are calculated for customized 
124.7 	living, foster care, and residential care component services as follows:
124.8 	(1) the home management and support services base wage equals 33.33 percent of the 
124.9 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for personal and home 
124.10 	care aide (SOC code 39-9021); 33.33 percent of the Minneapolis-St. Paul-Bloomington, 
124.11 	MN-WI MetroSA average wage for food preparation workers (SOC code 35-2021); and 
124.12 	33.34 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage 
124.13 	for maids and housekeeping cleaners (SOC code 37-2012);
124.14 	(2) the home care aide base wage equals 50 percent of the Minneapolis-St. 
124.15 	Paul-Bloomington, MN-WI MetroSA average wage for home health aides (SOC code 
124.16 	31-1011); and 50 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA 
124.17 	average wage for nursing assistants (SOC code 31-1014);
124.18 	(3) the home health aide base wage equals 20 percent of the Minneapolis-St. 
124.19 	Paul-Bloomington, MN-WI MetroSA average wage for licensed practical and licensed 
124.20 	vocational nurses (SOC code 29-2061); and 80 percent of the Minneapolis-St. 
124.21 	Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code 
124.22 	31-1014); and
124.23 	(4) the medication setups by licensed practical nurse base wage equals ten percent of 
124.24 	the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed practical 
124.25 	and licensed vocational nurses (SOC code 29-2061); and 90 percent of the Minneapolis-St. 
124.26 	Paul-Bloomington, MN-WI MetroSA average wage for registered nurses (SOC code 
124.27 	29-1141).
124.28 	(b) Base wages are calculated for the following services as follows:
124.29 	(1) the chore services base wage equals 100 percent of the Minneapolis-St. 
124.30 	Paul-Bloomington, MN-WI MetroSA average wage for landscaping and groundskeeping 
124.31 	workers (SOC code 37-3011);
124.32 	(2) the companion services base wage equals 50 percent of the Minneapolis-St. 
124.33 	Paul-Bloomington, MN-WI MetroSA average wage for personal and home care aides (SOC 
125.1 	code 39-9021); and 50 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA 
125.2 	average wage for maids and housekeeping cleaners (SOC code 37-2012);
125.3 	(3) the homemaker services and assistance with personal care base wage equals 60 
125.4 	percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for 
125.5 	personal and home care aide (SOC code 39-9021); 20 percent of the Minneapolis-St. 
125.6 	Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code 
125.7 	31-1014); and 20 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA 
125.8 	average wage for maids and housekeeping cleaners (SOC code 37-2012);
125.9 	(4) the homemaker services and cleaning base wage equals 60 percent of the 
125.10 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for personal and home 
125.11 	care aide (SOC code 39-9021); 20 percent of the Minneapolis-St. Paul-Bloomington, MN-WI 
125.12 	MetroSA average wage for nursing assistants (SOC code 31-1014); and 20 percent of the 
125.13 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for maids and 
125.14 	housekeeping cleaners (SOC code 37-2012);
125.15 	(5) the homemaker services and home management base wage equals 60 percent of the 
125.16 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for personal and home 
125.17 	care aide (SOC code 39-9021); 20 percent of the Minneapolis-St. Paul-Bloomington, MN-WI 
125.18 	MetroSA average wage for nursing assistants (SOC code 31-1014); and 20 percent of the 
125.19 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for maids and 
125.20 	housekeeping cleaners (SOC code 37-2012);
125.21 	(6) the in-home respite care services base wage equals five percent of the Minneapolis-St. 
125.22 	Paul-Bloomington, MN-WI MetroSA average wage for registered nurses (SOC code 
125.23 	29-1141); 75 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average 
125.24 	wage for nursing assistants (SOC code 31-1014); and 20 percent of the Minneapolis-St. 
125.25 	Paul-Bloomington, MN-WI MetroSA average wage for licensed practical and licensed 
125.26 	vocational nurses (SOC code 29-2061);
125.27 	(7) the out-of-home respite care services base wage equals five percent of the 
125.28 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for registered nurses 
125.29 	(SOC code 29-1141); 75 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA 
125.30 	average wage for nursing assistants (SOC code 31-1014); and 20 percent of the 
125.31 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed practical 
125.32 	and licensed vocational nurses (SOC code 29-2061); and
125.33 	(8) the individual community living support base wage equals 20 percent of the 
125.34 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed practical 
126.1 	and licensed vocational nurses (SOC code 29-2061); and 80 percent of the Minneapolis-St. 
126.2 	Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code 
126.3 	31-1014).
126.4 	(c) Base wages are calculated for the following values as follows:
126.5 	(1) the registered nurse base wage equals 100 percent of the Minneapolis-St. 
126.6 	Paul-Bloomington, MN-WI MetroSA average wage for registered nurses (SOC code 
126.7 	29-1141); and
126.8 	(2) the social worker base wage equals 100 percent of the Minneapolis-St. 
126.9 	Paul-Bloomington, MN-WI MetroSA average wage for medical and public health social 
126.10 	workers (SOC code 21-1022).
126.11 	(d) If any of the SOC codes and positions are no longer available, the commissioner 
126.12 	shall, in consultation with stakeholders, select a new SOC code and position that is the 
126.13 	closest match to the previously used SOC position.

126.14 	Sec. 17. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision 
126.15 	to read:
126.16 		Subd. 15.Payment rates; factors. The commissioner shall use the following factors:
126.17 	(1) the payroll taxes and benefits factor is the sum of net payroll taxes and benefits 
126.18 	divided by the sum of all salaries for all nursing facilities on the most recent and available 
126.19 	cost report;
126.20 	(2) the general and administrative factor is the sum of net general and administrative 
126.21 	expenses minus administrative salaries divided by total operating expenses for all nursing 
126.22 	facilities on the most recent and available cost report;
126.23 	(3) the program plan support factor is 12.8 percent to cover the cost of direct service 
126.24 	staff needed to provide support for the home and community-based service when not engaged 
126.25 	in direct contact with clients.
126.26 	(4) the registered nurse management and supervision factor equals 15 percent of the 
126.27 	product of the position's base wage and the sum of the factors in clauses (1) to (3); and
126.28 	(5) the social worker supervision factor equals 15 percent of the product of the position's 
126.29 	base wage and the sum of the factors in clauses (1) to (3).

127.1 	Sec. 18. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision 
127.2 	to read:
127.3 		Subd. 16.Payment rates; component rates. (a) For the purposes of this subdivision, 
127.4 	the "adjusted base wage" for a position equals the position's base wage plus:
127.5 	(1) the position's base wage multiplied by the payroll taxes and benefits factor;
127.6 	(2) the position's base wage multiplied by the general and administrative factor; and
127.7 	(3) the position's base wage multiplied by the program plan support factor.
127.8 	(b) For medication setups by licensed nurse, registered nurse, and social worker services, 
127.9 	the component rate for each service equals the respective position's adjusted base wage.
127.10 	(c) For home management and support services, home care aide, and home health aide 
127.11 	services, the component rate for each service equals the respective position's adjusted base 
127.12 	wage plus the registered nurse management and supervision factor.
127.13 	(d) The home management and support services component rate shall be used for payment 
127.14 	for socialization and transportation component rates under elderly waiver customized living.
127.15 	(e) The 15-minute unit rates for chore services and companion services are calculated 
127.16 	as follows:
127.17 	(1) sum the adjusted base wage for the respective position and the social worker factor; 
127.18 	and
127.19 	(2) divide the result of clause (1) by four.
127.20 	(f) The 15-minute unit rates for homemaker services and assistance with personal care, 
127.21 	homemaker services and cleaning, and homemaker services and home management are 
127.22 	calculated as follows:
127.23 	(1) sum the adjusted base wage for the respective position and the registered nurse 
127.24 	management and supervision factor; and
127.25 	(2) divide the result of clause (1) by four.
127.26 	(g) The 15-minute unit rate for in-home respite care services is calculated as follows:
127.27 	(1) sum the adjusted base wage for in-home respite care services and the registered nurse 
127.28 	management and supervision factor; and
127.29 	(2) divide the result of clause (1) by four.
128.1 	(h) The in-home respite care services daily rate equals the in-home respite care services 
128.2 	15-minute unit rate multiplied by 18.
128.3 	(i) The 15-minute unit rate for out-of-home respite care is calculated as follows:
128.4 	(1) sum the out-of-home respite care services adjusted base wage and the registered 
128.5 	nurse management and supervision factor; and
128.6 	(2) divide the result of clause (1) by four.
128.7 	(j) The out-of-home respite care services daily rate equals the out-of-home respite care 
128.8 	services 15-minute unit rate multiplied by 18.
128.9 	(k) The individual community living support rate is calculated as follows:
128.10 	(1) sum the adjusted base wage for the home care aide rate in subdivision 14, paragraph 
128.11 	(a), clause (2), and the social worker factor; and
128.12 	(2) divide the result of clause (1) by four.
128.13 	(l) The home delivered meals rate equals $9.30. Beginning July 1, 2018, the commissioner 
128.14 	shall increase the home delivered meals rate every July 1 by the percent increase in the 
128.15 	nursing facility dietary per diem using the two most recent and available nursing facility 
128.16 	cost reports.
128.17 	(m) The adult day services rate is based on the home care aide rate in subdivision 14, 
128.18 	paragraph (a), clause (2), plus the additional factors from subdivision 15, except that the 
128.19 	general and administrative factor used shall be 20 percent. The nonregistered nurse portion 
128.20 	of the rate shall be multiplied by 0.25, to reflect an assumed-ratio staffing of one caregiver 
128.21 	to four clients, and divided by four to determine the 15-minute unit rate. The registered 
128.22 	nurse portion is divided by four to determine the 15-minute unit rate and $0.63 per 15-minute 
128.23 	unit is added to cover the cost of meals.
128.24 	(n) The adult day services bath 15-minute unit rate is the same as the calculation of the 
128.25 	adult day services 15-minute unit rate without the adjustment for staffing ratio.
128.26 	(o) If a bath is authorized for an adult day services client, at least two 15-minute units 
128.27 	must be authorized to allow for adequate time to meet client needs. Adult day services may 
128.28 	be authorized for up to 48 units, or 12 hours, per day based on client and family caregiver 
128.29 	needs.

129.1 	Sec. 19. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision 
129.2 	to read:
129.3 		Subd. 17.Evaluation of rate methodology. The commissioner, in consultation with 
129.4 	stakeholders, shall conduct a study to evaluate the following:
129.5 	(1) base wages in subdivision 14, to determine if the standard occupational classification 
129.6 	codes for each rate and component rate are an appropriate representation of staff who deliver 
129.7 	the services; and
129.8 	(2) factors in subdivision 15, and adjusted base wage calculation in subdivision 16, to 
129.9 	determine if the factors and calculations appropriately address nonwage provider costs.
129.10 	By January 1, 2019, the commissioner shall submit a report to the legislature on the 
129.11 	changes to the rate methodology in this statute, based on the results of the evaluation. Where 
129.12 	feasible, the report shall address the impact of the new rates on the workforce situation and 
129.13 	client access to services. The report should include any changes to the rate calculations 
129.14 	methods that the commissioner recommends.

129.15 	Sec. 20. Minnesota Statutes 2016, section 256B.431, subdivision 10, is amended to read:
129.16 		Subd. 10.Property rate adjustments and construction projects. A nursing facility 
129.17 	completing a construction project that is eligible for a rate adjustment under section 
129.18 	256B.434, subdivision 4f, and that was not approved through the moratorium exception 
129.19 	process in section 144A.073 must request from the commissioner a property-related payment 
129.20 	rate adjustment. If the request is made within 60 days after the construction project's 
129.21 	completion date, The effective date of the rate adjustment is the first of the month of January 
129.22 	or July, whichever occurs first following both the construction project's completion date
129.23 	and submission of the provider's rate adjustment request. If the request is made more than 
129.24 	60 days after the completion date, the rate adjustment is effective on the first of the month 
129.25 	following the request. The commissioner shall provide a rate notice reflecting the allowable 
129.26 	costs within 60 days after receiving all the necessary information to compute the rate 
129.27 	adjustment. No sooner than the effective date of the rate adjustment for the construction 
129.28 	project, a nursing facility may adjust its rates by the amount anticipated to be allowed. Any 
129.29 	amounts collected from private pay residents in excess of the allowable rate must be repaid 
129.30 	to private pay residents with interest at the rate used by the commissioner of revenue for 
129.31 	the late payment of taxes and in effect on the date the rate increase is effective. Construction 
129.32 	projects with completion dates within one year of the completion date associated with the 
129.33 	property rate adjustment request and phased projects with project completion dates within 
129.34 	three years of the last phase of the phased project must be aggregated for purposes of the 
130.1 	minimum thresholds in subdivisions 16 and 17, and the maximum threshold in section 
130.2 	144A.071, subdivision 2. "Construction project" and "project construction costs" have the 
130.3 	meanings given them in Minnesota Statutes, section 144A.071, subdivision 1a.

130.4 	EFFECTIVE DATE. This section is effective for projects completed after January 1, 
130.5 	2018.

130.6 	Sec. 21. Minnesota Statutes 2016, section 256B.431, subdivision 16, is amended to read:
130.7 		Subd. 16.Major additions and replacements; equity incentive. For rate years beginning 
130.8 	after June 30, 1993, if a nursing facility acquires capital assets in connection with a project 
130.9 	approved under the moratorium exception process in section 144A.073 or in connection 
130.10 	with an addition to or replacement of buildings, attached fixtures, or land improvements 
130.11 	for which the total historical cost of those capital asset additions exceeds the lesser of 
130.12 	$150,000 or ten percent of the most recent appraised value, the nursing facility shall be 
130.13 	eligible for an equity incentive payment rate as in paragraphs (a) to (d). This computation 
130.14 	is separate from the determination of the nursing facility's rental rate. An equity incentive 
130.15 	payment rate as computed under this subdivision is limited to one in a 12-month period.
130.16 	(a) An eligible nursing facility shall receive an equity incentive payment rate equal to 
130.17 	the allowable historical cost of the capital asset acquired, minus the allowable debt directly 
130.18 	identified to that capital asset, multiplied by the equity incentive factor as described in 
130.19 	paragraphs (b) and (c), and divided by the nursing facility's occupancy factor under 
130.20 	subdivision 3f, paragraph (c). This amount shall be added to the nursing facility's total 
130.21 	payment rate and shall be effective the same day as the incremental increase in paragraph 
130.22 	(d) or subdivision 17. The allowable historical cost of the capital assets and the allowable 
130.23 	debt shall be determined as provided in Minnesota Rules, parts 9549.0010 to 9549.0080, 
130.24 	and this section.
130.25 	(b) The equity incentive factor shall be determined under clauses (1) to (4):
130.26 	(1) divide the initial allowable debt in paragraph (a) by the initial historical cost of the 
130.27 	capital asset additions referred to in paragraph (a), then cube the quotient,
130.28 	(2) subtract the amount calculated in clause (1) from the number one,
130.29 	(3) determine the difference between the rental factor and the lesser of two percentage 
130.30 	points above the posted yield for standard conventional fixed rate mortgages of the Federal 
130.31 	Home Loan Mortgage Corporation as published in the Wall Street Journal and in effect on 
130.32 	the first day of the month the debt or cost is incurred, or 16 percent,
130.33 	(4) multiply the amount calculated in clause (2) by the amount calculated in clause (3).
131.1 	(c) The equity incentive payment rate shall be limited to the term of the allowable debt 
131.2 	in paragraph (a), not greater than 20 years nor less than ten years. If no debt is incurred in 
131.3 	acquiring the capital asset, the equity incentive payment rate shall be paid for ten years. The 
131.4 	sale of a nursing facility under subdivision 14 shall terminate application of the equity 
131.5 	incentive payment rate effective on the date provided in subdivision 14, paragraph (f), for 
131.6 	the sale.
131.7 	(d) A nursing facility with an addition to or a renovation of its buildings, attached fixtures, 
131.8 	or land improvements meeting the criteria in this subdivision and not receiving the 
131.9 	property-related payment rate adjustment in subdivision 17, shall receive the incremental 
131.10 	increase in the nursing facility's rental rate as determined under Minnesota Rules, parts 
131.11 	9549.0010 to 9549.0080, and this section. The incremental increase shall be added to the 
131.12 	nursing facility's property-related payment rate. The effective date of this incremental 
131.13 	increase shall be the first day of the month of January or July, whichever occurs first 
131.14 	following the month in date on which the addition or replacement is completed.

131.15 	EFFECTIVE DATE. This section is effective for additions or replacements completed 
131.16 	after January 1, 2018.

131.17 	Sec. 22. Minnesota Statutes 2016, section 256B.431, subdivision 30, is amended to read:
131.18 		Subd. 30.Bed layaway and delicensure. (a) For rate years beginning on or after July 
131.19 	1, 2000, a nursing facility reimbursed under this section which has placed beds on layaway 
131.20 	shall, for purposes of application of the downsizing incentive in subdivision 3a, paragraph 
131.21 	(c), and calculation of the rental per diem, have those beds given the same effect as if the 
131.22 	beds had been delicensed so long as the beds remain on layaway. At the time of a layaway, 
131.23 	a facility may change its single bed election for use in calculating capacity days under 
131.24 	Minnesota Rules, part 9549.0060, subpart 11. The property payment rate increase shall be 
131.25 	effective the first day of the month of January or July, whichever occurs first following the 
131.26 	month indate on which the layaway of the beds becomes effective under section 144A.071, 
131.27 	subdivision 4b.
131.28 	(b) For rate years beginning on or after July 1, 2000, notwithstanding any provision to 
131.29 	the contrary under section 256B.434, a nursing facility reimbursed under that section which
131.30 	that has placed beds on layaway shall, for so long as the beds remain on layaway, be allowed 
131.31 	to:
131.32 	(1) aggregate the applicable investment per bed limits based on the number of beds 
131.33 	licensed immediately prior to entering the alternative payment system;
132.1 	(2) retain or change the facility's single bed election for use in calculating capacity days 
132.2 	under Minnesota Rules, part 9549.0060, subpart 11; and
132.3 	(3) establish capacity days based on the number of beds immediately prior to the layaway 
132.4 	and the number of beds after the layaway.
132.5 	The commissioner shall increase the facility's property payment rate by the incremental 
132.6 	increase in the rental per diem resulting from the recalculation of the facility's rental per 
132.7 	diem applying only the changes resulting from the layaway of beds and clauses (1), (2), and 
132.8 	(3). If a facility reimbursed under section 256B.434 completes a moratorium exception 
132.9 	project after its base year, the base year property rate shall be the moratorium project property 
132.10 	rate. The base year rate shall be inflated by the factors in section 256B.434, subdivision 4, 
132.11 	paragraph (c). The property payment rate increase shall be effective the first day of the 
132.12 	month of January or July, whichever occurs first following the month indate on which the 
132.13 	layaway of the beds becomes effective.
132.14 	(c) If a nursing facility removes a bed from layaway status in accordance with section 
132.15 	144A.071, subdivision 4b, the commissioner shall establish capacity days based on the 
132.16 	number of licensed and certified beds in the facility not on layaway and shall reduce the 
132.17 	nursing facility's property payment rate in accordance with paragraph (b).
132.18 	(d) For the rate years beginning on or after July 1, 2000, notwithstanding any provision 
132.19 	to the contrary under section 256B.434, a nursing facility reimbursed under that section, 
132.20 	which that has delicensed beds after July 1, 2000, by giving notice of the delicensure to the 
132.21 	commissioner of health according to the notice requirements in section 144A.071, subdivision 
132.22 	4b, shall be allowed to:
132.23 	(1) aggregate the applicable investment per bed limits based on the number of beds 
132.24 	licensed immediately prior to entering the alternative payment system;
132.25 	(2) retain or change the facility's single bed election for use in calculating capacity days 
132.26 	under Minnesota Rules, part 9549.0060, subpart 11; and
132.27 	(3) establish capacity days based on the number of beds immediately prior to the 
132.28 	delicensure and the number of beds after the delicensure.
132.29 	The commissioner shall increase the facility's property payment rate by the incremental 
132.30 	increase in the rental per diem resulting from the recalculation of the facility's rental per 
132.31 	diem applying only the changes resulting from the delicensure of beds and clauses (1), (2), 
132.32 	and (3). If a facility reimbursed under section 256B.434 completes a moratorium exception 
132.33 	project after its base year, the base year property rate shall be the moratorium project property 
133.1 	rate. The base year rate shall be inflated by the factors in section 256B.434, subdivision 4, 
133.2 	paragraph (c). The property payment rate increase shall be effective the first day of the 
133.3 	month of January or July, whichever occurs first following the month indate on which the 
133.4 	delicensure of the beds becomes effective.
133.5 	(e) For nursing facilities reimbursed under this section or section 256B.434, any beds 
133.6 	placed on layaway shall not be included in calculating facility occupancy as it pertains to 
133.7 	leave days defined in Minnesota Rules, part 9505.0415.
133.8 	(f) For nursing facilities reimbursed under this section or section 256B.434, the rental 
133.9 	rate calculated after placing beds on layaway may not be less than the rental rate prior to 
133.10 	placing beds on layaway.
133.11 	(g) A nursing facility receiving a rate adjustment as a result of this section shall comply 
133.12 	with section 256B.47, subdivision 2 256R.06, subdivision 5.
133.13 	(h) A facility that does not utilize the space made available as a result of bed layaway 
133.14 	or delicensure under this subdivision to reduce the number of beds per room or provide 
133.15 	more common space for nursing facility uses or perform other activities related to the 
133.16 	operation of the nursing facility shall have its property rate increase calculated under this 
133.17 	subdivision reduced by the ratio of the square footage made available that is not used for 
133.18 	these purposes to the total square footage made available as a result of bed layaway or 
133.19 	delicensure.

133.20 	EFFECTIVE DATE. This section is effective for layaways occurring after July 1, 2017.

133.21 	Sec. 23. Minnesota Statutes 2016, section 256B.434, subdivision 4, is amended to read:
133.22 		Subd. 4.Alternate rates for nursing facilities. Effective for the rate years beginning 
133.23 	on and after January 1, 2019, a nursing facility's case mix property payment ratesrate for 
133.24 	the second and subsequent years of a facility's contract under this section are the previous 
133.25 	rate year's contractproperty payment ratesrate plus an inflation adjustment and, for facilities 
133.26 	reimbursed under this section or section 256B.431, an adjustment to include the cost of any 
133.27 	increase in Health Department licensing fees for the facility taking effect on or after July 
133.28 	1, 2001. The index for the inflation adjustment must be based on the change in the Consumer 
133.29 	Price Index-All Items (United States City average) (CPI-U) forecasted by the commissioner 
133.30 	of management and budget's national economic consultant Reports and Forecasts Division 
133.31 	of the Department of Human Services, as forecasted in the fourth quarter of the calendar 
133.32 	year preceding the rate year. The inflation adjustment must be based on the 12-month period 
133.33 	from the midpoint of the previous rate year to the midpoint of the rate year for which the 
134.1 	rate is being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1, 
134.2 	2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007, July 
134.3 	1, 2008, October 1, 2009, and October 1, 2010, this paragraph shall apply only to the 
134.4 	property-related payment rate. For the rate years beginning on October 1, 2011, October 1, 
134.5 	2012, October 1, 2013, October 1, 2014, October 1, 2015, January 1, 2016, and January 1, 
134.6 	2017, the rate adjustment under this paragraph shall be suspended. Beginning in 2005, 
134.7 	adjustment to the property payment rate under this section and section 256B.431 shall be 
134.8 	effective on October 1. In determining the amount of the property-related payment rate 
134.9 	adjustment under this paragraph, the commissioner shall determine the proportion of the 
134.10 	facility's rates that are property-related based on the facility's most recent cost report.

134.11 	EFFECTIVE DATE. This section is effective the day following final enactment.

134.12 	Sec. 24. Minnesota Statutes 2016, section 256B.434, subdivision 4f, is amended to read:
134.13 		Subd. 4f.Construction project rate adjustments effective October 1, 2006. (a) 
134.14 	Effective October 1, 2006, facilities reimbursed under this section may receive a property 
134.15 	rate adjustment for construction projects exceeding the threshold in section 256B.431, 
134.16 	subdivision 16, and below the threshold in section 144A.071, subdivision 2, clause (a). For 
134.17 	these projects, capital assets purchased shall be counted as construction project costs for a 
134.18 	rate adjustment request made by a facility if they are: (1) purchased within 24 months of 
134.19 	the completion of the construction project; (2) purchased after the completion date of any 
134.20 	prior construction project; and (3) are not purchased prior to July 14, 2005. Except as 
134.21 	otherwise provided in this subdivision, the definitions, rate calculation methods, and 
134.22 	principles in sections 144A.071 and 256B.431 and Minnesota Rules, parts 9549.0010 to 
134.23 	9549.0080, shall be used to calculate rate adjustments for allowable construction projects 
134.24 	under this subdivision and section 144A.073. Facilities completing construction projects 
134.25 	between October 1, 2005, and October 1, 2006, are eligible to have a property rate adjustment 
134.26 	effective October 1, 2006. Facilities completing projects after October 1, 2006, are eligible 
134.27 	for a property rate adjustment effective on the first day of the month following the completion 
134.28 	date. Facilities completing projects after January 1, 2018, are eligible for a property rate 
134.29 	adjustment effective on the first day of the month of January or July, whichever occurs 
134.30 	immediately following the completion date.
134.31 	(b) Notwithstanding subdivision 18, as of July 14, 2005, facilities with rates set under 
134.32 	section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080, that commenced a 
134.33 	construction project on or after October 1, 2004, and do not have a contract under subdivision 
134.34 	3 by September 30, 2006, are eligible to request a rate adjustment under section 256B.431, 
135.1 	subdivision 10, through September 30, 2006. If the request results in the commissioner 
135.2 	determining a rate adjustment is allowable, the rate adjustment is effective on the first of 
135.3 	the month following project completion. These facilities shall be allowed to accumulate 
135.4 	construction project costs for the period October 1, 2004, to September 30, 2006.
135.5 	(c) Facilities shall be allowed construction project rate adjustments no sooner than 12 
135.6 	months after completing a previous construction project. Facilities must request the rate 
135.7 	adjustment according to section 256B.431, subdivision 10.
135.8 	(d) Capacity days shall be computed according to Minnesota Rules, part 9549.0060, 
135.9 	subpart 11. For rate calculations under this section, the number of licensed beds in the 
135.10 	nursing facility shall be the number existing after the construction project is completed and 
135.11 	the number of days in the nursing facility's reporting period shall be 365.
135.12 	(e) The value of assets to be recognized for a total replacement project as defined in 
135.13 	section 256B.431, subdivision 17d, shall be computed as described in clause (1). The value 
135.14 	of assets to be recognized for all other projects shall be computed as described in clause 
135.15 	(2).
135.16 	(1) Replacement-cost-new limits under section 256B.431, subdivision 17e, and the 
135.17 	number of beds allowed under subdivision 3a, paragraph (c), shall be used to compute the 
135.18 	maximum amount of assets allowable in a facility's property rate calculation. If a facility's 
135.19 	current request for a rate adjustment results from the completion of a construction project 
135.20 	that was previously approved under section 144A.073, the assets to be used in the rate 
135.21 	calculation cannot exceed the lesser of the amount determined under sections 144A.071, 
135.22 	subdivision 2, and 144A.073, subdivision 3b, or the actual allowable costs of the construction 
135.23 	project. A current request that is not the result of a project under section 144A.073 cannot 
135.24 	exceed the limit under section 144A.071, subdivision 2, paragraph (a). Applicable credits 
135.25 	must be deducted from the cost of the construction project.
135.26 	(2)(i) Replacement-cost-new limits under section 256B.431, subdivision 17e, and the 
135.27 	number of beds allowed under section 256B.431, subdivision 3a, paragraph (c), shall be 
135.28 	used to compute the maximum amount of assets allowable in a facility's property rate 
135.29 	calculation.
135.30 	(ii) The value of a facility's assets to be compared to the amount in item (i) begins with 
135.31 	the total appraised value from the last rate notice a facility received when its rates were set 
135.32 	under section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080. This value 
135.33 	shall be indexed by the factor in section 256B.431, subdivision 3f, paragraph (a), for each 
135.34 	rate year the facility received an inflation factor on its property-related rate when its rates 
136.1 	were set under this section. The value of assets listed as previous capital additions, capital 
136.2 	additions, and special projects on the facility's base year rate notice and the value of assets 
136.3 	related to a construction project for which the facility received a rate adjustment when its 
136.4 	rates were determined under this section shall be added to the indexed appraised value.
136.5 	(iii) The maximum amount of assets to be recognized in computing a facility's rate 
136.6 	adjustment after a project is completed is the lesser of the aggregate replacement-cost-new 
136.7 	limit computed in (i) minus the assets recognized in (ii) or the actual allowable costs of the 
136.8 	construction project.
136.9 	(iv) If a facility's current request for a rate adjustment results from the completion of a 
136.10 	construction project that was previously approved under section 144A.073, the assets to be 
136.11 	added to the rate calculation cannot exceed the lesser of the amount determined under 
136.12 	sections 144A.071, subdivision 2, and 144A.073, subdivision 3b, or the actual allowable 
136.13 	costs of the construction project. A current request that is not the result of a project under 
136.14 	section 144A.073 cannot exceed the limit stated in section 144A.071, subdivision 2, 
136.15 	paragraph (a). Assets disposed of as a result of a construction project and applicable credits 
136.16 	must be deducted from the cost of the construction project.
136.17 	(f) For construction projects approved under section 144A.073, allowable debt may 
136.18 	never exceed the lesser of the cost of the assets purchased, the threshold limit in section 
136.19 	144A.071, subdivision 2, or the replacement-cost-new limit less previously existing capital 
136.20 	debt.
136.21 	(g) For construction projects that were not approved under section 144A.073, allowable 
136.22 	debt is limited to the lesser of the threshold in section 144A.071, subdivision 2, for such 
136.23 	construction projects or the applicable limit in paragraph (e), clause (1) or (2), less previously 
136.24 	existing capital debt. Amounts of debt taken out that exceed the costs of a construction 
136.25 	project shall not be allowed regardless of the use of the funds.
136.26 	For all construction projects being recognized, interest expense and average debt shall 
136.27 	be computed based on the first 12 months following project completion. "Previously existing 
136.28 	capital debt" means capital debt recognized on the last rate determined under section 
136.29 	256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080, and the amount of debt 
136.30 	recognized for a construction project for which the facility received a rate adjustment when 
136.31 	its rates were determined under this section.
136.32 	For a total replacement project as defined in section 256B.431, subdivision 17d, the 
136.33 	value of previously existing capital debt shall be zero.
137.1 	(h) In addition to the interest expense allowed from the application of paragraph (f), the 
137.2 	amounts allowed under section 256B.431, subdivision 17a, paragraph (a), clauses (2) and 
137.3 	(3), will be added to interest expense.
137.4 	(i) The equity portion of the construction project shall be computed as the allowable 
137.5 	assets in paragraph (e), less the average debt in paragraph (f). The equity portion must be 
137.6 	multiplied by 5.66 percent and the allowable interest expense in paragraph (f) must be added. 
137.7 	This sum must be divided by 95 percent of capacity days to compute the construction project 
137.8 	rate adjustment.
137.9 	(j) For projects that are not a total replacement of a nursing facility, the amount in 
137.10 	paragraph (i) is adjusted for nonreimbursable areas and then added to the current property 
137.11 	payment rate of the facility.
137.12 	(k) For projects that are a total replacement of a nursing facility, the amount in paragraph 
137.13 	(i) becomes the new property payment rate after being adjusted for nonreimbursable areas. 
137.14 	Any amounts existing in a facility's rate before the effective date of the construction project 
137.15 	for equity incentives under section 256B.431, subdivision 16; capital repairs and replacements 
137.16 	under section 256B.431, subdivision 15; or refinancing incentives under section 256B.431, 
137.17 	subdivision 19, shall be removed from the facility's rates.
137.18 	(l) No additional equipment allowance is allowed under Minnesota Rules, part 9549.0060, 
137.19 	subpart 10, as the result of construction projects under this section. Allowable equipment 
137.20 	shall be included in the construction project costs.
137.21 	(m) Capital assets purchased after the completion date of a construction project shall be 
137.22 	counted as construction project costs for any future rate adjustment request made by a facility 
137.23 	under section 144A.071, subdivision 2, clause (a), if they are purchased within 24 months 
137.24 	of the completion of the future construction project.
137.25 	(n) In subsequent rate years, the property payment rate for a facility that results from 
137.26 	the application of this subdivision shall be the amount inflated in subdivision 4.
137.27 	(o) Construction projects are eligible for an equity incentive under section 256B.431, 
137.28 	subdivision 16. When computing the equity incentive for a construction project under this 
137.29 	subdivision, only the allowable costs and allowable debt related to the construction project 
137.30 	shall be used. The equity incentive shall not be a part of the property payment rate and not 
137.31 	inflated under subdivision 4. Effective October 1, 2006, all equity incentives for nursing 
137.32 	facilities reimbursed under this section shall be allowed for a duration determined under 
137.33 	section 256B.431, subdivision 16, paragraph (c).

138.1 	EFFECTIVE DATE. This section is effective January 1, 2018.

138.2 	Sec. 25. Minnesota Statutes 2016, section 256B.50, subdivision 1b, is amended to read:
138.3 		Subd. 1b.Filing an appeal. To appeal, the provider shall file with the commissioner a 
138.4 	written notice of appeal; the appeal must be postmarked or received by the commissioner 
138.5 	within 60 days of the publication date the determination of the payment rate was mailed or 
138.6 	personally received by a provider, whichever is earlier printed on the rate notice. The notice 
138.7 	of appeal must specify each disputed item; the reason for the dispute; the total dollar amount 
138.8 	in dispute for each separate disallowance, allocation, or adjustment of each cost item or part 
138.9 	of a cost item; the computation that the provider believes is correct; the authority in statute 
138.10 	or rule upon which the provider relies for each disputed item; the name and address of the 
138.11 	person or firm with whom contacts may be made regarding the appeal; and other information 
138.12 	required by the commissioner.

138.13 	EFFECTIVE DATE. This section is effective the day following final enactment.

138.14 	Sec. 26. Minnesota Statutes 2016, section 256B.5012, is amended by adding a subdivision 
138.15 	to read:
138.16 		Subd. 3a.Therapeutic leave days. Notwithstanding Minnesota Rules, part 9505.0415, 
138.17 	subpart 7, a vacant bed in an intermediate care facility for persons with developmental 
138.18 	disabilities shall be counted as a reserved bed when determining occupancy rates and 
138.19 	eligibility for payment of a therapeutic leave day.

138.20 	Sec. 27. Minnesota Statutes 2016, section 256B.5012, is amended by adding a subdivision 
138.21 	to read:
138.22 		Subd. 17.ICF/DD rate increase effective July 1, 2017; Murray County. Effective 
138.23 	July 1, 2017, the daily rate for an intermediate care facility for persons with developmental 
138.24 	disabilities located in Murray County that is classified as a class B facility and licensed for 
138.25 	14 beds is $400. This increase is in addition to any other increase that is effective on July 
138.26 	1, 2017.

138.27 	Sec. 28. Minnesota Statutes 2016, section 256R.02, subdivision 4, is amended to read:
138.28 		Subd. 4.Administrative costs. "Administrative costs" means the identifiable costs for 
138.29 	administering the overall activities of the nursing home. These costs include salaries and 
138.30 	wages of the administrator, assistant administrator, business office employees, security 
138.31 	guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases related 
139.1 	to business office functions, licenses, and permits except as provided in the external fixed 
139.2 	costs category, employee recognition, travel including meals and lodging, all training except 
139.3 	as specified in subdivision 17, voice and data communication or transmission, office supplies, 
139.4 	property and liability insurance and other forms of insurance not designated to other areas
139.5 	except insurance that is a fringe benefit under subdivision 22, personnel recruitment, legal 
139.6 	services, accounting services, management or business consultants, data processing, 
139.7 	information technology, Web site, central or home office costs, business meetings and 
139.8 	seminars, postage, fees for professional organizations, subscriptions, security services, 
139.9 	advertising, board of directors fees, working capital interest expense, and bad debts,and
139.10 	bad debt collection fees, and costs incurred for travel and housing for persons employed by 
139.11 	a supplemental nursing services agency as defined in section 144A.70, subdivision 6.

139.12 	EFFECTIVE DATE. This section is effective October 1, 2017.

139.13 	Sec. 29. Minnesota Statutes 2016, section 256R.02, subdivision 17, is amended to read:
139.14 		Subd. 17.Direct care costs. "Direct care costs" means costs for the wages of nursing 
139.15 	administration, direct care registered nurses, licensed practical nurses, certified nursing 
139.16 	assistants, trained medication aides, employees conducting training in resident care topics 
139.17 	and associated fringe benefits and payroll taxes; services from a supplemental nursing 
139.18 	services agency; supplies that are stocked at nursing stations or on the floor and distributed 
139.19 	or used individually, including, but not limited to: alcohol, applicators, cotton balls, 
139.20 	incontinence pads, disposable ice bags, dressings, bandages, water pitchers, tongue 
139.21 	depressors, disposable gloves, enemas, enema equipment, soap, medication cups, diapers, 
139.22 	plastic waste bags, sanitary products, thermometers, hypodermic needles and syringes, 
139.23 	clinical reagents or similar diagnostic agents, drugs that are not paid on a separate fee 
139.24 	schedule by the medical assistance program or any other payer, and technology related to 
139.25 	the provision of nursing care to residents, such as electronic charting systems; costs of 
139.26 	materials used for resident care training, and training courses outside of the facility attended 
139.27 	by direct care staff on resident care topics; and costs for nurse consultants, pharmacy 
139.28 	consultants, and medical directors. Salaries and payroll taxes for nurse consultants who 
139.29 	work out of a central office must be allocated proportionately by total resident days or by 
139.30 	direct identification to the nursing facilities served by those consultants.

139.31 	EFFECTIVE DATE. This section is effective October 1, 2017.

140.1 	Sec. 30. Minnesota Statutes 2016, section 256R.02, subdivision 18, is amended to read:
140.2 		Subd. 18.Employer health insurance costs. "Employer health insurance costs" means 
140.3 	premium expenses for group coverage and reinsurance,; actual expenses incurred for 
140.4 	self-insured plans, including reinsurance; and employer contributions to employee health 
140.5 	reimbursement and health savings accounts. Premium and expense costs and contributions 
140.6 	are allowable for (1) all employees and (2) the spouse and dependents of those employees 
140.7 	who meet the definition of full-time employees under the federal Affordable Care Act, 
140.8 	Public Law 111-148 are employed on average at least 30 hours per week.

140.9 	EFFECTIVE DATE. This section is effective the day following final enactment.

140.10 	Sec. 31. Minnesota Statutes 2016, section 256R.02, subdivision 19, is amended to read:
140.11 		Subd. 19.External fixed costs. "External fixed costs" means costs related to the nursing 
140.12 	home surcharge under section 256.9657, subdivision 1; licensure fees under section 144.122; 
140.13 	family advisory council fee under section 144A.33; scholarships under section 256R.37; 
140.14 	planned closure rate adjustments under section 256R.40; consolidation rate adjustments 
140.15 	under section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d; 
140.16 	single-bed room incentives under section 256R.41; property taxes, assessments, and payments 
140.17 	in lieu of taxes; employer health insurance costs; quality improvement incentive payment 
140.18 	rate adjustments under section 256R.39; performance-based incentive payments under 
140.19 	section 256R.38; special dietary needs under section 256R.51; rate adjustments for 
140.20 	compensation-related costs for minimum wage changes under section 256R.49 provided 
140.21 	on or after January 1, 2018; and Public Employees Retirement Association employer costs.

140.22 	Sec. 32. Minnesota Statutes 2016, section 256R.02, subdivision 22, is amended to read:
140.23 		Subd. 22.Fringe benefit costs. "Fringe benefit costs" means the costs for group life, 
140.24 	dental, workers' compensation, and other employee insurances and short- and long-term 
140.25 	disability, long-term care insurance, accident insurance, supplemental insurance, legal 
140.26 	assistance insurance, profit sharing, health insurance costs not covered under subdivision 
140.27 	18, including costs associated with part-time employee family members or retirees, and
140.28 	pension and retirement plan contributions, except for the Public Employees Retirement 
140.29 	Association and employer health insurance costs; profit sharing; and retirement plans for 
140.30 	which the employer pays all or a portion of the costs.

141.1 	Sec. 33. Minnesota Statutes 2016, section 256R.02, subdivision 42, is amended to read:
141.2 		Subd. 42.Raw food costs. "Raw food costs" means the cost of food provided to nursing 
141.3 	facility residents and the allocation of dietary credits. Also included are special dietary 
141.4 	supplements used for tube feeding or oral feeding, such as elemental high nitrogen diet.

141.5 	Sec. 34. Minnesota Statutes 2016, section 256R.02, is amended by adding a subdivision 
141.6 	to read:
141.7 		Subd. 42a.Real estate taxes. "Real estate taxes" means the real estate tax liability shown 
141.8 	on the annual property tax statement of the nursing facility for the reporting period. The 
141.9 	term does not include personnel costs or fees for late payment.

141.10 	Sec. 35. Minnesota Statutes 2016, section 256R.02, is amended by adding a subdivision 
141.11 	to read:
141.12 		Subd. 48a.Special assessments. "Special assessments" means the actual special 
141.13 	assessments and related interest paid during the reporting period. The term does not include 
141.14 	personnel costs or fees for late payment.

141.15 	Sec. 36. Minnesota Statutes 2016, section 256R.02, subdivision 52, is amended to read:
141.16 		Subd. 52.Therapy costs. "Therapy costs" means any costs related to medical assistance
141.17 	therapy services provided to residents that are not billed separately billable from the daily 
141.18 	operating rate.

141.19 	Sec. 37. Minnesota Statutes 2016, section 256R.06, subdivision 5, is amended to read:
141.20 		Subd. 5.Notice to residents. (a) No increase in nursing facility rates for private paying 
141.21 	residents shall be effective unless the nursing facility notifies the resident or person 
141.22 	responsible for payment of the increase in writing 30 days before the increase takes effect.
141.23 	The notice must include the amount of the rate increase, the new payment rate, and the date 
141.24 	the rate increase takes effect.
141.25 	A nursing facility may adjust its rates without giving the notice required by this 
141.26 	subdivision when the purpose of the rate adjustment is to reflect a change in the case mix 
141.27 	classification of the resident. The nursing facility shall notify private pay residents of any 
141.28 	rate increase related to a change in case mix classifications in a timely manner after 
141.29 	confirmation of the case mix classification change is received from the Department of 
141.30 	Health.
142.1 	If the state fails to set rates as required by section 256R.09, subdivision 1, the time 
142.2 	required for giving notice is decreased by the number of days by which the state was late 
142.3 	in setting the rates.
142.4 	(b) If the state does not set rates by the date required in section 256R.09, subdivision 1, 
142.5 	or otherwise provides nursing facilities with retroactive notification of the amount of a rate 
142.6 	increase, nursing facilities shall meet the requirement for advance notice by informing the 
142.7 	resident or person responsible for payments, on or before the effective date of the increase, 
142.8 	that a rate increase will be effective on that date. The requirements of paragraph (a) do not 
142.9 	apply to situations described in this paragraph.
142.10 	If the exact amount has not yet been determined, the nursing facility may raise the rates 
142.11 	by the amount anticipated to be allowed. Any amounts collected from private pay residents 
142.12 	in excess of the allowable rate must be repaid to private pay residents with interest at the 
142.13 	rate used by the commissioner of revenue for the late payment of taxes and in effect on the 
142.14 	date the rate increase is effective.

142.15 	Sec. 38. Minnesota Statutes 2016, section 256R.07, is amended by adding a subdivision 
142.16 	to read:
142.17 		Subd. 6.Electronic signature. For documentation requiring a signature under this 
142.18 	chapter or section 256B.431 or 256B.434, use of an electronic signature as defined under 
142.19 	section 325L.02, paragraph (h), is allowed.

142.20 	Sec. 39. Minnesota Statutes 2016, section 256R.10, is amended by adding a subdivision 
142.21 	to read:
142.22 		Subd. 7.Not specified allowed costs. When the cost category for allowed cost items or 
142.23 	services is not specified in this chapter or the provider reimbursement manual, the 
142.24 	commissioner, in consultation with stakeholders, shall determine the cost category for the 
142.25 	allowed cost item or service.

142.26 	EFFECTIVE DATE. This section is effective the day following final enactment.

142.27 	Sec. 40. [256R.18] REPORT BY COMMISSIONER OF HUMAN SERVICES.
142.28 	Beginning January 1, 2019, the commissioner shall provide to the house of representatives 
142.29 	and senate committees with jurisdiction over nursing facility payment rates a biennial report 
142.30 	on the effectiveness of the reimbursement system in improving quality, restraining costs, 
142.31 	and any other features of the system as determined by the commissioner.

143.1 	EFFECTIVE DATE. This section is effective the day following final enactment.

143.2 	Sec. 41. Minnesota Statutes 2016, section 256R.37, is amended to read:
143.3 	256R.37 SCHOLARSHIPS.
143.4 	(a) For the 27-month period beginning October 1, 2015, through December 31, 2017, 
143.5 	the commissioner shall allow a scholarship per diem of up to 25 cents for each nursing 
143.6 	facility with no scholarship per diem that is requesting a scholarship per diem to be added 
143.7 	to the external fixed payment rate to be used:
143.8 	(1) for employee scholarships that satisfy the following requirements:
143.9 	(i) scholarships are available to all employees who work an average of at least ten hours 
143.10 	per week at the facility except the administrator, and to reimburse student loan expenses 
143.11 	for newly hired and recently graduated registered nurses and licensed practical nurses, and 
143.12 	training expenses for nursing assistants as specified in section 144A.611, subdivisions 2
143.13 	and 4, who are newly hired and have graduated within the last 12 months; and
143.14 	(ii) the course of study is expected to lead to career advancement with the facility or in 
143.15 	long-term care, including medical care interpreter services and social work; and
143.16 	(2) to provide job-related training in English as a second language.
143.17 	(b) All facilities may annually request a rate adjustment under this section by submitting 
143.18 	information to the commissioner on a schedule and in a form supplied by the commissioner. 
143.19 	The commissioner shall allow a scholarship payment rate equal to the reported and allowable 
143.20 	costs divided by resident days.
143.21 	(c) In calculating the per diem under paragraph (b), the commissioner shall allow costs 
143.22 	related to tuition, direct educational expenses, and reasonable costs as defined by the 
143.23 	commissioner for child care costs and transportation expenses related to direct educational 
143.24 	expenses.
143.25 	(d) The rate increase under this section is an optional rate add-on that the facility must 
143.26 	request from the commissioner in a manner prescribed by the commissioner. The rate 
143.27 	increase must be used for scholarships as specified in this section.
143.28 	(e) For instances in which a rate adjustment will be 15 cents or greater, nursing facilities 
143.29 	that close beds during a rate year may request to have their scholarship adjustment under 
143.30 	paragraph (b) recalculated by the commissioner for the remainder of the rate year to reflect 
143.31 	the reduction in resident days compared to the cost report year.

143.32 	EFFECTIVE DATE. This section is effective October 1, 2017.

144.1 	Sec. 42. Minnesota Statutes 2016, section 256R.40, subdivision 1, is amended to read:
144.2 		Subdivision 1.Definitions. (a) The definitions in this subdivision apply to this section.
144.3 	(b) "Closure" means the cessation of operations of a nursing facility and delicensure and 
144.4 	decertification of all beds within the facility.
144.5 	(c) "Closure plan" means a plan to close a nursing facility and reallocate a portion of 
144.6 	the resulting savings to provide planned closure rate adjustments at other facilities.
144.7 	(d) "Commencement of closure" means the date on which residents and designated 
144.8 	representatives are notified of a planned closure as provided in section 144A.161, subdivision 
144.9 	5a, as part of an approved closure plan.
144.10 	(e) "Completion of closure" means the date on which the final resident of the nursing 
144.11 	facility designated for closure in an approved closure plan is discharged from the facility
144.12 	or the date that beds from a partial closure are delicensed and decertified.
144.13 	(f) "Partial closure" means the delicensure and decertification of a portion of the beds 
144.14 	within the facility.
144.15 	(g) "Planned closure rate adjustment" means an increase in a nursing facility's operating 
144.16 	rates resulting from a planned closure or a planned partial closure of another facility.

144.17 	Sec. 43. Minnesota Statutes 2016, section 256R.40, subdivision 5, is amended to read:
144.18 		Subd. 5.Planned closure rate adjustment. (a) The commissioner shall calculate the 
144.19 	amount of the planned closure rate adjustment available under subdivision 6 according to 
144.20 	clauses (1) to (4):
144.21 	(1) the amount available is the net reduction of nursing facility beds multiplied by $2,080;
144.22 	(2) the total number of beds in the nursing facility or facilities receiving the planned 
144.23 	closure rate adjustment must be identified;
144.24 	(3) capacity days are determined by multiplying the number determined under clause 
144.25 	(2) by 365; and
144.26 	(4) the planned closure rate adjustment is the amount available in clause (1), divided by 
144.27 	capacity days determined under clause (3).
144.28 	(b) A planned closure rate adjustment under this section is effective on the first day of 
144.29 	the month of January or July, whichever occurs immediately following completion of closure 
144.30 	of the facility designated for closure in the application and becomes part of the nursing 
144.31 	facility's external fixed payment rate.
145.1 	(c) Upon the request of a closing facility, the commissioner must allow the facility a 
145.2 	closure rate adjustment as provided under section 144A.161, subdivision 10.
145.3 	(d) A facility that has received a planned closure rate adjustment may reassign it to 
145.4 	another facility that is under the same ownership at any time within three years of its effective 
145.5 	date. The amount of the adjustment is computed according to paragraph (a).
145.6 	(e) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, the 
145.7 	commissioner shall recalculate planned closure rate adjustments for facilities that delicense 
145.8 	beds under this section on or after July 1, 2001, to reflect the increase in the per bed dollar 
145.9 	amount. The recalculated planned closure rate adjustment is effective from the date the per 
145.10 	bed dollar amount is increased.

145.11 	EFFECTIVE DATE. This section is effective for closures occurring after July 1, 2017.

145.12 	Sec. 44. Minnesota Statutes 2016, section 256R.41, is amended to read:
145.13 	256R.41 SINGLE-BED ROOM INCENTIVE.
145.14 	(a) Beginning July 1, 2005, the operating payment rate for nursing facilities reimbursed 
145.15 	under this chapter shall be increased by 20 percent multiplied by the ratio of the number of 
145.16 	new single-bed rooms created divided by the number of active beds on July 1, 2005, for 
145.17 	each bed closure that results in the creation of a single-bed room after July 1, 2005. The 
145.18 	commissioner may implement rate adjustments for up to 3,000 new single-bed rooms each 
145.19 	year. For eligible bed closures for which the commissioner receives a notice from a facility 
145.20 	during a calendar quarter that a bed has been delicensed and a new single-bed room has 
145.21 	been established, the rate adjustment in this paragraph shall be effective on either the first 
145.22 	day of the second month of January or July, whichever occurs first following that calendar 
145.23 	quarter the date of the bed delicensure.
145.24 	(b) A nursing facility is prohibited from discharging residents for purposes of establishing 
145.25 	single-bed rooms. A nursing facility must submit documentation to the commissioner in a 
145.26 	form prescribed by the commissioner, certifying the occupancy status of beds closed to 
145.27 	create single-bed rooms. In the event that the commissioner determines that a facility has 
145.28 	discharged a resident for purposes of establishing a single-bed room, the commissioner shall 
145.29 	not provide a rate adjustment under paragraph (a).

145.30 	EFFECTIVE DATE. This section is effective for closures occurring after July 1, 2017.

146.1 	Sec. 45. Minnesota Statutes 2016, section 256R.47, is amended to read:
146.2 	256R.47 RATE ADJUSTMENT FOR CRITICAL ACCESS NURSING 
146.3 	FACILITIES.
146.4 	(a) The commissioner, in consultation with the commissioner of health, may designate 
146.5 	certain nursing facilities as critical access nursing facilities. The designation shall be granted 
146.6 	on a competitive basis, within the limits of funds appropriated for this purpose.
146.7 	(b) The commissioner shall request proposals from nursing facilities every two years. 
146.8 	Proposals must be submitted in the form and according to the timelines established by the 
146.9 	commissioner. In selecting applicants to designate, the commissioner, in consultation with 
146.10 	the commissioner of health, and with input from stakeholders, shall develop criteria designed 
146.11 	to preserve access to nursing facility services in isolated areas, rebalance long-term care, 
146.12 	and improve quality. To the extent practicable, the commissioner shall ensure an even 
146.13 	distribution of designations across the state.
146.14 	(c) The commissioner shall allow the benefits in clauses (1) to (5) for nursing facilities 
146.15 	designated as critical access nursing facilities:
146.16 	(1) partial rebasing, with the commissioner allowing a designated facility operating 
146.17 	payment rates being the sum of up to 60 percent of the operating payment rate determined 
146.18 	in accordance with section 256R.21, subdivision 3, and at least 40 percent, with the sum of 
146.19 	the two portions being equal to 100 percent, of the operating payment rate that would have 
146.20 	been allowed had the facility not been designated. The commissioner may adjust these 
146.21 	percentages by up to 20 percent and may approve a request for less than the amount allowed;
146.22 	(2) enhanced payments for leave days. Notwithstanding section 256R.43, upon 
146.23 	designation as a critical access nursing facility, the commissioner shall limit payment for 
146.24 	leave days to 60 percent of that nursing facility's total payment rate for the involved resident, 
146.25 	and shall allow this payment only when the occupancy of the nursing facility, inclusive of 
146.26 	bed hold days, is equal to or greater than 90 percent;
146.27 	(3) two designated critical access nursing facilities, with up to 100 beds in active service, 
146.28 	may jointly apply to the commissioner of health for a waiver of Minnesota Rules, part 
146.29 	4658.0500, subpart 2, in order to jointly employ a director of nursing. The commissioner 
146.30 	of health shall consider each waiver request independently based on the criteria under 
146.31 	Minnesota Rules, part 4658.0040;
146.32 	(4) the minimum threshold under section 256B.431, subdivision 15, paragraph (e), shall 
146.33 	be 40 percent of the amount that would otherwise apply; and
147.1 	(5) the quality-based rate limits under section 256R.23, subdivisions 5 to 7, apply to 
147.2 	designated critical access nursing facilities.
147.3 	(d) Designation of a critical access nursing facility is for a period of two years, after 
147.4 	which the benefits allowed under paragraph (c) shall be removed. Designated facilities may 
147.5 	apply for continued designation.
147.6 	(e) This section is suspended and no state or federal funding shall be appropriated or 
147.7 	allocated for the purposes of this section from January 1, 2016, to December 31, 2017 2019.

147.8 	EFFECTIVE DATE. This section is effective the day following final enactment.

147.9 	Sec. 46. Minnesota Statutes 2016, section 256R.49, subdivision 1, is amended to read:
147.10 		Subdivision 1.Rate adjustments for compensation-related costs. (a) Operating payment 
147.11 	rates of all nursing facilities that are reimbursed under this chapter shall be increased effective 
147.12 	for rate years beginning on and after October 1, 2014, to address changes in compensation 
147.13 	costs for nursing facility employees paid less than $14 per hour in accordance with this 
147.14 	section. Rate increases provided under this section before October 1, 2016, expire effective 
147.15 	January 1, 2018, and rate increases provided on or after October 1, 2016, expire effective 
147.16 	January 1, 2019.
147.17 	(b) Nursing facilities that receive approval of the applications in subdivision 2 must 
147.18 	receive rate adjustments according to subdivision 4. The rate adjustments must be used to 
147.19 	pay compensation costs for nursing facility employees paid less than $14 per hour.

147.20 	EFFECTIVE DATE. This section is effective the day following final enactment.

147.21 	Sec. 47. DIRECTION TO THE COMMISSIONER; ADULT DAY SERVICES 
147.22 	STAFFING RATIOS; ELDERLY WAIVER.
 147.23 	The commissioner of human services shall:
147.24 	(1) study existing adult day services models, including resident acuity, staffing and 
147.25 	support levels, and quality assurance;
147.26 	(2) project demand for adult day services into the future; and
147.27 	(3) report to the legislature by January 1, 2019.

147.28 	EFFECTIVE DATE. This section is effective July 1, 2017.

148.1 	Sec. 48. ALZHEIMER'S DISEASE WORKING GROUP.
148.2 		Subdivision 1.Members. (a) The Minnesota Board on Aging must appoint 16 members 
148.3 	to an Alzheimer's disease working group, as follows:
148.4 	(1) a caregiver of a person who has been diagnosed with Alzheimer's disease;
148.5 	(2) a person who has been diagnosed with Alzheimer's disease;
148.6 	(3) two representatives from the nursing facility or senior housing profession;
148.7 	(4) a representative of the home care or adult day services profession;
148.8 	(5) two geriatricians, one of whom serves a diverse or underserved community;
148.9 	(6) a psychologist who specializes in dementia care;
148.10 	(7) an Alzheimer's researcher;
148.11 	(8) a representative of the Alzheimer's Association;
148.12 	(9) two members from community-based organizations serving one or more diverse or 
148.13 	underserved communities;
148.14 	(10) the commissioner of human services or a designee;
148.15 	(11) the commissioner of health or a designee;
148.16 	(12) the ombudsman for long-term care or a designee; and
148.17 	(13) one member of the Minnesota Board on Aging, selected by the board.
148.18 	(b) The executive director of the Minnesota Board on Aging serves on the working group 
148.19 	as a nonvoting member.
148.20 	(c) The appointing authorities under this subdivision must complete their appointments 
148.21 	no later than December 15, 2017.
148.22 	(d) To the extent practicable, the membership of the working group must reflect the 
148.23 	diversity in Minnesota, and must include representatives from rural and metropolitan areas 
148.24 	and representatives of different ethnicities, races, genders, ages, cultural groups, and abilities.
148.25 		Subd. 2.Duties; recommendations. The Alzheimer's disease working group must 
148.26 	review and revise the 2011 report, Preparing Minnesota for Alzheimer's: the Budgetary, 
148.27 	Social and Personal Impacts. The working group shall consider and make recommendations 
148.28 	and findings on the following issues as related to Alzheimer's disease or other dementias:
148.29 	(1) analysis and assessment of public health and health care data to accurately determine 
148.30 	trends and disparities in cognitive decline;
149.1 	(2) public awareness, knowledge, and attitudes, including knowledge gaps, stigma, 
149.2 	availability of information, and supportive community environments;
149.3 	(3) risk reduction, including health education and health promotion on risk factors, 
149.4 	safety, and potentially avoidable hospitalizations;
149.5 	(4) diagnosis and treatment, including early detection, access to diagnosis, quality of 
149.6 	dementia care, and cost of treatment;
149.7 	(5) professional education and training, including geriatric education for licensed health 
149.8 	care professionals and dementia-specific training for direct care workers, first responders, 
149.9 	and other professionals in communities;
149.10 	(6) residential services, including cost to families as well as regulation and licensing 
149.11 	gaps; and
149.12 	(7) cultural competence and responsiveness to reduce health disparities and improve 
149.13 	access to high-quality dementia care.
149.14 		Subd. 3.Meetings. The Board on Aging must convene the first meeting of the working 
149.15 	group no later than January 15, 2018. Before the first meeting, the Board on Aging must 
149.16 	designate one member to serve as chair. Meetings of the working group must be open to 
149.17 	the public, and to the extent practicable, technological means, such as Web casts, shall be 
149.18 	used to reach the greatest number of people throughout the state. The working group may 
149.19 	not meet more than five times.
149.20 		Subd. 4.Compensation. Members of the working group serve without compensation, 
149.21 	but may be reimbursed for allowed actual and necessary expenses incurred in the performance 
149.22 	of the member's duties for the working group in the same manner and amount as authorized 
149.23 	by the commissioner's plan adopted under Minnesota Statutes, section 43A.18, subdivision 
149.24 	2.
149.25 		Subd. 5.Administrative support. The Minnesota Board on Aging shall provide 
149.26 	administrative support and arrange meeting space for the working group.
149.27 		Subd. 6.Report. The Board on Aging must submit a report providing the findings and 
149.28 	recommendations of the working group, including any draft legislation necessary to 
149.29 	implement the recommendations, to the governor and chairs and ranking minority members 
149.30 	of the legislative committees with jurisdiction over health care by January 15, 2019.
149.31 		Subd. 7.Expiration. The working group expires June 30, 2019, or the day after the 
149.32 	working group submits the report required in subdivision 6, whichever is earlier.

150.1 	Sec. 49. ELECTRONIC SERVICE DELIVERY DOCUMENTATION SYSTEM.
 150.2 		Subdivision 1.Documentation; establishment. The commissioner of human services 
150.3 	shall establish implementation requirements and standards for an electronic service delivery 
150.4 	documentation system to comply with the 21st Century Cures Act, Public Law 114-255. 
150.5 	Within available appropriations, the commissioner shall take steps to comply with the 
150.6 	electronic visit verification requirements in the 21st Century Cures Act, Public Law 114-255.
150.7 		Subd. 2.Definitions. (a) For purposes of this section, the terms in this subdivision have 
150.8 	the meanings given them.
150.9 	(b) "Electronic service delivery documentation" means the electronic documentation of 
150.10 	the:
150.11 	(1) type of service performed;
150.12 	(2) individual receiving the service;
150.13 	(3) date of the service;
150.14 	(4) location of the service delivery;
150.15 	(5) individual providing the service; and
150.16 	(6) time the service begins and ends.
150.17 	(c) "Electronic service delivery documentation system" means a system that provides 
150.18 	electronic service delivery documentation that complies with the 21st Century Cures Act, 
150.19 	Public Law 114-255, and the requirements of subdivision 3.
150.20 	(d) "Service" means one of the following:
150.21 	(1) personal care assistance services as defined in Minnesota Statutes, section 256B.0625, 
150.22 	subdivision 19a, and provided according to Minnesota Statutes, section 256B.0659; or
150.23 	(2) community first services and supports under Minnesota Statutes, section 256B.85.
150.24 		Subd. 3.Requirements. (a) In developing implementation requirements for an electronic 
150.25 	service delivery documentation system, the commissioner shall consider electronic visit 
150.26 	verification systems and other electronic service delivery documentation methods. The 
150.27 	commissioner shall convene stakeholders that will be impacted by an electronic service 
150.28 	delivery system, including service providers and their representatives, service recipients 
150.29 	and their representatives, and, as appropriate, those with expertise in the development and 
150.30 	operation of an electronic service delivery documentation system, to ensure that the 
150.31 	requirements:
151.1 	(1) are minimally administratively and financially burdensome to a provider;
151.2 	(2) are minimally burdensome to the service recipient and the least disruptive to the 
151.3 	service recipient in receiving and maintaining allowed services;
151.4 	(3) consider existing best practices and use of electronic service delivery documentation;
151.5 	(4) are conducted according to all state and federal laws;
151.6 	(5) are effective methods for preventing fraud when balanced against the requirements 
151.7 	of clauses (1) and (2); and
151.8 	(6) are consistent with the Department of Human Services' policies related to covered 
151.9 	services, flexibility of service use, and quality assurance.
151.10 	(b) The commissioner shall make training available to providers on the electronic service 
151.11 	delivery documentation system requirements.
151.12 	(c) The commissioner shall establish baseline measurements related to preventing fraud 
151.13 	and establish measures to determine the effect of electronic service delivery documentation 
151.14 	requirements on program integrity.
151.15 		Subd. 4.Legislative report. (a) The commissioner shall submit a report by January 15, 
151.16 	2018, to the chairs and ranking minority members of the legislative committees with 
151.17 	jurisdiction over human services with recommendations, based on the requirements of 
151.18 	subdivision 3, to establish electronic service delivery documentation system requirements 
151.19 	and standards. The report shall identify:
151.20 	(1) the essential elements necessary to operationalize a base-level electronic service 
151.21 	delivery documentation system to be implemented by January 1, 2019; and
151.22 	(2) enhancements to the base-level electronic service delivery documentation system to 
151.23 	be implemented by January 1, 2019, or after, with projected operational costs and the costs 
151.24 	and benefits for system enhancements.
151.25 	(b) The report must also identify current regulations on service providers that are either 
151.26 	inefficient, minimally effective, or will be unnecessary with the implementation of an 
151.27 	electronic service delivery documentation system.

151.28 	EFFECTIVE DATE. This section is effective the day following final enactment.

151.29 	Sec. 50. REVISOR'S INSTRUCTION.
 151.30 	The revisor of statutes, in consultation with the House Research Department, Office of 
151.31 	Senate Counsel, Research, and Fiscal Analysis, and Department of Human Services shall 
152.1 	prepare legislation for the 2018 legislative session to recodify laws governing the elderly 
152.2 	waiver program in Minnesota Statutes, chapter 256B.

152.3 	EFFECTIVE DATE. This section is effective the day following final enactment.

152.4 	ARTICLE 4
152.5 	HEALTH CARE

152.6 	Section 1. Minnesota Statutes 2016, section 3.972, is amended by adding a subdivision 
152.7 	to read:
152.8 		Subd. 2a.Audits of Department of Human Services. (a) To ensure continuous 
152.9 	legislative oversight and accountability, the legislative auditor shall give high priority to 
152.10 	auditing the programs, services, and benefits administered by the Department of Human 
152.11 	Services. The audits shall determine whether the department offered programs and provided 
152.12 	services and benefits only to eligible persons and organizations, and complied with applicable 
152.13 	legal requirements.
152.14 	(b) The legislative auditor shall, based on an assessment of risk and using professional 
152.15 	standards to provide a statistically significant sample, no less than three times each year, 
152.16 	test a representative sample of persons enrolled in a medical assistance program or 
152.17 	MinnesotaCare to determine whether they are eligible to receive benefits under those 
152.18 	programs. The legislative auditor shall report the results to the commissioner of human 
152.19 	services and recommend corrective actions. The commissioner shall provide a response to 
152.20 	the legislative auditor within 20 business days, including corrective actions to be taken to 
152.21 	address any problems identified by the legislative auditor and anticipated completion dates. 
152.22 	The legislative auditor shall monitor the commissioner's implementation of corrective actions 
152.23 	and periodically report the results to the Legislative Audit Commission and the chairs and 
152.24 	ranking minority members of the legislative committees with jurisdiction over health and 
152.25 	human services policy and finance. The legislative auditor's reports to the commission and 
152.26 	the chairs and ranking minority members must include recommendations for any legislative 
152.27 	actions needed to ensure that medical assistance and MinnesotaCare benefits are provided 
152.28 	only to eligible persons.

152.29 	Sec. 2. Minnesota Statutes 2016, section 3.972, is amended by adding a subdivision to 
152.30 	read:
152.31 		Subd. 2b.Audits of managed care organizations. (a) The legislative auditor shall audit 
152.32 	each managed care organization that contracts with the commissioner of human services to 
152.33 	provide health care services under sections 256B.69, 256B.692, and 256L.12. The legislative 
153.1 	auditor shall design the audits to determine if a managed care organization used the public 
153.2 	money in compliance with federal and state laws, rules, and in accordance with provisions 
153.3 	in the managed care organization's contract with the commissioner of human services. The 
153.4 	legislative auditor shall determine the schedule and scope of the audit work and may contract 
153.5 	with vendors to assist with the audits. The managed care organization must cooperate with 
153.6 	the legislative auditor and must provide the legislative auditor with all data, documents, and 
153.7 	other information, regardless of classification, that the legislative auditor requests to conduct 
153.8 	an audit. The legislative auditor shall periodically report audit results and recommendations 
153.9 	to the Legislative Audit Commission and the chairs and ranking minority members of the 
153.10 	legislative committees with jurisdiction over health and human services policy and finance.
153.11 	(b) For purposes of this subdivision, a "managed care organization" means a 
153.12 	demonstration provider as defined under section 256B.69, subdivision 2.

153.13 	Sec. 3. Minnesota Statutes 2016, section 62U.02, is amended to read:
153.14 	62U.02 PAYMENT RESTRUCTURING; QUALITY INCENTIVE PAYMENTS.
153.15 		Subdivision 1.Development. (a) The commissioner of health shall develop a standardized 
153.16 	set of measures for use by health plan companies as specified in subdivision 5. As part of 
153.17 	the standardized set of measures, the commissioner shall establish statewide measures by 
153.18 	which to assess the quality of health care services offered by health care providers, including 
153.19 	health care providers certified as health care homes under section 256B.0751. Quality 
153.20 	measures must be based on medical evidence and be developed through a process in which 
153.21 	providers participate. The statewide measures shall be used for the quality incentive payment 
153.22 	system developed in subdivision 2 and the quality transparency requirements in subdivision 
153.23 	3. The statewide measures must:
153.24 	(1) for purposes of assessing the quality of care provided at physician clinics, including 
153.25 	clinics certified as health care homes under section 256B.0751, be selected from the available 
153.26 	measures as defined in Code of Federal Regulations, title 42, part 414 or 495, as amended, 
153.27 	unless the stakeholders identified under paragraph (b) determine that a particular diagnosis, 
153.28 	condition, service, or procedure is not reflected in any of the available measures in a way 
153.29 	that meets identified needs;
153.30 	(2) be based on medical evidence;
153.31 	(3) be developed through a process in which providers participate and consumer and 
153.32 	community input and perspectives are obtained;
154.1 	(1) (4) include uniform definitions, measures, and forms for submission of data, to the 
154.2 	greatest extent possible;
154.3 	(2) (5) seek to avoid increasing the administrative burden on health care providers; and
154.4 	(3) be initially based on existing quality indicators for physician and hospital services, 
154.5 	which are measured and reported publicly by quality measurement organizations, including, 
154.6 	but not limited to, Minnesota Community Measurement and specialty societies;
154.7 	(4) (6) place a priority on measures of health care outcomes, rather than process measures, 
154.8 	wherever possible; and
154.9 	(5) incorporate measures for primary care, including preventive services, coronary artery 
154.10 	and heart disease, diabetes, asthma, depression, and other measures as determined by the 
154.11 	commissioner.
154.12 	The measures may also include measures of care infrastructure and patient satisfaction.
154.13 	(b) By June 30, 2018, the commissioner shall develop a measurement framework that 
154.14 	identifies the most important elements for assessing the quality of care, articulates statewide 
154.15 	quality improvement goals, ensures clinical relevance, fosters alignment with other 
154.16 	measurement efforts, and defines the roles of stakeholders. By December 15, 2018, the 
154.17 	commissioner shall use the framework to update the statewide measures used to assess the 
154.18 	quality of health care services offered by health care providers, including health care 
154.19 	providers certified as health care homes under section 256B.0751. No more than six statewide 
154.20 	measures shall be required for single-specialty physician practices and no more than ten 
154.21 	statewide measures shall be required for multispecialty physician practices. Measures in 
154.22 	addition to the six statewide measures for single-specialty practices and the ten statewide 
154.23 	measures for multispecialty practices may be included for a physician practice if derived 
154.24 	from administrative claims data. Care infrastructure measures collected according to section 
154.25 	62J.495 shall not be counted toward the maximum number of measures specified in this 
154.26 	paragraph. The commissioner shall develop the framework in consultation with stakeholders 
154.27 	that include consumer, community, and advocacy organizations representing diverse 
154.28 	communities and patients; health plan companies; health care providers whose quality is 
154.29 	assessed, including providers who serve primarily socioeconomically complex patient 
154.30 	populations; health care purchasers; community health boards; and quality improvement 
154.31 	and measurement organizations. The commissioner, in consultation with stakeholders, shall 
154.32 	review the framework at least once every three years. The commissioner shall also submit 
154.33 	a report to the chairs and ranking minority members of the legislative committees with 
154.34 	jurisdiction over health and human services policy and finance by September 30, 2018, 
155.1 	summarizing the development of the measurement framework and making recommendations 
155.2 	on the type and appropriate maximum number of measures in the statewide measures set 
155.3 	for implementation on January 1, 2020.
155.4 	(b) (c) Effective July 1, 2016, the commissioner shall stratify quality measures by race, 
155.5 	ethnicity, preferred language, and country of origin beginning with five measures, and 
155.6 	stratifying additional measures to the extent resources are available. On or after January 1, 
155.7 	2018, the commissioner may require measures to be stratified by other sociodemographic 
155.8 	factors or composite indices of multiple factors that according to reliable data are correlated 
155.9 	with health disparities and have an impact on performance on quality or cost indicators. 
155.10 	New methods of stratifying data under this paragraph must be tested and evaluated through 
155.11 	pilot projects prior to adding them to the statewide system. In determining whether to add 
155.12 	additional sociodemographic factors and developing the methodology to be used, the 
155.13 	commissioner shall consider the reporting burden on providers and determine whether there 
155.14 	are alternative sources of data that could be used. The commissioner shall ensure that 
155.15 	categories and data collection methods are developed in consultation with those communities 
155.16 	impacted by health disparities using culturally appropriate community engagement principles 
155.17 	and methods. The commissioner shall implement this paragraph in coordination with the 
155.18 	contracting entity retained under subdivision 4, in order to build upon the data stratification 
155.19 	methodology that has been developed and tested by the entity. Nothing in this paragraph 
155.20 	expands or changes the commissioner's authority to collect, analyze, or report health care 
155.21 	data. Any data collected to implement this paragraph must be data that is available or is 
155.22 	authorized to be collected under other laws. Nothing in this paragraph grants authority to 
155.23 	the commissioner to collect or analyze patient-level or patient-specific data of the patient 
155.24 	characteristics identified under this paragraph.
155.25 	(c) (d) The statewide measures shall be reviewed at least annually by the commissioner.
155.26 		Subd. 2.Quality incentive payments. (a) By July 1, 2009, the commissioner shall 
155.27 	develop a system of quality incentive payments under which providers are eligible for 
155.28 	quality-based payments that are in addition to existing payment levels, based upon a 
155.29 	comparison of provider performance against specified targets, and improvement over time. 
155.30 	The targets must be based upon and consistent with the quality measures established under 
155.31 	subdivision 1.
155.32 	(b) To the extent possible, the payment system must adjust for variations in patient 
155.33 	population in order to reduce incentives to health care providers to avoid high-risk patients 
155.34 	or populations, including those with risk factors related to race, ethnicity, language, country 
155.35 	of origin, and sociodemographic factors.
156.1 	(c) The requirements of section 62Q.101 do not apply under this incentive payment 
156.2 	system.
156.3 		Subd. 3.Quality transparency. (a) The commissioner shall establish standards for 
156.4 	measuring health outcomes, establish a system for risk adjusting quality measures, and issue 
156.5 	annual periodic public reports on trends in provider quality beginning July 1, 2010 at the 
156.6 	statewide, regional, or clinic levels.
156.7 	(b) Effective July 1, 2017, the risk adjustment system established under this subdivision 
156.8 	shall adjust for patient characteristics identified under subdivision 1, paragraph (b) (c), that 
156.9 	are correlated with health disparities and have an impact on performance on cost and quality 
156.10 	measures. The risk adjustment method may consist of reporting based on an 
156.11 	actual-to-expected comparison that reflects the characteristics of the patient population 
156.12 	served by the clinic or hospital. The commissioner shall implement this paragraph in 
156.13 	coordination with any contracting entity retained under subdivision 4.
156.14 	(c) By January 1, 2010, Physician clinics and hospitals shall submit standardized 
156.15 	electronic information on the outcomes and processes associated with patient care for the 
156.16 	identified statewide measures to the commissioner or the commissioner's designee in the 
156.17 	formats specified by the commissioner, which must include alternative formats for clinics 
156.18 	or hospitals experiencing technological or economic barriers to submission in standardized 
156.19 	electronic form. In addition to measures of care processes and outcomes, the report may 
156.20 	include other measures designated by the commissioner, including, but not limited to, care 
156.21 	infrastructure and patient satisfaction. The commissioner shall ensure that any quality data 
156.22 	reporting requirements established under this subdivision are not duplicative of publicly 
156.23 	reported, communitywide quality reporting activities currently under way in Minnesota. 
156.24 	The commissioner shall ensure that any quality data reporting requirements for physician 
156.25 	clinics are aligned with the specifications and timelines for the selected measures as defined 
156.26 	in subdivision 1, paragraph (a), clause (1). The commissioner may develop additional data 
156.27 	on race, ethnicity, preferred language, country of origin, or other sociodemographic factors 
156.28 	as identified under subdivision 1, paragraph (c), and as required for stratification or risk 
156.29 	adjustment. None of the statewide measures selected shall require providers to use an external 
156.30 	vendor to administer or collect data. Nothingin this subdivision is intended to replace or 
156.31 	duplicate current privately supported activities related to quality measurement and reporting 
156.32 	in Minnesota.
156.33 		Subd. 4.Contracting. The commissioner may contract with a private entity or consortium 
156.34 	of private entities to complete the tasks in subdivisions 1 to 3. The private entity or 
156.35 	consortium must be nonprofit and have governance that includes representatives from the 
157.1 	following stakeholder groups: health care providers, including providers serving high 
157.2 	concentrations of patients and communities impacted by health disparities; health plan 
157.3 	companies; consumers, including consumers representing groups who experience health 
157.4 	disparities; employers or other health care purchasers; and state government. No one 
157.5 	stakeholder group shall have a majority of the votes on any issue or hold extraordinary 
157.6 	powers not granted to any other governance stakeholder.
157.7 		Subd. 5.Implementation. (a) By January 1, 2010, Health plan companies shall use the 
157.8 	standardized quality set of measures established under this section and shall not require 
157.9 	providers to use and report health plan company-specific quality and outcome measures.
157.10 	(b) By July 1, 2010, the commissioner of management and budget shall implement this 
157.11 	incentive payment system for all participants in the state employee group insurance program.

157.12 	Sec. 4. Minnesota Statutes 2016, section 256.01, is amended by adding a subdivision to 
157.13 	read:
157.14 		Subd. 18f.Asset verification system. The commissioner shall implement the Asset 
157.15 	Verification System (AVS) according to Public Law 110-252, title VII, section 7001(d), to 
157.16 	verify assets for an individual applying for or renewing health care benefits under section 
157.17 	256B.055, subdivision 7.

157.18 	EFFECTIVE DATE. This section is effective July 1, 2017.

157.19 	Sec. 5. Minnesota Statutes 2016, section 256.9685, subdivision 1, is amended to read:
157.20 		Subdivision 1.Authority. (a) The commissioner shall establish procedures for 
157.21 	determining medical assistance payment rates under a prospective payment system for 
157.22 	inpatient hospital services in hospitals that qualify as vendors of medical assistance. The 
157.23 	commissioner shall establish, by rule, procedures for implementing this section and sections 
157.24 	256.9686, 256.969, and 256.9695. Services must meet the requirements of section 256B.04, 
157.25 	subdivision 15, to be eligible for payment.
157.26 	(b) The commissioner may reduce the types of inpatient hospital admissions that are 
157.27 	required to be certified as medically necessary after notice in the State Register and a 30-day 
157.28 	comment period.

157.29 	Sec. 6. Minnesota Statutes 2016, section 256.9685, subdivision 1a, is amended to read:
157.30 		Subd. 1a.Administrative reconsideration. Notwithstanding section 256B.04, 
157.31 	subdivision 15, the commissioner shall establish an administrative reconsideration process 
158.1 	for appeals of inpatient hospital services determined to be medically unnecessary. A physician 
158.2 	or hospital may request a reconsideration of the decision that inpatient hospital services are 
158.3 	not medically necessary by submitting a written request for review to the commissioner 
158.4 	within 30 days after receiving notice of the decision. The reconsideration process shall take 
158.5 	place prior to the procedures of subdivision 1b and shall be conducted by physicians the 
158.6 	medical review agent that are is independent of the case under reconsideration. A majority 
158.7 	decision by the physicians is necessary to make a determination that the services were not 
158.8 	medically necessary.

158.9 	Sec. 7. Minnesota Statutes 2016, section 256.9686, subdivision 8, is amended to read:
158.10 		Subd. 8.Rate year. "Rate year" means a calendar year from January 1 to December 31.
158.11 	Effective with the 2012 base year, rate year means a state fiscal year from July 1 to June 
158.12 	30.

158.13 	EFFECTIVE DATE. This section is effective the day following final enactment.

158.14 	Sec. 8. Minnesota Statutes 2016, section 256.969, subdivision 1, is amended to read:
158.15 		Subdivision 1.Hospital cost index. (a) The hospital cost index shall be the change in 
158.16 	the Centers for Medicare and Medicaid Services Inpatient Hospital Market Basket. The 
158.17 	commissioner shall use the indices as forecasted for the midpoint of the prior rate year to 
158.18 	the midpoint of the current rate year.
158.19 	(b) Except as authorized under this section, for fiscal years beginning on or after July 
158.20 	1, 1993, the commissioner of human services shall not provide automatic annual inflation 
158.21 	adjustments for hospital payment rates under medical assistance.

158.22 	EFFECTIVE DATE. This section is effective July 1, 2017.

158.23 	Sec. 9. Minnesota Statutes 2016, section 256.969, subdivision 2b, is amended to read:
158.24 		Subd. 2b.Hospital payment rates. (a) For discharges occurring on or after November 
158.25 	1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according 
158.26 	to the following:
158.27 	(1) critical access hospitals as defined by Medicare shall be paid using a cost-based 
158.28 	methodology;
158.29 	(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology 
158.30 	under subdivision 25;
159.1 	(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation 
159.2 	distinct parts as defined by Medicare shall be paid according to the methodology under 
159.3 	subdivision 12; and
159.4 	(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.
159.5 	(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not 
159.6 	be rebased, except that a Minnesota long-term hospital shall be rebased effective January 
159.7 	1, 2011, based on its most recent Medicare cost report ending on or before September 1, 
159.8 	2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on 
159.9 	December 31, 2010. For rate setting periods after November 1, 2014, in which the base 
159.10 	years are updated, a Minnesota long-term hospital's base year shall remain within the same 
159.11 	period as other hospitals.
159.12 	(c) Effective for discharges occurring on and after November 1, 2014, payment rates 
159.13 	for hospital inpatient services provided by hospitals located in Minnesota or the local trade 
159.14 	area, except for the hospitals paid under the methodologies described in paragraph (a), 
159.15 	clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a 
159.16 	manner similar to Medicare. The base year for the rates effective November 1, 2014, shall 
159.17 	be calendar year 2012. The rebasing under this paragraph shall be budget neutral, ensuring 
159.18 	that the total aggregate payments under the rebased system are equal to the total aggregate 
159.19 	payments that were made for the same number and types of services in the base year. Separate 
159.20 	budget neutrality calculations shall be determined for payments made to critical access 
159.21 	hospitals and payments made to hospitals paid under the DRG system. Only the rate increases 
159.22 	or decreases under subdivision 3a or 3c that applied to the hospitals being rebased during 
159.23 	the entire base period shall be incorporated into the budget neutrality calculation.
159.24 	(d) For discharges occurring on or after November 1, 2014, through the next rebasing 
159.25 	that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph 
159.26 	(a), clause (4), shall include adjustments to the projected rates that result in no greater than 
159.27 	a five percent increase or decrease from the base year payments for any hospital. Any 
159.28 	adjustments to the rates made by the commissioner under this paragraph and paragraph (e) 
159.29 	shall maintain budget neutrality as described in paragraph (c).
159.30 	(e) For discharges occurring on or after November 1, 2014, through the next two rebasing 
159.31 	that occurs periods the commissioner may make additional adjustments to the rebased rates, 
159.32 	and when evaluating whether additional adjustments should be made, the commissioner 
159.33 	shall consider the impact of the rates on the following:
159.34 	(1) pediatric services;
160.1 	(2) behavioral health services;
160.2 	(3) trauma services as defined by the National Uniform Billing Committee;
160.3 	(4) transplant services;
160.4 	(5) obstetric services, newborn services, and behavioral health services provided by 
160.5 	hospitals outside the seven-county metropolitan area;
160.6 	(6) outlier admissions;
160.7 	(7) low-volume providers; and
160.8 	(8) services provided by small rural hospitals that are not critical access hospitals.
160.9 	(f) Hospital payment rates established under paragraph (c) must incorporate the following:
160.10 	(1) for hospitals paid under the DRG methodology, the base year payment rate per 
160.11 	admission is standardized by the applicable Medicare wage index and adjusted by the 
160.12 	hospital's disproportionate population adjustment;
160.13 	(2) for critical access hospitals, payment rates for discharges between November 1, 2014, 
160.14 	and June 30, 2015, shall be set to the same rate of payment that applied for discharges on 
160.15 	October 31, 2014;
160.16 	(3) the cost and charge data used to establish hospital payment rates must only reflect 
160.17 	inpatient services covered by medical assistance; and
160.18 	(4) in determining hospital payment rates for discharges occurring on or after the rate 
160.19 	year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per 
160.20 	discharge shall be based on the cost-finding methods and allowable costs of the Medicare 
160.21 	program in effect during the base year or years. In determining hospital payment rates for 
160.22 	discharges in subsequent base years, the per discharge rates shall be based on the cost-finding 
160.23 	methods and allowable costs of the Medicare program in effect during the base year or 
160.24 	years.
160.25 	(g) The commissioner shall validate the rates effective November 1, 2014, by applying 
160.26 	the rates established under paragraph (c), and any adjustments made to the rates under 
160.27 	paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the 
160.28 	total aggregate payments for the same number and types of services under the rebased rates 
160.29 	are equal to the total aggregate payments made during calendar year 2013.
160.30 	(h) Effective for discharges occurring on or after July 1, 2017, and every two years 
160.31 	thereafter, payment rates under this section shall be rebased to reflect only those changes 
160.32 	in hospital costs between the existing base year and the next base year. Changes in costs 
161.1 	between base years shall be measured using the lower of the hospital cost index defined in 
161.2 	subdivision 1, paragraph (a), or the percentage change in the case mix adjusted cost per 
161.3 	claim. The commissioner shall establish the base year for each rebasing period considering 
161.4 	the most recent year for which filed Medicare cost reports are available. The estimated 
161.5 	change in the average payment per hospital discharge resulting from a scheduled rebasing 
161.6 	must be calculated and made available to the legislature by January 15 of each year in which 
161.7 	rebasing is scheduled to occur, and must include by hospital the differential in payment 
161.8 	rates compared to the individual hospital's costs.
161.9 	(i) Effective for discharges occurring on or after July 1, 2015, inpatient payment rates 
161.10 	for critical access hospitals located in Minnesota or the local trade area shall be determined 
161.11 	using a new cost-based methodology. The commissioner shall establish within the 
161.12 	methodology tiers of payment designed to promote efficiency and cost-effectiveness. 
161.13 	Payment rates for hospitals under this paragraph shall be set at a level that does not exceed 
161.14 	the total cost for critical access hospitals as reflected in base year cost reports. Until the 
161.15 	next rebasing that occurs, the new methodology shall result in no greater than a five percent 
161.16 	decrease from the base year payments for any hospital, except a hospital that had payments 
161.17 	that were greater than 100 percent of the hospital's costs in the base year shall have their 
161.18 	rate set equal to 100 percent of costs in the base year. The rates paid for discharges on and 
161.19 	after July 1, 2016, covered under this paragraph shall be increased by the inflation factor 
161.20 	in subdivision 1, paragraph (a). The new cost-based rate shall be the final rate and shall not 
161.21 	be settled to actual incurred costs. Hospitals shall be assigned a payment tier based on the 
161.22 	following criteria:
161.23 	(1) hospitals that had payments at or below 80 percent of their costs in the base year 
161.24 	shall have a rate set that equals 85 percent of their base year costs;
161.25 	(2) hospitals that had payments that were above 80 percent, up to and including 90 
161.26 	percent of their costs in the base year shall have a rate set that equals 95 percent of their 
161.27 	base year costs; and
161.28 	(3) hospitals that had payments that were above 90 percent of their costs in the base year 
161.29 	shall have a rate set that equals 100 percent of their base year costs.
161.30 	(j) The commissioner may refine the payment tiers and criteria for critical access hospitals 
161.31 	to coincide with the next rebasing under paragraph (h). The factors used to develop the new 
161.32 	methodology may include, but are not limited to:
161.33 	(1) the ratio between the hospital's costs for treating medical assistance patients and the 
161.34 	hospital's charges to the medical assistance program;
162.1 	(2) the ratio between the hospital's costs for treating medical assistance patients and the 
162.2 	hospital's payments received from the medical assistance program for the care of medical 
162.3 	assistance patients;
162.4 	(3) the ratio between the hospital's charges to the medical assistance program and the 
162.5 	hospital's payments received from the medical assistance program for the care of medical 
162.6 	assistance patients;
162.7 	(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);
162.8 	(5) the proportion of that hospital's costs that are administrative and trends in 
162.9 	administrative costs; and
162.10 	(6) geographic location.

162.11 	EFFECTIVE DATE. This section is effective July 1, 2017.

162.12 	Sec. 10. Minnesota Statutes 2016, section 256.969, subdivision 3a, is amended to read:
162.13 		Subd. 3a.Payments. (a) Acute care hospital billings under the medical assistance program 
162.14 	must not be submitted until the recipient is discharged. However, the commissioner shall 
162.15 	establish monthly interim payments for inpatient hospitals that have individual patient 
162.16 	lengths of stay over 30 days regardless of diagnostic category. Except as provided in section 
162.17 	256.9693, medical assistance reimbursement for treatment of mental illness shall be 
162.18 	reimbursed based on diagnostic classifications. Individual hospital payments established 
162.19 	under this section and sections 256.9685, 256.9686, and 256.9695, in addition to third-party 
162.20 	and recipient liability, for discharges occurring during the rate year shall not exceed, in 
162.21 	aggregate, the charges for the medical assistance covered inpatient services paid for the 
162.22 	same period of time to the hospital. Services that have rates established under subdivision 
162.23 	11 or 12, must be limited separately from other services. After consulting with the affected 
162.24 	hospitals, the commissioner may consider related hospitals one entity and may merge the 
162.25 	payment rates while maintaining separate provider numbers. The operating and property 
162.26 	base rates per admission or per day shall be derived from the best Medicare and claims data 
162.27 	available when rates are established. The commissioner shall determine the best Medicare 
162.28 	and claims data, taking into consideration variables of recency of the data, audit disposition, 
162.29 	settlement status, and the ability to set rates in a timely manner. The commissioner shall 
162.30 	notify hospitals of payment rates 30 days prior to implementation. The rate setting data 
162.31 	must reflect the admissions data used to establish relative values. The commissioner may 
162.32 	adjust base year cost, relative value, and case mix index data to exclude the costs of services 
162.33 	that have been discontinued by the October 1 of the year preceding the rate year or that are 
163.1 	paid separately from inpatient services. Inpatient stays that encompass portions of two or 
163.2 	more rate years shall have payments established based on payment rates in effect at the time 
163.3 	of admission unless the date of admission preceded the rate year in effect by six months or 
163.4 	more. In this case, operating payment rates for services rendered during the rate year in 
163.5 	effect and established based on the date of admission shall be adjusted to the rate year in 
163.6 	effect by the hospital cost index.
163.7 	(b) For fee-for-service admissions occurring on or after July 1, 2002, the total payment, 
163.8 	before third-party liability and spenddown, made to hospitals for inpatient services is reduced 
163.9 	by .5 percent from the current statutory rates.
163.10 	(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service 
163.11 	admissions occurring on or after July 1, 2003, made to hospitals for inpatient services before 
163.12 	third-party liability and spenddown, is reduced five percent from the current statutory rates. 
163.13 	Mental health services within diagnosis related groups 424 to 432 or corresponding 
163.14 	APR-DRGs, and facilities defined under subdivision 16 are excluded from this paragraph.
163.15 	(d) In addition to the reduction in paragraphs (b) and (c), the total payment for 
163.16 	fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for 
163.17 	inpatient services before third-party liability and spenddown, is reduced 6.0 percent from 
163.18 	the current statutory rates. Mental health services within diagnosis related groups 424 to 
163.19 	432 or corresponding APR-DRGs, and facilities defined under subdivision 16 are excluded 
163.20 	from this paragraph. Payments made to managed care plans shall be reduced for services 
163.21 	provided on or after January 1, 2006, to reflect this reduction.
163.22 	(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
163.23 	fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made 
163.24 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 
163.25 	3.46 percent from the current statutory rates. Mental health services with diagnosis related 
163.26 	groups 424 to 432 or corresponding APR-DRGs, and facilities defined under subdivision 
163.27 	16 are excluded from this paragraph. Payments made to managed care plans shall be reduced 
163.28 	for services provided on or after January 1, 2009, through June 30, 2009, to reflect this 
163.29 	reduction.
163.30 	(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
163.31 	fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2011, made 
163.32 	to hospitals for inpatient services before third-party liability and spenddown, is reduced 1.9 
163.33 	percent from the current statutory rates. Mental health services with diagnosis related groups 
163.34 	424 to 432 or corresponding APR-DRGs, and facilities defined under subdivision 16 are 
164.1 	excluded from this paragraph. Payments made to managed care plans shall be reduced for 
164.2 	services provided on or after July 1, 2009, through June 30, 2011, to reflect this reduction.
164.3 	(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for 
164.4 	fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for inpatient 
164.5 	services before third-party liability and spenddown, is reduced 1.79 percent from the current 
164.6 	statutory rates. Mental health services with diagnosis related groups 424 to 432 or 
164.7 	corresponding APR-DRGs, and facilities defined under subdivision 16 are excluded from 
164.8 	this paragraph. Payments made to managed care plans shall be reduced for services provided 
164.9 	on or after July 1, 2011, to reflect this reduction.
164.10 	(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total payment 
164.11 	for fee-for-service admissions occurring on or after July 1, 2009, made to hospitals for 
164.12 	inpatient services before third-party liability and spenddown, is reduced one percent from 
164.13 	the current statutory rates. Facilities defined under subdivision 16 are excluded from this 
164.14 	paragraph. Payments made to managed care plans shall be reduced for services provided 
164.15 	on or after October 1, 2009, to reflect this reduction.
164.16 	(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total payment 
164.17 	for fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for 
164.18 	inpatient services before third-party liability and spenddown, is reduced 1.96 percent from 
164.19 	the current statutory rates. Facilities defined under subdivision 16 are excluded from this 
164.20 	paragraph. Payments made to managed care plans shall be reduced for services provided 
164.21 	on or after January 1, 2011, to reflect this reduction.
164.22 	(j) Effective for discharges on and after November 1, 2014, from hospitals paid under 
164.23 	subdivision 2b, paragraph (a), clauses (1) and (4), the rate adjustments in this subdivision 
164.24 	must be incorporated into the rebased rates established under subdivision 2b, paragraph (c), 
164.25 	and must not be applied to each claim.
164.26 	(k) Effective for discharges on and after July 1, 2015, from hospitals paid under 
164.27 	subdivision 2b, paragraph (a), clauses (2) and (3), the rate adjustments in this subdivision 
164.28 	must be incorporated into the rates and must not be applied to each claim.
164.29 	(l) Effective for discharges on and after July 1, 2017, from hospitals paid under 
164.30 	subdivision 2b, paragraph (a), clause (2), the rate adjustments in this subdivision must be 
164.31 	incorporated into the rates and must not be applied to each claim.

164.32 	EFFECTIVE DATE. This section is effective July 1, 2017.

165.1 	Sec. 11. Minnesota Statutes 2016, section 256.969, subdivision 8, is amended to read:
165.2 		Subd. 8.Unusual length of stay experience. (a) The commissioner shall establish day 
165.3 	outlier thresholds for each diagnostic category established under subdivision 2 at two standard 
165.4 	deviations beyond the mean length of stay. Payment for the days beyond the outlier threshold 
165.5 	shall be in addition to the operating and property payment rates per admission established 
165.6 	under subdivisions 2 and 2b. Payment for outliers shall be at 70 percent of the allowable 
165.7 	operating cost, after adjustment by the case mix index, hospital cost index, relative values 
165.8 	and the disproportionate population adjustment. The outlier threshold for neonatal and burn 
165.9 	diagnostic categories shall be established at one standard deviation beyond the mean length 
165.10 	of stay, and payment shall be at 90 percent of allowable operating cost calculated in the 
165.11 	same manner as other outliers. A hospital may choose an alternative to the 70 percent outlier 
165.12 	payment that is at a minimum of 60 percent and a maximum of 80 percent if the 
165.13 	commissioner is notified in writing of the request by October 1 of the year preceding the 
165.14 	rate year. The chosen percentage applies to all diagnostic categories except burns and 
165.15 	neonates. The percentage of allowable cost that is unrecognized by the outlier payment shall 
165.16 	be added back to the base year operating payment rate per admission.
165.17 	(b) Effective for admissions and transfers occurring on and after November 1, 2014, the 
165.18 	commissioner shall establish payment rates for outlier payments that are based on Medicare 
165.19 	methodologies.

165.20 	EFFECTIVE DATE. This section is effective July 1, 2017.

165.21 	Sec. 12. Minnesota Statutes 2016, section 256.969, subdivision 8c, is amended to read:
165.22 		Subd. 8c.Hospital residents. (a) For discharges occurring on or after November 1, 
165.23 	2014, payments for hospital residents shall be made as follows:
165.24 	(1) payments for the first 180 days of inpatient care shall be the APR-DRG system plus 
165.25 	any outliers; and
165.26 	(2) payment for all medically necessary patient care subsequent to the first 180 days 
165.27 	shall be reimbursed at a rate computed by multiplying the statewide average cost-to-charge 
165.28 	ratio by the usual and customary charges.
165.29 	(b) For discharges occurring on or after July 1, 2017, payment for hospital residents 
165.30 	shall be equal to the payments under subdivision 8, paragraph (b).

165.31 	EFFECTIVE DATE. This section is effective July 1, 2017.

166.1 	Sec. 13. Minnesota Statutes 2016, section 256.969, subdivision 9, is amended to read:
166.2 		Subd. 9.Disproportionate numbers of low-income patients served. (a) For admissions 
166.3 	occurring on or after July 1, 1993, the medical assistance disproportionate population 
166.4 	adjustment shall comply with federal law and shall be paid to a hospital, excluding regional 
166.5 	treatment centers and facilities of the federal Indian Health Service, with a medical assistance 
166.6 	inpatient utilization rate in excess of the arithmetic mean. The adjustment must be determined 
166.7 	as follows:
166.8 	(1) for a hospital with a medical assistance inpatient utilization rate above the arithmetic 
166.9 	mean for all hospitals excluding regional treatment centers and facilities of the federal Indian 
166.10 	Health Service but less than or equal to one standard deviation above the mean, the 
166.11 	adjustment must be determined by multiplying the total of the operating and property 
166.12 	payment rates by the difference between the hospital's actual medical assistance inpatient 
166.13 	utilization rate and the arithmetic mean for all hospitals excluding regional treatment centers 
166.14 	and facilities of the federal Indian Health Service; and
166.15 	(2) for a hospital with a medical assistance inpatient utilization rate above one standard 
166.16 	deviation above the mean, the adjustment must be determined by multiplying the adjustment 
166.17 	that would be determined under clause (1) for that hospital by 1.1. The commissioner shall 
166.18 	report annually on the number of hospitals likely to receive the adjustment authorized by 
166.19 	this paragraph. The commissioner shall specifically report on the adjustments received by 
166.20 	public hospitals and public hospital corporations located in cities of the first class.
166.21 	(b) Certified public expenditures made by Hennepin County Medical Center shall be 
166.22 	considered Medicaid disproportionate share hospital payments. Hennepin County and 
166.23 	Hennepin County Medical Center shall report by June 15, 2007, on payments made beginning 
166.24 	July 1, 2005, or another date specified by the commissioner, that may qualify for 
166.25 	reimbursement under federal law. Based on these reports, the commissioner shall apply for 
166.26 	federal matching funds.
166.27 	(c) Upon federal approval of the related state plan amendment, paragraph (b) is effective 
166.28 	retroactively from July 1, 2005, or the earliest effective date approved by the Centers for 
166.29 	Medicare and Medicaid Services.
166.30 	(d) Effective July 1, 2015, disproportionate share hospital (DSH) payments shall be paid 
166.31 	in accordance with a new methodology using 2012 as the base year. Annual payments made 
166.32 	under this paragraph shall equal the total amount of payments made for 2012. A licensed 
166.33 	children's hospital shall receive only a single DSH factor for children's hospitals. Other 
166.34 	DSH factors may be combined to arrive at a single factor for each hospital that is eligible 
167.1 	for DSH payments. The new methodology shall make payments only to hospitals located 
167.2 	in Minnesota and include the following factors:
167.3 	(1) a licensed children's hospital with at least 1,000 fee-for-service discharges in the 
167.4 	base year shall receive a factor of 0.868. A licensed children's hospital with less than 1,000 
167.5 	fee-for-service discharges in the base year shall receive a factor of 0.7880;
167.6 	(2) a hospital that has in effect for the initial rate year a contract with the commissioner 
167.7 	to provide extended psychiatric inpatient services under section 256.9693 shall receive a 
167.8 	factor of 0.0160;
167.9 	(3) a hospital that has received payment from the fee-for-service program for at least 20 
167.10 	transplant services in the base year shall receive a factor of 0.0435;
167.11 	(4) a hospital that has a medical assistance utilization rate in the base year between 20 
167.12 	percent up to one standard deviation above the statewide mean utilization rate shall receive 
167.13 	a factor of 0.0468;
167.14 	(5) a hospital that has a medical assistance utilization rate in the base year that is at least 
167.15 	one standard deviation above the statewide mean utilization rate but is less than three standard 
167.16 	deviations above the mean shall receive a factor of 0.2300; and
167.17 	(6) a hospital that has a medical assistance utilization rate in the base year that is at least 
167.18 	three standard deviations above the statewide mean utilization rate shall receive a factor of 
167.19 	0.3711.
167.20 	(e) Any payments or portion of payments made to a hospital under this subdivision that 
167.21 	are subsequently returned to the commissioner because the payments are found to exceed 
167.22 	the hospital-specific DSH limit for that hospital shall be redistributed, proportionate to the 
167.23 	number of fee-for-service discharges, to other DSH-eligible nonchildren's non-children's
167.24 	hospitals that have a medical assistance utilization rate that is at least one standard deviation 
167.25 	above the mean.

167.26 	EFFECTIVE DATE. This section is effective July 1, 2017.

167.27 	Sec. 14. Minnesota Statutes 2016, section 256.969, subdivision 12, is amended to read:
167.28 		Subd. 12.Rehabilitation hospitals and distinct parts. (a) Units of hospitals that are 
167.29 	recognized as rehabilitation distinct parts by the Medicare program shall have separate 
167.30 	provider numbers under the medical assistance program for rate establishment and billing 
167.31 	purposes only. These units shall also have operating payment rates and the disproportionate 
168.1 	population adjustment, if allowed by federal law, established separately from other inpatient 
168.2 	hospital services.
168.3 	(b) The commissioner shall establish separate relative values under subdivision 2 for 
168.4 	rehabilitation hospitals and distinct parts as defined by the Medicare program. Effective for 
168.5 	discharges occurring on and after November 1, 2014, the commissioner, to the extent 
168.6 	possible, shall replicate the existing payment rate methodology under the new diagnostic 
168.7 	classification system. The result must be budget neutral, ensuring that the total aggregate 
168.8 	payments under the new system are equal to the total aggregate payments made for the same 
168.9 	number and types of services in the base year, calendar year 2012.
168.10 	(c) For individual hospitals that did not have separate medical assistance rehabilitation 
168.11 	provider numbers or rehabilitation distinct parts in the base year, hospitals shall provide the 
168.12 	information needed to separate rehabilitation distinct part cost and claims data from other 
168.13 	inpatient service data.
168.14 	(d) Effective with discharges on or after July 1, 2017, payment to rehabilitation hospitals 
168.15 	shall be established under subdivision 2b, paragraph (a), clause (4).

168.16 	EFFECTIVE DATE. This section is effective July 1, 2017.

168.17 	Sec. 15. Minnesota Statutes 2016, section 256.9695, subdivision 1, is amended to read:
168.18 		Subdivision 1.Appeals. A hospital may appeal a decision arising from the application 
168.19 	of standards or methods under section 256.9685, 256.9686, or 256.969, if an appeal would 
168.20 	result in a change to the hospital's payment rate or payments. Both overpayments and 
168.21 	underpayments that result from the submission of appeals shall be implemented. Regardless 
168.22 	of any appeal outcome, relative values, Medicare wage indexes, Medicare cost-to-charge 
168.23 	ratios, and policy adjusters shall not be recalculated changed. The appeal shall be heard by 
168.24 	an administrative law judge according to sections 14.57 to 14.62, or upon agreement by 
168.25 	both parties, according to a modified appeals procedure established by the commissioner 
168.26 	and the Office of Administrative Hearings. In any proceeding under this section, the appealing 
168.27 	party must demonstrate by a preponderance of the evidence that the commissioner's 
168.28 	determination is incorrect or not according to law.
168.29 	(a) To appeal a payment rate or payment determination or a determination made from 
168.30 	base year information, the hospital shall file a written appeal request to the commissioner 
168.31 	within 60 days of the date the preliminary payment rate determination was mailed. The 
168.32 	appeal request shall specify: (i) the disputed items; (ii) the authority in federal or state statute 
168.33 	or rule upon which the hospital relies for each disputed item; and (iii) the name and address 
169.1 	of the person to contact regarding the appeal. Facts to be considered in any appeal of base 
169.2 	year information are limited to those in existence at the time the payment rates of the first 
169.3 	rate year were established from the base year information. In the case of Medicare settled 
169.4 	appeals, the 60-day appeal period shall begin on the mailing date of the notice by the 
169.5 	Medicare program or the date the medical assistance payment rate determination notice is 
169.6 	mailed, whichever is later 12 months after the last day of the calendar year that is the base 
169.7 	year for the payment rates in dispute.
169.8 	(b) To appeal a payment rate or payment change that results from a difference in case 
169.9 	mix between the base year and a rate year, the procedures and requirements of paragraph 
169.10 	(a) apply. However, the appeal must be filed with the commissioner within 120 days after 
169.11 	the end of a rate year. A case mix appeal must apply to the cost of services to all medical 
169.12 	assistance patients that received inpatient services from the hospital during the rate year 
169.13 	appealed. For case mix appeals filed after January 1, 1997, the difference in case mix and 
169.14 	the corresponding payment adjustment must exceed a threshold of five percent.

169.15 	Sec. 16. Minnesota Statutes 2016, section 256B.04, subdivision 12, is amended to read:
169.16 		Subd. 12.Limitation on services. (a) Place limits on the types of services covered by 
169.17 	medical assistance, the frequency with which the same or similar services may be covered 
169.18 	by medical assistance for an individual recipient, and the amount paid for each covered 
169.19 	service. The state agency shall promulgate rules establishing maximum reimbursement rates 
169.20 	for emergency and nonemergency transportation.
169.21 	The rules shall provide:
169.22 	(1) an opportunity for all recognized transportation providers to be reimbursed for 
169.23 	nonemergency transportation consistent with the maximum rates established by the agency;
169.24 	and
169.25 	(2) reimbursement of public and private nonprofit providers serving the disabled 
169.26 	population generally at reasonable maximum rates that reflect the cost of providing the 
169.27 	service regardless of the fare that might be charged by the provider for similar services to 
169.28 	individuals other than those receiving medical assistance or medical care under this chapter; 
169.29 	and.
169.30 	(3) reimbursement for each additional passenger carried on a single trip at a substantially 
169.31 	lower rate than the first passenger carried on that trip.
169.32 	(b) The commissioner shall encourage providers reimbursed under this chapter to 
169.33 	coordinate their operation with similar services that are operating in the same community. 
170.1 	To the extent practicable, the commissioner shall encourage eligible individuals to utilize 
170.2 	less expensive providers capable of serving their needs.
170.3 	(c) For the purpose of this subdivision and section 256B.02, subdivision 8, and effective 
170.4 	on January 1, 1981, "recognized provider of transportation services" means an operator of 
170.5 	special transportation service as defined in section 174.29 that has been issued a current 
170.6 	certificate of compliance with operating standards of the commissioner of transportation 
170.7 	or, if those standards do not apply to the operator, that the agency finds is able to provide 
170.8 	the required transportation in a safe and reliable manner. Until January 1, 1981, "recognized 
170.9 	transportation provider" includes an operator of special transportation service that the agency 
170.10 	finds is able to provide the required transportation in a safe and reliable manner.

170.11 	Sec. 17. Minnesota Statutes 2016, section 256B.04, subdivision 24, is amended to read:
170.12 		Subd. 24.Medicaid waiver requests and state plan amendments. The commissioner 
170.13 	shall notify the chairs and ranking minority members of the legislative committees with 
170.14 	jurisdiction over medical assistance at least 30 days before submitting a new Medicaid 
170.15 	waiver request to the federal government. Prior to submitting any Medicaid waiver request 
170.16 	or Medicaid state plan amendment to the federal government for approval, the commissioner 
170.17 	shall publish the text of the waiver request or state plan amendment, and a summary of and 
170.18 	explanation of the need for the request, on the agency's Web site and provide a 30-day public 
170.19 	comment period. The commissioner shall notify the public of the availability of this 
170.20 	information through the agency's electronic subscription service. The commissioner shall 
170.21 	consider public comments when preparing the final waiver request or state plan amendment 
170.22 	that is to be submitted to the federal government for approval. The commissioner shall also 
170.23 	publish on the agency's Web site notice of any federal decision related to the state request 
170.24 	for approval, within 30 days of the decision. This notice must describe any modifications 
170.25 	to the state request that have been agreed to by the commissioner as a condition of receiving 
170.26 	federal approval.

170.27 	Sec. 18. Minnesota Statutes 2016, section 256B.056, subdivision 3b, is amended to read:
170.28 		Subd. 3b.Treatment of trusts. (a) A "medical assistance qualifying trust" is a revocable 
170.29 	or irrevocable trust, or similar legal device, established on or before August 10, 1993, by a 
170.30 	person or the person's spouse under the terms of which the person receives or could receive 
170.31 	payments from the trust principal or income and the trustee has discretion in making payments 
170.32 	to the person from the trust principal or income. Notwithstanding that definition, a medical 
170.33 	assistance qualifying trust does not include: (1) a trust set up by will; (2) a trust set up before 
171.1 	April 7, 1986, solely to benefit a person with a developmental disability living in an 
171.2 	intermediate care facility for persons with developmental disabilities; or (3) a trust set up 
171.3 	by a person with payments made by the Social Security Administration pursuant to the 
171.4 	United States Supreme Court decision in Sullivan v. Zebley, 110 S. Ct. 885 (1990). The 
171.5 	maximum amount of payments that a trustee of a medical assistance qualifying trust may 
171.6 	make to a person under the terms of the trust is considered to be available assets to the 
171.7 	person, without regard to whether the trustee actually makes the maximum payments to the 
171.8 	person and without regard to the purpose for which the medical assistance qualifying trust 
171.9 	was established.
171.10 	(b) Except as provided in paragraphs (c) and (d), Trusts established after August 10, 
171.11 	1993, are treated according to section 13611(b) of the Omnibus Budget Reconciliation Act 
171.12 	of 1993 (OBRA), Public Law 103-66 United States Code, title 42, section 1396p(d).
171.13 	(c) For purposes of paragraph (d), a pooled trust means a trust established under United 
171.14 	States Code, title 42, section 1396p(d)(4)(C).
171.15 	(d) A beneficiary's interest in a pooled trust is considered an available asset unless the 
171.16 	trust provides that upon the death of the beneficiary or termination of the trust during the 
171.17 	beneficiary's lifetime, whichever is sooner, the department receives any amount, up to the 
171.18 	amount of medical assistance benefits paid on behalf of the beneficiary, remaining in the 
171.19 	beneficiary's trust account after a deduction for reasonable administrative fees and expenses, 
171.20 	and an additional remainder amount. The retained remainder amount of the subaccount 
171.21 	must not exceed ten percent of the account value at the time of the beneficiary's death or 
171.22 	termination of the trust, and must only be used for the benefit of disabled individuals who 
171.23 	have a beneficiary interest in the pooled trust.
171.24 	(e) Trusts may be established on or after December 12, 2016, by a person who has been 
171.25 	determined to be disabled, according to United States Code, title 42, section 1396p(d)(4)(A), 
171.26 	as amended by section 5007 of the 21st Century Cures Act, Public Law 114-255.

171.27 	EFFECTIVE DATE. This section is effective the day following final enactment.

171.28 	Sec. 19. Minnesota Statutes 2016, section 256B.056, subdivision 3c, is amended to read:
171.29 		Subd. 3c.Asset limitations for families and children. (a) A household of two or more 
171.30 	persons must not own more than $20,000 in total net assets, and a household of one person 
171.31 	must not own more than $10,000 in total net assets. In addition to these maximum amounts, 
171.32 	an eligible individual or family may accrue interest on these amounts, but they must be 
171.33 	reduced to the maximum at the time of an eligibility redetermination. The value of assets 
172.1 	that are not considered in determining eligibility for medical assistance for families and 
172.2 	children is the value of those assets excluded under the AFDC state plan as of July 16, 1996, 
172.3 	as required by the Personal Responsibility and Work Opportunity Reconciliation Act of 
172.4 	1996 (PRWORA), Public Law 104-193, with the following exceptions:
172.5 	(1) household goods and personal effects are not considered;
172.6 	(2) capital and operating assets of a trade or business up to $200,000 are not considered, 
172.7 	except that a bank account that contains personal income or assets, or is used to pay personal 
172.8 	expenses, is not considered a capital or operating asset of a trade or business;
172.9 	(3) one motor vehicle is excluded for each person of legal driving age who is employed 
172.10 	or seeking employment;
172.11 	(4) assets designated as burial expenses are excluded to the same extent they are excluded 
172.12 	by the Supplemental Security Income program;
172.13 	(5) court-ordered settlements up to $10,000 are not considered;
172.14 	(6) individual retirement accounts and funds are not considered;
172.15 	(7) assets owned by children are not considered; and
172.16 	(8) effective July 1, 2009, certain assets owned by American Indians are excluded as 
172.17 	required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public 
172.18 	Law 111-5. For purposes of this clause, an American Indian is any person who meets the 
172.19 	definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
172.20 	The assets specified in clause (2) must be disclosed to the local agency at the time of 
172.21 	application and at the time of an eligibility redetermination, and must be verified upon 
172.22 	request of the local agency.
172.23 	(b) Beginning January 1, 2014, this subdivision applies only to parents and caretaker 
172.24 	relatives who qualify for medical assistance under subdivision 5.

172.25 	EFFECTIVE DATE. This section is effective July 1, 2017.

172.26 	Sec. 20. Minnesota Statutes 2016, section 256B.056, subdivision 5c, is amended to read:
172.27 		Subd. 5c.Excess income standard. (a) The excess income standard for parents and 
172.28 	caretaker relatives, pregnant women, infants, and children ages two through 20 is the standard 
172.29 	specified in subdivision 4, paragraph (b).
173.1 	(b) The excess income standard for a person whose eligibility is based on blindness, 
173.2 	disability, or age of 65 or more years shall equal 80 81 percent of the federal poverty 
173.3 	guidelines.

173.4 	EFFECTIVE DATE. This section is effective June 1, 2019.

173.5 	Sec. 21. Minnesota Statutes 2016, section 256B.0561, subdivision 2, is amended to read:
173.6 		Subd. 2.Periodic data matching. (a) Beginning March 1, 2016 April 1, 2018, the 
173.7 	commissioner shall conduct periodic data matching to identify recipients who, based on 
173.8 	available electronic data, may not meet eligibility criteria for the public health care program 
173.9 	in which the recipient is enrolled. The commissioner shall conduct data matching for medical 
173.10 	assistance or MinnesotaCare recipients at least once during a recipient's 12-month period 
173.11 	of eligibility.
173.12 	(b) If data matching indicates a recipient may no longer qualify for medical assistance 
173.13 	or MinnesotaCare, the commissioner must notify the recipient and allow the recipient no 
173.14 	more than 30 days to confirm the information obtained through the periodic data matching 
173.15 	or provide a reasonable explanation for the discrepancy to the state or county agency directly 
173.16 	responsible for the recipient's case. If a recipient does not respond within the advance notice 
173.17 	period or does not respond with information that demonstrates eligibility or provides a 
173.18 	reasonable explanation for the discrepancy within the 30-day time period, the commissioner 
173.19 	shall terminate the recipient's eligibility in the manner provided for by the laws and 
173.20 	regulations governing the health care program for which the recipient has been identified 
173.21 	as being ineligible.
173.22 	(c) The commissioner shall not terminate eligibility for a recipient who is cooperating 
173.23 	with the requirements of paragraph (b) and needs additional time to provide information in 
173.24 	response to the notification.
173.25 	(d) Any termination of eligibility for benefits under this section may be appealed as 
173.26 	provided for in sections 256.045 to 256.0451, and the laws governing the health care 
173.27 	programs for which eligibility is terminated.

173.28 	Sec. 22. Minnesota Statutes 2016, section 256B.0561, subdivision 4, is amended to read:
173.29 		Subd. 4.Report. By September 1, 2017 2019, and each September 1 thereafter, the 
173.30 	commissioner shall submit a report to the chairs and ranking minority members of the house 
173.31 	and senate committees with jurisdiction over human services finance that includes the 
173.32 	number of cases affected by periodic data matching under this section, the number of 
174.1 	recipients identified as possibly ineligible as a result of a periodic data match, and the number 
174.2 	of recipients whose eligibility was terminated as a result of a periodic data match. The report 
174.3 	must also specify, for recipients whose eligibility was terminated, how many cases were 
174.4 	closed due to failure to cooperate.

174.5 	Sec. 23. Minnesota Statutes 2016, section 256B.057, subdivision 9, as amended by Laws 
174.6 	2017, chapter 59, section 9, is amended to read:
174.7 		Subd. 9.Employed persons with disabilities. (a) Medical assistance may be paid for 
174.8 	a person who is employed and who:
174.9 	(1) but for excess earnings or assets, meets the definition of disabled under the 
174.10 	Supplemental Security Income program;
174.11 	(2) meets the asset limits in paragraph (d); and
174.12 	(3) pays a premium and other obligations under paragraph (e).
174.13 	(b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible 
174.14 	for medical assistance under this subdivision, a person must have more than $65 of earned 
174.15 	income. Earned income must have Medicare, Social Security, and applicable state and 
174.16 	federal taxes withheld. The person must document earned income tax withholding. Any 
174.17 	spousal income or assets shall be disregarded for purposes of eligibility and premium 
174.18 	determinations.
174.19 	(c) After the month of enrollment, a person enrolled in medical assistance under this 
174.20 	subdivision who:
174.21 	(1) is temporarily unable to work and without receipt of earned income due to a medical 
174.22 	condition, as verified by a physician, advanced practice registered nurse, or physician 
174.23 	assistant; or
174.24 	(2) loses employment for reasons not attributable to the enrollee, and is without receipt 
174.25 	of earned income may retain eligibility for up to four consecutive months after the month 
174.26 	of job loss. To receive a four-month extension, enrollees must verify the medical condition 
174.27 	or provide notification of job loss. All other eligibility requirements must be met and the 
174.28 	enrollee must pay all calculated premium costs for continued eligibility.
174.29 	(d) For purposes of determining eligibility under this subdivision, a person's assets must 
174.30 	not exceed $20,000, excluding:
174.31 	(1) all assets excluded under section 256B.056;
175.1 	(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, Keogh 
175.2 	plans, and pension plans;
175.3 	(3) medical expense accounts set up through the person's employer; and
175.4 	(4) spousal assets, including spouse's share of jointly held assets.
175.5 	(e) All enrollees must pay a premium to be eligible for medical assistance under this 
175.6 	subdivision, except as provided under clause (5).
175.7 	(1) An enrollee must pay the greater of a $35 premium or the premium calculated based 
175.8 	on the person's gross earned and unearned income and the applicable family size using a 
175.9 	sliding fee scale established by the commissioner, which begins at one percent of income 
175.10 	at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income for 
175.11 	those with incomes at or above 300 percent of the federal poverty guidelines.
175.12 	(2) Annual adjustments in the premium schedule based upon changes in the federal 
175.13 	poverty guidelines shall be effective for premiums due in July of each year.
175.14 	(3) All enrollees who receive unearned income must pay one-half of one percent of 
175.15 	unearned income in addition to the premium amount, except as provided under clause (5).
175.16 	(4) Increases in benefits under title II of the Social Security Act shall not be counted as 
175.17 	income for purposes of this subdivision until July 1 of each year.
175.18 	(5) Effective July 1, 2009, American Indians are exempt from paying premiums as 
175.19 	required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public 
175.20 	Law 111-5. For purposes of this clause, an American Indian is any person who meets the 
175.21 	definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
175.22 	(f) A person's eligibility and premium shall be determined by the local county agency. 
175.23 	Premiums must be paid to the commissioner. All premiums are dedicated to the 
175.24 	commissioner.
175.25 	(g) Any required premium shall be determined at application and redetermined at the 
175.26 	enrollee's six-month income review or when a change in income or household size is reported. 
175.27 	Enrollees must report any change in income or household size within ten days of when the 
175.28 	change occurs. A decreased premium resulting from a reported change in income or 
175.29 	household size shall be effective the first day of the next available billing month after the 
175.30 	change is reported. Except for changes occurring from annual cost-of-living increases, a 
175.31 	change resulting in an increased premium shall not affect the premium amount until the 
175.32 	next six-month review.
176.1 	(h) Premium payment is due upon notification from the commissioner of the premium 
176.2 	amount required. Premiums may be paid in installments at the discretion of the commissioner.
176.3 	(i) Nonpayment of the premium shall result in denial or termination of medical assistance 
176.4 	unless the person demonstrates good cause for nonpayment. Good cause exists if the 
176.5 	requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to D, are 
176.6 	met "Good cause" means an excuse for the enrollee's failure to pay the required premium 
176.7 	when due because the circumstances were beyond the enrollee's control or not reasonably 
176.8 	foreseeable. The commissioner shall determine whether good cause exists based on the 
176.9 	weight of the supporting evidence submitted by the enrollee to demonstrate good cause. 
176.10 	Except when an installment agreement is accepted by the commissioner, all persons 
176.11 	disenrolled for nonpayment of a premium must pay any past due premiums as well as current 
176.12 	premiums due prior to being reenrolled. Nonpayment shall include payment with a returned, 
176.13 	refused, or dishonored instrument. The commissioner may require a guaranteed form of 
176.14 	payment as the only means to replace a returned, refused, or dishonored instrument.
176.15 	(j) For enrollees whose income does not exceed 200 percent of the federal poverty 
176.16 	guidelines and who are also enrolled in Medicare, the commissioner shall reimburse the 
176.17 	enrollee for Medicare part B premiums under section 256B.0625, subdivision 15, paragraph 
176.18 	(a).

176.19 	EFFECTIVE DATE. This section is effective the day following final enactment.

176.20 	Sec. 24. Minnesota Statutes 2016, section 256B.059, subdivision 6, as amended by Laws 
176.21 	2017, chapter 40, article 1, section 66, is amended to read:
176.22 		Subd. 6.Temporary application. (a) During the period in which rules against spousal 
176.23 	impoverishment are temporarily applied according to section 2404 of the Patient Protection 
176.24 	Affordable Care Act, Public Law 111-148, as amended by the Health Care and Education 
176.25 	Reconciliation Act of 2010, Public Law 111-152, this section applies to an institutionalized 
176.26 	spouse:
176.27 	(1) applying for home and community-based waivers under sections 256B.092, 256B.093, 
176.28 	and 256B.49 on or after June 1, 2016;
176.29 	(2) enrolled in home and community-based waivers under sections 256B.092, 256B.093, 
176.30 	and 256B.49 before June 1, 2016, based on an application submitted on or after January 1, 
176.31 	2014; or
176.32 	(3) applying for services under section 256B.85 upon the effective date of that section.
177.1 	(b) During the applicable period of paragraph (a), the definition of "institutionalized 
177.2 	spouse" in subdivision 1, paragraph (e), also includes an institutionalized spouse referenced 
177.3 	in paragraph (a).

177.4 	EFFECTIVE DATE. This section is effective the day following final enactment.

177.5 	Sec. 25. Minnesota Statutes 2016, section 256B.0621, subdivision 10, is amended to read:
177.6 		Subd. 10.Payment rates. The commissioner shall set payment rates for targeted case 
177.7 	management under this subdivision. Case managers may bill according to the following 
177.8 	criteria:
177.9 	(1) for relocation targeted case management, case managers may bill for direct case 
177.10 	management activities, including face-to-face and contact, telephone contacts contact, and 
177.11 	interactive video contact according to section 256B.0924, subdivision 4a, in the lesser of:
177.12 	(i) 180 days preceding an eligible recipient's discharge from an institution; or
177.13 	(ii) the limits and conditions which apply to federal Medicaid funding for this service;
177.14 	(2) for home care targeted case management, case managers may bill for direct case 
177.15 	management activities, including face-to-face and telephone contacts; and
177.16 	(3) billings for targeted case management services under this subdivision shall not 
177.17 	duplicate payments made under other program authorities for the same purpose.

177.18 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
177.19 	of human services shall notify the revisor of statutes when federal approval is obtained.

177.20 	Sec. 26. Minnesota Statutes 2016, section 256B.0625, subdivision 1, is amended to read:
177.21 		Subdivision 1.Inpatient hospital services. (a) Medical assistance covers inpatient 
177.22 	hospital services. A second medical opinion is required prior to reimbursement for elective 
177.23 	surgeries requiring a second opinion. The commissioner shall publish in the State Register 
177.24 	a list of elective surgeries that require a second medical opinion prior to reimbursement, 
177.25 	and the criteria and standards for deciding whether an elective surgery should require a 
177.26 	second medical opinion. The list and the criteria and standards are not subject to the 
177.27 	requirements of sections 14.001 to 14.69. The commissioner's decision whether a second 
177.28 	medical opinion is required, made in accordance with rules governing that decision, is not 
177.29 	subject to administrative appeal.
178.1 	(b) When determining medical necessity for inpatient hospital services, the medical 
178.2 	review agent shall follow industry standard medical necessity criteria in determining the 
178.3 	following:
178.4 	(1) whether a recipient's admission is medically necessary;
178.5 	(2) whether the inpatient hospital services provided to the recipient were medically 
178.6 	necessary;
178.7 	(3) whether the recipient's continued stay was or will be medically necessary; and
178.8 	(4) whether all medically necessary inpatient hospital services were provided to the 
178.9 	recipient.
178.10 	The medical review agent will determine medical necessity of inpatient hospital services, 
178.11 	including inpatient psychiatric treatment, based on a review of the patient's medical condition 
178.12 	and records, in conjunction with industry standard evidence-based criteria to ensure consistent 
178.13 	and optimal application of medical appropriateness criteria.

178.14 	Sec. 27. Minnesota Statutes 2016, section 256B.0625, subdivision 3b, is amended to read:
178.15 		Subd. 3b.Telemedicine services. (a) Medical assistance covers medically necessary 
178.16 	services and consultations delivered by a licensed health care provider via telemedicine in 
178.17 	the same manner as if the service or consultation was delivered in person. Coverage is 
178.18 	limited to three telemedicine services per enrollee per calendar week. Telemedicine services 
178.19 	shall be paid at the full allowable rate.
178.20 	(b) The commissioner shall establish criteria that a health care provider must attest to 
178.21 	in order to demonstrate the safety or efficacy of delivering a particular service via 
178.22 	telemedicine. The attestation may include that the health care provider:
178.23 	(1) has identified the categories or types of services the health care provider will provide 
178.24 	via telemedicine;
178.25 	(2) has written policies and procedures specific to telemedicine services that are regularly 
178.26 	reviewed and updated;
178.27 	(3) has policies and procedures that adequately address patient safety before, during, 
178.28 	and after the telemedicine service is rendered;
178.29 	(4) has established protocols addressing how and when to discontinue telemedicine 
178.30 	services; and
178.31 	(5) has an established quality assurance process related to telemedicine services.
179.1 	(c) As a condition of payment, a licensed health care provider must document each 
179.2 	occurrence of a health service provided by telemedicine to a medical assistance enrollee. 
179.3 	Health care service records for services provided by telemedicine must meet the requirements 
179.4 	set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and must document:
179.5 	(1) the type of service provided by telemedicine;
179.6 	(2) the time the service began and the time the service ended, including an a.m. and p.m. 
179.7 	designation;
179.8 	(3) the licensed health care provider's basis for determining that telemedicine is an 
179.9 	appropriate and effective means for delivering the service to the enrollee;
179.10 	(4) the mode of transmission of the telemedicine service and records evidencing that a 
179.11 	particular mode of transmission was utilized;
179.12 	(5) the location of the originating site and the distant site;
179.13 	(6) if the claim for payment is based on a physician's telemedicine consultation with 
179.14 	another physician, the written opinion from the consulting physician providing the 
179.15 	telemedicine consultation; and
179.16 	(7) compliance with the criteria attested to by the health care provider in accordance 
179.17 	with paragraph (b).
179.18 	(d) For purposes of this subdivision, unless otherwise covered under this chapter, 
179.19 	"telemedicine" is defined as the delivery of health care services or consultations while the 
179.20 	patient is at an originating site and the licensed health care provider is at a distant site. A 
179.21 	communication between licensed health care providers, or a licensed health care provider 
179.22 	and a patient that consists solely of a telephone conversation, e-mail, or facsimile transmission 
179.23 	does not constitute telemedicine consultations or services. Telemedicine may be provided 
179.24 	by means of real-time two-way, interactive audio and visual communications, including the 
179.25 	application of secure video conferencing or store-and-forward technology to provide or 
179.26 	support health care delivery, which facilitate the assessment, diagnosis, consultation, 
179.27 	treatment, education, and care management of a patient's health care.
179.28 	(e) For purposes of this section, "licensed health care provider" is definedmeans a 
179.29 	licensed health care provider under section 62A.671, subdivision 6, and a mental health 
179.30 	practitioner defined under section 245.462, subdivision 17, or 245.4871, subdivision 26, 
179.31 	working under the general supervision of a mental health professional; "health care provider" 
179.32 	is defined under section 62A.671, subdivision 3; and "originating site" is defined under 
179.33 	section 62A.671, subdivision 7.

180.1 	EFFECTIVE DATE. This section is effective the day following final enactment.

180.2 	Sec. 28. Minnesota Statutes 2016, section 256B.0625, subdivision 7, is amended to read:
180.3 		Subd. 7.Home care nursing. Medical assistance covers home care nursing services in 
180.4 	a recipient's home. Recipients who are authorized to receive home care nursing services in 
180.5 	their home may use approved hours outside of the home during hours when normal life 
180.6 	activities take them outside of their home. To use home care nursing services at school, the 
180.7 	recipient or responsible party must provide written authorization in the care plan identifying 
180.8 	the chosen provider and the daily amount of services to be used at school. Medical assistance 
180.9 	does not cover home care nursing services for residents of a hospital, nursing facility, 
180.10 	intermediate care facility, or a health care facility licensed by the commissioner of health, 
180.11 	except as authorized in section 256B.64 for ventilator-dependent recipients in hospitals or
180.12 	unless a resident who is otherwise eligible is on leave from the facility and the facility either 
180.13 	pays for the home care nursing services or forgoes the facility per diem for the leave days 
180.14 	that home care nursing services are used. Total hours of service and payment allowed for 
180.15 	services outside the home cannot exceed that which is otherwise allowed in an in-home 
180.16 	setting according to sections 256B.0651 and 256B.0654 . All home care nursing services 
180.17 	must be provided according to the limits established under sections 256B.0651, 256B.0653, 
180.18 	and 256B.0654. Home care nursing services may not be reimbursed if the nurse is the family 
180.19 	foster care provider of a recipient who is under age 18, unless allowed under section 
180.20 	256B.0654, subdivision 4.

180.21 	Sec. 29. Minnesota Statutes 2016, section 256B.0625, subdivision 17, is amended to read:
180.22 		Subd. 17.Transportation costs. (a) "Nonemergency medical transportation service" 
180.23 	means motor vehicle transportation provided by a public or private person that serves 
180.24 	Minnesota health care program beneficiaries who do not require emergency ambulance 
180.25 	service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
180.26 	(b) Medical assistance covers medical transportation costs incurred solely for obtaining 
180.27 	emergency medical care or transportation costs incurred by eligible persons in obtaining 
180.28 	emergency or nonemergency medical care when paid directly to an ambulance company, 
180.29 	common carrier nonemergency medical transportation company, or other recognized 
180.30 	providers of transportation services. Medical transportation must be provided by:
180.31 	(1) nonemergency medical transportation providers who meet the requirements of this 
180.32 	subdivision;
180.33 	(2) ambulances, as defined in section 144E.001, subdivision 2;
181.1 	(3) taxicabs that meet the requirements of this subdivision;
181.2 	(4) public transit, as defined in section 174.22, subdivision 7; or
181.3 	(5) not-for-hire vehicles, including volunteer drivers.
181.4 	(c) Medical assistance covers nonemergency medical transportation provided by 
181.5 	nonemergency medical transportation providers enrolled in the Minnesota health care 
181.6 	programs. All nonemergency medical transportation providers must comply with the 
181.7 	operating standards for special transportation service as defined in sections 174.29 to 174.30
181.8 	and Minnesota Rules, chapter 8840, and in consultation with the Minnesota Department of 
181.9 	Transportation. All nonemergency medical transportation providers shall bill for 
181.10 	nonemergency medical transportation services in accordance with Minnesota health care 
181.11 	programs criteria. Publicly operated transit systems, volunteers, and not-for-hire vehicles 
181.12 	are exempt from the requirements outlined in this paragraph.
181.13 	(d) An organization may be terminated, denied, or suspended from enrollment if:
181.14 	(1) the provider has not initiated background studies on the individuals specified in 
181.15 	section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
181.16 	(2) the provider has initiated background studies on the individuals specified in section 
181.17 	174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:
181.18 	(i) the commissioner has sent the provider a notice that the individual has been 
181.19 	disqualified under section 245C.14; and
181.20 	(ii) the individual has not received a disqualification set-aside specific to the special 
181.21 	transportation services provider under sections 245C.22 and 245C.23.
181.22 	(e) The administrative agency of nonemergency medical transportation must:
181.23 	(1) adhere to the policies defined by the commissioner in consultation with the 
181.24 	Nonemergency Medical Transportation Advisory Committee;
181.25 	(2) pay nonemergency medical transportation providers for services provided to 
181.26 	Minnesota health care programs beneficiaries to obtain covered medical services;
181.27 	(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled 
181.28 	trips, and number of trips by mode; and
181.29 	(4) by July 1, 2016, in accordance with subdivision 18e, utilize a Web-based single 
181.30 	administrative structure assessment tool that meets the technical requirements established 
181.31 	by the commissioner, reconciles trip information with claims being submitted by providers, 
181.32 	and ensures prompt payment for nonemergency medical transportation services.
182.1 	(f) Until the commissioner implements the single administrative structure and delivery 
182.2 	system under subdivision 18e, clients shall obtain their level-of-service certificate from the 
182.3 	commissioner or an entity approved by the commissioner that does not dispatch rides for 
182.4 	clients using modes of transportation under paragraph (i), clauses (4), (5), (6), and (7).
182.5 	(g) The commissioner may use an order by the recipient's attending physician or a medical 
182.6 	or mental health professional to certify that the recipient requires nonemergency medical 
182.7 	transportation services. Nonemergency medical transportation providers shall perform 
182.8 	driver-assisted services for eligible individuals, when appropriate. Driver-assisted service 
182.9 	includes passenger pickup at and return to the individual's residence or place of business, 
182.10 	assistance with admittance of the individual to the medical facility, and assistance in 
182.11 	passenger securement or in securing of wheelchairs, child seats, or stretchers in the vehicle.
182.12 	Nonemergency medical transportation providers must take clients to the health care 
182.13 	provider using the most direct route, and must not exceed 30 miles for a trip to a primary 
182.14 	care provider or 60 miles for a trip to a specialty care provider, unless the client receives 
182.15 	authorization from the local agency.
182.16 	Nonemergency medical transportation providers may not bill for separate base rates for 
182.17 	the continuation of a trip beyond the original destination. Nonemergency medical 
182.18 	transportation providers must maintain trip logs, which include pickup and drop-off times, 
182.19 	signed by the medical provider or client, whichever is deemed most appropriate, attesting 
182.20 	to mileage traveled to obtain covered medical services. Clients requesting client mileage 
182.21 	reimbursement must sign the trip log attesting mileage traveled to obtain covered medical 
182.22 	services.
182.23 	(h) The administrative agency shall use the level of service process established by the 
182.24 	commissioner in consultation with the Nonemergency Medical Transportation Advisory 
182.25 	Committee to determine the client's most appropriate mode of transportation. If public transit 
182.26 	or a certified transportation provider is not available to provide the appropriate service mode 
182.27 	for the client, the client may receive a onetime service upgrade.
182.28 	(i) The covered modes of transportation, which may not be implemented without a new 
182.29 	rate structure, are:
182.30 	(1) client reimbursement, which includes client mileage reimbursement provided to 
182.31 	clients who have their own transportation, or to family or an acquaintance who provides 
182.32 	transportation to the client;
182.33 	(2) volunteer transport, which includes transportation by volunteers using their own 
182.34 	vehicle;
183.1 	(3) unassisted transport, which includes transportation provided to a client by a taxicab 
183.2 	or public transit. If a taxicab or public transit is not available, the client can receive 
183.3 	transportation from another nonemergency medical transportation provider;
183.4 	(4) assisted transport, which includes transport provided to clients who require assistance 
183.5 	by a nonemergency medical transportation provider;
183.6 	(5) lift-equipped/ramp transport, which includes transport provided to a client who is 
183.7 	dependent on a device and requires a nonemergency medical transportation provider with 
183.8 	a vehicle containing a lift or ramp;
183.9 	(6) protected transport, which includes transport provided to a client who has received 
183.10 	a prescreening that has deemed other forms of transportation inappropriate and who requires 
183.11 	a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety 
183.12 	locks, a video recorder, and a transparent thermoplastic partition between the passenger and 
183.13 	the vehicle driver; and (ii) who is certified as a protected transport provider; and
183.14 	(7) stretcher transport, which includes transport for a client in a prone or supine position 
183.15 	and requires a nonemergency medical transportation provider with a vehicle that can transport 
183.16 	a client in a prone or supine position.
183.17 	(j) The local agency shall be the single administrative agency and shall administer and 
183.18 	reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) when the 
183.19 	commissioner has developed, made available, and funded the Web-based single 
183.20 	administrative structure, assessment tool, and level of need assessment under subdivision 
183.21 	18e. The local agency's financial obligation is limited to funds provided by the state or 
183.22 	federal government.
183.23 	(k) The commissioner shall:
183.24 	(1) in consultation with the Nonemergency Medical Transportation Advisory Committee, 
183.25 	verify that the mode and use of nonemergency medical transportation is appropriate;
183.26 	(2) verify that the client is going to an approved medical appointment; and
183.27 	(3) investigate all complaints and appeals.
183.28 	(l) The administrative agency shall pay for the services provided in this subdivision and 
183.29 	seek reimbursement from the commissioner, if appropriate. As vendors of medical care, 
183.30 	local agencies are subject to the provisions in section 256B.041, the sanctions and monetary 
183.31 	recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
184.1 	(m) Payments for nonemergency medical transportation must be paid based on the client's 
184.2 	assessed mode under paragraph (h), not the type of vehicle used to provide the service. The 
184.3 	medical assistance reimbursement rates for nonemergency medical transportation services 
184.4 	that are payable by or on behalf of the commissioner for nonemergency medical 
184.5 	transportation services are:
184.6 	(1) $0.22 per mile for client reimbursement;
184.7 	(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer 
184.8 	transport;
184.9 	(3) equivalent to the standard fare for unassisted transport when provided by public 
184.10 	transit, and $11 for the base rate and $1.30 per mile when provided by a nonemergency 
184.11 	medical transportation provider;
184.12 	(4) $13 for the base rate and $1.30 per mile for assisted transport;
184.13 	(5) $18 for the base rate and $1.55 per mile for lift-equipped/ramp transport;
184.14 	(6) $75 for the base rate and $2.40 per mile for protected transport; and
184.15 	(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for 
184.16 	an additional attendant if deemed medically necessary.
184.17 	(n) The base rate for nonemergency medical transportation services in areas defined 
184.18 	under RUCA to be super rural is equal to 111.3 percent of the respective base rate in 
184.19 	paragraph (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation 
184.20 	services in areas defined under RUCA to be rural or super rural areas is:
184.21 	(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage 
184.22 	rate in paragraph (m), clauses (1) to (7); and
184.23 	(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage 
184.24 	rate in paragraph (m), clauses (1) to (7).
184.25 	(o) For purposes of reimbursement rates for nonemergency medical transportation 
184.26 	services under paragraphs (m) and (n), the zip code of the recipient's place of residence 
184.27 	shall determine whether the urban, rural, or super rural reimbursement rate applies.
184.28 	(p) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means 
184.29 	a census-tract based classification system under which a geographical area is determined 
184.30 	to be urban, rural, or super rural.
185.1 	(q) The commissioner, when determining reimbursement rates for nonemergency medical 
185.2 	transportation under paragraphs (m) and (n), shall exempt all modes of transportation listed 
185.3 	under paragraph (i) from Minnesota Rules, part 9505.0445, item R, subitem (2).

185.4 	Sec. 30. Minnesota Statutes 2016, section 256B.0625, subdivision 17b, is amended to 
185.5 	read:
185.6 		Subd. 17b.Documentation required. (a) As a condition for payment, nonemergency 
185.7 	medical transportation providers must document each occurrence of a service provided to 
185.8 	a recipient according to this subdivision. Providers must maintain odometer and other records 
185.9 	sufficient to distinguish individual trips with specific vehicles and drivers. The documentation 
185.10 	may be collected and maintained using electronic systems or software or in paper form but 
185.11 	must be made available and produced upon request. Program funds paid for transportation 
185.12 	that is not documented according to this subdivision shall be recovered by the department.
185.13 	(b) A nonemergency medical transportation provider must compile transportation records 
185.14 	that meet the following requirements:
185.15 	(1) the record must be in English and must be legible according to the standard of a 
185.16 	reasonable person;
185.17 	(2) the recipient's name must be on each page of the record; and
185.18 	(3) each entry in the record must document:
185.19 	(i) the date on which the entry is made;
185.20 	(ii) the date or dates the service is provided;
185.21 	(iii) the printed last name, first name, and middle initial of the driver;
185.22 	(iv) the signature of the driver attesting to the following: "I certify that I have accurately 
185.23 	reported in this record the trip miles I actually drove and the dates and times I actually drove 
185.24 	them. I understand that misreporting the miles driven and hours worked is fraud for which 
185.25 	I could face criminal prosecution or civil proceedings.";
185.26 	(v) the signature of the recipient or authorized party attesting to the following: "I certify 
185.27 	that I received the reported transportation service.", or the signature of the provider of 
185.28 	medical services certifying that the recipient was delivered to the provider;
185.29 	(vi) the address, or the description if the address is not available, of both the origin and 
185.30 	destination, and the mileage for the most direct route from the origin to the destination;
185.31 	(vii) the mode of transportation in which the service is provided;
186.1 	(viii) the license plate number of the vehicle used to transport the recipient;
186.2 	(ix) whether the service was ambulatory or nonambulatory until the modes under 
186.3 	subdivision 17 are implemented;
186.4 	(x) the time of the pickup and the time of the drop-off with "a.m." and "p.m." 
186.5 	designations;
186.6 	(xi) the name of the extra attendant when an extra attendant is used to provide special 
186.7 	transportation service; and
186.8 	(xii) the electronic source documentation used to calculate driving directions and mileage.

186.9 	Sec. 31. Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision 
186.10 	to read:
186.11 		Subd. 17c.Nursing facility transports. A Minnesota health care program enrollee 
186.12 	residing in, or being discharged from, a licensed nursing facility is exempt from a level of 
186.13 	need determination and is eligible for nonemergency medical transportation services until 
186.14 	the enrollee no longer resides in a licensed nursing facility, as provided in section 256B.04, 
186.15 	subdivision 14a.

186.16 	Sec. 32. Minnesota Statutes 2016, section 256B.0625, subdivision 18h, is amended to 
186.17 	read:
186.18 		Subd. 18h.Managed care. (a) The following subdivisions do not apply to managed 
186.19 	care plans and county-based purchasing plans:
186.20 	(1) subdivision 17, paragraphs (d) to (k) (a), (b), (i), and (n);
186.21 	(2) subdivision 18e 18; and
186.22 	(3) subdivision 18g 18a.
186.23 	(b) A nonemergency medical transportation provider must comply with the operating 
186.24 	standards for special transportation service specified in sections 174.29 to 174.30 and 
186.25 	Minnesota Rules, chapter 8840. Publicly operated transit systems, volunteers, and not-for-hire 
186.26 	vehicles are exempt from the requirements in this paragraph.

186.27 	Sec. 33. Minnesota Statutes 2016, section 256B.0625, subdivision 20, is amended to read:
186.28 		Subd. 20.Mental health case management. (a) To the extent authorized by rule of the 
186.29 	state agency, medical assistance covers case management services to persons with serious 
186.30 	and persistent mental illness and children with severe emotional disturbance. Services 
187.1 	provided under this section must meet the relevant standards in sections 245.461 to 245.4887, 
187.2 	the Comprehensive Adult and Children's Mental Health Acts, Minnesota Rules, parts 
187.3 	9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.
187.4 	(b) Entities meeting program standards set out in rules governing family community 
187.5 	support services as defined in section 245.4871, subdivision 17, are eligible for medical 
187.6 	assistance reimbursement for case management services for children with severe emotional 
187.7 	disturbance when these services meet the program standards in Minnesota Rules, parts 
187.8 	9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.
187.9 	(c) Medical assistance and MinnesotaCare payment for mental health case management 
187.10 	shall be made on a monthly basis. In order to receive payment for an eligible child, the 
187.11 	provider must document at least a face-to-face contact with the child, the child's parents, or 
187.12 	the child's legal representative. To receive payment for an eligible adult, the provider must 
187.13 	document:
187.14 	(1) at least a face-to-face contact with the adult or the adult's legal representative or a 
187.15 	contact by interactive video that meets the requirements of subdivision 20b; or
187.16 	(2) at least a telephone contact with the adult or the adult's legal representative and 
187.17 	document a face-to-face contact or a contact by interactive video that meets the requirements 
187.18 	of subdivision 20b with the adult or the adult's legal representative within the preceding 
187.19 	two months.
187.20 	(d) Payment for mental health case management provided by county or state staff shall 
187.21 	be based on the monthly rate methodology under section 256B.094, subdivision 6, paragraph 
187.22 	(b), with separate rates calculated for child welfare and mental health, and within mental 
187.23 	health, separate rates for children and adults.
187.24 	(e) Payment for mental health case management provided by Indian health services or 
187.25 	by agencies operated by Indian tribes may be made according to this section or other relevant 
187.26 	federally approved rate setting methodology.
187.27 	(f) Payment for mental health case management provided by vendors who contract with 
187.28 	a county or Indian tribe shall be based on a monthly rate negotiated by the host county or 
187.29 	tribe. The negotiated rate must not exceed the rate charged by the vendor for the same 
187.30 	service to other payers. If the service is provided by a team of contracted vendors, the county 
187.31 	or tribe may negotiate a team rate with a vendor who is a member of the team. The team 
187.32 	shall determine how to distribute the rate among its members. No reimbursement received 
187.33 	by contracted vendors shall be returned to the county or tribe, except to reimburse the county 
187.34 	or tribe for advance funding provided by the county or tribe to the vendor.
188.1 	(g) If the service is provided by a team which includes contracted vendors, tribal staff, 
188.2 	and county or state staff, the costs for county or state staff participation in the team shall be 
188.3 	included in the rate for county-provided services. In this case, the contracted vendor, the 
188.4 	tribal agency, and the county may each receive separate payment for services provided by 
188.5 	each entity in the same month. In order to prevent duplication of services, each entity must 
188.6 	document, in the recipient's file, the need for team case management and a description of 
188.7 	the roles of the team members.
188.8 	(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for 
188.9 	mental health case management shall be provided by the recipient's county of responsibility, 
188.10 	as defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds 
188.11 	used to match other federal funds. If the service is provided by a tribal agency, the nonfederal 
188.12 	share, if any, shall be provided by the recipient's tribe. When this service is paid by the state 
188.13 	without a federal share through fee-for-service, 50 percent of the cost shall be provided by 
188.14 	the recipient's county of responsibility.
188.15 	(i) Notwithstanding any administrative rule to the contrary, prepaid medical assistance 
188.16 	and MinnesotaCare include mental health case management. When the service is provided 
188.17 	through prepaid capitation, the nonfederal share is paid by the state and the county pays no 
188.18 	share.
188.19 	(j) The commissioner may suspend, reduce, or terminate the reimbursement to a provider 
188.20 	that does not meet the reporting or other requirements of this section. The county of 
188.21 	responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal agency, 
188.22 	is responsible for any federal disallowances. The county or tribe may share this responsibility 
188.23 	with its contracted vendors.
188.24 	(k) The commissioner shall set aside a portion of the federal funds earned for county 
188.25 	expenditures under this section to repay the special revenue maximization account under 
188.26 	section 256.01, subdivision 2, paragraph (o). The repayment is limited to:
188.27 	(1) the costs of developing and implementing this section; and
188.28 	(2) programming the information systems.
188.29 	(l) Payments to counties and tribal agencies for case management expenditures under 
188.30 	this section shall only be made from federal earnings from services provided under this 
188.31 	section. When this service is paid by the state without a federal share through fee-for-service, 
188.32 	50 percent of the cost shall be provided by the state. Payments to county-contracted vendors 
188.33 	shall include the federal earnings, the state share, and the county share.
189.1 	(m) Case management services under this subdivision do not include therapy, treatment, 
189.2 	legal, or outreach services.
189.3 	(n) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital, 
189.4 	and the recipient's institutional care is paid by medical assistance, payment for case 
189.5 	management services under this subdivision is limited to the lesser of:
189.6 	(1) the last 180 days of the recipient's residency in that facility and may not exceed more 
189.7 	than six months in a calendar year; or
189.8 	(2) the limits and conditions which apply to federal Medicaid funding for this service.
189.9 	(o) Payment for case management services under this subdivision shall not duplicate 
189.10 	payments made under other program authorities for the same purpose.
189.11 	(p) If the recipient is receiving care in a hospital, nursing facility, or residential setting 
189.12 	licensed under chapter 245A or 245D that is staffed 24 hours a day, seven days a week, 
189.13 	mental health targeted case management services must actively support identification of 
189.14 	community alternatives for the recipient and discharge planning.

189.15 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
189.16 	of human services shall notify the revisor of statutes when federal approval is obtained.

189.17 	Sec. 34. Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision 
189.18 	to read:
189.19 		Subd. 20b.Mental health targeted case management through interactive video. (a) 
189.20 	Subject to federal approval, contact made for targeted case management by interactive video 
189.21 	shall be eligible for payment if:
189.22 	(1) the person receiving targeted case management services is residing in:
189.23 	(i) a hospital;
189.24 	(ii) a nursing facility; or
189.25 	(iii) a residential setting licensed under chapter 245A or 245D or a boarding and lodging 
189.26 	establishment or lodging establishment that provides supportive services or health supervision 
189.27 	services according to section 157.17 that is staffed 24 hours a day, seven days a week;
189.28 	(2) interactive video is in the best interests of the person and is deemed appropriate by 
189.29 	the person receiving targeted case management or the person's legal guardian, the case 
189.30 	management provider, and the provider operating the setting where the person is residing;
190.1 	(3) the use of interactive video is approved as part of the person's written personal service 
190.2 	or case plan, taking into consideration the person's vulnerability and active personal 
190.3 	relationships; and
190.4 	(4) interactive video is used for up to, but not more than, 50 percent of the minimum 
190.5 	required face-to-face contact.
190.6 	(b) The person receiving targeted case management or the person's legal guardian has 
190.7 	the right to choose and consent to the use of interactive video under this subdivision and 
190.8 	has the right to refuse the use of interactive video at any time.
190.9 	(c) The commissioner shall establish criteria that a targeted case management provider 
190.10 	must attest to in order to demonstrate the safety or efficacy of delivering the service via 
190.11 	interactive video. The attestation may include that the case management provider has:
190.12 	(1) written policies and procedures specific to interactive video services that are regularly 
190.13 	reviewed and updated;
190.14 	(2) policies and procedures that adequately address client safety before, during, and after 
190.15 	the interactive video services are rendered;
190.16 	(3) established protocols addressing how and when to discontinue interactive video 
190.17 	services; and
190.18 	(4) established a quality assurance process related to interactive video services.
190.19 	(d) As a condition of payment, the targeted case management provider must document 
190.20 	the following for each occurrence of targeted case management provided by interactive 
190.21 	video:
190.22 	(1) the time the service began and the time the service ended, including an a.m. and p.m. 
190.23 	designation;
190.24 	(2) the basis for determining that interactive video is an appropriate and effective means 
190.25 	for delivering the service to the person receiving case management services;
190.26 	(3) the mode of transmission of the interactive video services and records evidencing 
190.27 	that a particular mode of transmission was utilized;
190.28 	(4) the location of the originating site and the distant site; and
190.29 	(5) compliance with the criteria attested to by the targeted case management provider 
190.30 	as provided in paragraph (c).

191.1 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
191.2 	of human services shall notify the revisor of statutes when federal approval is obtained.

191.3 	Sec. 35. Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision 
191.4 	to read:
191.5 		Subd. 31c.Preferred incontinence product program. The commissioner shall 
191.6 	implement a preferred incontinence product program by July 1, 2018. The program shall 
191.7 	require the commissioner to volume purchase incontinence products and related supplies 
191.8 	in accordance with section 256B.04, subdivision 14. Medical assistance coverage for 
191.9 	incontinence products and related supplies shall conform to the limitations established under 
191.10 	the program.

191.11 	Sec. 36. Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision 
191.12 	to read:
191.13 		Subd. 56a.Post-arrest community-based service coordination. (a) Medical assistance 
191.14 	covers post-arrest community-based service coordination for an individual who:
191.15 	(1) has been identified as having a mental illness or substance use disorder using a 
191.16 	screening tool approved by the commissioner;
191.17 	(2) does not require the security of a public detention facility and is not considered an 
191.18 	inmate of a public institution as defined in Code of Federal Regulations, title 42, section 
191.19 	435.1010;
191.20 	(3) meets the eligibility requirements in section 256B.056; and
191.21 	(4) has agreed to participate in post-arrest community-based service coordination through 
191.22 	a diversion contract in lieu of incarceration.
191.23 	(b) Post-arrest community-based service coordination means navigating services to 
191.24 	address a client's mental health, chemical health, social, economic, and housing needs, or 
191.25 	any other activity targeted at reducing the incidence of jail utilization and connecting 
191.26 	individuals with existing covered services available to them, including, but not limited to, 
191.27 	targeted case management, waiver case management, or care coordination.
191.28 	(c) Post-arrest community-based service coordination must be provided by an individual 
191.29 	who is an employee of a county or is under contract with a county to provide post-arrest 
191.30 	community-based coordination and is qualified under one of the following criteria:
192.1 	(1) a licensed mental health professional as defined in section 245.462, subdivision 18, 
192.2 	clauses (1) to (6);
192.3 	(2) a mental health practitioner as defined in section 245.462, subdivision 17, working 
192.4 	under the clinical supervision of a mental health professional; or
192.5 	(3) a certified peer specialist under section 256B.0615, working under the clinical 
192.6 	supervision of a mental health professional.
192.7 	(d) Reimbursement is allowed for up to 60 days following the initial determination of 
192.8 	eligibility.
192.9 	(e) Providers of post-arrest community-based service coordination shall annually report 
192.10 	to the commissioner on the number of individuals served, and number of the 
192.11 	community-based services that were accessed by recipients. The commissioner shall ensure 
192.12 	that services and payments provided under post-arrest community-based service coordination 
192.13 	do not duplicate services or payments provided under section 256B.0625, subdivision 20, 
192.14 	256B.0753, 256B.0755, or 256B.0757.
192.15 	(f) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of cost for 
192.16 	post-arrest community-based service coordination services shall be provided by the county 
192.17 	providing the services, from sources other than federal funds or funds used to match other 
192.18 	federal funds.

192.19 	EFFECTIVE DATE. This section is effective upon federal approval for services 
192.20 	provided on or after July 1, 2017. The commissioner of human services shall notify the 
192.21 	revisor of statutes when federal approval is obtained.

192.22 	Sec. 37. Minnesota Statutes 2016, section 256B.0625, subdivision 64, is amended to read:
192.23 		Subd. 64.Investigational drugs, biological products, and devices. (a) Medical 
192.24 	assistance and the early periodic screening, diagnosis, and treatment (EPSDT) program do 
192.25 	not cover costs incidental to, associated with, or resulting from the use of investigational 
192.26 	drugs, biological products, or devices as defined in section 151.375.
192.27 	(b) Notwithstanding paragraph (a), stiripentol may be covered by the EPSDT program 
192.28 	if all the following conditions are met:
192.29 	(1) the use of stiripentol is determined to be medically necessary;
192.30 	(2) the enrollee has a documented diagnosis of Dravet syndrome, regardless of whether 
192.31 	an SCN1A genetic mutation is found, or the enrollee is a child with malignant migrating 
192.32 	partial epilepsy in infancy due to an SCN2A genetic mutation;
193.1 	(3) all other available covered prescription medications that are medically necessary for 
193.2 	the enrollee have been tried without successful outcomes; and
193.3 	(4) the United States Food and Drug Administration has approved the treating physician's 
193.4 	individual patient investigational new drug application (IND) for the use of stiripentol for 
193.5 	treatment.
193.6 	This paragraph does not apply to MinnesotaCare coverage under chapter 256L.

193.7 	Sec. 38. Minnesota Statutes 2016, section 256B.0644, is amended to read:
193.8 	256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE 
193.9 	PROGRAMS.
193.10 	(a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a health 
193.11 	maintenance organization, as defined in chapter 62D, must participate as a provider or 
193.12 	contractor in the medical assistance program and MinnesotaCare as a condition of 
193.13 	participating as a provider in health insurance plans and programs or contractor for state 
193.14 	employees established under section 43A.18, the public employees insurance program under 
193.15 	section 43A.316, for health insurance plans offered to local statutory or home rule charter 
193.16 	city, county, and school district employees, the workers' compensation system under section 
193.17 	176.135, and insurance plans provided through the Minnesota Comprehensive Health 
193.18 	Association under sections 62E.01 to 62E.19. The limitations on insurance plans offered to 
193.19 	local government employees shall not be applicable in geographic areas where provider 
193.20 	participation is limited by managed care contracts with the Department of Human Services.
193.21 	This section does not apply to dental service providers providing dental services outside 
193.22 	the seven-county metropolitan area.
193.23 	(b) For providers other than health maintenance organizations, participation in the medical 
193.24 	assistance program means that:
193.25 	(1) the provider accepts new medical assistance and MinnesotaCare patients;
193.26 	(2) for providers other than dental service providers, at least 20 percent of the provider's 
193.27 	patients are covered by medical assistance and MinnesotaCare as their primary source of 
193.28 	coverage; or
193.29 	(3) for dental service providers providing dental services in the seven-county metropolitan 
193.30 	area, at least ten percent of the provider's patients are covered by medical assistance and 
193.31 	MinnesotaCare as their primary source of coverage, or the provider accepts new medical 
193.32 	assistance and MinnesotaCare patients who are children with special health care needs. For 
193.33 	purposes of this section, "children with special health care needs" means children up to age 
194.1 	18 who: (i) require health and related services beyond that required by children generally; 
194.2 	and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional 
194.3 	condition, including: bleeding and coagulation disorders; immunodeficiency disorders; 
194.4 	cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other 
194.5 	neurological diseases; visual impairment or deafness; Down syndrome and other genetic 
194.6 	disorders; autism; fetal alcohol syndrome; and other conditions designated by the 
194.7 	commissioner after consultation with representatives of pediatric dental providers and 
194.8 	consumers.
194.9 	(c) Patients seen on a volunteer basis by the provider at a location other than the provider's 
194.10 	usual place of practice may be considered in meeting the participation requirement in this 
194.11 	section. The commissioner shall establish participation requirements for health maintenance 
194.12 	organizations. The commissioner shall provide lists of participating medical assistance 
194.13 	providers on a quarterly basis to the commissioner of management and budget, the 
194.14 	commissioner of labor and industry, and the commissioner of commerce. Each of the 
194.15 	commissioners shall develop and implement procedures to exclude as participating providers 
194.16 	in the program or programs under their jurisdiction those providers who do not participate 
194.17 	in the medical assistance program. The commissioner of management and budget shall 
194.18 	implement this section through contracts with participating health and dental carriers.
194.19 	(d) A volunteer dentist who has signed a volunteer agreement under section 256B.0625, 
194.20 	subdivision 9a, shall not be considered to be participating in medical assistance or 
194.21 	MinnesotaCare for the purpose of this section.

194.22 	EFFECTIVE DATE. This section is effective upon receipt of any necessary federal 
194.23 	waiver or approval. The commissioner of human services shall notify the revisor of statutes 
194.24 	if a federal waiver or approval is sought and, if sought, when a federal waiver or approval 
194.25 	is obtained.

194.26 	Sec. 39. Minnesota Statutes 2016, section 256B.072, is amended to read:
194.27 	256B.072 PERFORMANCE REPORTING AND QUALITY IMPROVEMENT 
194.28 	SYSTEM.
194.29 		Subdivision 1.Performance measures. (a) The commissioner of human services shall 
194.30 	establish a performance reporting system for health care providers who provide health care 
194.31 	services to public program recipients covered under chapters 256B, 256D, and 256L, 
194.32 	reporting separately for managed care and fee-for-service recipients.
195.1 	(b) The measures used for the performance reporting system for medical groups shall 
195.2 	include measures of care for asthma, diabetes, hypertension, and coronary artery disease 
195.3 	and measures of preventive care services. The measures used for the performance reporting 
195.4 	system for inpatient hospitals shall include measures of care for acute myocardial infarction, 
195.5 	heart failure, and pneumonia, and measures of care and prevention of surgical infections. 
195.6 	In the case of a medical group, the measures used shall be consistent with measures published
195.7 	by nonprofit Minnesota or national organizations that produce and disseminate health care 
195.8 	quality measures or evidence-based health care guidelines section 62U.02, subdivision 1, 
195.9 	paragraph (a), clause (1). In the case of inpatient hospital measures, the commissioner shall 
195.10 	appoint the Minnesota Hospital Association and Stratis Health to advise on the development 
195.11 	of the performance measures to be used for hospital reporting. To enable a consistent 
195.12 	measurement process across the community, the commissioner may use measures of care 
195.13 	provided for patients in addition to those identified in paragraph (a). The commissioner 
195.14 	shall ensure collaboration with other health care reporting organizations so that the measures 
195.15 	described in this section are consistent with those reported by those organizations and used 
195.16 	by other purchasers in Minnesota.
195.17 	(c) The commissioner may require providers to submit information in a required format 
195.18 	to a health care reporting organization or to cooperate with the information collection 
195.19 	procedures of that organization. The commissioner may collaborate with a reporting 
195.20 	organization to collect information reported and to prevent duplication of reporting.
195.21 	(d) By October 1, 2007, and annually thereafter, the commissioner shall report through 
195.22 	a public Web site the results by medical groups and hospitals, where possible, of the measures 
195.23 	under this section, and shall compare the results by medical groups and hospitals for patients 
195.24 	enrolled in public programs to patients enrolled in private health plans. To achieve this 
195.25 	reporting, the commissioner may collaborate with a health care reporting organization that 
195.26 	operates a Web site suitable for this purpose.
195.27 	(e) Performance measures must be stratified as provided under section 62U.02, 
195.28 	subdivision 1, paragraph (b) (c), and risk-adjusted as specified in section 62U.02, subdivision 
195.29 	3, paragraph (b).
195.30 	(f) Notwithstanding paragraph (b), by January 1, 2019, the commissioner shall consider 
195.31 	and appropriately adjust quality metrics and benchmarks for providers who primarily serve 
195.32 	socioeconomically complex patient populations and request to be scored on additional 
195.33 	measures in this subdivision. This applies to all Minnesota health care programs, including 
195.34 	for patient populations enrolled in health plans, county-based purchasing plans, or managed 
195.35 	care organizations and for value-based purchasing arrangements, including, but not limited 
196.1 	to, initiatives operating under sections 256B.0751, 256B.0753, 256B.0755, 256B.0756, and 
196.2 	256B.0757.
196.3 	(g) Assessment of patient satisfaction with chronic pain management for the purpose of 
196.4 	determining compensation or quality incentive payments is prohibited. The commissioner 
196.5 	shall require managed care plans, county-based purchasing plans, and integrated health 
196.6 	partnerships to comply with this requirement as a condition of contract. This prohibition 
196.7 	does not apply to:
196.8 	(1) assessing patient satisfaction with chronic pain management for the purpose of quality 
196.9 	improvement; and
196.10 	(2) pain management as a part of a palliative care treatment plan to treat patients with 
196.11 	cancer or patients receiving hospice care.
196.12 		Subd. 2.Adjustment of quality metrics for special populations. Notwithstanding 
196.13 	subdivision 1, paragraph (b), by January 1, 2019, the commissioner shall consider and 
196.14 	appropriately adjust quality metrics and benchmarks for providers who primarily serve 
196.15 	socio-economically complex patient populations and request to be scored on additional 
196.16 	measures in this subdivision. This requirement applies to all medical assistance and 
196.17 	MinnesotaCare programs and enrollees, including persons enrolled in managed care and 
196.18 	county-based purchasing plans or other managed care organizations, persons receiving care 
196.19 	under fee-for-service, and persons receiving care under value-based purchasing arrangements, 
196.20 	including but not limited to initiatives operating under sections 256B.0751, 256B.0753, 
196.21 	256B.0755, 256B.0756, and 256B.0757.

196.22 	Sec. 40. Minnesota Statutes 2016, section 256B.0755, subdivision 1, is amended to read:
196.23 		Subdivision 1.Implementation. (a) The commissioner shall develop and authorize
196.24 	continue a demonstration project established under this section to test alternative and 
196.25 	innovative integrated health care delivery systems partnerships, including accountable care 
196.26 	organizations that provide services to a specified patient population for an agreed-upon total 
196.27 	cost of care or risk/gain sharing payment arrangement. The commissioner shall develop a 
196.28 	request for proposals for participation in the demonstration project in consultation with 
196.29 	hospitals, primary care providers, health plans, and other key stakeholders.
196.30 	(b) In developing the request for proposals, the commissioner shall:
196.31 	(1) establish uniform statewide methods of forecasting utilization and cost of care for 
196.32 	the appropriate Minnesota public program populations, to be used by the commissioner for 
196.33 	the health care delivery system integrated health partnership projects;
197.1 	(2) identify key indicators of quality, access, patient satisfaction, and other performance 
197.2 	indicators that will be measured, in addition to indicators for measuring cost savings;
197.3 	(3) allow maximum flexibility to encourage innovation and variation so that a variety 
197.4 	of provider collaborations are able to become health care delivery systems integrated health 
197.5 	partnerships, and may be customized for the special needs and barriers of patient populations 
197.6 	experiencing health disparities due to social, economic, racial, or ethnic factors,;
197.7 	(4) encourage and authorize different levels and types of financial risk;
197.8 	(5) encourage and authorize projects representing a wide variety of geographic locations, 
197.9 	patient populations, provider relationships, and care coordination models;
197.10 	(6) encourage projects that involve close partnerships between the health care delivery 
197.11 	system integrated health partnership and counties and nonprofit agencies that provide services 
197.12 	to patients enrolled with the health care delivery system integrated health partnership, 
197.13 	including social services, public health, mental health, community-based services, and 
197.14 	continuing care;
197.15 	(7) encourage projects established by community hospitals, clinics, and other providers 
197.16 	in rural communities;
197.17 	(8) identify required covered services for a total cost of care model or services considered 
197.18 	in whole or partially in an analysis of utilization for a risk/gain sharing model;
197.19 	(9) establish a mechanism to monitor enrollment;
197.20 	(10) establish quality standards for the delivery system integrated health partnership
197.21 	demonstrations that are appropriate for the particular patient population to be served; and
197.22 	(11) encourage participation of privately insured population so as to create sufficient 
197.23 	alignment in demonstration systems.
197.24 	(c) To be eligible to participate in the demonstration project an integrated health 
197.25 	partnership, a health care delivery system must:
197.26 	(1) provide required covered services and care coordination to recipients enrolled in the 
197.27 	health care delivery system integrated health partnership;
197.28 	(2) establish a process to monitor enrollment and ensure the quality of care provided;
197.29 	(3) in cooperation with counties and community social service agencies, coordinate the 
197.30 	delivery of health care services with existing social services programs;
197.31 	(4) provide a system for advocacy and consumer protection; and
198.1 	(5) adopt innovative and cost-effective methods of care delivery and coordination, which 
198.2 	may include the use of allied health professionals, telemedicine, patient educators, care 
198.3 	coordinators, and community health workers.
198.4 	(d) A health care delivery system An integrated health partnership demonstration may 
198.5 	be formed by the following groups of providers of services and suppliers if they have 
198.6 	established a mechanism for shared governance:
198.7 	(1) professionals in group practice arrangements;
198.8 	(2) networks of individual practices of professionals;
198.9 	(3) partnerships or joint venture arrangements between hospitals and health care 
198.10 	professionals;
198.11 	(4) hospitals employing professionals; and
198.12 	(5) other groups of providers of services and suppliers as the commissioner determines 
198.13 	appropriate.
198.14 	A managed care plan or county-based purchasing plan may participate in this 
198.15 	demonstration in collaboration with one or more of the entities listed in clauses (1) to (5).
198.16 	A health care delivery system An integrated health partnership may contract with a 
198.17 	managed care plan or a county-based purchasing plan to provide administrative services, 
198.18 	including the administration of a payment system using the payment methods established 
198.19 	by the commissioner for health care delivery systems integrated health partnerships.
198.20 	(e) The commissioner may require a health care delivery system an integrated health 
198.21 	partnership to enter into additional third-party contractual relationships for the assessment 
198.22 	of risk and purchase of stop loss insurance or another form of insurance risk management 
198.23 	related to the delivery of care described in paragraph (c).

198.24 	EFFECTIVE DATE. This section is effective January 1, 2018.

198.25 	Sec. 41. Minnesota Statutes 2016, section 256B.0755, subdivision 3, is amended to read:
198.26 		Subd. 3.Accountability. (a) Health care delivery systems Integrated health partnerships
198.27 	must accept responsibility for the quality of care based on standards established under 
198.28 	subdivision 1, paragraph (b), clause (10), and the cost of care or utilization of services 
198.29 	provided to its enrollees under subdivision 1, paragraph (b), clause (1). Accountability 
198.30 	standards must be appropriate to the particular population served.
199.1 	(b) A health care delivery system An integrated health partnership may contract and 
199.2 	coordinate with providers and clinics for the delivery of services and shall contract with 
199.3 	community health clinics, federally qualified health centers, community mental health 
199.4 	centers or programs, county agencies, and rural clinics to the extent practicable.
199.5 	(c) A health care delivery system An integrated health partnership must indicate how it 
199.6 	will coordinate with other services affecting its patients' health, quality of care, and cost of 
199.7 	care that are provided by other providers, county agencies, and other organizations in the 
199.8 	local service area. The health care delivery system integrated health partnership must indicate 
199.9 	how it will engage other providers, counties, and organizations, including county-based 
199.10 	purchasing plans, that provide services to patients of the health care delivery system
199.11 	integrated health partnership on issues related to local population health, including applicable 
199.12 	local needs, priorities, and public health goals. The health care delivery system integrated 
199.13 	health partnership must describe how local providers, counties, organizations, including 
199.14 	county-based purchasing plans, and other relevant purchasers were consulted in developing 
199.15 	the application to participate in the demonstration project.

199.16 	EFFECTIVE DATE. This section is effective January 1, 2018.

199.17 	Sec. 42. Minnesota Statutes 2016, section 256B.0755, subdivision 4, is amended to read:
199.18 		Subd. 4.Payment system. (a) In developing a payment system for health care delivery 
199.19 	systems integrated health partnerships, the commissioner shall establish a total cost of care 
199.20 	benchmark or a risk/gain sharing payment model to be paid for services provided to the 
199.21 	recipients enrolled in a health care delivery system an integrated health partnership.
199.22 	(b) The payment system may include incentive payments to health care delivery systems
199.23 	integrated health partnerships that meet or exceed annual quality and performance targets 
199.24 	realized through the coordination of care.
199.25 	(c) An amount equal to the savings realized to the general fund as a result of the 
199.26 	demonstration project shall be transferred each fiscal year to the health care access fund.
199.27 	(d) The payment system shall include a population-based payment that supports care 
199.28 	coordination services for all enrollees served by the integrated health partnerships, and is 
199.29 	risk-adjusted to reflect varying levels of care coordination intensiveness for enrollees with 
199.30 	chronic conditions, limited English skills, cultural differences, are homeless, or experience 
199.31 	health disparities or other barriers to health care. The population-based payment shall be a 
199.32 	per member, per month payment paid at least on a quarterly basis. Integrated health 
199.33 	partnerships receiving this payment must continue to meet cost and quality metrics under 
200.1 	the program to maintain eligibility for the population-based payment. An integrated health 
200.2 	partnership is eligible to receive a payment under this paragraph even if the partnership is 
200.3 	not participating in a risk-based or gain-sharing payment model and regardless of the size 
200.4 	of the patient population served by the integrated health partnership. Any integrated health 
200.5 	partnership participant certified as a health care home under section 256B.0751 that agrees 
200.6 	to a payment method that includes population-based payments for care coordination is not 
200.7 	eligible to receive health care home payment or care coordination fee authorized under 
200.8 	section 62U.03 or 256B.0753, subdivision 1, or in-reach care coordination under section 
200.9 	256B.0625, subdivision 56, for any medical assistance or MinnesotaCare recipients enrolled 
200.10 	or attributed to the integrated health partnership under this demonstration.

200.11 	EFFECTIVE DATE. This section is effective January 1, 2018.

200.12 	Sec. 43. Minnesota Statutes 2016, section 256B.0755, is amended by adding a subdivision 
200.13 	to read:
200.14 		Subd. 9.Patient incentives. The commissioner may authorize an integrated health 
200.15 	partnership to provide incentives for patients to:
200.16 	(1) see a primary care provider for an initial health assessment;
200.17 	(2) maintain a continuous relationship with the primary care provider; and
200.18 	(3) participate in ongoing health improvement and coordination of care activities.

200.19 	EFFECTIVE DATE. This section is effective January 1, 2018, or upon federal approval, 
200.20 	whichever is later.

200.21 	Sec. 44. Minnesota Statutes 2016, section 256B.0924, is amended by adding a subdivision 
200.22 	to read:
200.23 		Subd. 4a.Targeted case management through interactive video. (a) Subject to federal 
200.24 	approval, contact made for targeted case management by interactive video shall be eligible 
200.25 	for payment under subdivision 6 if:
200.26 	(1) the person receiving targeted case management services is residing in:
200.27 	(i) a hospital;
200.28 	(ii) a nursing facility; or
200.29 	(iii) a residential setting licensed under chapter 245A or 245D or a boarding and lodging 
200.30 	establishment or lodging establishment that provides supportive services or health supervision 
200.31 	services according to section 157.17 that is staffed 24 hours a day, seven days a week;
201.1 	(2) interactive video is in the best interests of the person and is deemed appropriate by 
201.2 	the person receiving targeted case management or the person's legal guardian, the case 
201.3 	management provider, and the provider operating the setting where the person is residing;
201.4 	(3) the use of interactive video is approved as part of the person's written personal service 
201.5 	or case plan; and
201.6 	(4) interactive video is used for up to, but not more than, 50 percent of the minimum 
201.7 	required face-to-face contact.
201.8 	(b) The person receiving targeted case management or the person's legal guardian has 
201.9 	the right to choose and consent to the use of interactive video under this subdivision and 
201.10 	has the right to refuse the use of interactive video at any time.
201.11 	(c) The commissioner shall establish criteria that a targeted case management provider 
201.12 	must attest to in order to demonstrate the safety or efficacy of delivering the service via 
201.13 	interactive video. The attestation may include that the case management provider has:
201.14 	(1) written policies and procedures specific to interactive video services that are regularly 
201.15 	reviewed and updated;
201.16 	(2) policies and procedures that adequately address client safety before, during, and after 
201.17 	the interactive video services are rendered;
201.18 	(3) established protocols addressing how and when to discontinue interactive video 
201.19 	services; and
201.20 	(4) established a quality assurance process related to interactive video services.
201.21 	(d) As a condition of payment, the targeted case management provider must document 
201.22 	the following for each occurrence of targeted case management provided by interactive 
201.23 	video:
201.24 	(1) the time the service began and the time the service ended, including an a.m. and p.m. 
201.25 	designation;
201.26 	(2) the basis for determining that interactive video is an appropriate and effective means 
201.27 	for delivering the service to the person receiving case management services;
201.28 	(3) the mode of transmission of the interactive video services and records evidencing 
201.29 	that a particular mode of transmission was utilized;
201.30 	(4) the location of the originating site and the distant site; and
202.1 	(5) compliance with the criteria attested to by the targeted case management provider 
202.2 	as provided in paragraph (c).

202.3 	EFFECTIVE DATE. This section is effective upon federal approval. The commissioner 
202.4 	of human services shall notify the revisor of statutes when federal approval is obtained.

202.5 	Sec. 45. Minnesota Statutes 2016, section 256B.196, subdivision 2, is amended to read:
202.6 		Subd. 2.Commissioner's duties. (a) For the purposes of this subdivision and subdivision 
202.7 	3, the commissioner shall determine the fee-for-service outpatient hospital services upper 
202.8 	payment limit for nonstate government hospitals. The commissioner shall then determine 
202.9 	the amount of a supplemental payment to Hennepin County Medical Center and Regions 
202.10 	Hospital for these services that would increase medical assistance spending in this category 
202.11 	to the aggregate upper payment limit for all nonstate government hospitals in Minnesota. 
202.12 	In making this determination, the commissioner shall allot the available increases between 
202.13 	Hennepin County Medical Center and Regions Hospital based on the ratio of medical 
202.14 	assistance fee-for-service outpatient hospital payments to the two facilities. The commissioner 
202.15 	shall adjust this allotment as necessary based on federal approvals, the amount of 
202.16 	intergovernmental transfers received from Hennepin and Ramsey Counties, and other factors, 
202.17 	in order to maximize the additional total payments. The commissioner shall inform Hennepin 
202.18 	County and Ramsey County of the periodic intergovernmental transfers necessary to match 
202.19 	federal Medicaid payments available under this subdivision in order to make supplementary 
202.20 	medical assistance payments to Hennepin County Medical Center and Regions Hospital 
202.21 	equal to an amount that when combined with existing medical assistance payments to 
202.22 	nonstate governmental hospitals would increase total payments to hospitals in this category 
202.23 	for outpatient services to the aggregate upper payment limit for all hospitals in this category 
202.24 	in Minnesota. Upon receipt of these periodic transfers, the commissioner shall make 
202.25 	supplementary payments to Hennepin County Medical Center and Regions Hospital.
202.26 	(b) For the purposes of this subdivision and subdivision 3, the commissioner shall 
202.27 	determine an upper payment limit for physicians and other billing professionals affiliated 
202.28 	with Hennepin County Medical Center and with Regions Hospital. The upper payment limit 
202.29 	shall be based on the average commercial rate or be determined using another method 
202.30 	acceptable to the Centers for Medicare and Medicaid Services. The commissioner shall 
202.31 	inform Hennepin County and Ramsey County of the periodic intergovernmental transfers 
202.32 	necessary to match the federal Medicaid payments available under this subdivision in order 
202.33 	to make supplementary payments to physicians and other billing professionals affiliated 
202.34 	with Hennepin County Medical Center and to make supplementary payments to physicians 
203.1 	and other billing professionals affiliated with Regions Hospital through HealthPartners 
203.2 	Medical Group equal to the difference between the established medical assistance payment 
203.3 	for physician and other billing professional services and the upper payment limit. Upon 
203.4 	receipt of these periodic transfers, the commissioner shall make supplementary payments 
203.5 	to physicians and other billing professionals affiliated with Hennepin County Medical Center 
203.6 	and shall make supplementary payments to physicians and other billing professionals 
203.7 	affiliated with Regions Hospital through HealthPartners Medical Group.
203.8 	(c) Beginning January 1, 2010, Hennepin County and Ramsey County may make monthly 
203.9 	voluntary intergovernmental transfers to the commissioner in amounts not to exceed 
203.10 	$12,000,000 per year from Hennepin County and $6,000,000 per year from Ramsey County. 
203.11 	The commissioner shall increase the medical assistance capitation payments to any licensed 
203.12 	health plan under contract with the medical assistance program that agrees to make enhanced 
203.13 	payments to Hennepin County Medical Center or Regions Hospital. The increase shall be 
203.14 	in an amount equal to the annual value of the monthly transfers plus federal financial 
203.15 	participation, with each health plan receiving its pro rata share of the increase based on the 
203.16 	pro rata share of medical assistance admissions to Hennepin County Medical Center and 
203.17 	Regions Hospital by those plans. For the purposes of this paragraph, "the base amount" 
203.18 	means the total annual value of increased medical assistance capitation payments, including 
203.19 	the voluntary intergovernmental transfers, under this paragraph in calendar year 2017. For 
203.20 	managed care contracts beginning on or after January 1, 2018, the commissioner shall reduce 
203.21 	the total annual value of increased medical assistance capitation payments under this 
203.22 	paragraph by an amount equal to ten percent of the base amount, and by an additional ten 
203.23 	percent of the base amount for each subsequent contract year until December 31, 2025.
203.24 	Upon the request of the commissioner, health plans shall submit individual-level cost data 
203.25 	for verification purposes. The commissioner may ratably reduce these payments on a pro 
203.26 	rata basis in order to satisfy federal requirements for actuarial soundness. If payments are 
203.27 	reduced, transfers shall be reduced accordingly. Any licensed health plan that receives 
203.28 	increased medical assistance capitation payments under the intergovernmental transfer 
203.29 	described in this paragraph shall increase its medical assistance payments to Hennepin 
203.30 	County Medical Center and Regions Hospital by the same amount as the increased payments 
203.31 	received in the capitation payment described in this paragraph. This paragraph expires 
203.32 	January 1, 2026.
203.33 	(d) For the purposes of this subdivision and subdivision 3, the commissioner shall 
203.34 	determine an upper payment limit for ambulance services affiliated with Hennepin County 
203.35 	Medical Center and the city of St. Paul, and ambulance services owned and operated by 
204.1 	another governmental entity that chooses to participate by requesting the commissioner to 
204.2 	determine an upper payment limit. The upper payment limit shall be based on the average 
204.3 	commercial rate or be determined using another method acceptable to the Centers for 
204.4 	Medicare and Medicaid Services. The commissioner shall inform Hennepin County and,
204.5 	the city of St. Paul, and other participating governmental entities of the periodic 
204.6 	intergovernmental transfers necessary to match the federal Medicaid payments available 
204.7 	under this subdivision in order to make supplementary payments to Hennepin County 
204.8 	Medical Center and, the city of St. Paul, and other participating governmental entities equal 
204.9 	to the difference between the established medical assistance payment for ambulance services 
204.10 	and the upper payment limit. Upon receipt of these periodic transfers, the commissioner 
204.11 	shall make supplementary payments to Hennepin County Medical Center and, the city of 
204.12 	St. Paul., and other participating governmental entities. A tribal government that owns and 
204.13 	operates an ambulance service is not eligible to participate under this subdivision.
204.14 	(e) For the purposes of this subdivision and subdivision 3, the commissioner shall 
204.15 	determine an upper payment limit for physicians, dentists, and other billing professionals 
204.16 	affiliated with the University of Minnesota and University of Minnesota Physicians. The 
204.17 	upper payment limit shall be based on the average commercial rate or be determined using 
204.18 	another method acceptable to the Centers for Medicare and Medicaid Services. The 
204.19 	commissioner shall inform the University of Minnesota Medical School and University of 
204.20 	Minnesota School of Dentistry of the periodic intergovernmental transfers necessary to 
204.21 	match the federal Medicaid payments available under this subdivision in order to make 
204.22 	supplementary payments to physicians, dentists, and other billing professionals affiliated 
204.23 	with the University of Minnesota and the University of Minnesota Physicians equal to the 
204.24 	difference between the established medical assistance payment for physician, dentist, and 
204.25 	other billing professional services and the upper payment limit. Upon receipt of these periodic 
204.26 	transfers, the commissioner shall make supplementary payments to physicians, dentists, 
204.27 	and other billing professionals affiliated with the University of Minnesota and the University 
204.28 	of Minnesota Physicians.
204.29 	(f) The commissioner shall inform the transferring governmental entities on an ongoing 
204.30 	basis of the need for any changes needed in the intergovernmental transfers in order to 
204.31 	continue the payments under paragraphs (a) to (d) (e), at their maximum level, including 
204.32 	increases in upper payment limits, changes in the federal Medicaid match, and other factors.
204.33 	(f) (g) The payments in paragraphs (a) to (d) (e) shall be implemented independently of 
204.34 	each other, subject to federal approval and to the receipt of transfers under subdivision 3.
205.1 	(h) All of the data and funding transactions related to the payments in paragraphs (a) to 
205.2 	(e) shall be between the commissioner and the governmental entities.
205.3 	(i) For purposes of this subdivision, billing professionals are limited to physicians, nurse 
205.4 	practitioners, nurse midwives, clinical nurse specialists, physician assistants, 
205.5 	anesthesiologists, certified registered nurse anesthetists, dentists, dental hygienists, and 
205.6 	dental therapists.

205.7 	EFFECTIVE DATE. Paragraph (d) is effective July 1, 2017, or upon federal approval, 
205.8 	whichever is later. The commissioner of human services shall notify the revisor of statutes 
205.9 	when federal approval is received.

205.10 	Sec. 46. Minnesota Statutes 2016, section 256B.196, subdivision 3, is amended to read:
205.11 		Subd. 3.Intergovernmental transfers. Based on the determination by the commissioner 
205.12 	under subdivision 2, Hennepin County and Ramsey County shall make periodic 
205.13 	intergovernmental transfers to the commissioner for the purposes of subdivision 2, paragraphs 
205.14 	(a) and (b). All of the intergovernmental transfers made by Hennepin County shall be used 
205.15 	to match federal payments to Hennepin County Medical Center under subdivision 2, 
205.16 	paragraph (a), and to physicians and other billing professionals affiliated with Hennepin 
205.17 	County Medical Center under subdivision 2, paragraph (b). All of the intergovernmental 
205.18 	transfers made by Ramsey County shall be used to match federal payments to Regions 
205.19 	Hospital under subdivision 2, paragraph (a), and to physicians and other billing professionals 
205.20 	affiliated with Regions Hospital through HealthPartners Medical Group under subdivision 
205.21 	2, paragraph (b). All of the intergovernmental transfer payments made by the University of 
205.22 	Minnesota Medical School and the University of Minnesota School of Dentistry shall be 
205.23 	used to match federal payments to the University of Minnesota and the University of 
205.24 	Minnesota Physicians under subdivision 2, paragraph (e).

205.25 	Sec. 47. Minnesota Statutes 2016, section 256B.196, subdivision 4, is amended to read:
205.26 		Subd. 4.Adjustments permitted. (a) The commissioner may adjust the 
205.27 	intergovernmental transfers under subdivision 3 and the payments under subdivision 2, 
205.28 	based on the commissioner's determination of Medicare upper payment limits, 
205.29 	hospital-specific charge limits, hospital-specific limitations on disproportionate share 
205.30 	payments, medical inflation, actuarial certification, average commercial rates for physician 
205.31 	and other professional services as defined in this section, and cost-effectiveness for purposes 
205.32 	of federal waivers. Any adjustments must be made on a proportional basis. The commissioner 
205.33 	may make adjustments under this subdivision only after consultation with the affected 
206.1 	counties, university schools, and hospitals. All payments under subdivision 2 and all 
206.2 	intergovernmental transfers under subdivision 3 are limited to amounts available after all 
206.3 	other base rates, adjustments, and supplemental payments in chapter 256B are calculated.
206.4 	(b) The ratio of medical assistance payments specified in subdivision 2 to the voluntary 
206.5 	intergovernmental transfers specified in subdivision 3 shall not be reduced except as provided 
206.6 	under paragraph (a).

206.7 	Sec. 48. Minnesota Statutes 2016, section 256B.69, subdivision 9e, is amended to read:
206.8 		Subd. 9e.Financial audits. (a) The legislative auditor shall conduct or contract with 
206.9 	vendors to conduct independent third-party financial audits of the information required to 
206.10 	be provided by audit managed care plans and county-based purchasing plans under 
206.11 	subdivision 9c, paragraph (b). The audits by the vendors shall be conducted as vendor 
206.12 	resources permit and in accordance with generally accepted government auditing standards 
206.13 	issued by the United States Government Accountability Office. The contract with the vendors 
206.14 	shall be designed and administered so as to render the independent third-party audits eligible 
206.15 	for a federal subsidy, if available. The contract shall require the audits to include a 
206.16 	determination of compliance with the federal Medicaid rate certification process to determine 
206.17 	if a managed care plan or county-based purchasing plan used public money in compliance 
206.18 	with federal and state laws, rules, and in accordance with provisions in the plan's contract 
206.19 	with the commissioner. The legislative auditor shall conduct the audits in accordance with 
206.20 	section 3.972, subdivision 2b.
206.21 	(b) For purposes of this subdivision, "independent third-party" means a vendor that is 
206.22 	independent in accordance with government auditing standards issued by the United States 
206.23 	Government Accountability Office.

206.24 	Sec. 49. Minnesota Statutes 2016, section 256B.75, is amended to read:
206.25 	256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
206.26 	(a) For outpatient hospital facility fee payments for services rendered on or after October 
206.27 	1, 1992, the commissioner of human services shall pay the lower of (1) submitted charge, 
206.28 	or (2) 32 percent above the rate in effect on June 30, 1992, except for those services for 
206.29 	which there is a federal maximum allowable payment. Effective for services rendered on 
206.30 	or after January 1, 2000, payment rates for nonsurgical outpatient hospital facility fees and 
206.31 	emergency room facility fees shall be increased by eight percent over the rates in effect on 
206.32 	December 31, 1999, except for those services for which there is a federal maximum allowable 
206.33 	payment. Services for which there is a federal maximum allowable payment shall be paid 
207.1 	at the lower of (1) submitted charge, or (2) the federal maximum allowable payment. Total 
207.2 	aggregate payment for outpatient hospital facility fee services shall not exceed the Medicare 
207.3 	upper limit. If it is determined that a provision of this section conflicts with existing or 
207.4 	future requirements of the United States government with respect to federal financial 
207.5 	participation in medical assistance, the federal requirements prevail. The commissioner 
207.6 	may, in the aggregate, prospectively reduce payment rates to avoid reduced federal financial 
207.7 	participation resulting from rates that are in excess of the Medicare upper limitations.
207.8 	(b) Notwithstanding paragraph (a), payment for outpatient, emergency, and ambulatory 
207.9 	surgery hospital facility fee services for critical access hospitals designated under section 
207.10 	144.1483, clause (9), shall be paid on a cost-based payment system that is based on the 
207.11 	cost-finding methods and allowable costs of the Medicare program. Effective for services 
207.12 	provided on or after July 1, 2015, rates established for critical access hospitals under this 
207.13 	paragraph for the applicable payment year shall be the final payment and shall not be settled 
207.14 	to actual costs. Effective for services delivered on or after the first day of the hospital's fiscal 
207.15 	year ending in 2016, the rate for outpatient hospital services shall be computed using 
207.16 	information from each hospital's Medicare cost report as filed with Medicare for the year 
207.17 	that is two years before the year that the rate is being computed. Rates shall be computed 
207.18 	using information from Worksheet C series until the department finalizes the medical 
207.19 	assistance cost reporting process for critical access hospitals. After the cost reporting process 
207.20 	is finalized, rates shall be computed using information from Title XIX Worksheet D series. 
207.21 	The outpatient rate shall be equal to ancillary cost plus outpatient cost, excluding costs 
207.22 	related to rural health clinics and federally qualified health clinics, divided by ancillary 
207.23 	charges plus outpatient charges, excluding charges related to rural health clinics and federally 
207.24 	qualified health clinics.
207.25 	(c) Effective for services provided on or after July 1, 2003, rates that are based on the 
207.26 	Medicare outpatient prospective payment system shall be replaced by a budget neutral 
207.27 	prospective payment system that is derived using medical assistance data. The commissioner 
207.28 	shall provide a proposal to the 2003 legislature to define and implement this provision.
207.29 	(d) For fee-for-service services provided on or after July 1, 2002, the total payment, 
207.30 	before third-party liability and spenddown, made to hospitals for outpatient hospital facility 
207.31 	services is reduced by .5 percent from the current statutory rate.
207.32 	(e) In addition to the reduction in paragraph (d), the total payment for fee-for-service 
207.33 	services provided on or after July 1, 2003, made to hospitals for outpatient hospital facility 
207.34 	services before third-party liability and spenddown, is reduced five percent from the current 
208.1 	statutory rates. Facilities defined under section 256.969, subdivision 16, are excluded from 
208.2 	this paragraph.
208.3 	(f) In addition to the reductions in paragraphs (d) and (e), the total payment for 
208.4 	fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient 
208.5 	hospital facility services before third-party liability and spenddown, is reduced three percent 
208.6 	from the current statutory rates. Mental health services and facilities defined under section 
208.7 	256.969, subdivision 16, are excluded from this paragraph.

208.8 	EFFECTIVE DATE. This section is effective July 1, 2017.

208.9 	Sec. 50. Minnesota Statutes 2016, section 256B.76, subdivision 1, as amended by Laws 
208.10 	2017, chapter 40, article 1, section 79, is amended to read:
208.11 		Subdivision 1.Physician reimbursement.  (a) Effective for services rendered on or after 
208.12 	October 1, 1992, the commissioner shall make payments for physician services as follows:
208.13 	(1) payment for level one Centers for Medicare and Medicaid Services' common 
208.14 	procedural coding system codes titled "office and other outpatient services," "preventive 
208.15 	medicine new and established patient," "delivery, antepartum, and postpartum care," "critical 
208.16 	care," cesarean delivery and pharmacologic management provided to psychiatric patients, 
208.17 	and level three codes for enhanced services for prenatal high risk, shall be paid at the lower 
208.18 	of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 30, 1992;
208.19 	(2) payments for all other services shall be paid at the lower of (i) submitted charges, 
208.20 	or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
208.21 	(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 
208.22 	percentile of 1989, less the percent in aggregate necessary to equal the above increases 
208.23 	except that payment rates for home health agency services shall be the rates in effect on 
208.24 	September 30, 1992.
208.25 	(b) Effective for services rendered on or after January 1, 2000, payment rates for physician 
208.26 	and professional services shall be increased by three percent over the rates in effect on 
208.27 	December 31, 1999, except for home health agency and family planning agency services. 
208.28 	The increases in this paragraph shall be implemented January 1, 2000, for managed care.
208.29 	(c) Effective for services rendered on or after July 1, 2009, payment rates for physician 
208.30 	and professional services shall be reduced by five percent, except that for the period July 
208.31 	1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent for the medical 
208.32 	assistance and general assistance medical care programs, over the rates in effect on June 
208.33 	30, 2009. This reduction and the reductions in paragraph (d) do not apply to office or other 
209.1 	outpatient visits, preventive medicine visits and family planning visits billed by physicians, 
209.2 	advanced practice nurses, or physician assistants in a family planning agency or in one of 
209.3 	the following primary care practices: general practice, general internal medicine, general 
209.4 	pediatrics, general geriatrics, and family medicine. This reduction and the reductions in 
209.5 	paragraph (d) do not apply to federally qualified health centers, rural health centers, and 
209.6 	Indian health services. Effective October 1, 2009, payments made to managed care plans 
209.7 	and county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall 
209.8 	reflect the payment reduction described in this paragraph.
209.9 	(d) Effective for services rendered on or after July 1, 2010, payment rates for physician 
209.10 	and professional services shall be reduced an additional seven percent over the five percent 
209.11 	reduction in rates described in paragraph (c). This additional reduction does not apply to 
209.12 	physical therapy services, occupational therapy services, and speech pathology and related 
209.13 	services provided on or after July 1, 2010. This additional reduction does not apply to 
209.14 	physician services billed by a psychiatrist or an advanced practice nurse with a specialty in 
209.15 	mental health. Effective October 1, 2010, payments made to managed care plans and 
209.16 	county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect 
209.17 	the payment reduction described in this paragraph.
209.18 	(e) Effective for services rendered on or after September 1, 2011, through June 30, 2013, 
209.19 	payment rates for physician and professional services shall be reduced three percent from 
209.20 	the rates in effect on August 31, 2011. This reduction does not apply to physical therapy 
209.21 	services, occupational therapy services, and speech pathology and related services.
209.22 	(f) Effective for services rendered on or after September 1, 2014, payment rates for 
209.23 	physician and professional services, including physical therapy, occupational therapy, speech 
209.24 	pathology, and mental health services shall be increased by five percent from the rates in 
209.25 	effect on August 31, 2014. In calculating this rate increase, the commissioner shall not 
209.26 	include in the base rate for August 31, 2014, the rate increase provided under section 
209.27 	256B.76, subdivision 7. This increase does not apply to federally qualified health centers, 
209.28 	rural health centers, and Indian health services. Payments made to managed care plans and 
209.29 	county-based purchasing plans shall not be adjusted to reflect payments under this paragraph.
209.30 	(g) Effective for services rendered on or after July 1, 2015, payment rates for physical 
209.31 	therapy, occupational therapy, and speech pathology and related services provided by a 
209.32 	hospital meeting the criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause 
209.33 	(4), shall be increased by 90 percent from the rates in effect on June 30, 2015. Payments 
209.34 	made to managed care plans and county-based purchasing plans shall not be adjusted to 
209.35 	reflect payments under this paragraph.
210.1 	(h) Any ratables effective before July 1, 2015, do not apply to autism early intensive 
210.2 	intervention benefits described in section 256B.0949.

210.3 	EFFECTIVE DATE. This section is effective the day following final enactment.

210.4 	Sec. 51. Minnesota Statutes 2016, section 256B.76, subdivision 2, is amended to read:
210.5 		Subd. 2.Dental reimbursement.  (a) Effective for services rendered on or after October 
210.6 	1, 1992, the commissioner shall make payments for dental services as follows:
210.7 	(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 percent 
210.8 	above the rate in effect on June 30, 1992; and
210.9 	(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th percentile 
210.10 	of 1989, less the percent in aggregate necessary to equal the above increases.
210.11 	(b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments 
210.12 	shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
210.13 	(c) Effective for services rendered on or after January 1, 2000, payment rates for dental 
210.14 	services shall be increased by three percent over the rates in effect on December 31, 1999.
210.15 	(d) Effective for services provided on or after January 1, 2002, payment for diagnostic 
210.16 	examinations and dental x-rays provided to children under age 21 shall be the lower of (1) 
210.17 	the submitted charge, or (2) 85 percent of median 1999 charges.
210.18 	(e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, 2000, 
210.19 	for managed care.
210.20 	(f) Effective for dental services rendered on or after October 1, 2010, by a state-operated 
210.21 	dental clinic, payment shall be paid on a reasonable cost basis that is based on the Medicare 
210.22 	principles of reimbursement. This payment shall be effective for services rendered on or 
210.23 	after January 1, 2011, to recipients enrolled in managed care plans or county-based 
210.24 	purchasing plans.
210.25 	(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics in 
210.26 	paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal year, a 
210.27 	supplemental state payment equal to the difference between the total payments in paragraph 
210.28 	(f) and $1,850,000 shall be paid from the general fund to state-operated services for the 
210.29 	operation of the dental clinics.
210.30 	(h) If the cost-based payment system for state-operated dental clinics described in 
210.31 	paragraph (f) does not receive federal approval, then state-operated dental clinics shall be 
210.32 	designated as critical access dental providers under subdivision 4, paragraph (b), and shall 
211.1 	receive the critical access dental reimbursement rate as described under subdivision 4, 
211.2 	paragraph (a).
211.3 	(i) Effective for services rendered on or after September 1, 2011, through June 30, 2013, 
211.4 	payment rates for dental services shall be reduced by three percent. This reduction does not 
211.5 	apply to state-operated dental clinics in paragraph (f).
211.6 	(j) Effective for services rendered on or after January 1, 2014, payment rates for dental 
211.7 	services shall be increased by five percent from the rates in effect on December 31, 2013. 
211.8 	This increase does not apply to state-operated dental clinics in paragraph (f), federally 
211.9 	qualified health centers, rural health centers, and Indian health services. Effective January 
211.10 	1, 2014, payments made to managed care plans and county-based purchasing plans under 
211.11 	sections 256B.69, 256B.692, and 256L.12 shall reflect the payment increase described in 
211.12 	this paragraph.
211.13 	(k) Effective for services rendered on or after July 1, 2015, through December 31, 2016, 
211.14 	the commissioner shall increase payment rates for services furnished by dental providers 
211.15 	located outside of the seven-county metropolitan area by the maximum percentage possible 
211.16 	above the rates in effect on June 30, 2015, while remaining within the limits of funding 
211.17 	appropriated for this purpose. This increase does not apply to state-operated dental clinics 
211.18 	in paragraph (f), federally qualified health centers, rural health centers, and Indian health 
211.19 	services. Effective January 1, 2016, through December 31, 2016, payments to managed care 
211.20 	plans and county-based purchasing plans under sections 256B.69 and 256B.692 shall reflect 
211.21 	the payment increase described in this paragraph. The commissioner shall require managed 
211.22 	care and county-based purchasing plans to pass on the full amount of the increase, in the 
211.23 	form of higher payment rates to dental providers located outside of the seven-county 
211.24 	metropolitan area.
211.25 	(l) Effective for services provided on or after January 1, 2017, the commissioner shall 
211.26 	increase payment rates by 9.65 percent for dental services provided outside of the 
211.27 	seven-county metropolitan area. This increase does not apply to state-operated dental clinics 
211.28 	in paragraph (f), federally qualified health centers, rural health centers, or Indian health 
211.29 	services. Effective January 1, 2017, payments to managed care plans and county-based 
211.30 	purchasing plans under sections 256B.69 and 256B.692 shall reflect the payment increase 
211.31 	described in this paragraph.
211.32 	(m) Effective for services provided on or after July 1, 2017, the commissioner shall 
211.33 	increase payment rates by 23.8 percent for dental services provided to enrollees under the 
211.34 	age of 21. This rate increase does not apply to state-operated dental clinics in paragraph (f), 
212.1 	federally qualified health centers, rural health centers, or Indian health centers. This rate 
212.2 	increase does not apply to managed care plans and county-based purchasing plans.

212.3 	Sec. 52. Minnesota Statutes 2016, section 256B.761, is amended to read:
212.4 	256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
212.5 	(a) Effective for services rendered on or after July 1, 2001, payment for medication 
212.6 	management provided to psychiatric patients, outpatient mental health services, day treatment 
212.7 	services, home-based mental health services, and family community support services shall 
212.8 	be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the 50th percentile of 
212.9 	1999 charges.
212.10 	(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health 
212.11 	services provided by an entity that operates: (1) a Medicare-certified comprehensive 
212.12 	outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, 1993, 
212.13 	with at least 33 percent of the clients receiving rehabilitation services in the most recent 
212.14 	calendar year who are medical assistance recipients, will be increased by 38 percent, when 
212.15 	those services are provided within the comprehensive outpatient rehabilitation facility and 
212.16 	provided to residents of nursing facilities owned by the entity.
212.17 	(c) The commissioner shall establish three levels of payment for mental health diagnostic 
212.18 	assessment, based on three levels of complexity. The aggregate payment under the tiered 
212.19 	rates must not exceed the projected aggregate payments for mental health diagnostic 
212.20 	assessment under the previous single rate. The new rate structure is effective January 1, 
212.21 	2011, or upon federal approval, whichever is later.
212.22 	(d) In addition to rate increases otherwise provided, the commissioner may restructure 
212.23 	coverage policy and rates to improve access to adult rehabilitative mental health services 
212.24 	under section 256B.0623 and related mental health support services under section 256B.021, 
212.25 	subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and 2016, the projected 
212.26 	state share of increased costs due to this paragraph is transferred from adult mental health 
212.27 	grants under sections 245.4661 and 256E.12. The transfer for fiscal year 2016 is a permanent 
212.28 	base adjustment for subsequent fiscal years. Payments made to managed care plans and 
212.29 	county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect 
212.30 	the rate changes described in this paragraph.
212.31 	(e) Any ratables effective before July 1, 2015, do not apply to autism early intensive 
212.32 	intervention benefits described in section 256B.0949.

212.33 	EFFECTIVE DATE. This section is effective July 1, 2017.

213.1 	Sec. 53. [256B.7635] REIMBURSEMENT FOR EVIDENCE-BASED PUBLIC 
213.2 	HEALTH NURSE HOME VISITS.
213.3 	Effective for services provided on or after January 1, 2018, prenatal and postpartum 
213.4 	follow-up home visits provided by public health nurses or registered nurses supervised by 
213.5 	a public health nurse using evidence-based models shall be paid $140 per visit. 
213.6 	Evidence-based postpartum follow-up home visits must be administered by home visiting 
213.7 	programs that meet the United States Department of Health and Human Services criteria 
213.8 	for evidence-based models and are identified by the commissioner of health as eligible to 
213.9 	be implemented under the Maternal, Infant, and Early Childhood Home Visiting program. 
213.10 	Home visits must target mothers and their children beginning with prenatal visits through 
213.11 	age three for the child.

213.12 	Sec. 54. Minnesota Statutes 2016, section 256B.766, is amended to read:
213.13 	256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
213.14 	(a) Effective for services provided on or after July 1, 2009, total payments for basic care 
213.15 	services, shall be reduced by three percent, except that for the period July 1, 2009, through 
213.16 	June 30, 2011, total payments shall be reduced by 4.5 percent for the medical assistance 
213.17 	and general assistance medical care programs, prior to third-party liability and spenddown 
213.18 	calculation. Effective July 1, 2010, the commissioner shall classify physical therapy services, 
213.19 	occupational therapy services, and speech-language pathology and related services as basic 
213.20 	care services. The reduction in this paragraph shall apply to physical therapy services, 
213.21 	occupational therapy services, and speech-language pathology and related services provided 
213.22 	on or after July 1, 2010.
213.23 	(b) Payments made to managed care plans and county-based purchasing plans shall be 
213.24 	reduced for services provided on or after October 1, 2009, to reflect the reduction effective 
213.25 	July 1, 2009, and payments made to the plans shall be reduced effective October 1, 2010, 
213.26 	to reflect the reduction effective July 1, 2010.
213.27 	(c) Effective for services provided on or after September 1, 2011, through June 30, 2013, 
213.28 	total payments for outpatient hospital facility fees shall be reduced by five percent from the 
213.29 	rates in effect on August 31, 2011.
213.30 	(d) Effective for services provided on or after September 1, 2011, through June 30, 2013, 
213.31 	total payments for ambulatory surgery centers facility fees, medical supplies and durable 
213.32 	medical equipment not subject to a volume purchase contract, prosthetics and orthotics, 
213.33 	renal dialysis services, laboratory services, public health nursing services, physical therapy 
214.1 	services, occupational therapy services, speech therapy services, eyeglasses not subject to 
214.2 	a volume purchase contract, hearing aids not subject to a volume purchase contract, and 
214.3 	anesthesia services shall be reduced by three percent from the rates in effect on August 31, 
214.4 	2011.
214.5 	(e) Effective for services provided on or after September 1, 2014, payments for 
214.6 	ambulatory surgery centers facility fees, hospice services, renal dialysis services, laboratory 
214.7 	services, public health nursing services, eyeglasses not subject to a volume purchase contract, 
214.8 	and hearing aids not subject to a volume purchase contract shall be increased by three percent 
214.9 	and payments for outpatient hospital facility fees shall be increased by three percent. 
214.10 	Payments made to managed care plans and county-based purchasing plans shall not be 
214.11 	adjusted to reflect payments under this paragraph.
214.12 	(f) Payments for medical supplies and durable medical equipment not subject to a volume 
214.13 	purchase contract, and prosthetics and orthotics, provided on or after July 1, 2014, through 
214.14 	June 30, 2015, shall be decreased by .33 percent. Payments for medical supplies and durable 
214.15 	medical equipment not subject to a volume purchase contract, and prosthetics and orthotics, 
214.16 	provided on or after July 1, 2015, shall be increased by three percent from the rates as 
214.17 	determined under paragraphs (i) and (j).
214.18 	(g) Effective for services provided on or after July 1, 2015, payments for outpatient 
214.19 	hospital facility fees, medical supplies and durable medical equipment not subject to a 
214.20 	volume purchase contract, prosthetics, and orthotics, and laboratory services to a hospital 
214.21 	meeting the criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause (4), 
214.22 	shall be increased by 90 percent from the rates in effect on June 30, 2015. Payments made 
214.23 	to managed care plans and county-based purchasing plans shall not be adjusted to reflect 
214.24 	payments under this paragraph.
214.25 	(h) This section does not apply to physician and professional services, inpatient hospital 
214.26 	services, family planning services, mental health services, dental services, prescription 
214.27 	drugs, medical transportation, federally qualified health centers, rural health centers, Indian 
214.28 	health services, and Medicare cost-sharing.
214.29 	(i) Effective for services provided on or after July 1, 2015, the following categories of
214.30 	medical supplies and durable medical equipment shall be individually priced items: enteral 
214.31 	nutrition and supplies, customized and other specialized tracheostomy tubes and supplies, 
214.32 	electric patient lifts, and durable medical equipment repair and service. This paragraph does 
214.33 	not apply to medical supplies and durable medical equipment subject to a volume purchase 
214.34 	contract, products subject to the preferred diabetic testing supply program, and items provided 
215.1 	to dually eligible recipients when Medicare is the primary payer for the item. The 
215.2 	commissioner shall not apply any medical assistance rate reductions to durable medical 
215.3 	equipment as a result of Medicare competitive bidding.
215.4 	(j) Effective for services provided on or after July 1, 2015, medical assistance payment 
215.5 	rates for durable medical equipment, prosthetics, orthotics, or supplies shall be increased 
215.6 	as follows:
215.7 	(1) payment rates for durable medical equipment, prosthetics, orthotics, or supplies that 
215.8 	were subject to the Medicare competitive bid that took effect in January of 2009 shall be 
215.9 	increased by 9.5 percent; and
215.10 	(2) payment rates for durable medical equipment, prosthetics, orthotics, or supplies on 
215.11 	the medical assistance fee schedule, whether or not subject to the Medicare competitive bid 
215.12 	that took effect in January of 2009, shall be increased by 2.94 percent, with this increase 
215.13 	being applied after calculation of any increased payment rate under clause (1).
215.14 	This paragraph does not apply to medical supplies and durable medical equipment subject 
215.15 	to a volume purchase contract, products subject to the preferred diabetic testing supply 
215.16 	program, items provided to dually eligible recipients when Medicare is the primary payer 
215.17 	for the item, and individually priced items identified in paragraph (i). Payments made to 
215.18 	managed care plans and county-based purchasing plans shall not be adjusted to reflect the 
215.19 	rate increases in this paragraph.
215.20 	(k) Effective for nonpressure support ventilators provided on or after January 1, 2016, 
215.21 	the rate shall be the lower of the submitted charge or the Medicare fee schedule rate. Effective 
215.22 	for pressure support ventilators provided on or after January 1, 2016, the rate shall be the 
215.23 	lower of the submitted charge or 47 percent above the Medicare fee schedule rate. For 
215.24 	payments made in accordance with this paragraph, if, and to the extent that, the commissioner 
215.25 	identifies that the state has received federal financial participation for ventilators in excess 
215.26 	of the amount allowed effective January 1, 2018, under United States Code, title 42, section 
215.27 	1396b(i)(27), the state shall repay the excess amount to the Centers for Medicare and 
215.28 	Medicaid Services with state funds and maintain the full payment rate under this paragraph.

215.29 	EFFECTIVE DATE. This section is effective retroactively from January 1, 2016.

215.30 	Sec. 55. Minnesota Statutes 2016, section 256L.03, subdivision 1, is amended to read:
215.31 		Subdivision 1.Covered health services. (a) "Covered health services" means the health 
215.32 	services reimbursed under chapter 256B, with the exception of special education services, 
215.33 	home care nursing services, adult dental care services other than services covered under 
216.1 	section 256B.0625, subdivision 9, orthodontic services, nonemergency medical transportation 
216.2 	services, personal care assistance and case management services, and nursing home or 
216.3 	intermediate care facilities services.
216.4 	(b) No public funds shall be used for coverage of abortion under MinnesotaCare except 
216.5 	where the life of the female would be endangered or substantial and irreversible impairment 
216.6 	of a major bodily function would result if the fetus were carried to term; or where the 
216.7 	pregnancy is the result of rape or incest.
216.8 	(c) Covered health services shall be expanded as provided in this section.
216.9 	(d) For the purposes of covered health services under this section, "child" means an 
216.10 	individual younger than 19 years of age.

216.11 	Sec. 56. Minnesota Statutes 2016, section 256L.03, subdivision 1a, is amended to read:
216.12 		Subd. 1a. Children; MinnesotaCare health care reform waiver.  Children are eligible 
216.13 	for coverage of all services that are eligible for reimbursement under the medical assistance 
216.14 	program according to chapter 256B, except special education services and that abortion 
216.15 	services under MinnesotaCare shall be limited as provided under subdivision 1. Children 
216.16 	are exempt from the provisions of subdivision 5, regarding co-payments. Children who are 
216.17 	lawfully residing in the United States but who are not "qualified noncitizens" under title IV 
216.18 	of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Public 
216.19 	Law 104-193, Statutes at Large, volume 110, page 2105, are eligible for coverage of all 
216.20 	services provided under the medical assistance program according to chapter 256B.

216.21 	Sec. 57. Minnesota Statutes 2016, section 256L.03, subdivision 5, is amended to read:
216.22 		Subd. 5.Cost-sharing. (a) Except as otherwise provided in this subdivision, the 
216.23 	MinnesotaCare benefit plan shall include the following cost-sharing requirements for all 
216.24 	enrollees:
216.25 	(1) $3 per prescription for adult enrollees;
216.26 	(2) $25 for eyeglasses for adult enrollees;
216.27 	(3) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 
216.28 	episode of service which is required because of a recipient's symptoms, diagnosis, or 
216.29 	established illness, and which is delivered in an ambulatory setting by a physician or 
216.30 	physician assistant, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 
216.31 	audiologist, optician, or optometrist;
217.1 	(4) $6 for nonemergency visits to a hospital-based emergency room for services provided 
217.2 	through December 31, 2010, and $3.50 effective January 1, 2011; and
217.3 	(5) a family deductible equal to $2.75 per month per family and adjusted annually by 
217.4 	the percentage increase in the medical care component of the CPI-U for the period of 
217.5 	September to September of the preceding calendar year, rounded to the next-higher five 
217.6 	cent increment.
217.7 	(b) Paragraph (a) does (a) Co-payments, coinsurance, and deductibles do not apply to 
217.8 	children under the age of 21 and to American Indians as defined in Code of Federal 
217.9 	Regulations, title 42, section 447.51 600.5.
217.10 	(c) Paragraph (a), clause (3), does not apply to mental health services.
217.11 	(d) MinnesotaCare reimbursements to fee-for-service providers and payments to managed 
217.12 	care plans or county-based purchasing plans shall not be increased as a result of the reduction 
217.13 	of the co-payments in paragraph (a), clause (4), effective January 1, 2011.
217.14 	(e) The commissioner, through the contracting process under section 256L.12, may 
217.15 	allow managed care plans and county-based purchasing plans to waive the family deductible 
217.16 	under paragraph (a), clause (5). The value of the family deductible shall not be included in 
217.17 	the capitation payment to managed care plans and county-based purchasing plans. Managed 
217.18 	care plans and county-based purchasing plans shall certify annually to the commissioner 
217.19 	the dollar value of the family deductible.
217.20 	(f) (b) The commissioner shall increase adjust co-payments, coinsurance, and deductibles
217.21 	for covered services in a manner sufficient to reduce maintain the actuarial value of the 
217.22 	benefit to 94 percent. The cost-sharing changes described in this paragraph do not apply to 
217.23 	eligible recipients or services exempt from cost-sharing under state law. The cost-sharing 
217.24 	changes described in this paragraph shall not be implemented prior to January 1, 2016.
217.25 	(g) (c) The cost-sharing changes authorized under paragraph (f) (b) must satisfy the 
217.26 	requirements for cost-sharing under the Basic Health Program as set forth in Code of Federal 
217.27 	Regulations, title 42, sections 600.510 and 600.520.

217.28 	EFFECTIVE DATE. This section is effective January 1, 2018.

217.29 	Sec. 58. Minnesota Statutes 2016, section 256L.11, is amended by adding a subdivision 
217.30 	to read:
217.31 		Subd. 6a.Dental providers. Effective for dental services provided to MinnesotaCare 
217.32 	enrollees on or after January 1, 2018, the commissioner shall increase payment rates to 
218.1 	dental providers by 54 percent. Payments made to prepaid health plans under section 256L.12 
218.2 	shall reflect the payment increase described in this subdivision. The prepaid health plans 
218.3 	under contract with the commissioner shall provide payments to dental providers that are 
218.4 	at least equal to a rate that includes the payment rate specified in this subdivision, and if 
218.5 	applicable to the provider, the rates described under subdivision 7.

218.6 	Sec. 59. Minnesota Statutes 2016, section 256L.11, subdivision 7, is amended to read:
218.7 		Subd. 7.Critical access dental providers. Effective for dental services provided to 
218.8 	MinnesotaCare enrollees on or after July 1, 2016 2017, the commissioner shall increase 
218.9 	payment rates to dentists and dental clinics deemed by the commissioner to be critical access 
218.10 	providers under section 256B.76, subdivision 4, by 32.5 20 percent above the payment rate 
218.11 	that would otherwise be paid to the provider, except for a dental clinic or dental group 
218.12 	described in section 256B.76, subdivision 4, paragraph (b), in which the commissioner shall 
218.13 	increase the payment rate by 30 percent above the payment rate that would otherwise be 
218.14 	paid to the provider. The commissioner shall pay the prepaid health plans under contract 
218.15 	with the commissioner amounts sufficient to reflect this rate increase. The prepaid health 
218.16 	plan must pass this rate increase to providers who have been identified by the commissioner 
218.17 	as critical access dental providers under section 256B.76, subdivision 4.

218.18 	Sec. 60. Minnesota Statutes 2016, section 256L.15, subdivision 2, is amended to read:
218.19 		Subd. 2.Sliding fee scale; monthly individual or family income. (a) The commissioner 
218.20 	shall establish a sliding fee scale to determine the percentage of monthly individual or family 
218.21 	income that households at different income levels must pay to obtain coverage through the 
218.22 	MinnesotaCare program. The sliding fee scale must be based on the enrollee's monthly 
218.23 	individual or family income.
218.24 	(b) Beginning January 1, 2014, MinnesotaCare enrollees shall pay premiums according 
218.25 	to the premium scale specified in paragraph (d).
218.26 	(c) Paragraph (b) does not apply to:
218.27 	(1) children 20 years of age or younger; and
218.28 	(2) individuals with household incomes below 35 percent of the federal poverty 
218.29 	guidelines.
218.30 	(d) The following premium scale is established for each individual in the household who 
218.31 	is 21 years of age or older and enrolled in MinnesotaCare:

219.1
219.2	Federal Poverty Guideline 
Greater than or Equal to
	Less than
	Individual Premium 
Amount
	
219.3	35%
	55%
	$4
	
219.4	55%
	80%
	$6
	
219.5	80%
	90%
	$8
	
219.6	90%
	100%
	$10
	
219.7	100%
	110%
	$12
	
219.8	110%
	120%
	$14
	
219.9	120%
	130%
	$15
	
219.10	130%
	140%
	$16
	
219.11	140%
	150%
	$25
	
219.12	150%
	160%
	$29 $37
	
219.13	160%
	170%
	$33 $44
	
219.14	170%
	180%
	$38 $52
	
219.15	180%
	190%
	$43 $61
	
219.16	190%
	200%
	$50 $71
	
219.17	200%
		$80

219.18 	EFFECTIVE DATE. This section is effective August 1, 2015.

219.19 	Sec. 61. CAPITATION PAYMENT DELAY.
 219.20 	(a) The commissioner of human services shall delay the medical assistance capitation 
219.21 	payment to managed care plans and county-based purchasing plans due in May 2019 until 
219.22 	July 1, 2019. The payment shall be made no earlier than July 1, 2019, and no later than July 
219.23 	31, 2019.
219.24 	(b) The commissioner of human services shall delay the medical assistance capitation 
219.25 	payment to managed care plans and county-based purchasing plans due in May 2021 until 
219.26 	July 1, 2021. The payment shall be made no earlier than July 1, 2021, and no later than July 
219.27 	31, 2021.

219.28 	Sec. 62. FEDERAL WAIVER OR APPROVAL; STATE PROGRAM 
219.29 	PARTICIPATION REQUIREMENT.
 219.30 	The commissioner of human services shall seek any federal waiver or approval necessary 
219.31 	to implement section 38.

220.1 	Sec. 63. OPIOID USE AND ACUPUNCTURE STUDY.
 220.2 	(a) The commissioner of human services, within the limits of available appropriations, 
220.3 	shall study the use of opiates for the treatment of chronic pain conditions when acupuncture 
220.4 	services are also part of the treatment for chronic pain as compared to opiate use among 
220.5 	medical assistance recipients who are not receiving acupuncture. In comparing the sample 
220.6 	groups, the commissioner shall look at each group's opiate use and other services as identified 
220.7 	by the commissioner.
220.8 	(b) The aggregate findings of the study shall be submitted by the commissioner to the 
220.9 	chairs and ranking minority members of the legislative committees with jurisdiction over 
220.10 	health and human services policy and finance by February 15, 2018. The report shall not 
220.11 	contain or disclose any patient identifying data.

220.12 	Sec. 64. STUDY OF PAYMENT RATES FOR DURABLE MEDICAL EQUIPMENT 
220.13 	AND SUPPLIES.
 220.14 	The commissioner of human services shall study the impact of basing medical assistance 
220.15 	payment for durable medical equipment and medical supplies on Medicare payment rates, 
220.16 	as limited by the payment provisions in the 21st Century Cures Act, Public Law 114-255, 
220.17 	on access by medical assistance enrollees to these items. The study must include 
220.18 	recommendations for ensuring and improving access by medical assistance enrollees to 
220.19 	durable medical equipment and medical supplies. The commissioner shall report study 
220.20 	results and recommendations to the chairs and ranking minority members of the legislative 
220.21 	committees with jurisdiction over health and human services policy and finance by January 
220.22 	1, 2019.

220.23 	Sec. 65. ELIGIBILITY VERIFICATION FEDERAL COMPLIANCE.
 220.24 	The commissioner of human services shall implement a process to terminate coverage 
220.25 	for medical assistance enrollees who fail to submit requested verifications within 95 days 
220.26 	of coverage approval. The commissioner shall implement a manual process by July 1, 2017, 
220.27 	with the counties and tribal agencies, and provide them with instructions and necessary 
220.28 	reports. The commissioner shall ensure that the Minnesota eligibility technology system 
220.29 	(METS) has the required functionality to implement an automated process by April 1, 2018.

221.1 	Sec. 66. REVISOR'S INSTRUCTION.
 221.2 	The revisor of statutes, in the next edition of Minnesota Statutes, shall change the term 
221.3 	"health care delivery system" and similar terms to "integrated health partnership" and similar 
221.4 	terms, wherever it appears in Minnesota Statutes, section 256B.0755.

221.5 	Sec. 67.  REPEALER.
 221.6 	(a) Minnesota Statutes 2016, sections 256B.19, subdivision 1c; and 256B.64, are repealed.
221.7 	(b) Minnesota Rules, part 9500.1140, subparts 3, 4, 5, and 6, are repealed.

221.8 	ARTICLE 5
221.9 	HEALTH INSURANCE

221.10 	Section 1. Minnesota Statutes 2016, section 62A.04, subdivision 1, is amended to read:
221.11 		Subdivision 1.Reference. (a) Any reference to "standard provisions" which may appear 
221.12 	in other sections and which refer to accident and sickness or accident and health insurance 
221.13 	shall hereinafter be construed as referring to accident and sickness policy provisions.
221.14 	(b) Notwithstanding paragraph (a), the following do not apply to health plans:
221.15 	(1) subdivision 2, clauses (5) to (10) and (12);
221.16 	(2) subdivision 3, clauses (1) and (3) to (7); and
221.17 	(3) subdivisions 6 and 10.

221.18 	EFFECTIVE DATE. This section is effective for policies offered, sold, issued, or 
221.19 	renewed on or after January 1, 2018.

221.20 	Sec. 2. Minnesota Statutes 2016, section 62A.21, subdivision 2a, is amended to read:
221.21 		Subd. 2a.Continuation privilege. Every policy described in subdivision 1 shall contain 
221.22 	a provision which permits continuation of coverage under the policy for the insured's former 
221.23 	spouse and dependent children upon, which is defined as required by section 62A.302, and 
221.24 	former spouse, who was covered on the day before the entry of a valid decree of dissolution 
221.25 	of marriage. The coverage shall be continued until the earlier of the following dates:
221.26 	(a) the date the insured's former spouse becomes covered under any other group health 
221.27 	plan; or
221.28 	(b) the date coverage would otherwise terminate under the policy.
222.1 	If the coverage is provided under a group policy, any required premium contributions 
222.2 	for the coverage shall be paid by the insured on a monthly basis to the group policyholder 
222.3 	for remittance to the insurer. The policy must require the group policyholder to, upon request, 
222.4 	provide the insured with written verification from the insurer of the cost of this coverage 
222.5 	promptly at the time of eligibility for this coverage and at any time during the continuation 
222.6 	period. In no event shall the amount of premium charged exceed 102 percent of the cost to 
222.7 	the plan for such period of coverage for other similarly situated spouses and dependent 
222.8 	children with respect to whom the marital relationship has not dissolved, without regard to 
222.9 	whether such cost is paid by the employer or employee.
222.10 	Upon request by the insured's former spouse, who was covered on the day before the 
222.11 	entry of a valid decree of dissolution, or dependent child, a health carrier must provide the 
222.12 	instructions necessary to enable the child or former spouse to elect continuation of coverage.

222.13 	EFFECTIVE DATE. This section is effective for policies offered, sold, issued, or 
222.14 	renewed on or after January 1, 2018.

222.15 	Sec. 3. Minnesota Statutes 2016, section 62A.3075, is amended to read:
222.16 	62A.3075 CANCER CHEMOTHERAPY TREATMENT COVERAGE.
222.17 	(a) A health plan company that provides coverage under a health plan for cancer 
222.18 	chemotherapy treatment shall not require a higher co-payment, deductible, or coinsurance 
222.19 	amount for a prescribed, orally administered anticancer medication that is used to kill or 
222.20 	slow the growth of cancerous cells than what the health plan requires for an intravenously 
222.21 	administered or injected cancer medication that is provided, regardless of formulation or 
222.22 	benefit category determination by the health plan company.
222.23 	(b) A health plan company must not achieve compliance with this section by imposing 
222.24 	an increase in co-payment, deductible, or coinsurance amount for an intravenously 
222.25 	administered or injected cancer chemotherapy agent covered under the health plan.
222.26 	(c) Nothing in this section shall be interpreted to prohibit a health plan company from 
222.27 	requiring prior authorization or imposing other appropriate utilization controls in approving 
222.28 	coverage for any chemotherapy.
222.29 	(d) A plan offered by the commissioner of management and budget under section 43A.23
222.30 	is deemed to be at parity and in compliance with this section.
222.31 	(e) A health plan company is in compliance with this section if it does not include orally 
222.32 	administered anticancer medication in the fourth tier of its pharmacy benefit.
223.1 	(f) A health plan company that provides coverage under a health plan for cancer 
223.2 	chemotherapy treatment must indicate the level of coverage for orally administered anticancer 
223.3 	medication within its pharmacy benefit filing with the commissioner.

223.4 	EFFECTIVE DATE. This section is effective January 1, 2018, and applies to health 
223.5 	plans offered, sold, issued, or renewed on or after that date.

223.6 	Sec. 4. Minnesota Statutes 2016, section 62D.105, is amended to read:
223.7 	62D.105 COVERAGE OF CURRENT SPOUSE, FORMER SPOUSE, AND 
223.8 	CHILDREN.
223.9 		Subdivision 1.Requirement. Every health maintenance contract, which in addition to 
223.10 	covering the enrollee also provides coverage to the spouse and, dependent children, which 
223.11 	is defined as required by section 62A.302, and former spouse who was covered on the day 
223.12 	before the entry of a valid decree of dissolution of marriage, of the enrollee shall: (1) permit 
223.13 	the spouse, former spouse, and dependent children to elect to continue coverage when the 
223.14 	enrollee becomes enrolled for benefits under title XVIII of the Social Security Act 
223.15 	(Medicare); and (2) permit the dependent children to continue coverage when they cease 
223.16 	to be dependent children under the generally applicable requirement of the plan.
223.17 		Subd. 2.Continuation privilege. The coverage described in subdivision 1 may be 
223.18 	continued until the earlier of the following dates:
223.19 	(1) the date coverage would otherwise terminate under the contract;
223.20 	(2) 36 months after continuation by the spouse, former spouse, or dependent was elected; 
223.21 	or
223.22 	(3) the date the spouse, former spouse, or dependent children become covered under 
223.23 	another group health plan or Medicare.
223.24 	If coverage is provided under a group policy, any required fees for the coverage shall 
223.25 	be paid by the enrollee on a monthly basis to the group contract holder for remittance to the 
223.26 	health maintenance organization. In no event shall the fee charged exceed 102 percent of 
223.27 	the cost to the plan for such coverage for other similarly situated spouse and dependent 
223.28 	children to whom subdivision 1 is not applicable, without regard to whether such cost is 
223.29 	paid by the employer or employee.

223.30 	EFFECTIVE DATE. This section is effective for policies offered, sold, issued, or 
223.31 	renewed on or after January 1, 2018.

224.1 	Sec. 5. Minnesota Statutes 2016, section 62E.04, subdivision 11, is amended to read:
224.2 		Subd. 11.Essential health benefits package Affordable Care Act compliant plans.
 224.3 	For individual or small group health plans that include the essential health benefits package 
224.4 	and are any policy of accident and health insurance subject to the requirements of the 
224.5 	Affordable Care Act, as defined under section 62A.011, subdivision 1a, that is offered, sold, 
224.6 	issued, or renewed on or after January 1, 2014 2018, the requirements of this section do not 
224.7 	apply.

224.8 	EFFECTIVE DATE. This section is effective for policies offered, sold, issued, or 
224.9 	renewed on or after January 1, 2018.

224.10 	Sec. 6. Minnesota Statutes 2016, section 62E.05, subdivision 1, is amended to read:
224.11 		Subdivision 1.Certification. Upon application by an insurer, fraternal, or employer for 
224.12 	certification of a plan of health coverage as a qualified plan or a qualified Medicare 
224.13 	supplement plan for the purposes of sections 62E.01 to 62E.19, the commissioner shall 
224.14 	make a determination within 90 days as to whether the plan is qualified. All plans of health 
224.15 	coverage, except Medicare supplement policies, shall be labeled as "qualified" or 
224.16 	"nonqualified" on the front of the policy or contract, or on the schedule page. All qualified 
224.17 	plans shall indicate whether they are number one, two, or three coverage plans. For any 
224.18 	policy of accident and health insurance subject to the requirements of the Affordable Care 
224.19 	Act, as defined under section 62A.011, subdivision 1a, that is offered, sold, issued, or 
224.20 	renewed on or after January 1, 2018, the requirements of this section do not apply.

224.21 	EFFECTIVE DATE. This section is effective for policies offered, sold, issued, or 
224.22 	renewed on or after January 1, 2018.

224.23 	Sec. 7. Minnesota Statutes 2016, section 62E.06, is amended by adding a subdivision to 
224.24 	read:
224.25 		Subd. 5.Affordable Care Act compliant plans. For any policy of accident and health 
224.26 	insurance subject to the requirements of the Affordable Care Act, as defined under section 
224.27 	62A.011, subdivision 1a, that is offered, sold, issued, or renewed on or after January 1, 
224.28 	2018, the requirements of this section do not apply.

224.29 	EFFECTIVE DATE. This section is effective for policies offered, sold, issued, or 
224.30 	renewed on or after January 1, 2018.

225.1 	Sec. 8. Laws 2017, chapter 2, article 1, section 5, is amended to read:
225.2 	Sec. 5. SUNSET.
 225.3 	This article sunsets June 30, other than section 2, subdivision 5; section 3; and section 
225.4 	7, sunsets August 31, 2018.

225.5 	Sec. 9. Laws 2017, chapter 2, article 1, section 7, is amended to read:
225.6 	Sec. 7. APPROPRIATIONS.
 225.7 	(a) $311,788,000 in fiscal year 2017 is appropriated from the general fund to the 
225.8 	commissioner of management and budget for premium assistance under section 2. This 
225.9 	appropriation is onetime and is available through June 30 August 31, 2018.
225.10 	(b) $157,000 in fiscal year 2017 is appropriated from the general fund to the legislative 
225.11 	auditor for purposes of section 3. This appropriation is onetime.
225.12 	(c) Any unexpended amount from the appropriation in paragraph (a) after June 30, 2018, 
225.13 	shall be transferred on July 1 no later than August 31, 2018, from the general fund to the 
225.14 	budget reserve account under Minnesota Statutes, section 16A.152, subdivision 1a.

225.15 	Sec. 10. Laws 2017, chapter 13, article 1, section 15, is amended to read:
225.16 	Sec. 15. MINNESOTA PREMIUM SECURITY PLAN FUNDING.
 225.17 	(a) The Minnesota Comprehensive Health Association shall fund the operational and 
225.18 	administrative costs and reinsurance payments of the Minnesota security plan and association 
225.19 	using the following amounts deposited in the premium security plan account in Minnesota 
225.20 	Statutes, section 62E.25, subdivision 1, in the following order:
225.21 	(1) any federal funding available;
225.22 	(2) funds deposited under article 1, sections 12 and 13;
225.23 	(3) any state funds from the health care access fund; and
225.24 	(4) any state funds from the general fund.
225.25 	(b) The association shall transfer from the premium security plan account any general 
225.26 	fund amount state funds not used for the Minnesota premium security plan by June 30, 
225.27 	2021, to the commissioner of commerce. Any amount transferred to the commissioner of 
225.28 	commerce shall be deposited in the general fund.
225.29 	(c) The association shall transfer from the premium security plan account any health 
225.30 	care access fund amount not used for the Minnesota premium security plan by June 30, 
226.1 	2021, to the commissioner of commerce. Any amount transferred to the commissioner of 
226.2 	commerce shall be deposited in the health care access fund in Minnesota Statutes, section 
226.3 	16A.724.
226.4 	(d) (c) The Minnesota Comprehensive Health Association may not spend more than 
226.5 	$271,000,000 for benefit year 2018 and not more than $271,000,000 for benefit year 2019 
226.6 	for the operational and administrative costs of, and reinsurance payments under, the 
226.7 	Minnesota premium security plan.

226.8 	Sec. 11. MORATORIUM ON CONVERSION TRANSACTIONS.
 226.9 	(a) Notwithstanding Laws 2017, chapter 2, article 2, a nonprofit health service plan 
226.10 	corporation operating under Minnesota Statutes, chapter 62C, or health maintenance 
226.11 	organization operating under Minnesota Statutes, chapter 62D, as of January 1, 2017, may 
226.12 	only merge or consolidate with; or convert, or transfer all or a substantial portion of its 
226.13 	assets to an entity that is a corporation organized under Minnesota Statutes, chapter 317A.
226.14 	(b) Paragraph (a) does not apply if the service plan corporation or health maintenance 
226.15 	organization files an intent to dissolve due to insolvency of the corporation in accordance 
226.16 	with Minnesota Statutes, chapter 317A, or insolvency proceedings are commenced under 
226.17 	Minnesota Statutes, chapter 60B.
226.18 	(c) Nothing in this section shall be construed to authorize a health maintenance 
226.19 	organization or a nonprofit health service plan corporation to engage in any transaction or 
226.20 	activities not otherwise permitted under state law.
226.21 	(d) This section expires July 1, 2019.

226.22 	EFFECTIVE DATE. This section is effective the day following final enactment.

226.23 	ARTICLE 6
226.24 	DIRECT CARE AND TREATMENT

226.25 	Section 1. Minnesota Statutes 2016, section 252.50, subdivision 5, is amended to read:
226.26 		Subd. 5.Location of programs. (a) In determining the location of state-operated, 
226.27 	community-based programs, the needs of the individual client shall be paramount. The 
226.28 	commissioner shall also take into account:
226.29 	(1) prioritization of beds in state-operated, community-based programs for individuals 
226.30 	with complex behavioral needs that cannot be met by private community-based providers;
227.1 	(2) choices made by individuals who chose to move to a more integrated setting, and 
227.2 	shall coordinate with the lead agency to ensure that appropriate person-centered transition 
227.3 	plans are created;
227.4 	(3) the personal preferences of the persons being served and their families as determined 
227.5 	by Minnesota Rules, parts 9525.0004 to 9525.0036;
227.6 	(2) (4) the location of the support services established by the individual service plans of 
227.7 	the persons being served;
227.8 	(3) (5) the appropriate grouping of the persons served;
227.9 	(4) (6) the availability of qualified staff;
227.10 	(5) (7) the need for state-operated, community-based programs in the geographical region 
227.11 	of the state; and
227.12 	(6) (8) a reasonable commuting distance from a regional treatment center or the residences 
227.13 	of the program staff.
227.14 	(b) State-operated, community-based programs must be located according to section 
227.15 	252.28.

227.16 	Sec. 2. Minnesota Statutes 2016, section 253B.10, subdivision 1, is amended to read:
227.17 		Subdivision 1.Administrative requirements. (a) When a person is committed, the 
227.18 	court shall issue a warrant or an order committing the patient to the custody of the head of 
227.19 	the treatment facility. The warrant or order shall state that the patient meets the statutory 
227.20 	criteria for civil commitment.
227.21 	(b) The commissioner shall prioritize patients being admitted from jail or a correctional 
227.22 	institution who are:
227.23 	(1) ordered confined in a state hospital for an examination under Minnesota Rules of 
227.24 	Criminal Procedure, rules 20.01, subdivision 4, paragraph (a), and 20.02, subdivision 2;
227.25 	(2) under civil commitment for competency treatment and continuing supervision under 
227.26 	Minnesota Rules of Criminal Procedure, rule 20.01, subdivision 7;
227.27 	(3) found not guilty by reason of mental illness under Minnesota Rules of Criminal 
227.28 	Procedure, rule 20.02, subdivision 8, and under civil commitment or are ordered to be 
227.29 	detained in a state hospital or other facility pending completion of the civil commitment 
227.30 	proceedings; or
228.1 	(4) committed under this chapter to the commissioner after dismissal of the patient's 
228.2 	criminal charges.
228.3 	Patients described in this paragraph must be admitted to a service operated by the 
228.4 	commissioner within 48 hours. The commitment must be ordered by the court as provided 
228.5 	in section 253B.09, subdivision 1, paragraph (c).
228.6 	(c) Upon the arrival of a patient at the designated treatment facility, the head of the 
228.7 	facility shall retain the duplicate of the warrant and endorse receipt upon the original warrant 
228.8 	or acknowledge receipt of the order. The endorsed receipt or acknowledgment must be filed 
228.9 	in the court of commitment. After arrival, the patient shall be under the control and custody 
228.10 	of the head of the treatment facility.
228.11 	(d) Copies of the petition for commitment, the court's findings of fact and conclusions 
228.12 	of law, the court order committing the patient, the report of the examiners, and the prepetition 
228.13 	report, and any medical and behavioral information available shall be provided promptly
228.14 	at the time of admission of a patient to the designated treatment facility. This information 
228.15 	shall also be provided by the head of the treatment facility to treatment facility staff in a 
228.16 	consistent and timely manner and pursuant to all applicable laws.

228.17 	Sec. 3. REVIEW OF ALTERNATIVES TO STATE-OPERATED GROUP HOMES 
228.18 	HOUSING ONE PERSON.
 228.19 	The commissioner of human services shall review the potential for, and the viability of, 
228.20 	alternatives to state-operated group homes housing one person. The intent is to create housing 
228.21 	options for individuals who do not belong in an institutionalized setting, but need additional 
228.22 	support before transitioning to a more independent community placement. The review shall 
228.23 	include an analysis of existing housing settings operated by counties and private providers, 
228.24 	as well as the potential for new housing settings, and determine the viability for use by 
228.25 	state-operated services. The commissioner shall seek input from interested stakeholders as 
228.26 	part of the review. An update, including alternatives identified, will be provided by the 
228.27 	commissioner to the members of the legislative committees having jurisdiction over human 
228.28 	services issues no later than January 15, 2018.

228.29 	ARTICLE 7
228.30 	CHILDREN AND FAMILIES

228.31 	Section 1. Minnesota Statutes 2016, section 13.32, is amended by adding a subdivision 
228.32 	to read:
229.1 		Subd. 12.Access by welfare system. County personnel in the welfare system may 
229.2 	request access to education data in order to coordinate services for a student or family. The 
229.3 	request must be submitted to the chief administrative officer of the school and must include 
229.4 	the basis for the request and a description of the information that is requested. The chief 
229.5 	administrative officer must provide a copy of the request to the parent or legal guardian of 
229.6 	the student who is the subject of the request, along with a form the parent or legal guardian 
229.7 	may execute to consent to the release of specified information to the requester. Education 
229.8 	data may be released under this subdivision only if the parent or legal guardian gives 
229.9 	informed consent to the release.

229.10 	Sec. 2. Minnesota Statutes 2016, section 13.46, subdivision 1, is amended to read:
229.11 		Subdivision 1.Definitions. As used in this section:
229.12 	(a) "Individual" means an individual according to section 13.02, subdivision 8, but does 
229.13 	not include a vendor of services.
229.14 	(b) "Program" includes all programs for which authority is vested in a component of the 
229.15 	welfare system according to statute or federal law, including, but not limited to, Native 
229.16 	American tribe programs that provide a service component of the welfare system, the aid 
229.17 	to families with dependent children program formerly codified in sections 256.72 to 256.87, 
229.18 	Minnesota family investment program, temporary assistance for needy families program, 
229.19 	medical assistance, general assistance, general assistance medical care formerly codified in 
229.20 	chapter 256D, child care assistance program, and child support collections.
229.21 	(c) "Welfare system" includes the Department of Human Services, local social services 
229.22 	agencies, county welfare agencies, county public health agencies, county veteran services 
229.23 	agencies, county housing agencies, private licensing agencies, the public authority responsible 
229.24 	for child support enforcement, human services boards, community mental health center 
229.25 	boards, state hospitals, state nursing homes, the ombudsman for mental health and 
229.26 	developmental disabilities, Native American tribes to the extent a tribe provides a service 
229.27 	component of the welfare system, and persons, agencies, institutions, organizations, and 
229.28 	other entities under contract to any of the above agencies to the extent specified in the 
229.29 	contract.
229.30 	(d) "Mental health data" means data on individual clients and patients of community 
229.31 	mental health centers, established under section 245.62, mental health divisions of counties 
229.32 	and other providers under contract to deliver mental health services, or the ombudsman for 
229.33 	mental health and developmental disabilities.
230.1 	(e) "Fugitive felon" means a person who has been convicted of a felony and who has 
230.2 	escaped from confinement or violated the terms of probation or parole for that offense.
230.3 	(f) "Private licensing agency" means an agency licensed by the commissioner of human 
230.4 	services under chapter 245A to perform the duties under section 245A.16.

230.5 	Sec. 3. Minnesota Statutes 2016, section 13.46, subdivision 2, is amended to read:
230.6 		Subd. 2.General. (a) Data on individuals collected, maintained, used, or disseminated 
230.7 	by the welfare system are private data on individuals, and shall not be disclosed except:
230.8 	(1) according to section 13.05;
230.9 	(2) according to court order;
230.10 	(3) according to a statute specifically authorizing access to the private data;
230.11 	(4) to an agent of the welfare system and an investigator acting on behalf of a county, 
230.12 	the state, or the federal government, including a law enforcement person or attorney in the 
230.13 	investigation or prosecution of a criminal, civil, or administrative proceeding relating to the 
230.14 	administration of a program;
230.15 	(5) to personnel of the welfare system who require the data to verify an individual's 
230.16 	identity; determine eligibility, amount of assistance, and the need to provide services to an 
230.17 	individual or family across programs; coordinate services for an individual or family; 
230.18 	evaluate the effectiveness of programs; assess parental contribution amounts; and investigate 
230.19 	suspected fraud;
230.20 	(6) to administer federal funds or programs;
230.21 	(7) between personnel of the welfare system working in the same program;
230.22 	(8) to the Department of Revenue to assess parental contribution amounts for purposes 
230.23 	of section 252.27, subdivision 2a, administer and evaluate tax refund or tax credit programs 
230.24 	and to identify individuals who may benefit from these programs. The following information 
230.25 	may be disclosed under this paragraph: an individual's and their dependent's names, dates 
230.26 	of birth, Social Security numbers, income, addresses, and other data as required, upon 
230.27 	request by the Department of Revenue. Disclosures by the commissioner of revenue to the 
230.28 	commissioner of human services for the purposes described in this clause are governed by 
230.29 	section 270B.14, subdivision 1. Tax refund or tax credit programs include, but are not limited 
230.30 	to, the dependent care credit under section 290.067, the Minnesota working family credit 
230.31 	under section 290.0671, the property tax refund and rental credit under section 290A.04, 
230.32 	and the Minnesota education credit under section 290.0674;
231.1 	(9) between the Department of Human Services, the Department of Employment and 
231.2 	Economic Development, and when applicable, the Department of Education, for the following 
231.3 	purposes:
231.4 	(i) to monitor the eligibility of the data subject for unemployment benefits, for any 
231.5 	employment or training program administered, supervised, or certified by that agency;
231.6 	(ii) to administer any rehabilitation program or child care assistance program, whether 
231.7 	alone or in conjunction with the welfare system;
231.8 	(iii) to monitor and evaluate the Minnesota family investment program or the child care 
231.9 	assistance program by exchanging data on recipients and former recipients of food support, 
231.10 	cash assistance under chapter 256, 256D, 256J, or 256K, child care assistance under chapter 
231.11 	119B, medical programs under chapter 256B or 256L, or a medical program formerly 
231.12 	codified under chapter 256D; and
231.13 	(iv) to analyze public assistance employment services and program utilization, cost, 
231.14 	effectiveness, and outcomes as implemented under the authority established in Title II, 
231.15 	Sections 201-204 of the Ticket to Work and Work Incentives Improvement Act of 1999. 
231.16 	Health records governed by sections 144.291 to 144.298 and "protected health information" 
231.17 	as defined in Code of Federal Regulations, title 45, section 160.103, and governed by Code 
231.18 	of Federal Regulations, title 45, parts 160-164, including health care claims utilization 
231.19 	information, must not be exchanged under this clause;
231.20 	(10) to appropriate parties in connection with an emergency if knowledge of the 
231.21 	information is necessary to protect the health or safety of the individual or other individuals 
231.22 	or persons;
231.23 	(11) data maintained by residential programs as defined in section 245A.02 may be 
231.24 	disclosed to the protection and advocacy system established in this state according to Part 
231.25 	C of Public Law 98-527 to protect the legal and human rights of persons with developmental 
231.26 	disabilities or other related conditions who live in residential facilities for these persons if 
231.27 	the protection and advocacy system receives a complaint by or on behalf of that person and 
231.28 	the person does not have a legal guardian or the state or a designee of the state is the legal 
231.29 	guardian of the person;
231.30 	(12) to the county medical examiner or the county coroner for identifying or locating 
231.31 	relatives or friends of a deceased person;
232.1 	(13) data on a child support obligor who makes payments to the public agency may be 
232.2 	disclosed to the Minnesota Office of Higher Education to the extent necessary to determine 
232.3 	eligibility under section 136A.121, subdivision 2, clause (5);
232.4 	(14) participant Social Security numbers and names collected by the telephone assistance 
232.5 	program may be disclosed to the Department of Revenue to conduct an electronic data 
232.6 	match with the property tax refund database to determine eligibility under section 237.70, 
232.7 	subdivision 4a;
232.8 	(15) the current address of a Minnesota family investment program participant may be 
232.9 	disclosed to law enforcement officers who provide the name of the participant and notify 
232.10 	the agency that:
232.11 	(i) the participant:
232.12 	(A) is a fugitive felon fleeing to avoid prosecution, or custody or confinement after 
232.13 	conviction, for a crime or attempt to commit a crime that is a felony under the laws of the 
232.14 	jurisdiction from which the individual is fleeing; or
232.15 	(B) is violating a condition of probation or parole imposed under state or federal law;
232.16 	(ii) the location or apprehension of the felon is within the law enforcement officer's 
232.17 	official duties; and
232.18 	(iii) the request is made in writing and in the proper exercise of those duties;
232.19 	(16) the current address of a recipient of general assistance may be disclosed to probation 
232.20 	officers and corrections agents who are supervising the recipient and to law enforcement 
232.21 	officers who are investigating the recipient in connection with a felony level offense;
232.22 	(17) information obtained from food support applicant or recipient households may be 
232.23 	disclosed to local, state, or federal law enforcement officials, upon their written request, for 
232.24 	the purpose of investigating an alleged violation of the Food Stamp Act, according to Code 
232.25 	of Federal Regulations, title 7, section 272.1(c);
232.26 	(18) the address, Social Security number, and, if available, photograph of any member 
232.27 	of a household receiving food support shall be made available, on request, to a local, state, 
232.28 	or federal law enforcement officer if the officer furnishes the agency with the name of the 
232.29 	member and notifies the agency that:
232.30 	(i) the member:
232.31 	(A) is fleeing to avoid prosecution, or custody or confinement after conviction, for a 
232.32 	crime or attempt to commit a crime that is a felony in the jurisdiction the member is fleeing;
233.1 	(B) is violating a condition of probation or parole imposed under state or federal law; 
233.2 	or
233.3 	(C) has information that is necessary for the officer to conduct an official duty related 
233.4 	to conduct described in subitem (A) or (B);
233.5 	(ii) locating or apprehending the member is within the officer's official duties; and
233.6 	(iii) the request is made in writing and in the proper exercise of the officer's official duty;
233.7 	(19) the current address of a recipient of Minnesota family investment program, general 
233.8 	assistance, or food support may be disclosed to law enforcement officers who, in writing, 
233.9 	provide the name of the recipient and notify the agency that the recipient is a person required 
233.10 	to register under section 243.166, but is not residing at the address at which the recipient is 
233.11 	registered under section 243.166;
233.12 	(20) certain information regarding child support obligors who are in arrears may be 
233.13 	made public according to section 518A.74;
233.14 	(21) data on child support payments made by a child support obligor and data on the 
233.15 	distribution of those payments excluding identifying information on obligees may be 
233.16 	disclosed to all obligees to whom the obligor owes support, and data on the enforcement 
233.17 	actions undertaken by the public authority, the status of those actions, and data on the income 
233.18 	of the obligor or obligee may be disclosed to the other party;
233.19 	(22) data in the work reporting system may be disclosed under section 256.998, 
233.20 	subdivision 7;
233.21 	(23) to the Department of Education for the purpose of matching Department of Education 
233.22 	student data with public assistance data to determine students eligible for free and 
233.23 	reduced-price meals, meal supplements, and free milk according to United States Code, 
233.24 	title 42, sections 1758, 1761, 1766, 1766a, 1772, and 1773; to allocate federal and state 
233.25 	funds that are distributed based on income of the student's family; and to verify receipt of 
233.26 	energy assistance for the telephone assistance plan;
233.27 	(24) the current address and telephone number of program recipients and emergency 
233.28 	contacts may be released to the commissioner of health or a community health board as 
233.29 	defined in section 145A.02, subdivision 5, when the commissioner or community health 
233.30 	board has reason to believe that a program recipient is a disease case, carrier, suspect case, 
233.31 	or at risk of illness, and the data are necessary to locate the person;
233.32 	(25) to other state agencies, statewide systems, and political subdivisions of this state, 
233.33 	including the attorney general, and agencies of other states, interstate information networks, 
234.1 	federal agencies, and other entities as required by federal regulation or law for the 
234.2 	administration of the child support enforcement program;
234.3 	(26) to personnel of public assistance programs as defined in section 256.741, for access 
234.4 	to the child support system database for the purpose of administration, including monitoring 
234.5 	and evaluation of those public assistance programs;
234.6 	(27) to monitor and evaluate the Minnesota family investment program by exchanging 
234.7 	data between the Departments of Human Services and Education, on recipients and former 
234.8 	recipients of food support, cash assistance under chapter 256, 256D, 256J, or 256K, child 
234.9 	care assistance under chapter 119B, medical programs under chapter 256B or 256L, or a 
234.10 	medical program formerly codified under chapter 256D;
234.11 	(28) to evaluate child support program performance and to identify and prevent fraud 
234.12 	in the child support program by exchanging data between the Department of Human Services, 
234.13 	Department of Revenue under section 270B.14, subdivision 1, paragraphs (a) and (b), 
234.14 	without regard to the limitation of use in paragraph (c), Department of Health, Department 
234.15 	of Employment and Economic Development, and other state agencies as is reasonably 
234.16 	necessary to perform these functions;
234.17 	(29) counties operating child care assistance programs under chapter 119B may 
234.18 	disseminate data on program participants, applicants, and providers to the commissioner of 
234.19 	education;
234.20 	(30) child support data on the child, the parents, and relatives of the child may be 
234.21 	disclosed to agencies administering programs under titles IV-B and IV-E of the Social 
234.22 	Security Act, as authorized by federal law; or
234.23 	(31) to a health care provider governed by sections 144.291 to 144.298, to the extent 
234.24 	necessary to coordinate services;
234.25 	(32) to the chief administrative officer of a school to coordinate services for a student 
234.26 	and family; data that may be disclosed under this clause are limited to name, date of birth, 
234.27 	gender, and address; or
234.28 	(33) to county correctional agencies to the extent necessary to coordinate services and 
234.29 	diversion programs; data that may be disclosed under this clause are limited to name, client 
234.30 	demographics, program, case status, and county worker information.
234.31 	(b) Information on persons who have been treated for drug or alcohol abuse may only 
234.32 	be disclosed according to the requirements of Code of Federal Regulations, title 42, sections 
234.33 	2.1 to 2.67.
235.1 	(c) Data provided to law enforcement agencies under paragraph (a), clause (15), (16), 
235.2 	(17), or (18), or paragraph (b), are investigative data and are confidential or protected 
235.3 	nonpublic while the investigation is active. The data are private after the investigation 
235.4 	becomes inactive under section 13.82, subdivision 5, paragraph (a) or (b).
235.5 	(d) Mental health data shall be treated as provided in subdivisions 7, 8, and 9, but are 
235.6 	not subject to the access provisions of subdivision 10, paragraph (b).
235.7 	For the purposes of this subdivision, a request will be deemed to be made in writing if 
235.8 	made through a computer interface system.

235.9 	Sec. 4. Minnesota Statutes 2016, section 13.84, subdivision 5, is amended to read:
235.10 		Subd. 5.Disclosure. Private or confidential court services data shall not be disclosed 
235.11 	except:
235.12 	(a) pursuant to section 13.05;
235.13 	(b) pursuant to a statute specifically authorizing disclosure of court services data;
235.14 	(c) with the written permission of the source of confidential data;
235.15 	(d) to the court services department, parole or probation authority or state or local 
235.16 	correctional agency or facility having statutorily granted supervision over the individual 
235.17 	subject of the data, or to county personnel within the welfare system;
235.18 	(e) pursuant to subdivision 6;
235.19 	(f) pursuant to a valid court order; or
235.20 	(g) pursuant to section 611A.06, subdivision 3a.

235.21 	Sec. 5. Minnesota Statutes 2016, section 119B.011, subdivision 20, is amended to read:
235.22 		Subd. 20.Transition year families. "Transition year families" means families who have 
235.23 	received MFIP assistance, or who were eligible to receive MFIP assistance after choosing 
235.24 	to discontinue receipt of the cash portion of MFIP assistance under section 256J.31, 
235.25 	subdivision 12, or families who have received DWP assistance under section 256J.95 for 
235.26 	at least three of the last six months before losing eligibility for MFIP or DWP. 
235.27 	Notwithstanding Minnesota Rules, parts 3400.0040, subpart 10, and 3400.0090, subpart 2, 
235.28 	transition year child care may be used to support employment, approved education or training 
235.29 	programs, or job search that meets the requirements of section 119B.10. Transition year 
235.30 	child care is not available to families who have been disqualified from MFIP or DWP due 
235.31 	to fraud.

236.1 	EFFECTIVE DATE. This section is effective October 23, 2017.

236.2 	Sec. 6. Minnesota Statutes 2016, section 119B.011, subdivision 20a, is amended to read:
236.3 		Subd. 20a.Transition year extension families. "Transition year extension families" 
236.4 	means families who have completed their transition year of child care assistance under this 
236.5 	subdivision and who are eligible for, but on a waiting list for, services under section 119B.03. 
236.6 	For purposes of sections 119B.03, subdivision 3, and 119B.05, subdivision 1, clause (2), 
236.7 	families participating in extended transition year shall not be considered transition year 
236.8 	families. Notwithstanding Minnesota Rules, parts 3400.0040, subpart 10, and 3400.0090, 
236.9 	subpart 2, transition year extension child care may be used to support employment, approved 
236.10 	education or training programs, or a job search that meets the requirements of section 
236.11 	119B.10 for the length of time necessary for families to be moved from the basic sliding 
236.12 	fee waiting list into the basic sliding fee program.

236.13 	EFFECTIVE DATE. This section is effective October 23, 2017.

236.14 	Sec. 7. Minnesota Statutes 2016, section 119B.025, subdivision 1, is amended to read:
236.15 		Subdivision 1.Factors which must be verified Applications. (a) The county shall 
236.16 	verify the following at all initial child care applications using the universal application:
236.17 	(1) identity of adults;
236.18 	(2) presence of the minor child in the home, if questionable;
236.19 	(3) relationship of minor child to the parent, stepparent, legal guardian, eligible relative 
236.20 	caretaker, or the spouses of any of the foregoing;
236.21 	(4) age;
236.22 	(5) immigration status, if related to eligibility;
236.23 	(6) Social Security number, if given;
236.24 	(7) counted income;
236.25 	(8) spousal support and child support payments made to persons outside the household;
236.26 	(9) residence; and
236.27 	(10) inconsistent information, if related to eligibility.
236.28 	(b) If a family did not use the universal application or child care addendum to apply for 
236.29 	child care assistance, the family must complete the universal application or child care 
236.30 	addendum at its next eligibility redetermination and the county must verify the factors listed 
237.1 	in paragraph (a) as part of that redetermination. Once a family has completed a universal 
237.2 	application or child care addendum, the county shall use the redetermination form described 
237.3 	in paragraph (c) for that family's subsequent redeterminations. Eligibility must be 
237.4 	redetermined at least every six months. A family is considered to have met the eligibility 
237.5 	redetermination requirement if a complete redetermination form and all required verifications 
237.6 	are received within 30 days after the date the form was due. When the 30th day after the 
237.7 	date the form was due falls on a Saturday, Sunday, or legal holiday, the 30-day time period 
237.8 	is extended to include the next succeeding day that is not a Saturday, Sunday, or legal 
237.9 	holiday. Assistance shall be payable retroactively from the redetermination due date. For a 
237.10 	family where at least one parent is under the age of 21, does not have a high school or 
237.11 	general equivalency diploma, and is a student in a school district or another similar program 
237.12 	that provides or arranges for child care, as well as parenting, social services, career and 
237.13 	employment supports, and academic support to achieve high school graduation, the 
237.14 	redetermination of eligibility shall be deferred beyond six months, but not to exceed 12 
237.15 	months, to the end of the student's school year. If a family reports a change in an eligibility 
237.16 	factor before the family's next regularly scheduled redetermination, the county must 
237.17 	recalculate eligibility without requiring verification of any eligibility factor that did not 
237.18 	change. Changes must be reported as required by section 256P.07. A change in income 
237.19 	occurs on the day the participant received the first payment reflecting the change in income.
237.20 	The county must mail a notice of approval or denial of assistance to the applicant within 
237.21 	30 calendar days after receiving the application. The county may extend the response time 
237.22 	by 15 calendar days if the applicant is informed of the extension.
237.23 	(c) The commissioner shall develop a redetermination form to redetermine eligibility 
237.24 	and a change report form to report changes that minimize paperwork for the county and the 
237.25 	participant.

237.26 	EFFECTIVE DATE. This section is effective October 23, 2017.

237.27 	Sec. 8. Minnesota Statutes 2016, section 119B.025, is amended by adding a subdivision 
237.28 	to read:
237.29 		Subd. 3.Redeterminations. (a) Notwithstanding Minnesota Rules, part 3400.0180, item 
237.30 	A, the county shall conduct a redetermination according to paragraphs (b) and (c).
237.31 	(b) The county shall use the redetermination form developed by the commissioner. The 
237.32 	county must verify the factors listed in subdivision 1, paragraph (a), as part of the 
237.33 	redetermination.
238.1 	(c) An applicant's eligibility must be redetermined no more frequently than every 12 
238.2 	months. The following criteria apply:
238.3 	(1) a family meets the eligibility redetermination requirements if a complete 
238.4 	redetermination form and all required verifications are received within 30 days after the 
238.5 	date the form was due;
238.6 	(2) if the 30th day after the date the form was due falls on a Saturday, Sunday, or holiday, 
238.7 	the 30-day time period is extended to include the next day that is not a Saturday, Sunday, 
238.8 	or holiday. Assistance shall be payable retroactively from the redetermination due date;
238.9 	(3) for a family where at least one parent is younger than 21 years of age, does not have 
238.10 	a high school degree or general equivalency diploma, and is a student in a school district 
238.11 	or another similar program that provides or arranges for child care, parenting, social services, 
238.12 	career and employment supports, and academic support to achieve high school graduation, 
238.13 	the redetermination of eligibility may be deferred beyond 12 months, to the end of the 
238.14 	student's school year; and
238.15 	(4) a family and the family's providers must be notified that the family's redetermination 
238.16 	is due at least 45 days before the end of the family's 12-month eligibility period.

238.17 	EFFECTIVE DATE. This section is effective October 23, 2017.

238.18 	Sec. 9. Minnesota Statutes 2016, section 119B.025, is amended by adding a subdivision 
238.19 	to read:
238.20 		Subd. 4.Changes in eligibility. (a) The county shall process a change in eligibility 
238.21 	factors according to paragraphs (b) to (g).
238.22 	(b) A family is subject to the reporting requirements in section 256P.07.
238.23 	(c) If a family reports a change or a change is known to the agency before the family's 
238.24 	regularly scheduled redetermination, the county must act on the change. The commissioner 
238.25 	shall establish standards for verifying a change.
238.26 	(d) A change in income occurs on the day the participant received the first payment 
238.27 	reflecting the change in income.
238.28 	(e) During a family's 12-month eligibility period, if the family's income increases and 
238.29 	remains at or below 85 percent of the state median income, adjusted for family size, there 
238.30 	is no change to the family's eligibility. The county shall not request verification of the 
238.31 	change. The co-payment fee shall not increase during the remaining portion of the family's 
238.32 	12-month eligibility period.
239.1 	(f) During a family's 12-month eligibility period, if the family's income increases and 
239.2 	exceeds 85 percent of the state median income, adjusted for family size, the family is not 
239.3 	eligible for child care assistance. The family must be given 15 calendar days to provide 
239.4 	verification of the change. If the required verification is not returned or confirms ineligibility, 
239.5 	the family's eligibility ends following a subsequent 15-day adverse action notice.
239.6 	(g) Notwithstanding Minnesota Rules, parts 3400.0040, subpart 3, and 3400.0170, 
239.7 	subpart 1, if an applicant or participant reports that employment ended, the agency may 
239.8 	accept a signed statement from the applicant or participant as verification that employment 
239.9 	ended.

239.10 	EFFECTIVE DATE. Paragraphs (a) and (b) are effective the day following final 
239.11 	enactment. Paragraphs (c) to (g) are effective October 23, 2017.

239.12 	Sec. 10. Minnesota Statutes 2016, section 119B.03, subdivision 3, is amended to read:
239.13 		Subd. 3.Eligible participants. Families that meet the eligibility requirements under 
239.14 	sections 119B.07,119B.09, and 119B.10, except MFIP participants, diversionary work 
239.15 	program, and transition year families are eligible for child care assistance under the basic 
239.16 	sliding fee program. Families enrolled in the basic sliding fee program shall be continued 
239.17 	until they are no longer eligible. Child care assistance provided through the child care fund 
239.18 	is considered assistance to the parent.

239.19 	EFFECTIVE DATE. This section is effective December 18, 2017.

239.20 	Sec. 11. Minnesota Statutes 2016, section 119B.05, subdivision 1, is amended to read:
239.21 		Subdivision 1.Eligible participants. Families eligible for child care assistance under 
239.22 	the MFIP child care program are:
239.23 	(1) MFIP participants who are employed or in job search and meet the requirements of 
239.24 	section 119B.10;
239.25 	(2) persons who are members of transition year families under section 119B.011, 
239.26 	subdivision 20, and meet the requirements of section 119B.10;
239.27 	(3) families who are participating in employment orientation or job search, or other 
239.28 	employment or training activities that are included in an approved employability development 
239.29 	plan under section 256J.95;
240.1 	(4) MFIP families who are participating in work job search, job support, employment, 
240.2 	or training activities as required in their employment plan, or in appeals, hearings, 
240.3 	assessments, or orientations according to chapter 256J;
240.4 	(5) MFIP families who are participating in social services activities under chapter 256J 
240.5 	as required in their employment plan approved according to chapter 256J;
240.6 	(6) families who are participating in services or activities that are included in an approved 
240.7 	family stabilization plan under section 256J.575;
240.8 	(7) families who are participating in programs as required in tribal contracts under section 
240.9 	119B.02, subdivision 2, or 256.01, subdivision 2;
240.10 	(8) families who are participating in the transition year extension under section 119B.011, 
240.11 	subdivision 20a; and
240.12 	(9) student parents as defined under section 119B.011, subdivision 19b.; and
240.13 	(10) student parents who turn 21 years of age and who continue to meet the other 
240.14 	requirements under section 119B.011, subdivision 19b. A student parent continues to be 
240.15 	eligible until the student parent is approved for basic sliding fee child care assistance or 
240.16 	until the student parent's redetermination, whichever comes first. At the student parent's 
240.17 	redetermination, if the student parent was not approved for basic sliding fee child care 
240.18 	assistance, a student parent's eligibility ends following a 15-day adverse action notice.

240.19 	EFFECTIVE DATE. This section is effective October 23, 2017.

240.20 	Sec. 12. Minnesota Statutes 2016, section 119B.09, subdivision 1, is amended to read:
240.21 		Subdivision 1.General eligibility requirements for all applicants for child care 
240.22 	assistance. (a) Child care services must be available to families who need child care to find 
240.23 	or keep employment or to obtain the training or education necessary to find employment 
240.24 	and who:
240.25 	(1) have household income less than or equal to 67 percent of the state median income, 
240.26 	adjusted for family size, at application and redetermination, and meet the requirements of 
240.27 	section 119B.05; receive MFIP assistance; and are participating in employment and training 
240.28 	services under chapter 256J; or
240.29 	(2) have household income less than or equal to 47 percent of the state median income, 
240.30 	adjusted for family size, at program entryapplication and less than or equal to 67 percent 
240.31 	of the state median income, adjusted for family size, at program exit redetermination.
240.32 	(b) Child care services must be made available as in-kind services.
241.1 	(c) All applicants for child care assistance and families currently receiving child care 
241.2 	assistance must be assisted and required to cooperate in establishment of paternity and 
241.3 	enforcement of child support obligations for all children in the family at application and 
241.4 	redetermination as a condition of program eligibility. For purposes of this section, a family 
241.5 	is considered to meet the requirement for cooperation when the family complies with the 
241.6 	requirements of section 256.741.
241.7 	(d) All applicants for child care assistance and families currently receiving child care 
241.8 	assistance must pay the co-payment fee under section 119B.12, subdivision 2, as a condition 
241.9 	of eligibility. The co-payment fee may include additional recoupment fees due to a child 
241.10 	care assistance program overpayment.

241.11 	EFFECTIVE DATE. Paragraphs (a) and (c) are effective October 23, 2017. Paragraph 
241.12 	(d) is effective the day following final enactment.

241.13 	Sec. 13. Minnesota Statutes 2016, section 119B.09, subdivision 4, is amended to read:
241.14 		Subd. 4.Eligibility; annual income; calculation. (a) Annual income of the applicant 
241.15 	family is the current monthly income of the family multiplied by 12 or the income for the 
241.16 	12-month period immediately preceding the date of application, or income calculated by 
241.17 	the method which provides the most accurate assessment of income available to the family.
241.18 	(b) Self-employment income must be calculated based on gross receipts less operating 
241.19 	expenses. Income must be recalculated when the family's income changes, but no less often 
241.20 	than every six months. For a family where at least one parent is under the age of 21, does 
241.21 	not have a high school or general equivalency diploma, and is a student in a school district 
241.22 	or another similar program that provides or arranges for child care, as well as parenting, 
241.23 	social services, career and employment supports, and academic support to achieve high 
241.24 	school graduation, income must be recalculated when the family's income changes, but 
241.25 	otherwise shall be deferred beyond six months, but not to exceed 12 months, to the end of 
241.26 	the student's school year.
241.27 	(c) Income changes are processed under section 119B.025, subdivision 4. Included lump 
241.28 	sums counted as income under section 256P.06, subdivision 3, must be annualized over 12 
241.29 	months. Income must be verified with documentary evidence. If the applicant does not have 
241.30 	sufficient evidence of income, verification must be obtained from the source of the income.

241.31 	EFFECTIVE DATE. This section is effective October 23, 2017.

242.1 	Sec. 14. Minnesota Statutes 2016, section 119B.09, subdivision 9a, is amended to read:
242.2 		Subd. 9a.Child care centers; assistance. (a) For the purposes of this subdivision, 
242.3 	"qualifying child" means a child who is not a child or dependent of an employee of the child 
242.4 	care provider. A child care center may receive authorizations for 25 or fewer children who 
242.5 	are dependents of the center's employees. If a child care center is authorized for more than 
242.6 	25 children who are dependents of center employees, the county cannot authorize additional 
242.7 	dependents of an employee until the number of children falls below 25.
242.8 	(b) Funds distributed under this chapter must not be paid for child care services that are 
242.9 	provided for a child or dependent of an employee under paragraph (a) unless at all times at 
242.10 	least 50 percent of the children for whom the child care provider is providing care are 
242.11 	qualifying children under paragraph (a).
242.12 	(c) If a child care provider satisfies the requirements for payment under paragraph (b), 
242.13 	but the percentage of qualifying children under paragraph (a) for whom the provider is 
242.14 	providing care falls below 50 percent, the provider shall have four weeks to raise the 
242.15 	percentage of qualifying children for whom the provider is providing care to at least 50 
242.16 	percent before payments to the provider are discontinued for child care services provided 
242.17 	for a child who is not a qualifying child.
242.18 	(d) This subdivision shall be implemented as follows:
242.19 	(1) no later than August 1, 2014, the commissioner shall issue a notice to providers who 
242.20 	have been identified as ineligible for funds distributed under this chapter as described in 
242.21 	paragraph (b); and
242.22 	(2) no later than January 5, 2015, payments to providers who do not comply with 
242.23 	paragraph (c) will be discontinued for child care services provided for children who are not 
242.24 	qualifying children.
242.25 	(e) If a child's authorization for child care assistance is terminated under this subdivision, 
242.26 	the county shall send a notice of adverse action to the provider and to the child's parent or 
242.27 	guardian, including information on the right to appeal, under Minnesota Rules, part 
242.28 	3400.0185.
242.29 	(f) (b) Funds paid to providers during the period of time between the issuance of a notice 
242.30 	under paragraph (d), clause (1), and discontinuation of payments under paragraph (d), clause 
242.31 	(2), when a center is authorized for more than 25 children who are dependents of center 
242.32 	employees must not be treated as overpayments under section 119B.11, subdivision 2a, due 
242.33 	to noncompliance with this subdivision.
243.1 	(g) (c) Nothing in this subdivision precludes the commissioner from conducting fraud 
243.2 	investigations relating to child care assistance, imposing sanctions, and obtaining monetary 
243.3 	recovery as otherwise provided by law.

243.4 	EFFECTIVE DATE. This section is effective April 23, 2018.

243.5 	Sec. 15. [119B.095] CHILD CARE AUTHORIZATIONS.
243.6 		Subdivision 1.General authorization requirements. (a) When authorizing the amount 
243.7 	of child care, the county agency must consider the amount of time the parent reports on the 
243.8 	application or redetermination form that the child attends preschool, a Head Start program, 
243.9 	or school while the parent is participating in an authorized activity.
243.10 	(b) Care must be authorized and scheduled with a provider based on the applicant's or 
243.11 	participant's verified activity schedule when:
243.12 	(1) the family requests care from more than one provider per child;
243.13 	(2) the family requests care from a legal nonlicensed provider; or
243.14 	(3) an applicant or participant is employed by any child care center that is licensed by 
243.15 	the Department of Human Services or has been identified as a high-risk Medicaid-enrolled 
243.16 	provider.
243.17 	(c) If the family remains eligible at redetermination, a new authorization with fewer 
243.18 	hours, the same hours, or increased hours may be determined.
243.19 		Subd. 2.Maintain steady child care authorizations. (a) Notwithstanding Minnesota 
243.20 	Rules, chapter 3400, the amount of child care authorized under section 119B.10 for 
243.21 	employment, education, or an MFIP or DWP employment plan shall continue at the same 
243.22 	number of hours or more hours until redetermination, including:
243.23 	(1) when the other parent moves in and is employed or has an education plan under 
243.24 	section 119B.10, subdivision 3, or has an MFIP or DWP employment plan; or
243.25 	(2) when the participant's work hours are reduced or a participant temporarily stops 
243.26 	working or attending an approved education program. Temporary changes include, but are 
243.27 	not limited to, a medical leave, seasonal employment fluctuations, or a school break between 
243.28 	semesters.
243.29 	(b) The county may increase the amount of child care authorized at any time if the 
243.30 	participant verifies the need for increased hours for authorized activities.
244.1 	(c) The county may reduce the amount of child care authorized if a parent requests a 
244.2 	reduction or because of a change in:
244.3 	(1) the child's school schedule;
244.4 	(2) the custody schedule; or
244.5 	(3) the provider's availability.
244.6 	(d) The amount of child care authorized for a family subject to subdivision 1, paragraph 
244.7 	(b), must change when the participant's activity schedule changes. Paragraph (a) does not 
244.8 	apply to a family subject to subdivision 1, paragraph (b).

244.9 	EFFECTIVE DATE. This section is effective December 18, 2017.

244.10 	Sec. 16. [119B.097] AUTHORIZATION WITH A SECONDARY PROVIDER.
244.11 	(a) If a child uses any combination of the following providers paid by child care 
244.12 	assistance, a parent must choose one primary provider and one secondary provider per child 
244.13 	that can be paid by child care assistance:
244.14 	(1) an individual or child care center licensed under chapter 245A;
244.15 	(2) an individual or child care center or facility holding a valid child care license issued 
244.16 	by another state or tribe; or
244.17 	(3) a child care center exempt from licensing under section 245A.03.
244.18 	(b) The amount of child care authorized with the secondary provider cannot exceed 20 
244.19 	hours per two-week service period, per child, and the amount of care paid to a child's 
244.20 	secondary provider is limited under section 119B.13, subdivision 1. The total amount of 
244.21 	child care authorized with both the primary and secondary provider cannot exceed the 
244.22 	amount of child care allowed based on the parents' eligible activity schedule, the child's 
244.23 	school schedule, and any other factors relevant to the family's child care needs.

244.24 	EFFECTIVE DATE. This section is effective April 23, 2018.

244.25 	Sec. 17. Minnesota Statutes 2016, section 119B.10, subdivision 1, is amended to read:
244.26 		Subdivision 1.Assistance for persons seeking and retaining employment. (a) Persons 
244.27 	who are seeking employment and who are eligible for assistance under this section are 
244.28 	eligible to receive up to 240 hours of child care assistance per calendar year.
244.29 	(b) At application and redetermination, employed persons who work at least an average 
244.30 	of 20 hours and full-time students who work at least an average of ten hours a week and 
245.1 	receive at least a minimum wage for all hours worked are eligible for continued child care 
245.2 	assistance for employment. For purposes of this section, work-study programs must be 
245.3 	counted as employment. An employed person with an MFIP or DWP employment plan 
245.4 	shall receive child care assistance as specified in the person's employment plan. Child care 
245.5 	assistance during employment must be authorized as provided in paragraphs (c) and (d).
245.6 	(c) When the person works for an hourly wage and the hourly wage is equal to or greater 
245.7 	than the applicable minimum wage, child care assistance shall be provided for the actual
245.8 	hours of employment, break, and mealtime during the employment and travel time up to 
245.9 	two hours per day.
245.10 	(d) When the person does not work for an hourly wage, child care assistance must be 
245.11 	provided for the lesser of:
245.12 	(1) the amount of child care determined by dividing gross earned income by the applicable 
245.13 	minimum wage, up to one hour every eight hours for meals and break time, plus up to two 
245.14 	hours per day for travel time; or
245.15 	(2) the amount of child care equal to the actual amount of child care used during 
245.16 	employment, including break and mealtime during employment, and travel time up to two 
245.17 	hours per day.

245.18 	EFFECTIVE DATE. This section is effective December 18, 2017.

245.19 	Sec. 18. Minnesota Statutes 2016, section 119B.10, is amended by adding a subdivision 
245.20 	to read:
245.21 		Subd. 3.Assistance for persons attending an approved education or training 
245.22 	program. (a) Money for an eligible person according to sections 119B.03, subdivision 3, 
245.23 	and 119B.05, subdivision 1, shall be used to reduce child care costs for a student. The county 
245.24 	shall not limit the duration of child care subsidies for a person in an employment or 
245.25 	educational program unless the person is ineligible for child care funds. Any other limitation 
245.26 	must be based on county policies included in the approved child care fund plan.
245.27 	(b) To be eligible, the student must be in good standing and be making satisfactory 
245.28 	progress toward the degree. The maximum length of time a student is eligible for child care 
245.29 	assistance under the child care fund for education and training is no more than the time 
245.30 	necessary to complete the credit requirements for an associate's or baccalaureate degree as 
245.31 	determined by the educational institution. Time limitations for child care assistance do not 
245.32 	apply to basic or remedial educational programs needed for postsecondary education or 
245.33 	employment. Basic or remedial educational programs include high school, general 
246.1 	equivalency diploma, and English as a second language programs. A program exempt from 
246.2 	this time limit must not run concurrently with a postsecondary program.
246.3 	(c) If a student meets the conditions of paragraphs (a) and (b), child care assistance must 
246.4 	be authorized for all hours of class time and credit hours, including independent study and 
246.5 	internships, and up to two hours of travel time per day. A postsecondary student shall receive 
246.6 	four hours of child care assistance per credit hour for study time and academic appointments 
246.7 	per service period.
246.8 	(d) For an MFIP or DWP participant, child care assistance must be authorized according 
246.9 	to the person's approved employment plan. If an MFIP or DWP participant receiving MFIP 
246.10 	or DWP child care assistance under this chapter moves to another county, continues to 
246.11 	participate in an authorized educational or training program, and remains eligible for MFIP 
246.12 	or DWP child care assistance, the participant must receive continued child care assistance 
246.13 	from the county responsible for the person's current employment plan under section 256G.07.
246.14 	(e) If a person with an approved education program under section 119B.03, subdivision 
246.15 	3, or 119B.05, subdivision 1, begins receiving MFIP or DWP assistance, the person continues 
246.16 	to receive child care assistance for the approved education program until the person's 
246.17 	education is included in an approved MFIP or DWP employment plan or until 
246.18 	redetermination, whichever occurs first.
246.19 	(f) If a person's MFIP or DWP assistance ends and the approved MFIP or DWP 
246.20 	employment plan included education, the person continues to be eligible for child care 
246.21 	assistance for education under transition year child care assistance until the person's education 
246.22 	is included in an approved education plan or until redetermination.

246.23 	EFFECTIVE DATE. This section is effective December 18, 2017.

246.24 	Sec. 19. [119B.105] EXTENDED ELIGIBILITY AND AUTHORIZATION.
246.25 		Subdivision 1.Three-month extended eligibility period. (a) A family in a situation 
246.26 	under paragraph (b) continues to be eligible for up to three months or until the family's 
246.27 	redetermination, whichever occurs first, rather than losing eligibility or having the family's 
246.28 	eligibility suspended. During extended eligibility, the amount of child care authorized shall 
246.29 	continue at the same number or more hours. The family must continue to meet all other 
246.30 	eligibility requirements under this chapter.
246.31 	(b) The family's three-month extended eligibility period applies when:
246.32 	(1) a participant's employment or education program ends permanently;
247.1 	(2) the other parent moves in and does not participate in an authorized activity;
247.2 	(3) a participant's MFIP assistance ends and the participant is not participating in an 
247.3 	authorized activity or the participant's participation in an authorized activity is unknown;
247.4 	(4) a student parent under section 119B.011, subdivision 19b, stops attending school; 
247.5 	or
247.6 	(5) a participant receiving basic sliding fee child care assistance or transition year child 
247.7 	care assistance applied for MFIP assistance and is not participating in an authorized activity 
247.8 	or the participant's participation in an authorized activity is unknown.
247.9 		Subd. 2.Extended eligibility and redetermination. (a) If the family received three 
247.10 	months of extended eligibility and redetermination is not due, to continue receiving child 
247.11 	care assistance the participant must be employed or have an education plan that meets the 
247.12 	requirements of section 119B.10, subdivision 3, or have an MFIP or DWP employment 
247.13 	plan. If child care assistance continues, the amount of child care authorized shall continue 
247.14 	at the same number or more hours until redetermination, unless a condition in section 
247.15 	119B.095, subdivision 2, paragraph (c), applies. A family subject to section 119B.095, 
247.16 	subdivision 1, paragraph (b), shall have child care authorized based on a verified activity 
247.17 	schedule.
247.18 	(b) If the family's redetermination occurs before the end of the three-month extended 
247.19 	eligibility period to continue receiving child care assistance, the participant must verify that 
247.20 	the participant meets eligibility and activity requirements for child care assistance under 
247.21 	this chapter. If child care assistance continues, the amount of child care authorized is based 
247.22 	on section 119B.10. A family subject to section 119B.095, subdivision 1, paragraph (b), 
247.23 	shall have child care authorized based on a verified activity schedule.

247.24 	EFFECTIVE DATE. This section is effective December 18, 2017.

247.25 	Sec. 20. Minnesota Statutes 2016, section 119B.12, subdivision 2, is amended to read:
247.26 		Subd. 2.Parent fee. A family must be assessed a parent fee for each service period. A 
247.27 	family's parent fee must be a fixed percentage of its annual gross income. Parent fees must 
247.28 	apply to families eligible for child care assistance under sections 119B.03 and 119B.05. 
247.29 	Income must be as defined in section 119B.011, subdivision 15. The fixed percentpercentage 
247.30 	is based on the relationship of the family's annual gross income to 100 percent of the annual 
247.31 	state median income. Parent fees must begin at 75 percent of the poverty level. The minimum 
247.32 	parent fees for families between 75 percent and 100 percent of poverty level must be $2 per 
247.33 	biweekly period. Parent fees must provide for graduated movement to full payment.  At 
248.1 	initial application, the parent fee is established for the family's 12-month eligibility period. 
248.2 	At redetermination, if the family remains eligible, the parent fee is recalculated and is 
248.3 	established for the next 12-month eligibility period. A parent fee shall not increase during 
248.4 	the 12-month eligibility period. Payment of part or all of a family's parent fee directly to 
248.5 	the family's child care provider on behalf of the family by a source other than the family 
248.6 	shall not affect the family's eligibility for child care assistance, and the amount paid shall 
248.7 	be excluded from the family's income. Child care providers who accept third-party payments 
248.8 	must maintain family specific documentation of payment source, amount, and time period 
248.9 	covered by the payment.

248.10 	EFFECTIVE DATE. This section is effective October 23, 2017.

248.11 	Sec. 21. Minnesota Statutes 2016, section 119B.13, subdivision 1, is amended to read:
248.12 		Subdivision 1.Subsidy restrictions. (a) Beginning February 3, 2014, the maximum 
248.13 	rate paid for child care assistance in any county or county price cluster under the child care 
248.14 	fund shall be the greater of the 25th percentile of the 2011 child care provider rate survey 
248.15 	or the maximum rate effective November 28, 2011. For a child care provider located within 
248.16 	the boundaries of a city located in two or more of the counties of Benton, Sherburne, and 
248.17 	Stearns, the maximum rate paid for child care assistance shall be equal to the maximum 
248.18 	rate paid in the county with the highest maximum reimbursement rates or the provider's 
248.19 	charge, whichever is less. The commissioner may: (1) assign a county with no reported 
248.20 	provider prices to a similar price cluster; and (2) consider county level access when 
248.21 	determining final price clusters.
248.22 	(b) A rate which includes a special needs rate paid under subdivision 3 may be in excess 
248.23 	of the maximum rate allowed under this subdivision.
248.24 	(c) The department shall monitor the effect of this paragraph on provider rates. The 
248.25 	county shall pay the provider's full charges for every child in care up to the maximum 
248.26 	established. The commissioner shall determine the maximum rate for each type of care on 
248.27 	an hourly, full-day, and weekly basis, including special needs and disability care.
248.28 	(d) If a child uses one provider, the maximum payment to a provider for one day of care 
248.29 	must not exceed the daily rate. The maximum payment to a provider for one week of care 
248.30 	must not exceed the weekly rate.
248.31 	(e) If a child uses two providers under section 119B.097, the maximum payment must 
248.32 	not exceed:
248.33 	(1) the daily rate for one day of care;
249.1 	(2) the weekly rate for one week of care by the child's primary provider; and
249.2 	(3) two daily rates during two weeks of care by a child's secondary provider.
249.3 	(d) (f) Child care providers receiving reimbursement under this chapter must not be paid 
249.4 	activity fees or an additional amount above the maximum rates for care provided during 
249.5 	nonstandard hours for families receiving assistance.
249.6 	(e) When(g) If the provider charge is greater than the maximum provider rate allowed, 
249.7 	the parent is responsible for payment of the difference in the rates in addition to any family 
249.8 	co-payment fee.
249.9 	(f) (h) All maximum provider rates changes shall be implemented on the Monday 
249.10 	following the effective date of the maximum provider rate.
249.11 	(g) (i) Notwithstanding Minnesota Rules, part 3400.0130, subpart 7, maximum 
249.12 	registration fees in effect on January 1, 2013, shall remain in effect.

249.13 	EFFECTIVE DATE. Paragraph (a) is effective July 1, 2018. Paragraphs (d) to (i) are 
249.14 	effective April 23, 2018.

249.15 	Sec. 22. Minnesota Statutes 2016, section 119B.13, subdivision 6, is amended to read:
249.16 		Subd. 6.Provider payments. (a) The provider shall bill for services provided within 
249.17 	ten days of the end of the service period. If bills are submitted within ten days of the end 
249.18 	of the service period, Payments under the child care fund shall be made within 3021 days 
249.19 	of receiving a complete bill from the provider. Counties or the state may establish policies 
249.20 	that make payments on a more frequent basis.
249.21 	(b) If a provider has received an authorization of care and been issued a billing form for 
249.22 	an eligible family, the bill must be submitted within 60 days of the last date of service on 
249.23 	the bill. A bill submitted more than 60 days after the last date of service must be paid if the 
249.24 	county determines that the provider has shown good cause why the bill was not submitted 
249.25 	within 60 days. Good cause must be defined in the county's child care fund plan under 
249.26 	section 119B.08, subdivision 3, and the definition of good cause must include county error. 
249.27 	Any bill submitted more than a year after the last date of service on the bill must not be 
249.28 	paid.
249.29 	(c) If a provider provided care for a time period without receiving an authorization of 
249.30 	care and a billing form for an eligible family, payment of child care assistance may only be 
249.31 	made retroactively for a maximum of six months from the date the provider is issued an 
249.32 	authorization of care and billing form.
250.1 	(d) A county or the commissioner may refuse to issue a child care authorization to a 
250.2 	licensed or legal nonlicensed provider, revoke an existing child care authorization to a 
250.3 	licensed or legal nonlicensed provider, stop payment issued to a licensed or legal nonlicensed 
250.4 	provider, or refuse to pay a bill submitted by a licensed or legal nonlicensed provider if:
250.5 	(1) the provider admits to intentionally giving the county materially false information 
250.6 	on the provider's billing forms;
250.7 	(2) a county or the commissioner finds by a preponderance of the evidence that the 
250.8 	provider intentionally gave the county materially false information on the provider's billing 
250.9 	forms, or provided false attendance records to a county or the commissioner;
250.10 	(3) the provider is in violation of child care assistance program rules, until the agency 
250.11 	determines those violations have been corrected;
250.12 	(4) the provider is operating after:
250.13 	(i) an order of suspension of the provider's license issued by the commissioner;
250.14 	(ii) an order of revocation of the provider's license; or
250.15 	(iii) a final order of conditional license issued by the commissioner for as long as the 
250.16 	conditional license is in effect;
250.17 	(5) the provider submits false attendance reports or refuses to provide documentation 
250.18 	of the child's attendance upon request; or
250.19 	(6) the provider gives false child care price information.
250.20 	(e) For purposes of paragraph (d), clauses (3), (5), and (6), the county or the commissioner 
250.21 	may withhold the provider's authorization or payment for a period of time not to exceed 
250.22 	three months beyond the time the condition has been corrected.
250.23 	(f) A county's payment policies must be included in the county's child care plan under 
250.24 	section 119B.08, subdivision 3. If payments are made by the state, in addition to being in 
250.25 	compliance with this subdivision, the payments must be made in compliance with section 
250.26 	16A.124.

250.27 	EFFECTIVE DATE. This section is effective September 25, 2017.

251.1 	Sec. 23. Minnesota Statutes 2016, section 245.814, is amended by adding a subdivision 
251.2 	to read:
251.3 		Subd. 5.Foster care parent liability insurance. The commissioner may use federal 
251.4 	reimbursement money earned on an expenditure for foster care parent liability insurance 
251.5 	premiums to offset the costs of the premiums.

251.6 	Sec. 24. Minnesota Statutes 2016, section 245A.50, subdivision 5, is amended to read:
251.7 		Subd. 5.Sudden unexpected infant death and abusive head trauma training. (a) 
251.8 	License holders must document that before staff persons, caregivers, and helpers assist in 
251.9 	the care of infants, they are instructed on the standards in section 245A.1435 and receive 
251.10 	training on reducing the risk of sudden unexpected infant death. In addition, license holders 
251.11 	must document that before staff persons, caregivers, and helpers assist in the care of infants 
251.12 	and children under school age, they receive training on reducing the risk of abusive head 
251.13 	trauma from shaking infants and young children. The training in this subdivision may be 
251.14 	provided as initial training under subdivision 1 or ongoing annual training under subdivision 
251.15 	7.
251.16 	(b) Sudden unexpected infant death reduction training required under this subdivision 
251.17 	must, at a minimum, address the risk factors related to sudden unexpected infant death, 
251.18 	means of reducing the risk of sudden unexpected infant death in child care, and license 
251.19 	holder communication with parents regarding reducing the risk of sudden unexpected infant 
251.20 	death.
251.21 	(c) Abusive head trauma training required under this subdivision must, at a minimum, 
251.22 	address the risk factors related to shaking infants and young children, means of reducing 
251.23 	the risk of abusive head trauma in child care, and license holder communication with parents 
251.24 	regarding reducing the risk of abusive head trauma.
251.25 	(d) Training for family and group family child care providers must be developed by the 
251.26 	commissioner in conjunction with the Minnesota Sudden Infant Death Center and approved 
251.27 	by the Minnesota Center for Professional Development. Sudden unexpected infant death 
251.28 	reduction training and abusive head trauma training may be provided in a single course of 
251.29 	no more than two hours in length.
251.30 	(e) Sudden unexpected infant death reduction training and abusive head trauma training 
251.31 	required under this subdivision must be completed in person or as allowed under subdivision 
251.32 	10, clause (1) or (2), at least once every two years. On the years when the license holder is 
251.33 	not receiving training in person or as allowed under subdivision 10, clause (1) or (2), the 
252.1 	license holder must receive sudden unexpected infant death reduction training and abusive 
252.2 	head trauma training through a video of no more than one hour in length. The video must 
252.3 	be developed or approved by the commissioner.
252.4 	(f) An individual who is related to the license holder as defined in section 245A.02, 
252.5 	subdivision 13, and who is involved only in the care of the license holder's own infant or 
252.6 	child under school age and who is not designated to be a caregiver, helper, or substitute, as 
252.7 	defined in Minnesota Rules, part 9502.0315, for the licensed program, is exempt from the 
252.8 	sudden unexpected infant death and abusive head trauma training.

252.9 	Sec. 25. Minnesota Statutes 2016, section 252.27, subdivision 2a, is amended to read:
252.10 		Subd. 2a.Contribution amount. (a) The natural or adoptive parents of a minor child, 
252.11 	including a child determined eligible for medical assistance without consideration of parental 
252.12 	income, must contribute to the cost of services used by making monthly payments on a 
252.13 	sliding scale based on income, unless the child is married or has been married, parental 
252.14 	rights have been terminated, or the child's adoption is subsidized according to chapter 259A 
252.15 	or through title IV-E of the Social Security Act. The parental contribution is a partial or full 
252.16 	payment for medical services provided for diagnostic, therapeutic, curing, treating, mitigating, 
252.17 	rehabilitation, maintenance, and personal care services as defined in United States Code, 
252.18 	title 26, section 213, needed by the child with a chronic illness or disability.
252.19 	(b) For households with adjusted gross income equal to or greater than 275 percent of 
252.20 	federal poverty guidelines, the parental contribution shall be computed by applying the 
252.21 	following schedule of rates to the adjusted gross income of the natural or adoptive parents:
252.22 	(1) if the adjusted gross income is equal to or greater than 275 percent of federal poverty 
252.23 	guidelines and less than or equal to 545 percent of federal poverty guidelines, the parental 
252.24 	contribution shall be determined using a sliding fee scale established by the commissioner 
252.25 	of human services which begins at 2.231.94 percent of adjusted gross income at 275 percent 
252.26 	of federal poverty guidelines and increases to 6.085.29 percent of adjusted gross income 
252.27 	for those with adjusted gross income up to 545 percent of federal poverty guidelines;
252.28 	(2) if the adjusted gross income is greater than 545 percent of federal poverty guidelines 
252.29 	and less than 675 percent of federal poverty guidelines, the parental contribution shall be 
252.30 	6.085.29 percent of adjusted gross income;
252.31 	(3) if the adjusted gross income is equal to or greater than 675 percent of federal poverty 
252.32 	guidelines and less than 975 percent of federal poverty guidelines, the parental contribution 
252.33 	shall be determined using a sliding fee scale established by the commissioner of human 
253.1 	services which begins at 6.085.29 percent of adjusted gross income at 675 percent of federal 
253.2 	poverty guidelines and increases to 8.17.05 percent of adjusted gross income for those with 
253.3 	adjusted gross income up to 975 percent of federal poverty guidelines; and
253.4 	(4) if the adjusted gross income is equal to or greater than 975 percent of federal poverty 
253.5 	guidelines, the parental contribution shall be 10.138.81 percent of adjusted gross income.
253.6 	If the child lives with the parent, the annual adjusted gross income is reduced by $2,400 
253.7 	prior to calculating the parental contribution. If the child resides in an institution specified 
253.8 	in section 256B.35, the parent is responsible for the personal needs allowance specified 
253.9 	under that section in addition to the parental contribution determined under this section. 
253.10 	The parental contribution is reduced by any amount required to be paid directly to the child 
253.11 	pursuant to a court order, but only if actually paid.
253.12 	(c) The household size to be used in determining the amount of contribution under 
253.13 	paragraph (b) includes natural and adoptive parents and their dependents, including the 
253.14 	child receiving services. Adjustments in the contribution amount due to annual changes in 
253.15 	the federal poverty guidelines shall be implemented on the first day of July following 
253.16 	publication of the changes.
253.17 	(d) For purposes of paragraph (b), "income" means the adjusted gross income of the 
253.18 	natural or adoptive parents determined according to the previous year's federal tax form, 
253.19 	except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds 
253.20 	have been used to purchase a home shall not be counted as income.
253.21 	(e) The contribution shall be explained in writing to the parents at the time eligibility 
253.22 	for services is being determined. The contribution shall be made on a monthly basis effective 
253.23 	with the first month in which the child receives services. Annually upon redetermination 
253.24 	or at termination of eligibility, if the contribution exceeded the cost of services provided, 
253.25 	the local agency or the state shall reimburse that excess amount to the parents, either by 
253.26 	direct reimbursement if the parent is no longer required to pay a contribution, or by a 
253.27 	reduction in or waiver of parental fees until the excess amount is exhausted. All 
253.28 	reimbursements must include a notice that the amount reimbursed may be taxable income 
253.29 	if the parent paid for the parent's fees through an employer's health care flexible spending 
253.30 	account under the Internal Revenue Code, section 125, and that the parent is responsible 
253.31 	for paying the taxes owed on the amount reimbursed.
253.32 	(f) The monthly contribution amount must be reviewed at least every 12 months; when 
253.33 	there is a change in household size; and when there is a loss of or gain in income from one 
253.34 	month to another in excess of ten percent. The local agency shall mail a written notice 30 
254.1 	days in advance of the effective date of a change in the contribution amount. A decrease in 
254.2 	the contribution amount is effective in the month that the parent verifies a reduction in 
254.3 	income or change in household size.
254.4 	(g) Parents of a minor child who do not live with each other shall each pay the 
254.5 	contribution required under paragraph (a). An amount equal to the annual court-ordered 
254.6 	child support payment actually paid on behalf of the child receiving services shall be deducted 
254.7 	from the adjusted gross income of the parent making the payment prior to calculating the 
254.8 	parental contribution under paragraph (b).
254.9 	(h) The contribution under paragraph (b) shall be increased by an additional five percent 
254.10 	if the local agency determines that insurance coverage is available but not obtained for the 
254.11 	child. For purposes of this section, "available" means the insurance is a benefit of employment 
254.12 	for a family member at an annual cost of no more than five percent of the family's annual 
254.13 	income. For purposes of this section, "insurance" means health and accident insurance 
254.14 	coverage, enrollment in a nonprofit health service plan, health maintenance organization, 
254.15 	self-insured plan, or preferred provider organization.
254.16 	Parents who have more than one child receiving services shall not be required to pay 
254.17 	more than the amount for the child with the highest expenditures. There shall be no resource 
254.18 	contribution from the parents. The parent shall not be required to pay a contribution in 
254.19 	excess of the cost of the services provided to the child, not counting payments made to 
254.20 	school districts for education-related services. Notice of an increase in fee payment must 
254.21 	be given at least 30 days before the increased fee is due.
254.22 	(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, in 
254.23 	the 12 months prior to July 1:
254.24 	(1) the parent applied for insurance for the child;
254.25 	(2) the insurer denied insurance;
254.26 	(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted a 
254.27 	complaint or appeal, in writing, to the commissioner of health or the commissioner of 
254.28 	commerce, or litigated the complaint or appeal; and
254.29 	(4) as a result of the dispute, the insurer reversed its decision and granted insurance.
254.30 	For purposes of this section, "insurance" has the meaning given in paragraph (h).
254.31 	A parent who has requested a reduction in the contribution amount under this paragraph 
254.32 	shall submit proof in the form and manner prescribed by the commissioner or county agency, 
254.33 	including, but not limited to, the insurer's denial of insurance, the written letter or complaint 
255.1 	of the parents, court documents, and the written response of the insurer approving insurance. 
255.2 	The determinations of the commissioner or county agency under this paragraph are not rules 
255.3 	subject to chapter 14.

255.4 	EFFECTIVE DATE. This section is effective July 1, 2017.

255.5 	Sec. 26. Minnesota Statutes 2016, section 256E.30, subdivision 2, is amended to read:
255.6 		Subd. 2.Allocation of money. (a) State money appropriated and community service 
255.7 	block grant money allotted to the state and all money transferred to the community service 
255.8 	block grant from other block grants shall be allocated annually to community action agencies 
255.9 	and Indian reservation governments under clauses (b) and (c), and to migrant and seasonal 
255.10 	farmworker organizations under clause (d).
255.11 	(b) The available annual money will provide base funding to all community action 
255.12 	agencies and the Indian reservations. Base funding amounts per agency are as follows: for 
255.13 	agencies with low income populations up to 3,999 1,999, $25,000; 4,000 2,000 to 23,999, 
255.14 	$50,000; and 24,000 or more, $100,000.
255.15 	(c) All remaining money of the annual money available after the base funding has been 
255.16 	determined must be allocated to each agency and reservation in proportion to the size of 
255.17 	the poverty level population in the agency's service area compared to the size of the poverty 
255.18 	level population in the state.
255.19 	(d) Allocation of money to migrant and seasonal farmworker organizations must not 
255.20 	exceed three percent of the total annual money available. Base funding allocations must be 
255.21 	made for all community action agencies and Indian reservations that received money under 
255.22 	this subdivision, in fiscal year 1984, and for community action agencies designated under 
255.23 	this section with a service area population of 35,000 or greater.

255.24 	Sec. 27. Minnesota Statutes 2016, section 256J.45, subdivision 2, is amended to read:
255.25 		Subd. 2.General information. The MFIP orientation must consist of a presentation 
255.26 	that informs caregivers of:
255.27 	(1) the necessity to obtain immediate employment;
255.28 	(2) the work incentives under MFIP, including the availability of the federal earned 
255.29 	income tax credit and the Minnesota working family tax credit;
255.30 	(3) the requirement to comply with the employment plan and other requirements of the 
255.31 	employment and training services component of MFIP, including a description of the range 
256.1 	of work and training activities that are allowable under MFIP to meet the individual needs 
256.2 	of participants;
256.3 	(4) the consequences for failing to comply with the employment plan and other program 
256.4 	requirements, and that the county agency may not impose a sanction when failure to comply 
256.5 	is due to the unavailability of child care or other circumstances where the participant has 
256.6 	good cause under subdivision 3;
256.7 	(5) the rights, responsibilities, and obligations of participants;
256.8 	(6) the types and locations of child care services available through the county agency;
256.9 	(7) the availability and the benefits of the early childhood health and developmental 
256.10 	screening under sections 121A.16 to 121A.19; 123B.02, subdivision 16; and 123B.10;
256.11 	(8) the caregiver's eligibility for transition year child care assistance under section 
256.12 	119B.05;
256.13 	(9) the availability of all health care programs, including transitional medical assistance;
256.14 	(10) the caregiver's option to choose an employment and training provider and information 
256.15 	about each provider, including but not limited to, services offered, program components, 
256.16 	job placement rates, job placement wages, and job retention rates;
256.17 	(11) the caregiver's option to request approval of an education and training plan according 
256.18 	to section 256J.53;
256.19 	(12) the work study programs available under the higher education system; and
256.20 	(13) information about the 60-month time limit exemptions under the family violence 
256.21 	waiver and referral information about shelters and programs for victims of family violence.; 
256.22 	and
256.23 	(14) information about the income exclusions under section 256P.06, subdivision 2.

256.24 	EFFECTIVE DATE. This section is effective December 1, 2018.

256.25 	Sec. 28. [256N.261] SUPPORT FOR ADOPTIVE, FOSTER, AND KINSHIP 
256.26 	FAMILIES.
256.27 		Subdivision 1.Program established. The commissioner shall design and implement a 
256.28 	coordinated program to reduce the need for placement changes or out-of-home placements 
256.29 	of children and youth in foster care, adoptive placements, and permanent physical and legal 
256.30 	custody kinship placements, and to improve the functioning and stability of these families. 
256.31 	To the extent federal funds are available, the commissioner shall provide the following 
257.1 	adoption and foster care-competent services and ensure that placements are trauma-informed 
257.2 	and child and family-centered:
257.3 	(1) a program providing information, referrals, a parent-to-parent support network, peer 
257.4 	support for youth, family activities, respite care, crisis services, educational support, and 
257.5 	mental health services for children and youth in adoption, foster care, and kinship placements 
257.6 	and adoptive, foster, and kinship families in Minnesota;
257.7 	(2) training offered statewide in Minnesota for adoptive and kinship families, and training 
257.8 	for foster families, and the professionals who serve the families, on the effects of trauma, 
257.9 	common disabilities of adopted children and children in foster care, and kinship placements, 
257.10 	and challenges in adoption, foster care, and kinship placements; and
257.11 	(3) periodic evaluation of these services to ensure program effectiveness in preserving 
257.12 	and improving the success of adoptive, foster, and kinship placements.
257.13 		Subd. 2.Definitions. (a) The definitions in this subdivision apply to this section.
257.14 	(b) "Child and family-centered" means individualized services that respond to a child's 
257.15 	or youth's strengths, interests, and current developmental stage, including social, cognitive, 
257.16 	emotional, physical, cultural, racial, and spiritual needs, and offer support to the entire 
257.17 	adoptive, foster, or kinship family.
257.18 	(c) "Trauma-informed" means care that acknowledges the effect trauma has on children 
257.19 	and the children's families; modifies services to respond to the effects of trauma; emphasizes 
257.20 	skill and strength-building rather than symptom management; and focuses on the physical 
257.21 	and psychological safety of the child and family.

257.22 	Sec. 29. Minnesota Statutes 2016, section 256P.06, subdivision 2, is amended to read:
257.23 		Subd. 2.Exempted individuals. (a) The following members of an assistance unit under 
257.24 	chapters 119B and 256J are exempt from having their earned income count towards the 
257.25 	income of an assistance unit:
257.26 	(1) children under six years old;
257.27 	(2) caregivers under 20 years of age enrolled at least half-time in school; and
257.28 	(3) minors enrolled in school full time.
257.29 	(b) The following members of an assistance unit are exempt from having their earned 
257.30 	and unearned income count towards the income of an assistance unit for 12 consecutive 
257.31 	calendar months, beginning the month following the marriage date, for benefits under chapter 
257.32 	256J if the household income does not exceed 275 percent of the federal poverty guideline:
258.1 	(1) a new spouse to a caretaker in an existing assistance unit; and
258.2 	(2) the spouse designated by a newly married couple, both of whom were already 
258.3 	members of an assistance unit under chapter 256J.
258.4 	(c) If members identified in paragraph (b) also receive assistance under section 119B.05, 
258.5 	they are exempt from having their earned and unearned income count towards the income 
258.6 	of the assistance unit if the household income prior to the exemption does not exceed 67 
258.7 	percent of the state median income for recipients for 26 consecutive biweekly periods 
258.8 	beginning the second biweekly period after the marriage date.

258.9 	EFFECTIVE DATE. This section is effective December 1, 2018.

258.10 	Sec. 30. Minnesota Statutes 2016, section 256P.07, subdivision 3, is amended to read:
258.11 		Subd. 3.Changes that must be reported. An assistance unit must report the changes 
258.12 	or anticipated changes specified in clauses (1) to (12) within ten days of the date they occur, 
258.13 	at the time of recertification of eligibility under section 256P.04, subdivisions 8 and 9, or 
258.14 	within eight calendar days of a reporting period, whichever occurs first. An assistance unit 
258.15 	must report other changes at the time of recertification of eligibility under section 256P.04, 
258.16 	subdivisions 8 and 9, or at the end of a reporting period, as applicable. When an agency 
258.17 	could have reduced or terminated assistance for one or more payment months if a delay in 
258.18 	reporting a change specified under clauses (1) to (12) had not occurred, the agency must 
258.19 	determine whether a timely notice could have been issued on the day that the change 
258.20 	occurred. When a timely notice could have been issued, each month's overpayment 
258.21 	subsequent to that notice must be considered a client error overpayment under section 
258.22 	119B.11, subdivision 2a, or 256P.08. Changes in circumstances that must be reported within 
258.23 	ten days must also be reported for the reporting period in which those changes occurred. 
258.24 	Within ten days, an assistance unit must report:
258.25 	(1) a change in earned income of $100 per month or greater with the exception of a 
258.26 	program under chapter 119B;
258.27 	(2) a change in unearned income of $50 per month or greater with the exception of a 
258.28 	program under chapter 119B;
258.29 	(3) a change in employment status and hours with the exception of a program under 
258.30 	chapter 119B;
258.31 	(4) a change in address or residence;
259.1 	(5) a change in household composition with the exception of programs under chapter 
259.2 	256I;
259.3 	(6) a receipt of a lump-sum payment with the exception of a program under chapter 
259.4 	119B;
259.5 	(7) an increase in assets if over $9,000 with the exception of programs under chapter 
259.6 	119B;
259.7 	(8) a change in citizenship or immigration status;
259.8 	(9) a change in family status with the exception of programs under chapter 256I;
259.9 	(10) a change in disability status of a unit member, with the exception of programs under 
259.10 	chapter 119B;
259.11 	(11) a new rent subsidy or a change in rent subsidy with the exception of a program 
259.12 	under chapter 119B; and
259.13 	(12) a sale, purchase, or transfer of real property with the exception of a program under 
259.14 	chapter 119B.

259.15 	EFFECTIVE DATE. This section is effective December 18, 2017.

259.16 	Sec. 31. Minnesota Statutes 2016, section 256P.07, subdivision 6, is amended to read:
259.17 		Subd. 6.Child care assistance programs-specific reporting. (a) In addition to 
259.18 	subdivision 3, an assistance unit under chapter 119B, within ten days of the change, must 
259.19 	report:
259.20 	(1) a change in a parentally responsible individual's visitation schedule or custody 
259.21 	arrangementschedule for any child receiving child care assistance program benefits; and
259.22 	(2) a change in permanent end in a parentally responsible individual's authorized activity 
259.23 	status.; and
259.24 	(3) if the unit's family's annual included income exceeds 85 percent of the state median 
259.25 	income, adjusted for family size.
259.26 	(b) An assistance unit subject to section 119B.095, subdivision 1, paragraph (b), must 
259.27 	report a change in the unit's authorized activity status.
259.28 	(c) An assistance unit must notify the county when the unit wants to reduce the number 
259.29 	of authorized hours for children in the unit.

259.30 	EFFECTIVE DATE. This section is effective December 18, 2017.

260.1 	Sec. 32. Minnesota Statutes 2016, section 260C.451, subdivision 6, is amended to read:
260.2 		Subd. 6.Reentering foster care and accessing services after 18 years of age and up 
260.3 	to 21 years of age. (a) Upon request of an individual who had been under the guardianship 
260.4 	of the commissioner and who has left foster care without being adopted, the responsible 
260.5 	social services agency which had been the commissioner's agent for purposes of the 
260.6 	guardianship shall develop with the individual a plan to increase the individual's ability to 
260.7 	live safely and independently using the plan requirements of section 260C.212, subdivision 
260.8 	1, paragraph (c), clause (12), and to assist the individual to meet one or more of the eligibility 
260.9 	criteria in subdivision 4 if the individual wants to reenter foster care. The responsible social 
260.10 	services agency shall provide foster care as required to implement the plan. The responsible 
260.11 	social services agency shall enter into a voluntary placement agreement under section 
260.12 	260C.229 with the individual if the plan includes foster care.
260.13 	(b) Individuals who had not been under the guardianship of the commissioner of human 
260.14 	services prior to 18 years of age may ask to reenter foster care after age 18 and, to the extent 
260.15 	funds are available, the responsible social services agency that had responsibility for planning 
260.16 	for the individual before discharge from foster care may shall provide foster care or other 
260.17 	services to the individual for the purpose of increasing the individual's ability to live safely 
260.18 	and independently and to meet the eligibility criteria in subdivision 3a, if the individual:
260.19 	(1) was in foster care for the six consecutive months prior to the person's 18th birthday, 
260.20 	or left foster care within six months prior to the person's 18th birthday, and was not 
260.21 	discharged home, adopted, or received into a relative's home under a transfer of permanent 
260.22 	legal and physical custody under section 260C.515, subdivision 4; or
260.23 	(2) was discharged from foster care while on runaway status after age 15.
260.24 	(c) In conjunction with a qualifying and eligible individual under paragraph (b) and 
260.25 	other appropriate persons, the responsible social services agency shall develop a specific 
260.26 	plan related to that individual's vocational, educational, social, or maturational needs and,
260.27 	to the extent funds are available, provide foster care as required to implement the plan. The 
260.28 	responsible social services agency shall enter into a voluntary placement agreement with 
260.29 	the individual if the plan includes foster care.
260.30 	(d) A child who left foster care while under guardianship of the commissioner of human 
260.31 	services retains eligibility for foster care for placement at any time prior to 21 years of age.

261.1 	Sec. 33. MINNESOTA BIRTH TO AGE EIGHT PILOT PROJECT.
 261.2 		Subdivision 1.Authorization. The commissioner of human services shall award a grant 
261.3 	to Dakota County to develop and implement pilots that will evaluate the impact of a 
261.4 	coordinated systems and service delivery approach on key developmental milestones and 
261.5 	outcomes that ultimately lead to reading proficiency by age eight within the target population. 
261.6 	The pilot program is from July 1, 2017, to June 30, 2021.
261.7 		Subd. 2.Pilot design and goals. The pilot will establish five key developmental milestone 
261.8 	markers from birth to age eight. Enrollees in the pilot will be developmentally assessed and 
261.9 	tracked by a technology solution that tracks developmental milestones along the established 
261.10 	developmental continuum. If a child's progress falls below established milestones and the 
261.11 	weighted scoring, the coordinated service system will focus on identified areas of concern, 
261.12 	mobilize appropriate supportive services, and offer services to identified children and their 
261.13 	families.
261.14 		Subd. 3.Program participants in phase 1 target population. Pilot program participants 
261.15 	must:
261.16 	(1) be enrolled in a Women's Infant & Children (WIC) program;
261.17 	(2) be participating in a family home visiting program, or nurse family practice, or 
261.18 	Healthy Families America (HFA);
261.19 	(3) be children and families qualifying for and participating in early language learners 
261.20 	(ELL) in the school district in which they reside; and
261.21 	(4) opt in and provide parental consent to participate in the pilot project.
261.22 		Subd. 4.Evaluation and report. The county or counties shall work with a third-party 
261.23 	evaluator to evaluate the effectiveness of the pilot and report to the legislative committees 
261.24 	with jurisdiction over human services policy and finance each year by February 1 with an 
261.25 	update on the progress of the pilot. The final report on the pilot is due January 1, 2022.

261.26 	Sec. 34. MINNESOTA PATHWAYS TO PROSPERITY AND WELL-BEING PILOT 
261.27 	PROJECT.
 261.28 		Subdivision 1.Authorization. The commissioner of human services may develop a 	
261.29 	pilot project that shall test an alternative financing model for the distribution of publicly 
261.30 	funded benefits. The commissioner may work with interested counties to develop the pilot 
261.31 	and determine the waivers that are necessary to implement the pilot project based on the 
261.32 	pilot design in subdivisions 2 and 3, and outcome measures in subdivision 4.
262.1 		Subd. 2.Pilot project goals. The goals of the pilot project are to:
262.2 	(1) reduce the historical separation among the state programs and systems affecting 
262.3 	families who are receiving public assistance;
262.4 	(2) eliminate, where possible, funding restrictions to allow a more comprehensive 
262.5 	approach to the needs of the families in the pilot project; and
262.6 	(3) focus on upstream, prevention-oriented supports and interventions.
262.7 		Subd. 3.Project participants. The pilot project developed by the commissioner may 
262.8 	include requirements that participants:
262.9 	(1) be 26 years of age or younger with a minimum of one child;
262.10 	(2) voluntarily agree to participate in the pilot project;
262.11 	(3) be eligible for, applying for, or receiving public benefits including but not limited 
262.12 	to housing assistance, education supports, employment supports, child care, transportation 
262.13 	supports, medical assistance, earned income tax credit, or the child care tax credit; and
262.14 	(4) be enrolled in an education program that is focused on obtaining a career that will 
262.15 	likely result in a livable wage.
262.16 		Subd. 4.Outcomes. The outcome measures for the pilot project must include:
262.17 	(1) improvement in the affordability, safety, and permanence of suitable housing;
262.18 	(2) improvement in family functioning and stability, including in the areas of behavioral 
262.19 	health, incarceration, involvement with the child welfare system, or equivalent indicators;
262.20 	(3) improvement in education readiness and outcomes for parents and children from 
262.21 	early childhood through high school, including reduction in absenteeism, preschool readiness 
262.22 	scores, third grade reading competency, graduation, GPA, and standardized test improvement;
262.23 	(4) improvement in attachment to the workforce of one or both parents, including 
262.24 	enhanced job stability; wage gains; career advancement; progress in career preparation; or 
262.25 	an equivalent combination of these or related measures; and
262.26 	(5) improvement in health care access and health outcomes for parents and children.

262.27 	Sec. 35. CHILD CARE CORRECTION ORDER POSTING GUIDELINES.
 262.28 	No later than November 1, 2017, the commissioner shall develop guidelines for posting 
262.29 	public licensing data for licensed child care programs. In developing the guidelines, the 
263.1 	commissioner shall consult with stakeholders, including licensed child care center providers, 
263.2 	family child care providers, and county agencies.

263.3 	Sec. 36.  REPEALER.
 263.4 	(a) Minnesota Statutes 2016, section 13.468, is repealed.
263.5 	(b) Minnesota Statutes 2016, section 119B.07, is repealed effective December 18, 2017.

263.6 	ARTICLE 8
263.7 	CHEMICAL AND MENTAL HEALTH SERVICES

263.8 	Section 1. Minnesota Statutes 2016, section 245.462, subdivision 9, is amended to read:
263.9 		Subd. 9.Diagnostic assessment. (a) "Diagnostic assessment" means a written summary 
263.10 	of the history, diagnosis, strengths, vulnerabilities, and general service needs of an adult 
263.11 	with a mental illness using diagnostic, interview, and other relevant mental health techniques 
263.12 	provided by a mental health professional used in developing an individual treatment plan 
263.13 	or individual community support plan. has the meaning given in Minnesota Rules, part 
263.14 	9505.0370, subpart 11, and is delivered as provided in Minnesota Rules, part 9505.0372, 
263.15 	subpart 1, items A, B, C, and E. Diagnostic assessment includes a standard, extended, or 
263.16 	brief diagnostic assessment, or an adult update.
263.17 	(b) A brief diagnostic assessment must include a face-to-face interview with the client 
263.18 	and a written evaluation of the client by a mental health professional or a clinical trainee, 
263.19 	as provided in Minnesota Rules, part 9505.0371, subpart 5, item C. The professional or 
263.20 	clinical trainee must gather initial components of a standard diagnostic assessment, including 
263.21 	the client's:
263.22 	(1) age;
263.23 	(2) description of symptoms, including reason for referral;
263.24 	(3) history of mental health treatment;
263.25 	(4) cultural influences and their impact on the client; and
263.26 	(5) mental status examination.
263.27 	(c) On the basis of the initial components, the professional or clinical trainee must draw 
263.28 	a provisional clinical hypothesis. The clinical hypothesis may be used to address the client's 
263.29 	immediate needs or presenting problem.
264.1 	(d) Treatment sessions conducted under authorization of a brief assessment may be used 
264.2 	to gather additional information necessary to complete a standard diagnostic assessment or 
264.3 	an extended diagnostic assessment.
264.4 	(e) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1), 
264.5 	unit (b), prior to completion of a client's initial diagnostic assessment, a client is eligible 
264.6 	for psychological testing as part of the diagnostic process.
264.7 	(f) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1), 
264.8 	unit (c), prior to completion of a client's initial diagnostic assessment, but in conjunction 
264.9 	with the diagnostic assessment process, a client is eligible for up to three individual or family 
264.10 	psychotherapy sessions or family psychoeducation sessions or a combination of the above 
264.11 	sessions not to exceed three sessions.
264.12 	(g) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item B, subitem (3), 
264.13 	unit (a), a brief diagnostic assessment may be used for a client's family who requires a 
264.14 	language interpreter to participate in the assessment.

264.15 	Sec. 2. [245.4662] GRANT PROGRAM; MENTAL HEALTH INNOVATION.
264.16 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
264.17 	the meanings given them.
264.18 	(b) "Community partnership" means a project involving the collaboration of two or more 
264.19 	eligible applicants.
264.20 	(c) "Eligible applicant" means an eligible county, Indian tribe, mental health service 
264.21 	provider, hospital, or community partnership. Eligible applicant does not include a 
264.22 	state-operated direct care and treatment facility or program under chapter 246.
264.23 	(d) "Intensive residential treatment services" has the meaning given in section 256B.0622, 
264.24 	subdivision 2.
264.25 	(e) "Metropolitan area" means the seven-county metropolitan area, as defined in section 
264.26 	473.121, subdivision 2.
264.27 		Subd. 2.Grants authorized. The commissioner of human services shall, in consultation 
264.28 	with stakeholders, award grants to eligible applicants to plan, establish, or operate programs 
264.29 	to improve accessibility and quality of community-based, outpatient mental health services 
264.30 	and reduce the number of clients admitted to regional treatment centers and community 
264.31 	behavioral health hospitals. The commissioner shall award half of all grant funds to eligible 
264.32 	applicants in the metropolitan area and half of all grant funds to eligible applicants outside 
265.1 	the metropolitan area. An applicant may apply for and the commissioner may award grants 
265.2 	for two-year periods. The commissioner may reallocate underspending among grantees 
265.3 	within the same grant period. The mental health innovation account is established under 
265.4 	section 246.18 for ongoing funding.
265.5 		Subd. 3.Allocation of grants. (a) An application must be on a form and contain 
265.6 	information as specified by the commissioner but at a minimum must contain:
265.7 	(1) a description of the purpose or project for which grant funds will be used;
265.8 	(2) a description of the specific problem the grant funds will address;
265.9 	(3) a letter of support from the local mental health authority;
265.10 	(4) a description of achievable objectives, a work plan, and a timeline for implementation 
265.11 	and completion of processes or projects enabled by the grant; and
265.12 	(5) a process for documenting and evaluating results of the grant.
265.13 	(b) The commissioner shall review each application to determine whether the application 
265.14 	is complete and whether the applicant and the project are eligible for a grant. In evaluating 
265.15 	applications according to paragraph (c), the commissioner shall establish criteria including, 
265.16 	but not limited to: the eligibility of the project; the applicant's thoroughness and clarity in 
265.17 	describing the problem grant funds are intended to address; a description of the applicant's 
265.18 	proposed project; a description of the population demographics and service area of the 
265.19 	proposed project; the manner in which the applicant will demonstrate the effectiveness of 
265.20 	any projects undertaken; the proposed project's longevity and demonstrated financial 
265.21 	sustainability after the initial grant period; and evidence of efficiencies and effectiveness 
265.22 	gained through collaborative efforts. The commissioner may also consider other relevant 
265.23 	factors. In evaluating applications, the commissioner may request additional information 
265.24 	regarding a proposed project, including information on project cost. An applicant's failure 
265.25 	to provide the information requested disqualifies an applicant. The commissioner shall 
265.26 	determine the number of grants awarded.
265.27 	(c) Eligible applicants may receive grants under this section for purposes including, but 
265.28 	not limited to, the following:
265.29 	(1) intensive residential treatment services providing time-limited mental health services 
265.30 	in a residential setting;
265.31 	(2) the creation of stand-alone urgent care centers for mental health and psychiatric 
265.32 	consultation services, crisis residential services, or collaboration between crisis teams and 
265.33 	critical access hospitals;
266.1 	(3) establishing new community mental health services or expanding the capacity of 
266.2 	existing services, including supportive housing; and
266.3 	(4) other innovative projects that improve options for mental health services in community 
266.4 	settings and reduce the number of clients who remain in regional treatment centers and 
266.5 	community behavioral health hospitals beyond when discharge is determined to be clinically 
266.6 	appropriate.
266.7 		Subd. 4.Report to legislature. By December 1, 2019, the commissioner of human 
266.8 	services shall deliver a report to the chairs and ranking minority members of the legislative 
266.9 	committees with jurisdiction over mental health issues on the outcomes of the projects 
266.10 	funded under this section. The report shall, at a minimum, include the amount of funding 
266.11 	awarded for each project, a description of the programs and services funded, plans for the 
266.12 	long-term sustainability of the projects, and data on outcomes for the programs and services 
266.13 	funded. Grantees must provide information and data requested by the commissioner to 
266.14 	support the development of this report.

266.15 	Sec. 3. Minnesota Statutes 2016, section 245.467, subdivision 2, is amended to read:
266.16 		Subd. 2.Diagnostic assessment. All providers of residential, acute care hospital inpatient, 
266.17 	and regional treatment centers must complete a diagnostic assessment for each of their 
266.18 	clients within five days of admission. Providers of outpatient and day treatment services 
266.19 	must complete a diagnostic assessment within five days after the adult's second visit or 
266.20 	within 30 days after intake, whichever occurs first. In cases where a diagnostic assessment 
266.21 	is available and has been completed within three years preceding admission, only an adult 
266.22 	diagnostic assessment update is necessary. An "adult diagnostic assessment update" means 
266.23 	a written summary by a mental health professional of the adult's current mental health status 
266.24 	and service needs and includes a face-to-face interview with the adult. If the adult's mental 
266.25 	health status has changed markedly since the adult's most recent diagnostic assessment, a 
266.26 	new diagnostic assessment is required. Compliance with the provisions of this subdivision 
266.27 	does not ensure eligibility for medical assistance reimbursement under chapter 256B.

266.28 	Sec. 4. Minnesota Statutes 2016, section 245.4871, is amended by adding a subdivision 
266.29 	to read:
266.30 		Subd. 11a.Diagnostic assessment. (a) "Diagnostic assessment" has the meaning given 
266.31 	in Minnesota Rules, part 9505.0370, subpart 11, and is delivered as provided in Minnesota 
266.32 	Rules, part 9505.0372, subpart 1, items A, B, C, and E. Diagnostic assessment includes a 
266.33 	standard, extended, or brief diagnostic assessment, or an adult update.
267.1 	(b) A brief diagnostic assessment must include a face-to-face interview with the client 
267.2 	and a written evaluation of the client by a mental health professional or a clinical trainee, 
267.3 	as provided in Minnesota Rules, part 9505.0371, subpart 5, item C. The professional or 
267.4 	clinical trainee must gather initial components of a standard diagnostic assessment, including 
267.5 	the client's:
267.6 	(1) age;
267.7 	(2) description of symptoms, including reason for referral;
267.8 	(3) history of mental health treatment;
267.9 	(4) cultural influences and their impact on the client; and
267.10 	(5) mental status examination.
267.11 	(c) On the basis of the brief components, the professional or clinical trainee must draw 
267.12 	a provisional clinical hypothesis. The clinical hypothesis may be used to address the client's 
267.13 	immediate needs or presenting problem.
267.14 	(d) Treatment sessions conducted under authorization of a brief assessment may be used 
267.15 	to gather additional information necessary to complete a standard diagnostic assessment or 
267.16 	an extended diagnostic assessment.
267.17 	(e) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1), 
267.18 	unit (b), prior to completion of a client's initial diagnostic assessment, a client is eligible 
267.19 	for psychological testing as part of the diagnostic process.
267.20 	(f) Notwithstanding Minnesota Rules, part 9505.0371, subpart 2, item A, subitem (1), 
267.21 	unit (c), prior to completion of a client's initial diagnostic assessment, but in conjunction 
267.22 	with the diagnostic assessment process, a client is eligible for up to three individual or family 
267.23 	psychotherapy sessions or family psychoeducation sessions or a combination of the above 
267.24 	sessions not to exceed three sessions.

267.25 	Sec. 5. Minnesota Statutes 2016, section 245.4871, is amended by adding a subdivision 
267.26 	to read:
267.27 		Subd. 18a.Functional assessment. "Functional assessment" means an assessment by 
267.28 	the case manager of the child's:
267.29 	(1) mental health symptoms as presented in the child's diagnostic assessment;
267.30 	(2) mental health needs as presented in the child's diagnostic assessment;
267.31 	(3) use of drugs and alcohol;
268.1 	(4) vocational and educational functioning;
268.2 	(5) social functioning, including the use of leisure time;
268.3 	(6) interpersonal functioning, including relationships with the child's family;
268.4 	(7) self-care and independent living capacity;
268.5 	(8) medical and dental health;
268.6 	(9) financial assistance needs;
268.7 	(10) housing and transportation needs; and
268.8 	(11) other needs and problems.

268.9 	Sec. 6. Minnesota Statutes 2016, section 245.4876, subdivision 2, is amended to read:
268.10 		Subd. 2.Diagnostic assessment. All residential treatment facilities and acute care 
268.11 	hospital inpatient treatment facilities that provide mental health services for children must 
268.12 	complete a diagnostic assessment for each of their child clients within five working days 
268.13 	of admission. Providers of outpatient and day treatment services for children must complete 
268.14 	a diagnostic assessment within five days after the child's second visit or 30 days after intake, 
268.15 	whichever occurs first. In cases where a diagnostic assessment is available and has been 
268.16 	completed within 180 days preceding admission, only updating is necessary. "Updating" 
268.17 	means a written summary by a mental health professional of the child's current mental health 
268.18 	status and service needs. If the child's mental health status has changed markedly since the 
268.19 	child's most recent diagnostic assessment, a new diagnostic assessment is required. 
268.20 	Compliance with the provisions of this subdivision does not ensure eligibility for medical 
268.21 	assistance reimbursement under chapter 256B.

268.22 	Sec. 7. Minnesota Statutes 2016, section 245.4889, subdivision 1, is amended to read:
268.23 		Subdivision 1.Establishment and authority. (a) The commissioner is authorized to 
268.24 	make grants from available appropriations to assist:
268.25 	(1) counties;
268.26 	(2) Indian tribes;
268.27 	(3) children's collaboratives under section 124D.23 or 245.493; or
268.28 	(4) mental health service providers.
268.29 	(b) The following services are eligible for grants under this section:
269.1 	(1) services to children with emotional disturbances as defined in section 245.4871, 
269.2 	subdivision 15, and their families;
269.3 	(2) transition services under section 245.4875, subdivision 8, for young adults under 
269.4 	age 21 and their families;
269.5 	(3) respite care services for children with severe emotional disturbances who are at risk 
269.6 	of out-of-home placement;
269.7 	(4) children's mental health crisis services;
269.8 	(5) mental health services for people from cultural and ethnic minorities;
269.9 	(6) children's mental health screening and follow-up diagnostic assessment and treatment;
269.10 	(7) services to promote and develop the capacity of providers to use evidence-based 
269.11 	practices in providing children's mental health services;
269.12 	(8) school-linked mental health services, including transportation for children receiving 
269.13 	school-linked mental health services when school is not in session;
269.14 	(9) building evidence-based mental health intervention capacity for children birth to age 
269.15 	five;
269.16 	(10) suicide prevention and counseling services that use text messaging statewide;
269.17 	(11) mental health first aid training;
269.18 	(12) training for parents, collaborative partners, and mental health providers on the 
269.19 	impact of adverse childhood experiences and trauma and development of an interactive 
269.20 	Web site to share information and strategies to promote resilience and prevent trauma;
269.21 	(13) transition age services to develop or expand mental health treatment and supports 
269.22 	for adolescents and young adults 26 years of age or younger;
269.23 	(14) early childhood mental health consultation;
269.24 	(15) evidence-based interventions for youth at risk of developing or experiencing a first 
269.25 	episode of psychosis, and a public awareness campaign on the signs and symptoms of 
269.26 	psychosis; and
269.27 	(16) psychiatric consultation for primary care practitioners.; and
269.28 	(17) providers to begin operations and meet program requirements when establishing a 
269.29 	new children's mental health program. These may be start-up grants.
270.1 	(c) Services under paragraph (b) must be designed to help each child to function and 
270.2 	remain with the child's family in the community and delivered consistent with the child's 
270.3 	treatment plan. Transition services to eligible young adults under this paragraph (b) must 
270.4 	be designed to foster independent living in the community.

270.5 	EFFECTIVE DATE. Clause (17) is effective the day following final enactment.

270.6 	Sec. 8. Minnesota Statutes 2016, section 245.91, subdivision 4, is amended to read:
270.7 		Subd. 4.Facility or program. "Facility" or "program" means a nonresidential or 
270.8 	residential program as defined in section 245A.02, subdivisions 10 and 14, that is required 
270.9 	to be licensed by the commissioner of human services, and any agency, facility, or program 
270.10 	that provides services or treatment for mental illness, developmental disabilities, chemical 
270.11 	dependency, or emotional disturbance that is required to be licensed, certified, or registered 
270.12 	by the commissioner of human services, health, or education; and an acute care inpatient 
270.13 	facility that provides services or treatment for mental illness, developmental disabilities, 
270.14 	chemical dependency, or emotional disturbance.

270.15 	EFFECTIVE DATE. This section is effective the day following final enactment.

270.16 	Sec. 9. Minnesota Statutes 2016, section 245.91, subdivision 6, is amended to read:
270.17 		Subd. 6.Serious injury. "Serious injury" means:
270.18 	(1) fractures;
270.19 	(2) dislocations;
270.20 	(3) evidence of internal injuries;
270.21 	(4) head injuries with loss of consciousness or potential for a closed head injury or 
270.22 	concussion without loss of consciousness requiring a medical assessment by a health care 
270.23 	professional, whether or not further medical attention was sought;
270.24 	(5) lacerations involving injuries to tendons or organs, and those for which complications 
270.25 	are present;
270.26 	(6) extensive second-degree or third-degree burns, and other burns for which 
270.27 	complications are present;
270.28 	(7) extensive second-degree or third-degree frostbite, and others for which complications 
270.29 	are present;
270.30 	(8) irreversible mobility or avulsion of teeth;
271.1 	(9) injuries to the eyeball;
271.2 	(10) ingestion of foreign substances and objects that are harmful;
271.3 	(11) near drowning;
271.4 	(12) heat exhaustion or sunstroke; and
271.5 	(13) attempted suicide; and
271.6 	(14) all other injuries and incidents considered serious after an assessment by a physician
271.7 	health care professional, including but not limited to self-injurious behavior, a medication 
271.8 	error requiring medical treatment, a suspected delay of medical treatment, a complication 
271.9 	of a previous injury, or a complication of medical treatment for an injury.

271.10 	EFFECTIVE DATE. This section is effective the day following final enactment.

271.11 	Sec. 10. Minnesota Statutes 2016, section 245.94, subdivision 1, is amended to read:
271.12 		Subdivision 1.Powers. (a) The ombudsman may prescribe the methods by which 
271.13 	complaints to the office are to be made, reviewed, and acted upon. The ombudsman may 
271.14 	not levy a complaint fee.
271.15 	(b) The ombudsman is a health oversight agency as defined in Code of Federal 
271.16 	Regulations, title 45, section 164.501. The ombudsman may access patient records according 
271.17 	to Code of Federal Regulations, title 42, section 2.53. For purposes of this paragraph, 
271.18 	"records" has the meaning given in Code of Federal Regulations, title 42, section 
271.19 	2.53(a)(1)(i).
271.20 	(c) The ombudsman may mediate or advocate on behalf of a client.
271.21 	(c) (d) The ombudsman may investigate the quality of services provided to clients and 
271.22 	determine the extent to which quality assurance mechanisms within state and county 
271.23 	government work to promote the health, safety, and welfare of clients, other than clients in 
271.24 	acute care facilities who are receiving services not paid for by public funds. The ombudsman 
271.25 	is a health oversight agency as defined in Code of Federal Regulations, title 45, section 
271.26 	164.501.
271.27 	(d) (e) At the request of a client, or upon receiving a complaint or other information 
271.28 	affording reasonable grounds to believe that the rights of a client one or more clients who 
271.29 	is may not be capable of requesting assistance have been adversely affected, the ombudsman 
271.30 	may gather information and data about and analyze, on behalf of the client, the actions of 
271.31 	an agency, facility, or program.
272.1 	(e) (f) The ombudsman may gather, on behalf of a client one or more clients, records of 
272.2 	an agency, facility, or program, or records related to clinical drug trials from the University 
272.3 	of Minnesota Department of Psychiatry, if the records relate to a matter that is within the 
272.4 	scope of the ombudsman's authority. If the records are private and the client is capable of 
272.5 	providing consent, the ombudsman shall first obtain the client's consent. The ombudsman 
272.6 	is not required to obtain consent for access to private data on clients with developmental 
272.7 	disabilities and individuals served by the Minnesota sex offender program. The ombudsman 
272.8 	may also take photographic or videographic evidence while reviewing the actions of an 
272.9 	agency, facility, or program, with the consent of the client. The ombudsman is not required 
272.10 	to obtain consent for access to private data on decedents who were receiving services for 
272.11 	mental illness, developmental disabilities, chemical dependency, or emotional disturbance. 
272.12 	All data collected, created, received, or maintained by the ombudsman are governed by 
272.13 	chapter 13 and other applicable law.
272.14 	(f) (g) Notwithstanding any law to the contrary, the ombudsman may subpoena a person 
272.15 	to appear, give testimony, or produce documents or other evidence that the ombudsman 
272.16 	considers relevant to a matter under inquiry. The ombudsman may petition the appropriate 
272.17 	court in Ramsey County to enforce the subpoena. A witness who is at a hearing or is part 
272.18 	of an investigation possesses the same privileges that a witness possesses in the courts or 
272.19 	under the law of this state. Data obtained from a person under this paragraph are private 
272.20 	data as defined in section 13.02, subdivision 12.
272.21 	(g) (h) The ombudsman may, at reasonable times in the course of conducting a review, 
272.22 	enter and view premises within the control of an agency, facility, or program.
272.23 	(h) (i) The ombudsman may attend Department of Human Services Review Board and 
272.24 	Special Review Board proceedings; proceedings regarding the transfer of clients, as defined 
272.25 	in section 246.50, subdivision 4, between institutions operated by the Department of Human 
272.26 	Services; and, subject to the consent of the affected client, other proceedings affecting the 
272.27 	rights of clients. The ombudsman is not required to obtain consent to attend meetings or 
272.28 	proceedings and have access to private data on clients with developmental disabilities and 
272.29 	individuals served by the Minnesota sex offender program.
272.30 	(i) (j) The ombudsman shall gather data of agencies, facilities, or programs classified 
272.31 	as private or confidential as defined in section 13.02, subdivisions 3 and 12, regarding 
272.32 	services provided to clients with developmental disabilities and individuals served by the 
272.33 	Minnesota sex offender program.
273.1 	(j) (k) To avoid duplication and preserve evidence, the ombudsman shall inform relevant 
273.2 	licensing or regulatory officials before undertaking a review of an action of the facility or 
273.3 	program.
273.4 	(l) The Office of Ombudsman shall provide the services of the Civil Commitment  
273.5 	Training and Resource Center.
273.6 	(k) (m) The ombudsman shall monitor the treatment of individuals participating in a 
273.7 	University of Minnesota Department of Psychiatry clinical drug trial and ensure that all 
273.8 	protections for human subjects required by federal law and the Institutional Review Board 
273.9 	are provided.
273.10 	(l) (n) Sections 245.91 to 245.97 are in addition to other provisions of law under which 
273.11 	any other remedy or right is provided.

273.12 	EFFECTIVE DATE. This section is effective the day following final enactment.

273.13 	Sec. 11. Minnesota Statutes 2016, section 245.97, subdivision 6, is amended to read:
273.14 		Subd. 6.Terms, compensation, and removal. The membership terms, compensation, 
273.15 	and removal of members of the committee and the filling of membership vacancies are 
273.16 	governed by section 15.0575 15.0597.

273.17 	EFFECTIVE DATE. This section is effective the day following final enactment.

273.18 	Sec. 12. Minnesota Statutes 2016, section 245A.03, subdivision 2, is amended to read:
273.19 		Subd. 2.Exclusion from licensure. (a) This chapter does not apply to:
273.20 	(1) residential or nonresidential programs that are provided to a person by an individual 
273.21 	who is related unless the residential program is a child foster care placement made by a 
273.22 	local social services agency or a licensed child-placing agency, except as provided in 
273.23 	subdivision 2a;
273.24 	(2) nonresidential programs that are provided by an unrelated individual to persons from 
273.25 	a single related family;
273.26 	(3) residential or nonresidential programs that are provided to adults who do not abuse 
273.27 	chemicals or who do not have a chemical dependency misuse substances or have a substance 
273.28 	use disorder, a mental illness, a developmental disability, a functional impairment, or a 
273.29 	physical disability;
273.30 	(4) sheltered workshops or work activity programs that are certified by the commissioner 
273.31 	of employment and economic development;
274.1 	(5) programs operated by a public school for children 33 months or older;
274.2 	(6) nonresidential programs primarily for children that provide care or supervision for 
274.3 	periods of less than three hours a day while the child's parent or legal guardian is in the 
274.4 	same building as the nonresidential program or present within another building that is 
274.5 	directly contiguous to the building in which the nonresidential program is located;
274.6 	(7) nursing homes or hospitals licensed by the commissioner of health except as specified 
274.7 	under section 245A.02;
274.8 	(8) board and lodge facilities licensed by the commissioner of health that do not provide 
274.9 	children's residential services under Minnesota Rules, chapter 2960, mental health or chemical 
274.10 	dependency treatment;
274.11 	(9) homes providing programs for persons placed by a county or a licensed agency for 
274.12 	legal adoption, unless the adoption is not completed within two years;
274.13 	(10) programs licensed by the commissioner of corrections;
274.14 	(11) recreation programs for children or adults that are operated or approved by a park 
274.15 	and recreation board whose primary purpose is to provide social and recreational activities;
274.16 	(12) programs operated by a school as defined in section 120A.22, subdivision 4; YMCA 
274.17 	as defined in section 315.44; YWCA as defined in section 315.44; or JCC as defined in 
274.18 	section 315.51, whose primary purpose is to provide child care or services to school-age 
274.19 	children;
274.20 	(13) Head Start nonresidential programs which operate for less than 45 days in each 
274.21 	calendar year;
274.22 	(14) noncertified boarding care homes unless they provide services for five or more 
274.23 	persons whose primary diagnosis is mental illness or a developmental disability;
274.24 	(15) programs for children such as scouting, boys clubs, girls clubs, and sports and art 
274.25 	programs, and nonresidential programs for children provided for a cumulative total of less 
274.26 	than 30 days in any 12-month period;
274.27 	(16) residential programs for persons with mental illness, that are located in hospitals;
274.28 	(17) the religious instruction of school-age children; Sabbath or Sunday schools; or the 
274.29 	congregate care of children by a church, congregation, or religious society during the period 
274.30 	used by the church, congregation, or religious society for its regular worship;
274.31 	(18) camps licensed by the commissioner of health under Minnesota Rules, chapter 
274.32 	4630;
275.1 	(19) mental health outpatient services for adults with mental illness or children with 
275.2 	emotional disturbance;
275.3 	(20) residential programs serving school-age children whose sole purpose is cultural or 
275.4 	educational exchange, until the commissioner adopts appropriate rules;
275.5 	(21) community support services programs as defined in section 245.462, subdivision 
275.6 	6, and family community support services as defined in section 245.4871, subdivision 17;
275.7 	(22) the placement of a child by a birth parent or legal guardian in a preadoptive home 
275.8 	for purposes of adoption as authorized by section 259.47;
275.9 	(23) settings registered under chapter 144D which provide home care services licensed 
275.10 	by the commissioner of health to fewer than seven adults;
275.11 	(24) chemical dependency or substance abuse use disorder treatment activities of licensed 
275.12 	professionals in private practice as defined in Minnesota Rules, part 9530.6405, subpart 15, 
275.13 	when the treatment activities are not paid for by the consolidated chemical dependency 
275.14 	treatment fund section 245G.01, subdivision 17;
275.15 	(25) consumer-directed community support service funded under the Medicaid waiver 
275.16 	for persons with developmental disabilities when the individual who provided the service 
275.17 	is:
275.18 	(i) the same individual who is the direct payee of these specific waiver funds or paid by 
275.19 	a fiscal agent, fiscal intermediary, or employer of record; and
275.20 	(ii) not otherwise under the control of a residential or nonresidential program that is 
275.21 	required to be licensed under this chapter when providing the service;
275.22 	(26) a program serving only children who are age 33 months or older, that is operated 
275.23 	by a nonpublic school, for no more than four hours per day per child, with no more than 20 
275.24 	children at any one time, and that is accredited by:
275.25 	(i) an accrediting agency that is formally recognized by the commissioner of education 
275.26 	as a nonpublic school accrediting organization; or
275.27 	(ii) an accrediting agency that requires background studies and that receives and 
275.28 	investigates complaints about the services provided.
275.29 	A program that asserts its exemption from licensure under item (ii) shall, upon request 
275.30 	from the commissioner, provide the commissioner with documentation from the accrediting 
275.31 	agency that verifies: that the accreditation is current; that the accrediting agency investigates 
276.1 	complaints about services; and that the accrediting agency's standards require background 
276.2 	studies on all people providing direct contact services; or
276.3 	(27) a program operated by a nonprofit organization incorporated in Minnesota or another 
276.4 	state that serves youth in kindergarten through grade 12; provides structured, supervised 
276.5 	youth development activities; and has learning opportunities take place before or after 
276.6 	school, on weekends, or during the summer or other seasonal breaks in the school calendar. 
276.7 	A program exempt under this clause is not eligible for child care assistance under chapter 
276.8 	119B. A program exempt under this clause must:
276.9 	(i) have a director or supervisor on site who is responsible for overseeing written policies 
276.10 	relating to the management and control of the daily activities of the program, ensuring the 
276.11 	health and safety of program participants, and supervising staff and volunteers;
276.12 	(ii) have obtained written consent from a parent or legal guardian for each youth 
276.13 	participating in activities at the site; and
276.14 	(iii) have provided written notice to a parent or legal guardian for each youth at the site 
276.15 	that the program is not licensed or supervised by the state of Minnesota and is not eligible 
276.16 	to receive child care assistance payments.;
276.17 	(28) a county that is an eligible vendor under section 254B.05 to provide care coordination 
276.18 	and comprehensive assessment services; or
276.19 	(29) a recovery community organization that is an eligible vendor under section 254B.05 
276.20 	to provide peer recovery support services.
276.21 	(b) For purposes of paragraph (a), clause (6), a building is directly contiguous to a 
276.22 	building in which a nonresidential program is located if it shares a common wall with the 
276.23 	building in which the nonresidential program is located or is attached to that building by 
276.24 	skyway, tunnel, atrium, or common roof.
276.25 	(c) Except for the home and community-based services identified in section 245D.03, 
276.26 	subdivision 1, nothing in this chapter shall be construed to require licensure for any services 
276.27 	provided and funded according to an approved federal waiver plan where licensure is 
276.28 	specifically identified as not being a condition for the services and funding.

276.29 	EFFECTIVE DATE. This section is effective January 1, 2018.

276.30 	Sec. 13. Minnesota Statutes 2016, section 245A.191, is amended to read:
276.31 	245A.191 PROVIDER ELIGIBILITY FOR PAYMENTS FROM THE CHEMICAL 
276.32 	DEPENDENCY CONSOLIDATED TREATMENT FUND.
277.1 	(a) When a chemical dependency substance use disorder treatment provider licensed 
277.2 	under this chapter, and governed by the standards of chapter 245G or Minnesota Rules, 
277.3 	parts 2960.0430 to 2960.0490or 9530.6405 to 9530.6505, agrees to meet the applicable 
277.4 	requirements under section 254B.05, subdivision 5, paragraphs (b), clauses (1) to (4) and 
277.5 	(6), (c), and (e), to be eligible for enhanced funding from the chemical dependency 
277.6 	consolidated treatment fund, the applicable requirements under section 254B.05 are also 
277.7 	licensing requirements that may be monitored for compliance through licensing investigations 
277.8 	and licensing inspections.
277.9 	(b) Noncompliance with the requirements identified under paragraph (a) may result in:
277.10 	(1) a correction order or a conditional license under section 245A.06, or sanctions under 
277.11 	section 245A.07;
277.12 	(2) nonpayment of claims submitted by the license holder for public program 
277.13 	reimbursement;
277.14 	(3) recovery of payments made for the service;
277.15 	(4) disenrollment in the public payment program; or
277.16 	(5) other administrative, civil, or criminal penalties as provided by law.

277.17 	EFFECTIVE DATE. This section is effective January 1, 2018.

277.18 	Sec. 14. [245G.01] DEFINITIONS.
277.19 		Subdivision 1.Scope. The terms used in this chapter have the meanings given them.
277.20 		Subd. 2.Administration of medication. "Administration of medication" means providing 
277.21 	a medication to a client, and includes the following tasks, performed in the following order:
277.22 	(1) checking the client's medication record;
277.23 	(2) preparing the medication for administration;
277.24 	(3) administering the medication to the client;
277.25 	(4) documenting the administration of the medication, or the reason for not administering 
277.26 	a medication as prescribed; and
277.27 	(5) reporting information to a licensed practitioner or a nurse regarding a problem with 
277.28 	the administration of medication or the client's refusal to take the medication, if applicable.
277.29 		Subd. 3.Adolescent. "Adolescent" means an individual under 18 years of age.
278.1 		Subd. 4.Alcohol and drug counselor. "Alcohol and drug counselor" has the meaning 
278.2 	given in section 148F.01, subdivision 5.
278.3 		Subd. 5.Applicant. "Applicant" has the meaning given in section 245A.02, subdivision 
278.4 	3.
278.5 		Subd. 6.Capacity management system. "Capacity management system" means a 
278.6 	database maintained by the department to compile and make information available to the 
278.7 	public about the waiting list status and current admission capability of each opioid treatment 
278.8 	program.
278.9 		Subd. 7.Central registry. "Central registry" means a database maintained by the 
278.10 	department to collect identifying information from two or more programs about an individual 
278.11 	applying for maintenance treatment or detoxification treatment for opioid addiction to 
278.12 	prevent an individual's concurrent enrollment in more than one program.
278.13 		Subd. 8.Client. "Client" means an individual accepted by a license holder for assessment 
278.14 	or treatment of a substance use disorder. An individual remains a client until the license 
278.15 	holder no longer provides or intends to provide the individual with treatment service.
278.16 		Subd. 9.Commissioner. "Commissioner" means the commissioner of human services.
278.17 		Subd. 10.Co-occurring disorders. "Co-occurring disorders" means a diagnosis of both 
278.18 	a substance use disorder and a mental health disorder.
278.19 		Subd. 11.Department. "Department" means the Department of Human Services.
278.20 		Subd. 12.Direct contact. "Direct contact" has the meaning given for "direct contact" 
278.21 	in section 245C.02, subdivision 11.
278.22 		Subd. 13.Face-to-face. "Face-to-face" means two-way, real-time, interactive and visual 
278.23 	communication between a client and a treatment service provider and includes services 
278.24 	delivered in person or via telemedicine.
278.25 		Subd. 14.License. "License" has the meaning given in section 245A.02, subdivision 8.
278.26 		Subd. 15.License holder. "License holder" has the meaning given in section 245A.02, 
278.27 	subdivision 9.
278.28 		Subd. 16.Licensed practitioner. "Licensed practitioner" means an individual who is 
278.29 	authorized to prescribe medication as defined in section 151.01, subdivision 23.
278.30 		Subd. 17.Licensed professional in private practice. "Licensed professional in private 
278.31 	practice" means an individual who:
279.1 	(1) is licensed under chapter 148F, or is exempt from licensure under that chapter but 
279.2 	is otherwise licensed to provide alcohol and drug counseling services;
279.3 	(2) practices solely within the permissible scope of the individual's license as defined 
279.4 	in the law authorizing licensure; and
279.5 	(3) does not affiliate with other licensed or unlicensed professionals to provide alcohol 
279.6 	and drug counseling services. Affiliation does not include conferring with another 
279.7 	professional or making a client referral.
279.8 		Subd. 18.Nurse. "Nurse" means an individual licensed and currently registered to 
279.9 	practice professional or practical nursing as defined in section 148.171, subdivisions 14 and 
279.10 	15.
279.11 		Subd. 19.Opioid treatment program or OTP. "Opioid treatment program" or "OTP" 
279.12 	means a program or practitioner engaged in opioid treatment of an individual that provides 
279.13 	dispensing of an opioid agonist treatment medication, along with a comprehensive range 
279.14 	of medical and rehabilitative services, when clinically necessary, to an individual to alleviate 
279.15 	the adverse medical, psychological, or physical effects of an opioid addiction. OTP includes 
279.16 	detoxification treatment, short-term detoxification treatment, long-term detoxification 
279.17 	treatment, maintenance treatment, comprehensive maintenance treatment, and interim 
279.18 	maintenance treatment.
279.19 		Subd. 20.Paraprofessional. "Paraprofessional" means an employee, agent, or 
279.20 	independent contractor of the license holder who performs tasks to support treatment service. 
279.21 	A paraprofessional may be referred to by a variety of titles including but not limited to 
279.22 	technician, case aide, or counselor assistant. If currently a client of the license holder, the 
279.23 	client cannot be a paraprofessional for the license holder.
279.24 		Subd. 21.Student intern. "Student intern" means an individual who is authorized by a 
279.25 	licensing board to provide services under supervision of a licensed professional.
279.26 		Subd. 22.Substance. "Substance" means alcohol, solvents, controlled substances as 
279.27 	defined in section 152.01, subdivision 4, and other mood-altering substances.
279.28 		Subd. 23.Substance use disorder. "Substance use disorder" has the meaning given in 
279.29 	the current Diagnostic and Statistical Manual of Mental Disorders.
279.30 		Subd. 24.Substance use disorder treatment. "Substance use disorder treatment" means 
279.31 	treatment of a substance use disorder, including the process of assessment of a client's needs, 
279.32 	development of planned methods, including interventions or services to address a client's 
279.33 	needs, provision of services, facilitation of services provided by other service providers, 
280.1 	and ongoing reassessment by a qualified professional when indicated. The goal of substance 
280.2 	use disorder treatment is to assist or support the client's efforts to recover from a substance 
280.3 	use disorder.
280.4 		Subd. 25.Target population. "Target population" means individuals with a substance 
280.5 	use disorder and the specified characteristics that a license holder proposes to serve.
280.6 		Subd. 26.Telemedicine. "Telemedicine" means the delivery of a substance use disorder 
280.7 	treatment service while the client is at an originating site and the licensed health care provider 
280.8 	is at a distant site as specified in section 254B.05, subdivision 5, paragraph (f).
280.9 		Subd. 27.Treatment director. "Treatment director" means an individual who meets 
280.10 	the qualifications specified in section 245G.11, subdivisions 1 and 3, and is designated by 
280.11 	the license holder to be responsible for all aspects of the delivery of treatment service.

280.12 	EFFECTIVE DATE. This section is effective January 1, 2018.

280.13 	Sec. 15. [245G.02] APPLICABILITY.
280.14 		Subdivision 1.Applicability. Except as provided in subdivisions 2 and 3, no person, 
280.15 	corporation, partnership, voluntary association, controlling individual, or other organization 
280.16 	may provide a substance use disorder treatment service to an individual with a substance 
280.17 	use disorder unless licensed by the commissioner.
280.18 		Subd. 2.Exemption from license requirement. This chapter does not apply to a county 
280.19 	or recovery community organization that is providing a service for which the county or 
280.20 	recovery community organization is an eligible vendor under section 254B.05. This chapter 
280.21 	does not apply to an organization whose primary functions are information, referral, 
280.22 	diagnosis, case management, and assessment for the purposes of client placement, education, 
280.23 	support group services, or self-help programs.  This chapter does not apply to the activities 
280.24 	of a licensed professional in private practice.
280.25 		Subd. 3.Excluded hospitals. This chapter does not apply to substance use disorder 
280.26 	treatment provided by a hospital licensed under chapter 62J, or under sections 144.50 to 
280.27 	144.56, unless the hospital accepts funds for substance use disorder treatment from the 
280.28 	consolidated chemical dependency treatment fund under chapter 254B, medical assistance 
280.29 	under chapter 256B, or MinnesotaCare or health care cost containment under chapter 256L, 
280.30 	or general assistance medical care formerly codified in chapter 256D.
281.1 		Subd. 4.Applicability of Minnesota Rules, chapter 2960. A residential adolescent 
281.2 	substance use disorder treatment program serving an individual younger than 16 years of 
281.3 	age must be licensed according to Minnesota Rules, chapter 2960.

281.4 	EFFECTIVE DATE. This section is effective January 1, 2018.

281.5 	Sec. 16. [245G.03] LICENSING REQUIREMENTS.
281.6 		Subdivision 1.License requirements. (a) An applicant for a license to provide substance 
281.7 	use disorder treatment must comply with the general requirements in chapters 245A and 
281.8 	245C, sections 626.556 and 626.557, and Minnesota Rules, chapter 9544.
281.9 	(b) The commissioner may grant variances to the requirements in this chapter that do 
281.10 	not affect the client's health or safety if the conditions in section 245A.04, subdivision 9, 
281.11 	are met.
281.12 		Subd. 2.Application. Before the commissioner issues a license, an applicant must 
281.13 	submit, on forms provided by the commissioner, any documents the commissioner requires.
281.14 		Subd. 3.Change in license terms. (a) The commissioner must determine whether a 
281.15 	new license is needed when a change in clauses (1) to (4) occurs. A license holder must 
281.16 	notify the commissioner before a change in one of the following occurs:
281.17 	(1) the Department of Health's licensure of the program;
281.18 	(2) whether the license holder provides services specified in sections 245G.18 to 245G.22;
281.19 	(3) location; or
281.20 	(4) capacity if the license holder meets the requirements of section 245G.21.
281.21 	(b) A license holder must notify the commissioner and must apply for a new license if 
281.22 	there is a change in program ownership.

281.23 	EFFECTIVE DATE. This section is effective January 1, 2018.

281.24 	Sec. 17. [245G.04] INITIAL SERVICES PLAN.
281.25 	(a) The license holder must complete an initial services plan on the day of service 
281.26 	initiation. The plan must address the client's immediate health and safety concerns, identify 
281.27 	the needs to be addressed in the first treatment session, and make treatment suggestions for 
281.28 	the client during the time between intake and completion of the individual treatment plan.
281.29 	(b) The initial services plan must include a determination of whether a client is a 
281.30 	vulnerable adult as defined in section 626.5572, subdivision 21. An adult client of a 
282.1 	residential program is a vulnerable adult. An individual abuse prevention plan, according 
282.2 	to sections 245A.65, subdivision 2, paragraph (b), and 626.557, subdivision 14, paragraph 
282.3 	(b), is required for a client who meets the definition of vulnerable adult.

282.4 	EFFECTIVE DATE. This section is effective January 1, 2018.

282.5 	Sec. 18. [245G.05] COMPREHENSIVE ASSESSMENT AND ASSESSMENT 
282.6 	SUMMARY.
282.7 		Subdivision 1.Comprehensive assessment. (a) A comprehensive assessment of the 
282.8 	client's substance use disorder must be administered face-to-face by an alcohol and drug 
282.9 	counselor within three calendar days after service initiation for a residential program or 
282.10 	during the initial session for all other programs. If the comprehensive assessment is not 
282.11 	completed during the initial session, the client-centered reason for the delay must be 
282.12 	documented in the client's file and the planned completion date. If the client received a 
282.13 	comprehensive assessment that authorized the treatment service, an alcohol and drug 
282.14 	counselor must review the assessment to determine compliance with this subdivision, 
282.15 	including applicable timelines. If available, the alcohol and drug counselor may use current 
282.16 	information provided by a referring agency or other source as a supplement. Information 
282.17 	gathered more than 45 days before the date of admission is not considered current. The 
282.18 	comprehensive assessment must include sufficient information to complete the assessment 
282.19 	summary according to subdivision 2 and the individual treatment plan according to section 
282.20 	245G.06. The comprehensive assessment must include information about the client's needs 
282.21 	that relate to substance use and personal strengths that support recovery, including:
282.22 	(1) age, sex, cultural background, sexual orientation, living situation, economic status, 
282.23 	and level of education;
282.24 	(2) circumstances of service initiation;
282.25 	(3) previous attempts at treatment for substance misuse or substance use disorder, 
282.26 	compulsive gambling, or mental illness;
282.27 	(4) substance use history including amounts and types of substances used, frequency 
282.28 	and duration of use, periods of abstinence, and circumstances of relapse, if any. For each 
282.29 	substance used within the previous 30 days, the information must include the date of the 
282.30 	most recent use and previous withdrawal symptoms;
282.31 	(5) specific problem behaviors exhibited by the client when under the influence of 
282.32 	substances;
283.1 	(6) family status, family history, including history or presence of physical or sexual 
283.2 	abuse, level of family support, and substance misuse or substance use disorder of a family 
283.3 	member or significant other;
283.4 	(7) physical concerns or diagnoses, the severity of the concerns, and whether the concerns 
283.5 	are being addressed by a health care professional;
283.6 	(8) mental health history and psychiatric status, including symptoms, disability, current 
283.7 	treatment supports, and psychotropic medication needed to maintain stability; the assessment 
283.8 	must utilize screening tools approved by the commissioner pursuant to section 245.4863 to 
283.9 	identify whether the client screens positive for co-occurring disorders;
283.10 	(9) arrests and legal interventions related to substance use;
283.11 	(10) ability to function appropriately in work and educational settings;
283.12 	(11) ability to understand written treatment materials, including rules and the client's 
283.13 	rights;
283.14 	(12) risk-taking behavior, including behavior that puts the client at risk of exposure to 
283.15 	blood-borne or sexually transmitted diseases;
283.16 	(13) social network in relation to expected support for recovery and leisure time activities 
283.17 	that are associated with substance use;
283.18 	(14) whether the client is pregnant and, if so, the health of the unborn child and the 
283.19 	client's current involvement in prenatal care;
283.20 	(15) whether the client recognizes problems related to substance use and is willing to 
283.21 	follow treatment recommendations; and
283.22 	(16) collateral information. If the assessor gathered sufficient information from the 
283.23 	referral source or the client to apply the criteria in parts 9530.6620 and 9530.6622, a collateral 
283.24 	contact is not required.
283.25 	(b) If the client is identified as having opioid use disorder or seeking treatment for opioid 
283.26 	use disorder, the program must provide educational information to the client concerning:
283.27 	(1) risks for opioid use disorder and dependence;
283.28 	(2) treatment options, including the use of a medication for opioid use disorder;
283.29 	(3) the risk of and recognizing opioid overdose; and
283.30 	(4) the use, availability, and administration of naloxone to respond to opioid overdose.
284.1 	(c) The commissioner shall develop educational materials that are supported by research 
284.2 	and updated periodically. The license holder must use the educational materials that are 
284.3 	approved by the commissioner to comply with this requirement.
284.4 	(d) If the comprehensive assessment is completed to authorize treatment service for the 
284.5 	client, at the earliest opportunity during the assessment interview the assessor shall determine 
284.6 	if:
284.7 	(1) the client is in severe withdrawal and likely to be a danger to self or others;
284.8 	(2) the client has severe medical problems that require immediate attention; or
284.9 	(3) the client has severe emotional or behavioral symptoms that place the client or others 
284.10 	at risk of harm.
284.11 	If one or more of the conditions in clauses (1) to (3) are present, the assessor must end the 
284.12 	assessment interview and follow the procedures in the program's medical services plan 
284.13 	under section 245G.08, subdivision 2, to help the client obtain the appropriate services. The 
284.14 	assessment interview may resume when the condition is resolved.
284.15 		Subd. 2.Assessment summary. (a) An alcohol and drug counselor must complete an 
284.16 	assessment summary within three calendar days after service initiation for a residential 
284.17 	program and within three sessions for all other programs. If the comprehensive assessment 
284.18 	is used to authorize the treatment service, the alcohol and drug counselor must prepare an 
284.19 	assessment summary on the same date the comprehensive assessment is completed. If the 
284.20 	comprehensive assessment and assessment summary are to authorize treatment services, 
284.21 	the assessor must determine appropriate services for the client using the dimensions in 
284.22 	Minnesota Rules, part 9530.6622, and document the recommendations.
284.23 	(b) An assessment summary must include:
284.24 	(1) a risk description according to section 245G.05 for each dimension listed in paragraph 
284.25 	(c);
284.26 	(2) a narrative summary supporting the risk descriptions; and
284.27 	(3) a determination of whether the client has a substance use disorder.
284.28 	(c) An assessment summary must contain information relevant to treatment service 
284.29 	planning and recorded in the dimensions in clauses (1) to (6). The license holder must 
284.30 	consider:
284.31 	(1) Dimension 1, acute intoxication/withdrawal potential; the client's ability to cope with 
284.32 	withdrawal symptoms and current state of intoxication;
285.1 	(2) Dimension 2, biomedical conditions and complications; the degree to which any 
285.2 	physical disorder of the client would interfere with treatment for substance use, and the 
285.3 	client's ability to tolerate any related discomfort. The license holder must determine the 
285.4 	impact of continued chemical use on the unborn child, if the client is pregnant;
285.5 	(3) Dimension 3, emotional, behavioral, and cognitive conditions and complications; 
285.6 	the degree to which any condition or complication is likely to interfere with treatment for 
285.7 	substance use or with functioning in significant life areas and the likelihood of harm to self 
285.8 	or others;
285.9 	(4) Dimension 4, readiness for change; the support necessary to keep the client involved 
285.10 	in treatment service;
285.11 	(5) Dimension 5, relapse, continued use, and continued problem potential; the degree 
285.12 	to which the client recognizes relapse issues and has the skills to prevent relapse of either 
285.13 	substance use or mental health problems; and
285.14 	(6) Dimension 6, recovery environment; whether the areas of the client's life are 
285.15 	supportive of or antagonistic to treatment participation and recovery.

285.16 	EFFECTIVE DATE. This section is effective January 1, 2018.

285.17 	Sec. 19. [245G.06] INDIVIDUAL TREATMENT PLAN.
285.18 		Subdivision 1.General. Each client must have an individual treatment plan developed 
285.19 	by an alcohol and drug counselor within seven days of service initiation for a residential 
285.20 	program and within three sessions for all other programs. The client must have active, direct 
285.21 	involvement in selecting the anticipated outcomes of the treatment process and developing 
285.22 	the treatment plan. The individual treatment plan must be signed by the client and the alcohol 
285.23 	and drug counselor and document the client's involvement in the development of the plan. 
285.24 	The plan may be a continuation of the initial services plan required in section 245G.04. 
285.25 	Treatment planning must include ongoing assessment of client needs. An individual treatment 
285.26 	plan must be updated based on new information gathered about the client's condition and 
285.27 	on whether methods identified have the intended effect. A change to the plan must be signed 
285.28 	by the client and the alcohol and drug counselor. The plan must provide for the involvement 
285.29 	of the client's family and people selected by the client as important to the success of treatment 
285.30 	at the earliest opportunity, consistent with the client's treatment needs and written consent.
285.31 		Subd. 2.Plan contents. An individual treatment plan must be recorded in the six 
285.32 	dimensions listed in section 245G.05, subdivision 2, paragraph (c), must address each issue 
286.1 	identified in the assessment summary, prioritized according to the client's needs and focus, 
286.2 	and must include:
286.3 	(1) specific methods to address each identified need, including amount, frequency, and 
286.4 	anticipated duration of treatment service. The methods must be appropriate to the client's 
286.5 	language, reading skills, cultural background, and strengths;
286.6 	(2) resources to refer the client to when the client's needs are to be addressed concurrently 
286.7 	by another provider; and
286.8 	(3) goals the client must reach to complete treatment and terminate services.
286.9 		Subd. 3.Documentation of treatment services; treatment plan review. (a) A review 
286.10 	of all treatment services must be documented weekly and include a review of:
286.11 	(1) care coordination activities;
286.12 	(2) medical and other appointments the client attended;
286.13 	(3) issues related to medications that are not documented in the medication administration 
286.14 	record; and
286.15 	(4) issues related to attendance for treatment services, including the reason for any client 
286.16 	absence from a treatment service.
286.17 	(b) A note must be entered immediately following any significant event. A significant 
286.18 	event is an event that impacts the client's relationship with other clients, staff, the client's 
286.19 	family, or the client's treatment plan.
286.20 	(c) A treatment plan review must be entered in a client's file weekly or after each treatment 
286.21 	service, whichever is less frequent, by the staff member providing the service. The review 
286.22 	must indicate the span of time covered by the review and each of the six dimensions listed 
286.23 	in section 245G.05, subdivision 2, paragraph (c). The review must:
286.24 	(1) indicate the date, type, and amount of each treatment service provided and the client's 
286.25 	response to each service;
286.26 	(2) address each goal in the treatment plan and whether the methods to address the goals 
286.27 	are effective;
286.28 	(3) include monitoring of any physical and mental health problems;
286.29 	(4) document the participation of others;
286.30 	(5) document staff recommendations for changes in the methods identified in the treatment 
286.31 	plan and whether the client agrees with the change; and
287.1 	(6) include a review and evaluation of the individual abuse prevention plan according 
287.2 	to section 245A.65.
287.3 	(d) Each entry in a client's record must be accurate, legible, signed, and dated. A late 
287.4 	entry must be clearly labeled "late entry." A correction to an entry must be made in a way 
287.5 	in which the original entry can still be read.
287.6 		Subd. 4.Service discharge summary. (a) An alcohol and drug counselor must write a  
287.7 	discharge summary for each client. The summary must be completed within five days of 
287.8 	the client's service termination or within five days from the client's or program's decision 
287.9 	to terminate services, whichever is earlier.
287.10 	(b) The service discharge summary must be recorded in the six dimensions listed in 
287.11 	section 245G.05, subdivision 2, paragraph (c), and include the following information:
287.12 	(1) the client's issues, strengths, and needs while participating in treatment, including 
287.13 	services provided;
287.14 	(2) the client's progress toward achieving each goal identified in the individual treatment 
287.15 	plan;
287.16 	(3) a risk description according to section 245G.05; and
287.17 	(4) the reasons for and circumstances of service termination. If a program discharges a 
287.18 	client at staff request, the reason for discharge and the procedure followed for the decision 
287.19 	to discharge must be documented and comply with the program's policies on staff-initiated 
287.20 	client discharge. If a client is discharged at staff request, the program must give the client 
287.21 	crisis and other referrals appropriate for the client's needs and offer assistance to the client 
287.22 	to access the services.
287.23 	(c) For a client who successfully completes treatment, the summary must also include:
287.24 	(1) the client's living arrangements at service termination;
287.25 	(2) continuing care recommendations, including transitions between more or less intense 
287.26 	services, or more frequent to less frequent services, and referrals made with specific attention 
287.27 	to continuity of care for mental health, as needed;
287.28 	(3) service termination diagnosis; and
287.29 	(4) the client's prognosis.

287.30 	EFFECTIVE DATE. This section is effective January 1, 2018.

288.1 	Sec. 20. [245G.07] TREATMENT SERVICE.
288.2 		Subdivision 1.Treatment service. (a) A license holder must offer the following treatment 
288.3 	services, unless clinically inappropriate and the justifying clinical rationale is documented:
288.4 	(1) individual and group counseling to help the client identify and address needs related 
288.5 	to substance use and develop strategies to avoid harmful substance use after discharge and 
288.6 	to help the client obtain the services necessary to establish a lifestyle free of the harmful 
288.7 	effects of substance use disorder;
288.8 	(2) client education strategies to avoid inappropriate substance use and health problems 
288.9 	related to substance use and the necessary lifestyle changes to regain and maintain health. 
288.10 	Client education must include information on tuberculosis education on a form approved 
288.11 	by the commissioner, the human immunodeficiency virus according to section 245A.19, 
288.12 	other sexually transmitted diseases, drug and alcohol use during pregnancy, and hepatitis. 
288.13 	A licensed alcohol and drug counselor must be present during an educational group;
288.14 	(3) a service to help the client integrate gains made during treatment into daily living 
288.15 	and to reduce the client's reliance on a staff member for support;
288.16 	(4) a service to address issues related to co-occurring disorders, including client education 
288.17 	on symptoms of mental illness, the possibility of comorbidity, and the need for continued 
288.18 	medication compliance while recovering from substance use disorder. A group must address 
288.19 	co-occurring disorders, as needed. When treatment for mental health problems is indicated, 
288.20 	the treatment must be integrated into the client's individual treatment plan;
288.21 	(5) on July 1, 2018, or upon federal approval, whichever is later, peer recovery support 
288.22 	services provided one-to-one by an individual in recovery. Peer support services include 
288.23 	education, advocacy, mentoring through self-disclosure of personal recovery experiences, 
288.24 	attending recovery and other support groups with a client, accompanying the client to 
288.25 	appointments that support recovery, assistance accessing resources to obtain housing, 
288.26 	employment, education, and advocacy services, and nonclinical recovery support to assist 
288.27 	the transition from treatment into the recovery community; and
288.28 	(6) on July 1, 2018, or upon federal approval, whichever is later, care coordination 
288.29 	provided by an individual who meets the staff qualifications in section 245G.11, subdivision 
288.30 	7. Care coordination services include:
288.31 	(i) assistance in coordination with significant others to help in the treatment planning 
288.32 	process whenever possible;
289.1 	(ii) assistance in coordination with and follow up for medical services as identified in 
289.2 	the treatment plan;
289.3 	(iii) facilitation of referrals to substance use disorder services as indicated by a client's 
289.4 	medical provider, comprehensive assessment, or treatment plan;
289.5 	(iv) facilitation of referrals to mental health services as identified by a client's 
289.6 	comprehensive assessment or treatment plan;
289.7 	(v) assistance with referrals to economic assistance, social services, housing resources, 
289.8 	and prenatal care according to the client's needs;
289.9 	(vi) life skills advocacy and support accessing treatment follow-up, disease management, 
289.10 	and education services, including referral and linkages to long-term services and supports 
289.11 	as needed; and
289.12 	(vii) documentation of the provision of care coordination services in the client's file.
289.13 	(b) A treatment service provided to a client must be provided according to the individual 
289.14 	treatment plan and must consider cultural differences and special needs of a client.
289.15 		Subd. 2.Additional treatment service. A license holder may provide or arrange the 
289.16 	following additional treatment service as a part of the client's individual treatment plan:
289.17 	(1) relationship counseling provided by a qualified professional to help the client identify 
289.18 	the impact of the client's substance use disorder on others and to help the client and persons 
289.19 	in the client's support structure identify and change behaviors that contribute to the client's 
289.20 	substance use disorder;
289.21 	(2) therapeutic recreation to allow the client to participate in recreational activities 
289.22 	without the use of mood-altering chemicals and to plan and select leisure activities that do 
289.23 	not involve the inappropriate use of chemicals;
289.24 	(3) stress management and physical well-being to help the client reach and maintain an 
289.25 	appropriate level of health, physical fitness, and well-being;
289.26 	(4) living skills development to help the client learn basic skills necessary for independent 
289.27 	living;
289.28 	(5) employment or educational services to help the client become financially independent;
289.29 	(6) socialization skills development to help the client live and interact with others in a 
289.30 	positive and productive manner; and
290.1 	(7) room, board, and supervision at the treatment site to provide the client with a safe 
290.2 	and appropriate environment to gain and practice new skills.
290.3 		Subd. 3.Counselors. A treatment service, including therapeutic recreation, must be 
290.4 	provided by an alcohol and drug counselor according to section 245G.11, unless the 
290.5 	individual providing the service is specifically qualified according to the accepted credential 
290.6 	required to provide the service. Therapeutic recreation does not include planned leisure 
290.7 	activities.
290.8 		Subd. 4.Location of service provision. The license holder may provide services at any 
290.9 	of the license holder's licensed locations or at another suitable location including a school, 
290.10 	government building, medical or behavioral health facility, or social service organization, 
290.11 	upon notification and approval of the commissioner. If services are provided off site from 
290.12 	the licensed site, the reason for the provision of services remotely must be documented.

290.13 	EFFECTIVE DATE. This section is effective January 1, 2018.

290.14 	Sec. 21. [245G.08] MEDICAL SERVICES.
290.15 		Subdivision 1.Health care services. An applicant or license holder must maintain a 
290.16 	complete description of the health care services, nursing services, dietary services, and 
290.17 	emergency physician services offered by the applicant or license holder.
290.18 		Subd. 2.Procedures. The applicant or license holder must have written procedures for 
290.19 	obtaining a medical intervention for a client, that are approved in writing by a physician 
290.20 	who is licensed under chapter 147, unless:
290.21 	(1) the license holder does not provide a service under section 245G.21; and
290.22 	(2) a medical intervention is referred to 911, the emergency telephone number, or the 
290.23 	client's physician.
290.24 		Subd. 3.Standing order protocol. A license holder that maintains a supply of naloxone 
290.25 	available for emergency treatment of opioid overdose must have a written standing order 
290.26 	protocol by a physician who is licensed under chapter 147, that permits the license holder 
290.27 	to maintain a supply of naloxone on site, and must require staff to undergo specific training 
290.28 	in administration of naloxone.
290.29 		Subd. 4.Consultation services. The license holder must have access to and document 
290.30 	the availability of a licensed mental health professional to provide diagnostic assessment 
290.31 	and treatment planning assistance.
291.1 		Subd. 5.Administration of medication and assistance with self-medication. (a) A 
291.2 	license holder must meet the requirements in this subdivision if a service provided includes 
291.3 	the administration of medication.
291.4 	(b) A staff member, other than a licensed practitioner or nurse, who is delegated by a 
291.5 	licensed practitioner or a registered nurse the task of administration of medication or assisting 
291.6 	with self-medication, must:
291.7 	(1) successfully complete a medication administration training program for unlicensed 
291.8 	personnel through an accredited Minnesota postsecondary educational institution. A staff 
291.9 	member's completion of the course must be documented in writing and placed in the staff 
291.10 	member's personnel file;
291.11 	(2) be trained according to a formalized training program that is taught by a registered 
291.12 	nurse and offered by the license holder. The training must include the process for 
291.13 	administration of naloxone, if naloxone is kept on site. A staff member's completion of the 
291.14 	training must be documented in writing and placed in the staff member's personnel records; 
291.15 	or
291.16 	(3) demonstrate to a registered nurse competency to perform the delegated activity. A 
291.17 	registered nurse must be employed or contracted to develop the policies and procedures for 
291.18 	administration of medication or assisting with self-administration of medication, or both.
291.19 	(c) A registered nurse must provide supervision as defined in section 148.171, subdivision 
291.20 	23. The registered nurse's supervision must include, at a minimum, monthly on-site 
291.21 	supervision or more often if warranted by a client's health needs. The policies and procedures 
291.22 	must include:
291.23 	(1) a provision that a delegation of administration of medication is limited to the 
291.24 	administration of a medication that is administered orally, topically, or as a suppository, an 
291.25 	eye drop, an ear drop, or an inhalant;
291.26 	(2) a provision that each client's file must include documentation indicating whether 
291.27 	staff must conduct the administration of medication or the client must self-administer 
291.28 	medication, or both;
291.29 	(3) a provision that a client may carry emergency medication such as nitroglycerin as 
291.30 	instructed by the client's physician;
291.31 	(4) a provision for the client to self-administer medication when a client is scheduled to 
291.32 	be away from the facility;
292.1 	(5) a provision that if a client self-administers medication when the client is present in 
292.2 	the facility, the client must self-administer medication under the observation of a trained 
292.3 	staff member;
292.4 	(6) a provision that when a license holder serves a client who is a parent with a child, 
292.5 	the parent may only administer medication to the child under a staff member's supervision;
292.6 	(7) requirements for recording the client's use of medication, including staff signatures 
292.7 	with date and time;
292.8 	(8) guidelines for when to inform a nurse of problems with self-administration of 
292.9 	medication, including a client's failure to administer, refusal of a medication, adverse 
292.10 	reaction, or error; and
292.11 	(9) procedures for acceptance, documentation, and implementation of a prescription, 
292.12 	whether written, verbal, telephonic, or electronic.
292.13 		Subd. 6.Control of drugs. A license holder must have and implement written policies 
292.14 	and procedures developed by a registered nurse that contain:
292.15 	(1) a requirement that each drug must be stored in a locked compartment. A Schedule 
292.16 	II drug, as defined by section 152.02, subdivision 3, must be stored in a separately locked 
292.17 	compartment, permanently affixed to the physical plant or medication cart;
292.18 	(2) a system which accounts for all scheduled drugs each shift;
292.19 	(3) a procedure for recording the client's use of medication, including the signature of 
292.20 	the staff member who completed the administration of the medication with the time and 
292.21 	date;
292.22 	(4) a procedure to destroy a discontinued, outdated, or deteriorated medication;
292.23 	(5) a statement that only authorized personnel are permitted access to the keys to a locked 
292.24 	compartment;
292.25 	(6) a statement that no legend drug supply for one client shall be given to another client; 
292.26 	and
292.27 	(7) a procedure for monitoring the available supply of naloxone on site, replenishing 
292.28 	the naloxone supply when needed, and destroying naloxone according to clause (4).

292.29 	EFFECTIVE DATE. This section is effective January 1, 2018.

293.1 	Sec. 22. [245G.09] CLIENT RECORDS.
293.2 		Subdivision 1.Client records required. (a) A license holder must maintain a file of 
293.3 	current and accurate client records on the premises where the treatment service is provided 
293.4 	or coordinated. For services provided off site, client records must be available at the program 
293.5 	and adhere to the same clinical and administrative policies and procedures as services 
293.6 	provided on site. The content and format of client records must be uniform and entries in 
293.7 	each record must be signed and dated by the staff member making the entry. Client records 
293.8 	must be protected against loss, tampering, or unauthorized disclosure according to section 
293.9 	254A.09, chapter 13, and Code of Federal Regulations, title 42, chapter 1, part 2, subpart 
293.10 	B, sections 2.1 to 2.67, and title 45, parts 160 to 164.
293.11 	(b) The program must have a policy and procedure that identifies how the program will 
293.12 	track and record client attendance at treatment activities, including the date, duration, and 
293.13 	nature of each treatment service provided to the client.
293.14 		Subd. 2.Record retention. The client records of a discharged client must be retained 
293.15 	by a license holder for seven years. A license holder that ceases to provide treatment service 
293.16 	must retain client records for seven years from the date of facility closure and must notify 
293.17 	the commissioner of the location of the client records and the name of the individual 
293.18 	responsible for maintaining the client's records.
293.19 		Subd. 3.Contents. Client records must contain the following:
293.20 	(1) documentation that the client was given information on client rights and 
293.21 	responsibilities, grievance procedures, tuberculosis, and HIV, and that the client was provided 
293.22 	an orientation to the program abuse prevention plan required under section 245A.65, 
293.23 	subdivision 2, paragraph (a), clause (4). If the client has an opioid use disorder, the record 
293.24 	must contain documentation that the client was provided educational information according 
293.25 	to section 245G.05, subdivision 1, paragraph (b);
293.26 	(2) an initial services plan completed according to section 245G.04;
293.27 	(3) a comprehensive assessment completed according to section 245G.05;
293.28 	(4) an assessment summary completed according to section 245G.05, subdivision 2;
293.29 	(5) an individual abuse prevention plan according to sections 245A.65, subdivision 2, 
293.30 	and 626.557, subdivision 14, when applicable;
293.31 	(6) an individual treatment plan according to section 245G.06, subdivisions 1 and 2;
294.1 	(7) documentation of treatment services and treatment plan review according to section 
294.2 	245G.06, subdivision 3; and
294.3 	(8) a summary at the time of service termination according to section 245G.06, 
294.4 	subdivision 4.

294.5 	EFFECTIVE DATE. This section is effective January 1, 2018.

294.6 	Sec. 23. [245G.10] STAFF REQUIREMENTS.
294.7 		Subdivision 1.Treatment director. A license holder must have a treatment director.
294.8 		Subd. 2.Alcohol and drug counselor supervisor. A license holder must employ an 
294.9 	alcohol and drug counselor supervisor who meets the requirements of section 245G.11, 
294.10 	subdivision 4. An individual may be simultaneously employed as a treatment director, 
294.11 	alcohol and drug counselor supervisor, and an alcohol and drug counselor if the individual 
294.12 	meets the qualifications for each position. If an alcohol and drug counselor is simultaneously 
294.13 	employed as an alcohol and drug counselor supervisor or treatment director, that individual 
294.14 	must be considered a 0.5 full-time equivalent alcohol and drug counselor for staff 
294.15 	requirements under subdivision 4.
294.16 		Subd. 3.Responsible staff member. A treatment director must designate a staff member 
294.17 	who, when present in the facility, is responsible for the delivery of treatment service. A 
294.18 	license holder must have a designated staff member during all hours of operation. A license 
294.19 	holder providing room and board and treatment at the same site must have a responsible 
294.20 	staff member on duty 24 hours a day. The designated staff member must know and understand 
294.21 	the implications of this chapter and sections 245A.65, 626.556, 626.557, and 626.5572.
294.22 		Subd. 4.Staff requirement.  It is the responsibility of the license holder to determine 
294.23 	an acceptable group size based on each client's needs except that treatment services provided 
294.24 	in a group shall not exceed 16 clients. A counselor in an opioid treatment program must not 
294.25 	supervise more than 50 clients. The license holder must maintain a record that documents 
294.26 	compliance with this subdivision.
294.27 		Subd. 5.Medical emergency. When a client is present, a license holder must have at 
294.28 	least one staff member on the premises who has a current American Red Cross standard 
294.29 	first aid certificate or an equivalent certificate and at least one staff member on the premises 
294.30 	who has a current American Red Cross community, American Heart Association, or 
294.31 	equivalent CPR certificate. A single staff member with both certifications satisfies this 
294.32 	requirement.

295.1 	EFFECTIVE DATE. This section is effective January 1, 2018.

295.2 	Sec. 24. [245G.11] STAFF QUALIFICATIONS.
295.3 		Subdivision 1.General qualifications. (a) All staff members who have direct contact 
295.4 	must be 18 years of age or older. At the time of employment, each staff member must meet 
295.5 	the qualifications in this subdivision. For purposes of this subdivision, "problematic substance 
295.6 	use" means a behavior or incident listed by the license holder in the personnel policies and 
295.7 	procedures according to section 245G.13, subdivision 1, clause (5).
295.8 	(b) A treatment director, supervisor, nurse, counselor, student intern, or other professional 
295.9 	must be free of problematic substance use for at least the two years immediately preceding 
295.10 	employment and must sign a statement attesting to that fact.
295.11 	(c) A paraprofessional, recovery peer, or any other staff member with direct contact 
295.12 	must be free of problematic substance use for at least one year immediately preceding 
295.13 	employment and must sign a statement attesting to that fact.
295.14 		Subd. 2.Employment; prohibition on problematic substance use. A staff member 
295.15 	with direct contact must be free from problematic substance use as a condition of 
295.16 	employment, but is not required to sign additional statements. A staff member with direct 
295.17 	contact who is not free from problematic substance use must be removed from any 
295.18 	responsibilities that include direct contact for the time period specified in subdivision 1. 
295.19 	The time period begins to run on the date of the last incident of problematic substance use 
295.20 	as described in the facility's policies and procedures according to section 245G.13, 
295.21 	subdivision 1, clause (5).
295.22 		Subd. 3.Treatment directors. A treatment director must:
295.23 	(1) have at least one year of work experience in direct service to an individual with 
295.24 	substance use disorder or one year of work experience in the management or administration 
295.25 	of direct service to an individual with substance use disorder;
295.26 	(2) have a baccalaureate degree or three years of work experience in administration or 
295.27 	personnel supervision in human services; and
295.28 	(3) know and understand the implications of this chapter, chapter 245A, and sections 
295.29 	626.556, 626.557, and 626.5572. Demonstration of the treatment director's knowledge must 
295.30 	be documented in the personnel record.
295.31 		Subd. 4.Alcohol and drug counselor supervisors. An alcohol and drug counselor 
295.32 	supervisor must:
296.1 	(1) meet the qualification requirements in subdivision 5;
296.2 	(2) have three or more years of experience providing individual and group counseling 
296.3 	to individuals with substance use disorder; and
296.4 	(3) know and understand the implications of this chapter and sections 245A.65, 626.556, 
296.5 	626.557, and 626.5572.
296.6 		Subd. 5.Alcohol and drug counselor qualifications. (a) An alcohol and drug counselor 
296.7 	must either be licensed or exempt from licensure under chapter 148F.
296.8 	(b) An individual who is exempt from licensure under chapter 148F, must meet one of 
296.9 	the following additional requirements:
296.10 	(1) completion of at least a baccalaureate degree with a major or concentration in social 
296.11 	work, nursing, sociology, human services, or psychology, or licensure as a registered nurse; 
296.12 	successful completion of a minimum of 120 hours of classroom instruction in which each 
296.13 	of the core functions listed in chapter 148F is covered; and successful completion of 440 
296.14 	hours of supervised experience as an alcohol and drug counselor, either as a student or a 
296.15 	staff member;
296.16 	(2) completion of at least 270 hours of drug counselor training in which each of the core 
296.17 	functions listed in chapter 148F is covered, and successful completion of 880 hours of 
296.18 	supervised experience as an alcohol and drug counselor, either as a student or as a staff 
296.19 	member;
296.20 	(3) current certification as an alcohol and drug counselor or alcohol and drug counselor 
296.21 	reciprocal, through the evaluation process established by the International Certification and 
296.22 	Reciprocity Consortium Alcohol and Other Drug Abuse, Inc.;
296.23 	(4) completion of a bachelor's degree including 480 hours of alcohol and drug counseling 
296.24 	education from an accredited school or educational program and 880 hours of alcohol and 
296.25 	drug counseling practicum; or
296.26 	(5) employment in a program formerly licensed under Minnesota Rules, parts 9530.5000 
296.27 	to 9530.6400, and successful completion of 6,000 hours of supervised work experience in 
296.28 	a licensed program as an alcohol and drug counselor prior to January 1, 2005.
296.29 	(c) An alcohol and drug counselor may not provide a treatment service that requires 
296.30 	professional licensure unless the individual possesses the necessary license.  For the purposes 
296.31 	of enforcing this section, the commissioner has the authority to monitor a service provider's 
296.32 	compliance with the relevant standards of the service provider's profession and may issue 
297.1 	licensing actions against the license holder according to sections 245A.05, 245A.06, and 
297.2 	245A.07, based on the commissioner's determination of noncompliance.
297.3 		Subd. 6.Paraprofessionals. A paraprofessional must have knowledge of client rights, 
297.4 	according to section 148F.165, and staff member responsibilities. A paraprofessional may 
297.5 	not admit, transfer, or discharge a client but may be responsible for the delivery of treatment 
297.6 	service according to section 245G.10, subdivision 3.
297.7 		Subd. 7.Care coordination provider qualifications. (a) Care coordination must be 
297.8 	provided by qualified staff. An individual is qualified to provide care coordination if the 
297.9 	individual:
297.10 	(1) is skilled in the process of identifying and assessing a wide range of client needs;
297.11 	(2) is knowledgeable about local community resources and how to use those resources 
297.12 	for the benefit of the client;
297.13 	(3) has successfully completed 30 hours of classroom instruction on care coordination 
297.14 	for an individual with substance use disorder;
297.15 	(4) has either:
297.16 	(i) a bachelor's degree in one of the behavioral sciences or related fields; or
297.17 	(ii) current certification as an alcohol and drug counselor, level I, by the Upper Midwest 
297.18 	Indian Council on Addictive Disorders; and
297.19 	(5) has at least 2,000 hours of supervised experience working with individuals with 
297.20 	substance use disorder.
297.21 	(b) A care coordinator must receive at least one hour of supervision regarding individual 
297.22 	service delivery from an alcohol and drug counselor weekly.
297.23 		Subd. 8.Recovery peer qualifications. A recovery peer must:
297.24 	(1) have a high school diploma or its equivalent;
297.25 	(2) have a minimum of one year in recovery from substance use disorder;
297.26 	(3) hold a current credential from a certification body approved by the commissioner 
297.27 	that demonstrates skills and training in the domains of ethics and boundaries, advocacy, 
297.28 	mentoring and education, and recovery and wellness support; and
297.29 	(4) receive ongoing supervision in areas specific to the domains of the recovery peer's 
297.30 	role by an alcohol and drug counselor or an individual with a certification approved by the 
297.31 	commissioner.
298.1 		Subd. 9.Volunteers. A volunteer may provide treatment service when the volunteer is 
298.2 	supervised and can be seen or heard by a staff member meeting the criteria in subdivision 
298.3 	4 or 5, but may not practice alcohol and drug counseling unless qualified under subdivision 
298.4 	5.
298.5 		Subd. 10.Student interns. A qualified staff member must supervise and be responsible 
298.6 	for a treatment service performed by a student intern and must review and sign each 
298.7 	assessment, progress note, and individual treatment plan prepared by a student intern. A 
298.8 	student intern must receive the orientation and training required in section 245G.13, 
298.9 	subdivisions 1, clause (7), and 2. No more than 50 percent of the treatment staff may be 
298.10 	students or licensing candidates with time documented to be directly related to the provision 
298.11 	of treatment services for which the staff are authorized.
298.12 		Subd. 11.Individuals with temporary permit. An individual with a temporary permit 
298.13 	from the Board of Behavioral Health and Therapy may provide chemical dependency 
298.14 	treatment service according to this subdivision if they meet the requirements of either 
298.15 	paragraph (a) or (b).
298.16 	(a) An individual with a temporary permit must be supervised by a licensed alcohol and 
298.17 	drug counselor assigned by the license holder. The supervising licensed alcohol and drug 
298.18 	counselor must document the amount and type of supervision provided at least on a weekly 
298.19 	basis. The supervision must relate to the clinical practice.
298.20 	(b) An individual with a temporary permit must be supervised by a clinical supervisor 
298.21 	approved by the Board of Behavioral Health and Therapy. The supervision must be 
298.22 	documented and meet the requirements of section 148F.04, subdivision 4.

298.23 	EFFECTIVE DATE. This section is effective January 1, 2018.

298.24 	Sec. 25. [245G.12] PROVIDER POLICIES AND PROCEDURES.
298.25 	A license holder must develop a written policies and procedures manual, indexed 
298.26 	according to section 245A.04, subdivision 14, paragraph (c), that provides staff members 
298.27 	immediate access to all policies and procedures and provides a client and other authorized 
298.28 	parties access to all policies and procedures. The manual must contain the following 
298.29 	materials:
298.30 	(1) assessment and treatment planning policies, including screening for mental health 
298.31 	concerns and treatment objectives related to the client's identified mental health concerns 
298.32 	in the client's treatment plan;
298.33 	(2) policies and procedures regarding HIV according to section 245A.19;
299.1 	(3) the license holder's methods and resources to provide information on tuberculosis 
299.2 	and tuberculosis screening to each client and to report a known tuberculosis infection 
299.3 	according to section 144.4804;
299.4 	(4) personnel policies according to section 245G.13;
299.5 	(5) policies and procedures that protect a client's rights according to section 245G.15;
299.6 	(6) a medical services plan according to section 245G.08;
299.7 	(7) emergency procedures according to section 245G.16;
299.8 	(8) policies and procedures for maintaining client records according to section 245G.09;
299.9 	(9) procedures for reporting the maltreatment of minors according to section 626.556, 
299.10 	and vulnerable adults according to sections 245A.65, 626.557, and 626.5572;
299.11 	(10) a description of treatment services, including the amount and type of services 
299.12 	provided;
299.13 	(11) the methods used to achieve desired client outcomes;
299.14 	(12) the hours of operation; and
299.15 	(13) the target population served.

299.16 	EFFECTIVE DATE. This section is effective January 1, 2018.

299.17 	Sec. 26. [245G.13] PROVIDER PERSONNEL POLICIES.
299.18 		Subdivision 1.Personnel policy requirements. A license holder must have written 
299.19 	personnel policies that are available to each staff member. The personnel policies must:
299.20 	(1) ensure that staff member retention, promotion, job assignment, or pay are not affected 
299.21 	by a good faith communication between a staff member and the department, the Department 
299.22 	of Health, the ombudsman for mental health and developmental disabilities, law enforcement, 
299.23 	or a local agency for the investigation of a complaint regarding a client's rights, health, or 
299.24 	safety;
299.25 	(2) contain a job description for each staff member position specifying responsibilities, 
299.26 	degree of authority to execute job responsibilities, and qualification requirements;
299.27 	(3) provide for a job performance evaluation based on standards of job performance 
299.28 	conducted on a regular and continuing basis, including a written annual review;
299.29 	(4) describe behavior that constitutes grounds for disciplinary action, suspension, or 
299.30 	dismissal, including policies that address staff member problematic substance use and the 
300.1 	requirements of section 245G.11, subdivision 1, policies prohibiting personal involvement 
300.2 	with a client in violation of chapter 604, and policies prohibiting client abuse described in 
300.3 	sections 245A.65, 626.556, 626.557, and 626.5572;
300.4 	(5) identify how the program will identify whether behaviors or incidents are problematic 
300.5 	substance use, including a description of how the facility must address:
300.6 	(i) receiving treatment for substance use within the period specified for the position in 
300.7 	the staff qualification requirements, including medication-assisted treatment;
300.8 	(ii) substance use that negatively impacts the staff member's job performance;
300.9 	(iii) chemical use that affects the credibility of treatment services with a client, referral 
300.10 	source, or other member of the community;
300.11 	(iv) symptoms of intoxication or withdrawal on the job; and
300.12 	(v) the circumstances under which an individual who participates in monitoring by the 
300.13 	health professional services program for a substance use or mental health disorder is able 
300.14 	to provide services to the program's clients;
300.15 	(6) include a chart or description of the organizational structure indicating lines of 
300.16 	authority and responsibilities;
300.17 	(7) include orientation within 24 working hours of starting for each new staff member 
300.18 	based on a written plan that, at a minimum, must provide training related to the staff member's 
300.19 	specific job responsibilities, policies and procedures, client confidentiality, HIV minimum 
300.20 	standards, and client needs; and
300.21 	(8) include policies outlining the license holder's response to a staff member with a 
300.22 	behavior problem that interferes with the provision of treatment service.
300.23 		Subd. 2.Staff development. (a) A license holder must ensure that each staff member 
300.24 	has the training described in this subdivision.
300.25 	(b) Each staff member must be trained every two years in:
300.26 	(1) client confidentiality rules and regulations and client ethical boundaries; and
300.27 	(2) emergency procedures and client rights as specified in sections 144.651, 148F.165, 
300.28 	and 253B.03.
300.29 	(c) Annually each staff member with direct contact must be trained on mandatory 
300.30 	reporting as specified in sections 245A.65, 626.556, 626.5561, 626.557, and 626.5572, 
301.1 	including specific training covering the license holder's policies for obtaining a release of 
301.2 	client information.
301.3 	(d) Upon employment and annually thereafter, each staff member with direct contact 
301.4 	must receive training on HIV minimum standards according to section 245A.19.
301.5 	(e) A treatment director, supervisor, nurse, or counselor must have a minimum of 12 
301.6 	hours of training in co-occurring disorders that includes competencies related to philosophy, 
301.7 	trauma-informed care, screening, assessment, diagnosis and person-centered treatment 
301.8 	planning, documentation, programming, medication, collaboration, mental health 
301.9 	consultation, and discharge planning. A new staff member who has not obtained the training 
301.10 	must complete the training within six months of employment. A staff member may request, 
301.11 	and the license holder may grant, credit for relevant training obtained before employment, 
301.12 	which must be documented in the staff member's personnel file.
301.13 		Subd. 3.Personnel files. The license holder must maintain a separate personnel file for 
301.14 	each staff member. At a minimum, the personnel file must conform to the requirements of 
301.15 	this chapter. A personnel file must contain the following:
301.16 	(1) a completed application for employment signed by the staff member and containing 
301.17 	the staff member's qualifications for employment;
301.18 	(2) documentation related to the staff member's background study data, according to 
301.19 	chapter 245C;
301.20 	(3) for a staff member who provides psychotherapy services, employer names and 
301.21 	addresses for the past five years for which the staff member provided psychotherapy services, 
301.22 	and documentation of an inquiry required by sections 604.20 to 604.205 made to the staff 
301.23 	member's former employer regarding substantiated sexual contact with a client;
301.24 	(4) documentation that the staff member completed orientation and training;
301.25 	(5) documentation that the staff member meets the requirements in section 245G.11;
301.26 	(6) documentation demonstrating the staff member's compliance with section 245G.08, 
301.27 	subdivision 3, for a staff member who conducts administration of medication; and
301.28 	(7) documentation demonstrating the staff member's compliance with section 245G.18, 
301.29 	subdivision 2, for a staff member that treats an adolescent client.

301.30 	EFFECTIVE DATE. This section is effective January 1, 2018.

302.1 	Sec. 27. [245G.14] SERVICE INITIATION AND TERMINATION POLICIES.
302.2 		Subdivision 1.Service initiation policy. A license holder must have a written service 
302.3 	initiation policy containing service initiation preferences that comply with this section and 
302.4 	Code of Federal Regulations, title 45, part 96.131, and specific service initiation criteria. 
302.5 	The license holder must not initiate services for an individual who does not meet the service 
302.6 	initiation criteria. The service initiation criteria must be either posted in the area of the 
302.7 	facility where services for a client are initiated, or given to each interested person upon 
302.8 	request. Titles of each staff member authorized to initiate services for a client must be listed 
302.9 	in the services initiation and termination policies.
302.10 		Subd. 2.License holder responsibilities. (a) The license holder must have and comply 
302.11 	with a written protocol for (1) assisting a client in need of care not provided by the license 
302.12 	holder, and (2) a client who poses a substantial likelihood of harm to the client or others, if 
302.13 	the behavior is beyond the behavior management capabilities of the staff members.
302.14 	(b) A service termination and denial of service initiation that poses an immediate threat 
302.15 	to the health of any individual or requires immediate medical intervention must be referred 
302.16 	to a medical facility capable of admitting the client.
302.17 	(c) A service termination policy and a denial of service initiation that involves the 
302.18 	commission of a crime against a license holder's staff member or on a license holder's 
302.19 	premises, as provided under Code of Federal Regulations, title 42, section 2.12(c)(5), and 
302.20 	title 45, parts 160 to 164, must be reported to a law enforcement agency with jurisdiction.
302.21 		Subd. 3.Service termination policies. A license holder must have a written policy 
302.22 	specifying the conditions when a client must be terminated from service. The service 
302.23 	termination policy must include:
302.24 	(1) procedures for a client whose services were terminated under subdivision 2;
302.25 	(2) a description of client behavior that constitutes reason for a staff-requested service 
302.26 	termination and a process for providing this information to a client;
302.27 	(3) a requirement that before discharging a client from a residential setting, for not 
302.28 	reaching treatment plan goals, the license holder must confer with other interested persons 
302.29 	to review the issues involved in the decision. The documentation requirements for a 
302.30 	staff-requested service termination must describe why the decision to discharge is warranted, 
302.31 	the reasons for the discharge, and the alternatives considered or attempted before discharging 
302.32 	the client;
303.1 	(4) procedures consistent with section 253B.16, subdivision 2, that staff members must 
303.2 	follow when a client admitted under chapter 253B is to have services terminated;
303.3 	(5) procedures a staff member must follow when a client leaves against staff or medical 
303.4 	advice and when the client may be dangerous to the client or others, including a policy that 
303.5 	requires a staff member to assist the client with assessing needs of care or other resources;
303.6 	(6) procedures for communicating staff-approved service termination criteria to a client, 
303.7 	including the expectations in the client's individual treatment plan according to section 
303.8 	245G.06; and
303.9 	(7) titles of each staff member authorized to terminate a client's service must be listed 
303.10 	in the service initiation and service termination policies.

303.11 	EFFECTIVE DATE. This section is effective January 1, 2018.

303.12 	Sec. 28. [245G.15] CLIENT RIGHTS PROTECTION.
303.13 		Subdivision 1.Explanation. A client has the rights identified in sections 144.651, 
303.14 	148F.165, 253B.03, and 254B.02, subdivision 2, as applicable. The license holder must 
303.15 	give each client at service initiation a written statement of the client's rights and 
303.16 	responsibilities. A staff member must review the statement with a client at that time.
303.17 		Subd. 2.Grievance procedure. At service initiation, the license holder must explain 
303.18 	the grievance procedure to the client or the client's representative. The grievance procedure 
303.19 	must be posted in a place visible to clients, and made available upon a client's or former 
303.20 	client's request. The grievance procedure must require that:
303.21 	(1) a staff member helps the client develop and process a grievance;
303.22 	(2) current telephone numbers and addresses of the Department of Human Services, 
303.23 	Licensing Division; the Office of Ombudsman for Mental Health and Developmental 
303.24 	Disabilities; the Department of Health Office of Health Facilities Complaints; and the Board 
303.25 	of Behavioral Health and Therapy, when applicable, be made available to a client; and
303.26 	(3) a license holder responds to the client's grievance within three days of a staff member's 
303.27 	receipt of the grievance, and the client may bring the grievance to the highest level of 
303.28 	authority in the program if not resolved by another staff member.
303.29 		Subd. 3.Photographs of client. (a) A photograph, video, or motion picture of a client 
303.30 	taken in the provision of treatment service is considered client records. A photograph for 
303.31 	identification and a recording by video or audio technology to enhance either therapy or 
303.32 	staff member supervision may be required of a client, but may only be available for use as 
304.1 	communications within a program. A client must be informed when the client's actions are 
304.2 	being recorded by camera or other technology, and the client must have the right to refuse 
304.3 	any recording or photography, except as authorized by this subdivision.
304.4 	(b) A license holder must have a written policy regarding the use of any personal 
304.5 	electronic device that can record, transmit, or make images of another client. A license 
304.6 	holder must inform each client of this policy and the client's right to refuse being 
304.7 	photographed or recorded.

304.8 	EFFECTIVE DATE. This section is effective January 1, 2018.

304.9 	Sec. 29. [245G.16] BEHAVIORAL EMERGENCY PROCEDURES.
304.10 	(a) A license holder or applicant must have written behavioral emergency procedures 
304.11 	that staff must follow when responding to a client who exhibits behavior that is threatening 
304.12 	to the safety of the client or others. Programs must incorporate person-centered planning 
304.13 	and trauma-informed care in the program's behavioral emergency procedure policies. The 
304.14 	procedures must include:
304.15 	(1) a plan designed to prevent a client from hurting themselves or others;
304.16 	(2) contact information for emergency resources that staff must consult when a client's 
304.17 	behavior cannot be controlled by the behavioral emergency procedures;
304.18 	(3) types of procedures that may be used;
304.19 	(4) circumstances under which behavioral emergency procedures may be used; and
304.20 	(5) staff members authorized to implement behavioral emergency procedures.
304.21 	(b) Behavioral emergency procedures must not be used to enforce facility rules or for 
304.22 	the convenience of staff. Behavioral emergency procedures must not be part of any client's 
304.23 	treatment plan, or used at any time for any reason except in response to specific current 
304.24 	behavior that threatens the safety of the client or others. Behavioral emergency procedures 
304.25 	may not include the use of seclusion or restraint.

304.26 	EFFECTIVE DATE. This section is effective January 1, 2018.

304.27 	Sec. 30. [245G.17] EVALUATION.
304.28 	A license holder must participate in the drug and alcohol abuse normative evaluation 
304.29 	system by submitting information about each client to the commissioner in a manner 
304.30 	prescribed by the commissioner. A license holder must submit additional information 
305.1 	requested by the commissioner that is necessary to meet statutory or federal funding 
305.2 	requirements.

305.3 	EFFECTIVE DATE. This section is effective January 1, 2018.

305.4 	Sec. 31. [245G.18] LICENSE HOLDERS SERVING ADOLESCENTS.
305.5 		Subdivision 1.License. A residential treatment program that serves an adolescent younger 
305.6 	than 16 years of age must be licensed as a residential program for a child in out-of-home 
305.7 	placement by the department unless the license holder is exempt under section 245A.03, 
305.8 	subdivision 2.
305.9 		Subd. 2.Alcohol and drug counselor qualifications. In addition to the requirements 
305.10 	specified in section 245G.11, subdivisions 1 and 5, an alcohol and drug counselor providing 
305.11 	treatment service to an adolescent must have:
305.12 	(1) an additional 30 hours of classroom instruction or one three-credit semester college 
305.13 	course in adolescent development. This training need only be completed one time; and
305.14 	(2) at least 150 hours of supervised experience as an adolescent counselor, either as a 
305.15 	student or as a staff member.
305.16 		Subd. 3.Staff ratios. At least 25 percent of a counselor's scheduled work hours must 
305.17 	be allocated to indirect services, including documentation of client services, coordination 
305.18 	of services with others, treatment team meetings, and other duties. A counseling group 
305.19 	consisting entirely of adolescents must not exceed 16 adolescents. It is the responsibility of 
305.20 	the license holder to determine an acceptable group size based on the needs of the clients.
305.21 		Subd. 4.Academic program requirements. A client who is required to attend school 
305.22 	must be enrolled and attending an educational program that was approved by the Department 
305.23 	of Education.
305.24 		Subd. 5.Program requirements. In addition to the requirements specified in the client's 
305.25 	treatment plan under section 245G.06, programs serving an adolescent must include:
305.26 	(1) coordination with the school system to address the client's academic needs;
305.27 	(2) when appropriate, a plan that addresses the client's leisure activities without chemical 
305.28 	use; and
305.29 	(3) a plan that addresses family involvement in the adolescent's treatment.

305.30 	EFFECTIVE DATE. This section is effective January 1, 2018.

306.1 	Sec. 32. [245G.19] LICENSE HOLDERS SERVING CLIENTS WITH CHILDREN.
306.2 		Subdivision 1.Health license requirements. In addition to the requirements of sections 
306.3 	245G.01 to 245G.17, a license holder that offers supervision of a child of a client is subject 
306.4 	to the requirements of this section. A license holder providing room and board for a client 
306.5 	and the client's child must have an appropriate facility license from the Department of 
306.6 	Health.
306.7 		Subd. 2.Supervision of a child. "Supervision of a child" means a caregiver is within 
306.8 	sight or hearing of an infant, toddler, or preschooler at all times so that the caregiver can 
306.9 	intervene to protect the child's health and safety. For a school-age child it means a caregiver 
306.10 	is available to help and care for the child to protect the child's health and safety.
306.11 		Subd. 3.Policy and schedule required. A license holder must meet the following 
306.12 	requirements:
306.13 	(1) have a policy and schedule delineating the times and circumstances when the license 
306.14 	holder is responsible for supervision of a child in the program and when the child's parents 
306.15 	are responsible for supervision of a child. The policy must explain how the program will 
306.16 	communicate its policy about supervision of a child responsibility to the parent; and
306.17 	(2) have written procedures addressing the actions a staff member must take if a child 
306.18 	is neglected or abused, including while the child is under the supervision of the child's 
306.19 	parent.
306.20 		Subd. 4.Additional licensing requirements. During the times the license holder is 
306.21 	responsible for the supervision of a child, the license holder must meet the following 
306.22 	standards:
306.23 	(1) child and adult ratios in Minnesota Rules, part 9502.0367;
306.24 	(2) day care training in section 245A.50;
306.25 	(3) behavior guidance in Minnesota Rules, part 9502.0395;
306.26 	(4) activities and equipment in Minnesota Rules, part 9502.0415;
306.27 	(5) physical environment in Minnesota Rules, part 9502.0425; and
306.28 	(6) water, food, and nutrition in Minnesota Rules, part 9502.0445, unless the license 
306.29 	holder has a license from the Department of Health.

306.30 	EFFECTIVE DATE. This section is effective January 1, 2018.

307.1 	Sec. 33. [245G.20] LICENSE HOLDERS SERVING PERSONS WITH 
307.2 	CO-OCCURRING DISORDERS.
307.3 	A license holder specializing in the treatment of a person with co-occurring disorders 
307.4 	must:
307.5 	(1) demonstrate that staff levels are appropriate for treating a client with a co-occurring 
307.6 	disorder, and that there are adequate staff members with mental health training;
307.7 	(2) have continuing access to a medical provider with appropriate expertise in prescribing 
307.8 	psychotropic medication;
307.9 	(3) have a mental health professional available for staff member supervision and 
307.10 	consultation;
307.11 	(4) determine group size, structure, and content considering the special needs of a client 
307.12 	with a co-occurring disorder;
307.13 	(5) have documentation of active interventions to stabilize mental health symptoms 
307.14 	present in the individual treatment plans and progress notes;
307.15 	(6) have continuing documentation of collaboration with continuing care mental health 
307.16 	providers, and involvement of the providers in treatment planning meetings;
307.17 	(7) have available program materials adapted to a client with a mental health problem;
307.18 	(8) have policies that provide flexibility for a client who may lapse in treatment or may 
307.19 	have difficulty adhering to established treatment rules as a result of a mental illness, with 
307.20 	the goal of helping a client successfully complete treatment; and
307.21 	(9) have individual psychotherapy and case management available during treatment 
307.22 	service.

307.23 	EFFECTIVE DATE. This section is effective January 1, 2018.

307.24 	Sec. 34. [245G.21] REQUIREMENTS FOR LICENSED RESIDENTIAL 
307.25 	TREATMENT.
307.26 		Subdivision 1.Applicability. A license holder who provides supervised room and board 
307.27 	at the licensed program site as a treatment component is defined as a residential program 
307.28 	according to section 245A.02, subdivision 14, and is subject to this section.
307.29 		Subd. 2.Visitors. A client must be allowed to receive visitors at times prescribed by 
307.30 	the license holder. The license holder must set and post a notice of visiting rules and hours, 
307.31 	including both day and evening times. A client's right to receive visitors other than a personal 
308.1 	physician, religious adviser, county case manager, parole or probation officer, or attorney 
308.2 	may be subject to visiting hours established by the license holder for all clients. The treatment 
308.3 	director or designee may impose limitations as necessary for the welfare of a client provided 
308.4 	the limitation and the reasons for the limitation are documented in the client's file. A client 
308.5 	must be allowed to receive visits at all reasonable times from the client's personal physician, 
308.6 	religious adviser, county case manager, parole or probation officer, and attorney.
308.7 		Subd. 3.Client property management. A license holder who provides room and board 
308.8 	and treatment services to a client in the same facility, and any license holder that accepts 
308.9 	client property must meet the requirements for handling client funds and property in section 
308.10 	245A.04, subdivision 13. License holders:
308.11 	(1) may establish policies regarding the use of personal property to ensure that treatment 
308.12 	activities and the rights of other clients are not infringed upon;
308.13 	(2) may take temporary custody of a client's property for violation of a facility policy;
308.14 	(3) must retain the client's property for a minimum of seven days after the client's service 
308.15 	termination if the client does not reclaim property upon service termination, or for a minimum 
308.16 	of 30 days if the client does not reclaim property upon service termination and has received 
308.17 	room and board services from the license holder; and
308.18 	(4) must return all property held in trust to the client at service termination regardless 
308.19 	of the client's service termination status, except that:
308.20 	(i) a drug, drug paraphernalia, or drug container that is subject to forfeiture under section 
308.21 	609.5316, must be given to the custody of a local law enforcement agency. If giving the 
308.22 	property to the custody of a local law enforcement agency violates Code of Federal 
308.23 	Regulations, title 42, sections 2.1 to 2.67, or title 45, parts 160 to 164, a drug, drug 
308.24 	paraphernalia, or drug container must be destroyed by a staff member designated by the 
308.25 	program director; and
308.26 	(ii) a weapon, explosive, and other property that can cause serious harm to the client or 
308.27 	others must be given to the custody of a local law enforcement agency, and the client must 
308.28 	be notified of the transfer and of the client's right to reclaim any lawful property transferred; 
308.29 	and
308.30 	(iii) a medication that was determined by a physician to be harmful after examining the 
308.31 	client must be destroyed, except when the client's personal physician approves the medication 
308.32 	for continued use.
309.1 		Subd. 4.Health facility license. A license holder who provides room and board and 
309.2 	treatment services in the same facility must have the appropriate license from the Department 
309.3 	of Health.
309.4 		Subd. 5.Facility abuse prevention plan. A license holder must establish and enforce 
309.5 	an ongoing facility abuse prevention plan consistent with sections 245A.65 and 626.557, 
309.6 	subdivision 14.
309.7 		Subd. 6.Individual abuse prevention plan. A license holder must prepare an individual 
309.8 	abuse prevention plan for each client as specified under sections 245A.65, subdivision 2, 
309.9 	and 626.557, subdivision 14.
309.10 		Subd. 7.Health services. A license holder must have written procedures for assessing 
309.11 	and monitoring a client's health, including a standardized data collection tool for collecting 
309.12 	health-related information about each client. The policies and procedures must be approved 
309.13 	and signed by a registered nurse.
309.14 		Subd. 8.Administration of medication. A license holder must meet the administration 
309.15 	of medications requirements of section 245G.08, subdivision 5, if services include medication 
309.16 	administration.

309.17 	EFFECTIVE DATE. This section is effective January 1, 2018.

309.18 	Sec. 35. [245G.22] OPIOID TREATMENT PROGRAMS.
309.19 		Subdivision 1.Additional requirements. (a) An opioid treatment program licensed 
309.20 	under this chapter must also comply with the requirements of this section and Code of 
309.21 	Federal Regulations, title 42, part 8. When federal guidance or interpretations are issued on 
309.22 	federal standards or requirements also required under this section, the federal guidance or 
309.23 	interpretations shall apply.
309.24 	(b) Where a standard in this section differs from a standard in an otherwise applicable 
309.25 	administrative rule or statute, the standard of this section applies.
309.26 		Subd. 2.Definitions. (a) For purposes of this section, the terms defined in this subdivision 
309.27 	have the meanings given them.
309.28 	(b) "Diversion" means the use of a medication for the treatment of opioid addiction being 
309.29 	diverted from intended use of the medication.
309.30 	(c) "Guest dose" means administration of a medication used for the treatment of opioid 
309.31 	addiction to a person who is not a client of the program that is administering or dispensing 
309.32 	the medication.
310.1 	(d) "Medical director" means a physician licensed to practice medicine in the jurisdiction 
310.2 	that the opioid treatment program is located who assumes responsibility for administering 
310.3 	all medical services performed by the program, either by performing the services directly 
310.4 	or by delegating specific responsibility to authorized program physicians and health care 
310.5 	professionals functioning under the medical director's direct supervision.
310.6 	(e) "Medication used for the treatment of opioid use disorder" means a medication 
310.7 	approved by the Food and Drug Administration for the treatment of opioid use disorder.
310.8 	(f) "Minnesota health care programs" has the meaning given in section 256B.0636.
310.9 	(g) "Opioid treatment program" has the meaning given in Code of Federal Regulations, 
310.10 	title 42, section 8.12, and includes programs licensed under this chapter.
310.11 	(h) "Placing authority" has the meaning given in Minnesota Rules, part 9530.6605, 
310.12 	subpart 21a.
310.13 	(i) "Unsupervised use" means the use of a medication for the treatment of opioid use 
310.14 	disorder dispensed for use by a client outside of the program setting.
310.15 		Subd. 3.Medication orders. Before the program may administer or dispense a medication 
310.16 	used for the treatment of opioid use disorder:
310.17 	(1) a client-specific order must be received from an appropriately credentialed physician 
310.18 	who is enrolled as a Minnesota health care programs provider and meets all applicable 
310.19 	provider standards;
310.20 	(2) the signed order must be documented in the client's record; and
310.21 	(3) if the physician that issued the order is not able to sign the order when issued, the 
310.22 	unsigned order must be entered in the client record at the time it was received, and the 
310.23 	physician must review the documentation and sign the order in the client's record within 72 
310.24 	hours of the medication being ordered. The license holder must report to the commissioner 
310.25 	any medication error that endangers a client's health, as determined by the medical director.
310.26 		Subd. 4.High dose requirements. A client being administered or dispensed a dose 
310.27 	beyond that set forth in subdivision 6, paragraph (a), clause (1), that exceeds 150 milligrams 
310.28 	of methadone or 24 milligrams of buprenorphine daily, and for each subsequent increase, 
310.29 	must meet face-to-face with a prescribing physician. The meeting must occur before the 
310.30 	administration or dispensing of the increased medication dose.
310.31 		Subd. 5.Drug testing. Each client enrolled in the program must receive a minimum of 
310.32 	eight random drug abuse tests per 12 months of treatment. Drug abuse tests must be 
311.1 	reasonably disbursed over the 12-month period. A license holder may elect to conduct more 
311.2 	drug abuse tests.
311.3 		Subd. 6.Criteria for unsupervised use. (a) To limit the potential for diversion of 
311.4 	medication used for the treatment of opioid use disorder to the illicit market, medication 
311.5 	dispensed to a client for unsupervised use shall be subject to the following requirements:
311.6 	(1) any client in an opioid treatment program may receive a single unsupervised use 
311.7 	dose for a day that the clinic is closed for business, including Sundays and state and federal 
311.8 	holidays; and
311.9 	(2) other treatment program decisions on dispensing medications used for the treatment 
311.10 	of opioid use disorder to a client for unsupervised use shall be determined by the medical 
311.11 	director.
311.12 	(b) In determining whether a client may be permitted unsupervised use of medications, 
311.13 	a physician with authority to prescribe must consider the criteria in this paragraph. The 
311.14 	criteria in this paragraph must also be considered when determining whether dispensing 
311.15 	medication for a client's unsupervised use is appropriate to increase or to extend the amount 
311.16 	of time between visits to the program. The criteria are:
311.17 	(1) absence of recent abuse of drugs including but not limited to opioids, non-narcotics, 
311.18 	and alcohol;
311.19 	(2) regularity of program attendance;
311.20 	(3) absence of serious behavioral problems at the program;
311.21 	(4) absence of known recent criminal activity such as drug dealing;
311.22 	(5) stability of the client's home environment and social relationships;
311.23 	(6) length of time in comprehensive maintenance treatment;
311.24 	(7) reasonable assurance that unsupervised use medication will be safely stored within 
311.25 	the client's home; and
311.26 	(8) whether the rehabilitative benefit the client derived from decreasing the frequency 
311.27 	of program attendance outweighs the potential risks of diversion or unsupervised use.
311.28 	(c) The determination, including the basis of the determination must be documented in 
311.29 	the client's medical record.
311.30 		Subd. 7.Restrictions for unsupervised use of methadone hydrochloride. (a) If a 
311.31 	physician with authority to prescribe determines that a client meets the criteria in subdivision 
312.1 	6 and may be dispensed a medication used for the treatment of opioid addiction, the 
312.2 	restrictions in this subdivision must be followed when the medication to be dispensed is 
312.3 	methadone hydrochloride.
312.4 	(b) During the first 90 days of treatment, the unsupervised use medication supply must 
312.5 	be limited to a maximum of a single dose each week and the client shall ingest all other 
312.6 	doses under direct supervision.
312.7 	(c) In the second 90 days of treatment, the unsupervised use medication supply must be 
312.8 	limited to two doses per week.
312.9 	(d) In the third 90 days of treatment, the unsupervised use medication supply must not 
312.10 	exceed three doses per week.
312.11 	(e) In the remaining months of the first year, a client may be given a maximum six-day 
312.12 	unsupervised use medication supply.
312.13 	(f) After one year of continuous treatment, a client may be given a maximum two-week 
312.14 	unsupervised use medication supply.
312.15 	(g) After two years of continuous treatment, a client may be given a maximum one-month 
312.16 	unsupervised use medication supply, but must make monthly visits to the program.
312.17 		Subd. 8.Restriction exceptions. When a license holder has reason to accelerate the 
312.18 	number of unsupervised use doses of methadone hydrochloride, the license holder must 
312.19 	comply with the requirements of Code of Federal Regulations, title 42, section 8.12, the 
312.20 	criteria for unsupervised use and must use the exception process provided by the federal 
312.21 	Center for Substance Abuse Treatment Division of Pharmacologic Therapies. For the 
312.22 	purposes of enforcement of this subdivision, the commissioner has the authority to monitor 
312.23 	a program for compliance with federal regulations and may issue licensing actions according 
312.24 	to sections 245A.05, 245A.06, and 245A.07 based on the commissioner's determination of 
312.25 	noncompliance.
312.26 		Subd. 9.Guest dose. To receive a guest dose, the client must be enrolled in an opioid 
312.27 	treatment program elsewhere in the state or country and be receiving the medication on a 
312.28 	temporary basis because the client is not able to receive the medication at the program in 
312.29 	which the client is enrolled. Such arrangements shall not exceed 30 consecutive days in any 
312.30 	one program and must not be for the convenience or benefit of either program. A guest dose 
312.31 	may also occur when the client's primary clinic is not open and the client is not receiving 
312.32 	unsupervised use doses.
313.1 		Subd. 10.Capacity management and waiting list system compliance. An opioid 
313.2 	treatment program must notify the department within seven days of the program reaching 
313.3 	both 90 and 100 percent of the program's capacity to care for clients. Each week, the program 
313.4 	must report its capacity, currently enrolled dosing clients, and any waiting list. A program 
313.5 	reporting 90 percent of capacity must also notify the department when the program's census 
313.6 	increases or decreases from the 90 percent level.
313.7 		Subd. 11.Waiting list. An opioid treatment program must have a waiting list system. 
313.8 	If the person seeking admission cannot be admitted within 14 days of the date of application, 
313.9 	each person seeking admission must be placed on the waiting list, unless the person seeking 
313.10 	admission is assessed by the program and found ineligible for admission according to this 
313.11 	chapter and Code of Federal Regulations, title 42, part 1, subchapter A, section 8.12(e), and 
313.12 	title 45, parts 160 to 164. The waiting list must assign a unique client identifier for each 
313.13 	person seeking treatment while awaiting admission. A person seeking admission on a waiting 
313.14 	list who receives no services under section 245G.07, subdivision 1, must not be considered 
313.15 	a client as defined in section 245G.01, subdivision 9.
313.16 		Subd. 12.Client referral. An opioid treatment program must consult the capacity 
313.17 	management system to ensure that a person on a waiting list is admitted at the earliest time 
313.18 	to a program providing appropriate treatment within a reasonable geographic area. If the 
313.19 	client was referred through a public payment system and if the program is not able to serve 
313.20 	the client within 14 days of the date of application for admission, the program must contact 
313.21 	and inform the referring agency of any available treatment capacity listed in the state capacity 
313.22 	management system.
313.23 		Subd. 13.Outreach. An opioid treatment program must carry out activities to encourage 
313.24 	an individual in need of treatment to undergo treatment. The program's outreach model 
313.25 	must:
313.26 	(1) select, train, and supervise outreach workers;
313.27 	(2) contact, communicate, and follow up with individuals with high-risk substance 
313.28 	misuse, individuals with high-risk substance misuse associates, and neighborhood residents 
313.29 	within the constraints of federal and state confidentiality requirements;
313.30 	(3) promote awareness among individuals who engage in substance misuse by injection 
313.31 	about the relationship between injecting substances and communicable diseases such as 
313.32 	HIV; and
313.33 	(4) recommend steps to prevent HIV transmission.
314.1 		Subd. 14.Central registry. (a) A license holder must comply with requirements to 
314.2 	submit information and necessary consents to the state central registry for each client 
314.3 	admitted, as specified by the commissioner. The license holder must submit data concerning 
314.4 	medication used for the treatment of opioid use disorder. The data must be submitted in a 
314.5 	method determined by the commissioner and the original information must be kept in the 
314.6 	client's record. The information must be submitted for each client at admission and discharge. 
314.7 	The program must document the date the information was submitted. The client's failure to 
314.8 	provide the information shall prohibit participation in an opioid treatment program. The 
314.9 	information submitted must include the client's:
314.10 	(1) full name and all aliases;
314.11 	(2) date of admission;
314.12 	(3) date of birth;
314.13 	(4) Social Security number or Alien Registration Number, if any;
314.14 	(5) current or previous enrollment status in another opioid treatment program;
314.15 	(6) government-issued photo identification card number; and
314.16 	(7) driver's license number, if any.
314.17 	(b) The requirements in paragraph (a) are effective upon the commissioner's 
314.18 	implementation of changes to the drug and alcohol abuse normative evaluation system or 
314.19 	development of an electronic system by which to submit the data.
314.20 		Subd. 15.Nonmedication treatment services; documentation. (a) The program must 
314.21 	offer at least 50 consecutive minutes of individual or group therapy treatment services as 
314.22 	defined in section 245G.07, subdivision 1, paragraph (a), clause (1), per week, for the first 
314.23 	ten weeks following admission, and at least 50 consecutive minutes per month thereafter. 
314.24 	As clinically appropriate, the program may offer these services cumulatively and not 
314.25 	consecutively in increments of no less than 15 minutes over the required time period, and 
314.26 	for a total of 60 minutes of treatment services over the time period, and must document the 
314.27 	reason for providing services cumulatively in the client's record. The program may offer 
314.28 	additional levels of service when deemed clinically necessary.
314.29 	(b) Notwithstanding the requirements of comprehensive assessments in section 245G.05, 
314.30 	the assessment must be completed within 21 days of service initiation.
314.31 	(c) Notwithstanding the requirements of individual treatment plans set forth in section 
314.32 	245G.06:
315.1 	(1) treatment plan contents for a maintenance client are not required to include goals 
315.2 	the client must reach to complete treatment and have services terminated;
315.3 	(2) treatment plans for a client in a taper or detox status must include goals the client 
315.4 	must reach to complete treatment and have services terminated;
315.5 	(3) for the initial ten weeks after admission for all new admissions, readmissions, and 
315.6 	transfers, progress notes must be entered in a client's file at least weekly and be recorded 
315.7 	in each of the six dimensions upon the development of the treatment plan and thereafter. 
315.8 	Subsequently, the counselor must document progress in the six dimensions at least once 
315.9 	monthly or, when clinical need warrants, more frequently; and
315.10 	(4) upon the development of the treatment plan and thereafter, treatment plan reviews 
315.11 	must occur weekly, or after each treatment service, whichever is less frequent, for the first 
315.12 	ten weeks after the treatment plan is developed. Following the first ten weeks of treatment 
315.13 	plan reviews, reviews may occur monthly, unless the client's needs warrant more frequent 
315.14 	revisions or documentation.
315.15 		Subd. 16.Prescription monitoring program. (a) The program must develop and 
315.16 	maintain a policy and procedure that requires the ongoing monitoring of the data from the 
315.17 	prescription monitoring program (PMP) for each client. The policy and procedure must 
315.18 	include how the program meets the requirements in paragraph (b).
315.19 	(b) If a medication used for the treatment of substance use disorder is administered or 
315.20 	dispensed to a client, the license holder shall be subject to the following requirements:
315.21 	(1) upon admission to a methadone clinic outpatient treatment program, a client must 
315.22 	be notified in writing that the commissioner of human services and the medical director 
315.23 	must monitor the PMP to review the prescribed controlled drugs a client received;
315.24 	(2) the medical director or the medical director's delegate must review the data from the 
315.25 	PMP described in section 152.126 before the client is ordered any controlled substance, as 
315.26 	defined under section 152.126, subdivision 1, paragraph (c), including medications used 
315.27 	for the treatment of opioid addiction, and the medical director's or the medical director's 
315.28 	delegate's subsequent reviews of the PMP data must occur at least every 90 days;
315.29 	(3) a copy of the PMP data reviewed must be maintained in the client's file;
315.30 	(4) when the PMP data contains a recent history of multiple prescribers or multiple 
315.31 	prescriptions for controlled substances, the physician's review of the data and subsequent 
315.32 	actions must be documented in the client's file within 72 hours and must contain the medical 
315.33 	director's determination of whether or not the prescriptions place the client at risk of harm 
316.1 	and the actions to be taken in response to the PMP findings. The provider must conduct 
316.2 	subsequent reviews of the PMP on a monthly basis; and
316.3 	(5) if at any time the medical director believes the use of the controlled substances places 
316.4 	the client at risk of harm, the program must seek the client's consent to discuss the client's 
316.5 	opioid treatment with other prescribers and must seek the client's consent for the other 
316.6 	prescriber to disclose to the opioid treatment program's medical director the client's condition 
316.7 	that formed the basis of the other prescriptions. If the information is not obtained within 
316.8 	seven days, the medical director must document whether or not changes to the client's 
316.9 	medication dose or number of unsupervised use doses are necessary until the information 
316.10 	is obtained.
316.11 	(c) The commissioner shall collaborate with the Minnesota Board of Pharmacy to develop 
316.12 	and implement an electronic system for the commissioner to routinely access the PMP data 
316.13 	to determine whether any client enrolled in an opioid addiction treatment program licensed 
316.14 	according to this section was prescribed or dispensed a controlled substance in addition to 
316.15 	that administered or dispensed by the opioid addiction treatment program. When the 
316.16 	commissioner determines there have been multiple prescribers or multiple prescriptions of 
316.17 	controlled substances for a client, the commissioner shall:
316.18 	(1) inform the medical director of the opioid treatment program only that the 
316.19 	commissioner determined the existence of multiple prescribers or multiple prescriptions of 
316.20 	controlled substances; and
316.21 	(2) direct the medical director of the opioid treatment program to access the data directly, 
316.22 	review the effect of the multiple prescribers or multiple prescriptions, and document the 
316.23 	review.
316.24 	(d) If determined necessary, the commissioner shall seek a federal waiver of, or exception 
316.25 	to, any applicable provision of Code of Federal Regulations, title 42, section 2.34(c), before 
316.26 	implementing this subdivision.
316.27 		Subd. 17.Policies and procedures. (a) A license holder must develop and maintain the 
316.28 	policies and procedures required in this subdivision.
316.29 	(b) For a program that is not open every day of the year, the license holder must maintain 
316.30 	a policy and procedure that permits a client to receive a single unsupervised use of medication 
316.31 	used for the treatment of opioid use disorder for days that the program is closed for business, 
316.32 	including, but not limited to, Sundays and state and federal holidays as required under 
316.33 	subdivision 6, paragraph (a), clause (1).
317.1 	(c) The license holder must maintain a policy and procedure that includes specific 
317.2 	measures to reduce the possibility of diversion. The policy and procedure must:
317.3 	(1) specifically identify and define the responsibilities of the medical and administrative 
317.4 	staff for performing diversion control measures; and
317.5 	(2) include a process for contacting no less than five percent of clients who have 
317.6 	unsupervised use of medication, excluding clients approved solely under subdivision 6, 
317.7 	paragraph (a), clause (1), to require clients to physically return to the program each month. 
317.8 	The system must require clients to return to the program within a stipulated time frame and 
317.9 	turn in all unused medication containers related to opioid use disorder treatment. The license 
317.10 	holder must document all related contacts on a central log and the outcome of the contact 
317.11 	for each client in the client's record.
317.12 	(d) Medication used for the treatment of opioid use disorder must be ordered, 
317.13 	administered, and dispensed according to applicable state and federal regulations and the 
317.14 	standards set by applicable accreditation entities. If a medication order requires assessment 
317.15 	by the person administering or dispensing the medication to determine the amount to be 
317.16 	administered or dispensed, the assessment must be completed by an individual whose 
317.17 	professional scope of practice permits an assessment. For the purposes of enforcement of 
317.18 	this paragraph, the commissioner has the authority to monitor the person administering or 
317.19 	dispensing the medication for compliance with state and federal regulations and the relevant 
317.20 	standards of the license holder's accreditation agency and may issue licensing actions 
317.21 	according to sections 245A.05, 245A.06, and 245A.07, based on the commissioner's 
317.22 	determination of noncompliance.
317.23 		Subd. 18.Quality improvement plan. The license holder must develop and maintain 
317.24 	a quality improvement plan that:
317.25 	(1) includes evaluation of the services provided to clients to identify issues that may 
317.26 	improve service delivery and client outcomes;
317.27 	(2) includes goals for the program to accomplish based on the evaluation;
317.28 	(3) is reviewed annually by the management of the program to determine whether the 
317.29 	goals were met and, if not, whether additional action is required;
317.30 	(4) is updated at least annually to include new or continued goals based on an updated 
317.31 	evaluation of services; and
317.32 	(5) identifies two specific goal areas, in addition to others identified by the program, 
317.33 	including:
318.1 	(i) a goal concerning oversight and monitoring of the premises around and near the 
318.2 	exterior of the program to reduce the possibility of medication used for the treatment of 
318.3 	opioid use disorder being inappropriately used by a client, including but not limited to the 
318.4 	sale or transfer of the medication to others; and
318.5 	(ii) a goal concerning community outreach, including but not limited to communications 
318.6 	with local law enforcement and county human services agencies, to increase coordination 
318.7 	of services and identification of areas of concern to be addressed in the plan.
318.8 		Subd. 19.Placing authorities. A program must provide certain notification and 
318.9 	client-specific updates to placing authorities for a client who is enrolled in Minnesota health 
318.10 	care programs. At the request of the placing authority, the program must provide 
318.11 	client-specific updates, including but not limited to informing the placing authority of 
318.12 	positive drug screenings and changes in medications used for the treatment of opioid use 
318.13 	disorder ordered for the client.
318.14 		Subd. 20.Duty to report suspected drug diversion. (a) To the fullest extent permitted 
318.15 	under Code of Federal Regulations, title 42, sections 2.1 to 2.67, a program shall report to 
318.16 	law enforcement any credible evidence that the program or its personnel knows, or reasonably 
318.17 	should know, that is directly related to a diversion crime on the premises of the program, 
318.18 	or a threat to commit a diversion crime.
318.19 	(b) "Diversion crime," for the purposes of this section, means diverting, attempting to 
318.20 	divert, or conspiring to divert Schedule I, II, III, or IV drugs, as defined in section 152.02, 
318.21 	on the program's premises.
318.22 	(c) The program must document the program's compliance with the requirement in 
318.23 	paragraph (a) in either a client's record or an incident report. A program's failure to comply 
318.24 	with paragraph (a) may result in sanctions as provided in sections 245A.06 and 245A.07.

318.25 	EFFECTIVE DATE. This section is effective July 1, 2017.

318.26 	Sec. 36. Minnesota Statutes 2016, section 246.18, subdivision 4, is amended to read:
318.27 		Subd. 4.Collections deposited in the general fund. Except as provided in subdivisions 
318.28 	5, 6, and 7, all receipts from collection efforts for the regional treatment centers, state nursing 
318.29 	homes, and other state facilities as defined in section 246.50, subdivision 3, must be deposited 
318.30 	in the general fund. From that amount, receipts from collection efforts for the Anoka-Metro 
318.31 	Regional Treatment Center and community behavioral health hospitals must be deposited 
318.32 	in accordance with subdivision 4a. The commissioner shall ensure that the departmental 
318.33 	financial reporting systems and internal accounting procedures comply with federal standards 
319.1 	for reimbursement for program and administrative expenditures and fulfill the purpose of 
319.2 	this paragraph subdivision.

319.3 	Sec. 37. Minnesota Statutes 2016, section 246.18, is amended by adding a subdivision to 
319.4 	read:
319.5 		Subd. 4a.Mental health innovation account. The mental health innovation account is 
319.6 	established in the special revenue fund. Beginning in fiscal year 2018, $1,000,000 of the 
319.7 	revenue generated by collection efforts from the Anoka-Metro Regional Treatment Center 
319.8 	and community behavioral health hospitals under section 246.54 must annually be deposited 
319.9 	into the mental health innovation account. Money deposited in the mental health innovation 
319.10 	account is appropriated to the commissioner of human services for the mental health 
319.11 	innovation grant program under section 245.4662.

319.12 	Sec. 38. Minnesota Statutes 2016, section 254A.01, is amended to read:
319.13 	254A.01 PUBLIC POLICY.
319.14 	It is hereby declared to be the public policy of this state that scientific evidence shows 
319.15 	that addiction to alcohol or other drugs is a chronic brain disorder with potential for 
319.16 	recurrence, and as with many other chronic conditions, people with substance use disorders 
319.17 	can be effectively treated and can enter recovery. The interests of society are best served 
319.18 	by reducing the stigma of substance use disorder and providing persons who are dependent 
319.19 	upon alcohol or other drugs with a comprehensive range of rehabilitative and social services
319.20 	that span intensity levels and are not restricted to a particular point in time. Further, it is 
319.21 	declared that treatment under these services shall be voluntary when possible: treatment 
319.22 	shall not be denied on the basis of prior treatment; treatment shall be based on an individual 
319.23 	treatment plan for each person undergoing treatment; treatment shall include a continuum 
319.24 	of services available for a person leaving a program of treatment; treatment shall include 
319.25 	all family members at the earliest possible phase of the treatment process.

319.26 	EFFECTIVE DATE. This section is effective January 1, 2018.

319.27 	Sec. 39. Minnesota Statutes 2016, section 254A.02, subdivision 2, is amended to read:
319.28 		Subd. 2.Approved treatment program. "Approved treatment program" means care 
319.29 	and treatment services provided by any individual, organization or association to drug 
319.30 	dependent persons with a substance use disorder, which meets the standards established by 
319.31 	the commissioner of human services.

319.32 	EFFECTIVE DATE. This section is effective January 1, 2018.

320.1 	Sec. 40. Minnesota Statutes 2016, section 254A.02, subdivision 3, is amended to read:
320.2 		Subd. 3.Comprehensive program. "Comprehensive program" means the range of 
320.3 	services which are to be made available for the purpose of prevention, care and treatment 
320.4 	of alcohol and drug abuse substance misuse and substance use disorder.

320.5 	EFFECTIVE DATE. This section is effective January 1, 2018.

320.6 	Sec. 41. Minnesota Statutes 2016, section 254A.02, subdivision 5, is amended to read:
320.7 		Subd. 5.Drug dependent person. "Drug dependent person" means any inebriate person 
320.8 	or any person incapable of self-management or management of personal affairs or unable 
320.9 	to function physically or mentally in an effective manner because of the abuse of a drug, 
320.10 	including alcohol.

320.11 	EFFECTIVE DATE. This section is effective January 1, 2018.

320.12 	Sec. 42. Minnesota Statutes 2016, section 254A.02, subdivision 6, is amended to read:
320.13 		Subd. 6.Facility. "Facility" means any treatment facility administered under an approved 
320.14 	treatment program established under Laws 1973, chapter 572.

320.15 	EFFECTIVE DATE. This section is effective January 1, 2018.

320.16 	Sec. 43. Minnesota Statutes 2016, section 254A.02, is amended by adding a subdivision 
320.17 	to read:
320.18 		Subd. 6a.Substance misuse. "Substance misuse" means the use of any psychoactive 
320.19 	or mood-altering substance, without compelling medical reason, in a manner that results in 
320.20 	mental, emotional, or physical impairment and causes socially dysfunctional or socially 
320.21 	disordering behavior and that results in psychological dependence or physiological addiction 
320.22 	as a function of continued use. Substance misuse has the same meaning as drug abuse or 
320.23 	abuse of drugs.

320.24 	EFFECTIVE DATE. This section is effective January 1, 2018.

320.25 	Sec. 44. Minnesota Statutes 2016, section 254A.02, subdivision 8, is amended to read:
320.26 		Subd. 8.Other drugs. "Other drugs" means any psychoactive chemical substance other 
320.27 	than alcohol.

320.28 	EFFECTIVE DATE. This section is effective January 1, 2018.

321.1 	Sec. 45. Minnesota Statutes 2016, section 254A.02, subdivision 10, is amended to read:
321.2 		Subd. 10.State authority. "State authority" is a division established within the 
321.3 	Department of Human Services for the purpose of relating the authority of state government 
321.4 	in the area of alcohol and drug abuse substance misuse and substance use disorder to the 
321.5 	alcohol and drug abuse substance misuse and substance use disorder-related activities within 
321.6 	the state.

321.7 	EFFECTIVE DATE. This section is effective January 1, 2018.

321.8 	Sec. 46. Minnesota Statutes 2016, section 254A.02, is amended by adding a subdivision 
321.9 	to read:
321.10 		Subd. 10a.Substance use disorder. "Substance use disorder" has the meaning given 
321.11 	in the current Diagnostic and Statistical Manual of Mental Disorders.

321.12 	EFFECTIVE DATE. This section is effective January 1, 2018.

321.13 	Sec. 47. Minnesota Statutes 2016, section 254A.03, is amended to read:
321.14 	254A.03 STATE AUTHORITY ON ALCOHOL AND DRUG ABUSE.
321.15 		Subdivision 1.Alcohol and Other Drug Abuse Section. There is hereby created an 
321.16 	Alcohol and Other Drug Abuse Section in the Department of Human Services. This section 
321.17 	shall be headed by a director. The commissioner may place the director's position in the 
321.18 	unclassified service if the position meets the criteria established in section 43A.08, 
321.19 	subdivision 1a. The section shall:
321.20 	(1) conduct and foster basic research relating to the cause, prevention and methods of 
321.21 	diagnosis, treatment and rehabilitation of alcoholic and other drug dependent persons with 
321.22 	substance misuse and substance use disorder;
321.23 	(2) coordinate and review all activities and programs of all the various state departments 
321.24 	as they relate to alcohol and other drug dependency and abuse problems associated with 
321.25 	substance misuse and substance use disorder;
321.26 	(3) develop, demonstrate, and disseminate new methods and techniques for the prevention, 
321.27 	early intervention, treatment and rehabilitation of alcohol and other drug abuse and 
321.28 	dependency problems recovery support for substance misuse and substance use disorder;
321.29 	(4) gather facts and information about alcoholism and other drug dependency and abuse
321.30 	substance misuse and substance use disorder, and about the efficiency and effectiveness of 
321.31 	prevention, treatment, and rehabilitation recovery support services from all comprehensive 
322.1 	programs, including programs approved or licensed by the commissioner of human services 
322.2 	or the commissioner of health or accredited by the Joint Commission on Accreditation of 
322.3 	Hospitals. The state authority is authorized to require information from comprehensive 
322.4 	programs which is reasonable and necessary to fulfill these duties. When required information 
322.5 	has been previously furnished to a state or local governmental agency, the state authority 
322.6 	shall collect the information from the governmental agency. The state authority shall 
322.7 	disseminate facts and summary information about alcohol and other drug abuse dependency
322.8 	problems associated with substance misuse and substance use disorder to public and private 
322.9 	agencies, local governments, local and regional planning agencies, and the courts for guidance 
322.10 	to and assistance in prevention, treatment and rehabilitation recovery support;
322.11 	(5) inform and educate the general public on alcohol and other drug dependency and 
322.12 	abuse problems substance misuse and substance use disorder;
322.13 	(6) serve as the state authority concerning alcohol and other drug dependency and abuse
322.14 	substance misuse and substance use disorder by monitoring the conduct of diagnosis and 
322.15 	referral services, research and comprehensive programs. The state authority shall submit a 
322.16 	biennial report to the governor and the legislature containing a description of public services 
322.17 	delivery and recommendations concerning increase of coordination and quality of services, 
322.18 	and decrease of service duplication and cost;
322.19 	(7) establish a state plan which shall set forth goals and priorities for a comprehensive 
322.20 	alcohol and other drug dependency and abuse program continuum of care for substance 
322.21 	misuse and substance use disorder for Minnesota. All state agencies operating alcohol and 
322.22 	other drug abuse or dependency substance misuse or substance use disorder programs or 
322.23 	administering state or federal funds for such programs shall annually set their program goals 
322.24 	and priorities in accordance with the state plan. Each state agency shall annually submit its 
322.25 	plans and budgets to the state authority for review. The state authority shall certify whether 
322.26 	proposed services comply with the comprehensive state plan and advise each state agency 
322.27 	of review findings;
322.28 	(8) make contracts with and grants to public and private agencies and organizations, 
322.29 	both profit and nonprofit, and individuals, using federal funds, and state funds as authorized 
322.30 	to pay for costs of state administration, including evaluation, statewide programs and services, 
322.31 	research and demonstration projects, and American Indian programs;
322.32 	(9) receive and administer monies money available for alcohol and drug abuse substance 
322.33 	misuse and substance use disorder programs under the alcohol, drug abuse, and mental 
322.34 	health services block grant, United States Code, title 42, sections 300X to 300X-9;
323.1 	(10) solicit and accept any gift of money or property for purposes of Laws 1973, chapter 
323.2 	572, and any grant of money, services, or property from the federal government, the state, 
323.3 	any political subdivision thereof, or any private source;
323.4 	(11) with respect to alcohol and other drug abuse substance misuse and substance use 
323.5 	disorder programs serving the American Indian community, establish guidelines for the 
323.6 	employment of personnel with considerable practical experience in alcohol and other drug 
323.7 	abuse problems substance misuse and substance use disorder, and understanding of social 
323.8 	and cultural problems related to alcohol and other drug abuse substance misuse and substance 
323.9 	use disorder, in the American Indian community.
323.10 		Subd. 2.American Indian programs. There is hereby created a section of American 
323.11 	Indian programs, within the Alcohol and Drug Abuse Section of the Department of Human 
323.12 	Services, to be headed by a special assistant for American Indian programs on alcoholism 
323.13 	and drug abuse substance misuse and substance use disorder and two assistants to that 
323.14 	position. The section shall be staffed with all personnel necessary to fully administer 
323.15 	programming for alcohol and drug abuse substance misuse and substance use disorder 
323.16 	services for American Indians in the state. The special assistant position shall be filled by 
323.17 	a person with considerable practical experience in and understanding of alcohol and other 
323.18 	drug abuse problems substance misuse and substance use disorder in the American Indian 
323.19 	community, who shall be responsible to the director of the Alcohol and Drug Abuse Section 
323.20 	created in subdivision 1 and shall be in the unclassified service. The special assistant shall 
323.21 	meet and consult with the American Indian Advisory Council as described in section 
323.22 	254A.035 and serve as a liaison to the Minnesota Indian Affairs Council and tribes to report 
323.23 	on the status of alcohol and other drug abuse substance misuse and substance use disorder
323.24 	among American Indians in the state of Minnesota. The special assistant with the approval 
323.25 	of the director shall:
323.26 	(1) administer funds appropriated for American Indian groups, organizations and 
323.27 	reservations within the state for American Indian alcoholism and drug abuse substance 
323.28 	misuse and substance use disorder programs;
323.29 	(2) establish policies and procedures for such American Indian programs with the 
323.30 	assistance of the American Indian Advisory Board; and
323.31 	(3) hire and supervise staff to assist in the administration of the American Indian program 
323.32 	section within the Alcohol and Drug Abuse Section of the Department of Human Services.
323.33 		Subd. 3.Rules for chemical dependency substance use disorder care. (a) The 
323.34 	commissioner of human services shall establish by rule criteria to be used in determining 
324.1 	the appropriate level of chemical dependency care for each recipient of public assistance 
324.2 	seeking treatment for alcohol or other drug dependency and abuse problems. substance 
324.3 	misuse or substance use disorder. Upon federal approval of a comprehensive assessment 
324.4 	as a Medicaid benefit, or on July 1, 2018, whichever is later, and notwithstanding the criteria 
324.5 	in Minnesota Rules, parts 9530.6600 to 9530.6655, an eligible vendor of comprehensive 
324.6 	assessments under section 254B.05 may determine and approve the appropriate level of 
324.7 	substance use disorder treatment for a recipient of public assistance. The process for 
324.8 	determining an individual's financial eligibility for the consolidated chemical dependency 
324.9 	treatment fund or determining an individual's enrollment in or eligibility for a publicly 
324.10 	subsidized health plan is not affected by the individual's choice to access a comprehensive 
324.11 	assessment for placement.
324.12 	(b) The commissioner shall develop and implement a utilization review process for 
324.13 	publicly funded treatment placements to monitor and review the clinical appropriateness 
324.14 	and timeliness of all publicly funded placements in treatment.

324.15 	EFFECTIVE DATE. This section is effective January 1, 2018.

324.16 	Sec. 48. Minnesota Statutes 2016, section 254A.035, subdivision 1, is amended to read:
324.17 		Subdivision 1.Establishment. There is created an American Indian Advisory Council 
324.18 	to assist the state authority on alcohol and drug abuse substance misuse and substance use 
324.19 	disorder in proposal review and formulating policies and procedures relating to chemical 
324.20 	dependency and the abuse of alcohol and other drugs substance misuse and substance use 
324.21 	disorder by American Indians.

324.22 	EFFECTIVE DATE. This section is effective January 1, 2018.

324.23 	Sec. 49. Minnesota Statutes 2016, section 254A.04, is amended to read:
324.24 	254A.04 CITIZENS ADVISORY COUNCIL.
324.25 	There is hereby created an Alcohol and Other Drug Abuse Advisory Council to advise 
324.26 	the Department of Human Services concerning the problems of alcohol and other drug 
324.27 	dependency and abuse substance misuse and substance use disorder, composed of ten 
324.28 	members. Five members shall be individuals whose interests or training are in the field of 
324.29 	alcohol dependency alcohol-specific substance use disorder and abuse alcohol misuse; and 
324.30 	five members whose interests or training are in the field of dependency substance use 
324.31 	disorder and abuse of drugs misuse of substances other than alcohol. The terms, compensation 
324.32 	and removal of members shall be as provided in section 15.059. The council expires June 
325.1 	30, 2018. The commissioner of human services shall appoint members whose terms end in 
325.2 	even-numbered years. The commissioner of health shall appoint members whose terms end 
325.3 	in odd-numbered years.

325.4 	EFFECTIVE DATE. This section is effective January 1, 2018.

325.5 	Sec. 50. Minnesota Statutes 2016, section 254A.08, is amended to read:
325.6 	254A.08 DETOXIFICATION CENTERS.
325.7 		Subdivision 1.Detoxification services. Every county board shall provide detoxification 
325.8 	services for drug dependent persons any person incapable of self-management or management 
325.9 	of personal affairs or unable to function physically or mentally in an effective manner 
325.10 	because of the use of a drug, including alcohol. The board may utilize existing treatment 
325.11 	programs and other agencies to meet this responsibility.
325.12 		Subd. 2.Program requirements. For the purpose of this section, a detoxification 
325.13 	program means a social rehabilitation program licensed by the Department of Human 
325.14 	Services under chapter 245A, and governed by the standards of Minnesota Rules, parts 
325.15 	9530.6510 to 9530.6590, and established for the purpose of facilitating access into care and 
325.16 	treatment by detoxifying and evaluating the person and providing entrance into a 
325.17 	comprehensive program. Evaluation of the person shall include verification by a professional, 
325.18 	after preliminary examination, that the person is intoxicated or has symptoms of chemical 
325.19 	dependency substance misuse or substance use disorder and appears to be in imminent 
325.20 	danger of harming self or others. A detoxification program shall have available the services 
325.21 	of a licensed physician for medical emergencies and routine medical surveillance. A 
325.22 	detoxification program licensed by the Department of Human Services to serve both adults 
325.23 	and minors at the same site must provide for separate sleeping areas for adults and minors.

325.24 	EFFECTIVE DATE. This section is effective January 1, 2018.

325.25 	Sec. 51. Minnesota Statutes 2016, section 254A.09, is amended to read:
325.26 	254A.09 CONFIDENTIALITY OF RECORDS.
325.27 	The Department of Human Services shall assure confidentiality to individuals who are 
325.28 	the subject of research by the state authority or are recipients of alcohol or drug abuse
325.29 	substance misuse or substance use disorder information, assessment, or treatment from a 
325.30 	licensed or approved program. The commissioner shall withhold from all persons not 
325.31 	connected with the conduct of the research the names or other identifying characteristics 
325.32 	of a subject of research unless the individual gives written permission that information 
326.1 	relative to treatment and recovery may be released. Persons authorized to protect the privacy 
326.2 	of subjects of research may not be compelled in any federal, state or local, civil, criminal, 
326.3 	administrative or other proceeding to identify or disclose other confidential information 
326.4 	about the individuals. Identifying information and other confidential information related to 
326.5 	alcohol or drug abuse substance misuse or substance use disorder information, assessment, 
326.6 	treatment, or aftercare services may be ordered to be released by the court for the purpose 
326.7 	of civil or criminal investigations or proceedings if, after review of the records considered 
326.8 	for disclosure, the court determines that the information is relevant to the purpose for which 
326.9 	disclosure is requested. The court shall order disclosure of only that information which is 
326.10 	determined relevant. In determining whether to compel disclosure, the court shall weigh 
326.11 	the public interest and the need for disclosure against the injury to the patient, to the treatment 
326.12 	relationship in the program affected and in other programs similarly situated, and the actual 
326.13 	or potential harm to the ability of programs to attract and retain patients if disclosure occurs. 
326.14 	This section does not exempt any person from the reporting obligations under section 
326.15 	626.556, nor limit the use of information reported in any proceeding arising out of the abuse 
326.16 	or neglect of a child. Identifying information and other confidential information related to 
326.17 	alcohol or drug abuse information substance misuse or substance use disorder, assessment, 
326.18 	treatment, or aftercare services may be ordered to be released by the court for the purpose 
326.19 	of civil or criminal investigations or proceedings. No information may be released pursuant 
326.20 	to this section that would not be released pursuant to section 595.02, subdivision 2.

326.21 	EFFECTIVE DATE. This section is effective January 1, 2018.

326.22 	Sec. 52. Minnesota Statutes 2016, section 254A.19, subdivision 3, is amended to read:
326.23 		Subd. 3.Financial conflicts of interest. (a) Except as provided in paragraph (b) or, (c),
326.24 	or (d), an assessor conducting a chemical use assessment under Minnesota Rules, parts 
326.25 	9530.6600 to 9530.6655, may not have any direct or shared financial interest or referral 
326.26 	relationship resulting in shared financial gain with a treatment provider.
326.27 	(b) A county may contract with an assessor having a conflict described in paragraph (a) 
326.28 	if the county documents that:
326.29 	(1) the assessor is employed by a culturally specific service provider or a service provider 
326.30 	with a program designed to treat individuals of a specific age, sex, or sexual preference;
326.31 	(2) the county does not employ a sufficient number of qualified assessors and the only 
326.32 	qualified assessors available in the county have a direct or shared financial interest or a 
326.33 	referral relationship resulting in shared financial gain with a treatment provider; or
327.1 	(3) the county social service agency has an existing relationship with an assessor or 
327.2 	service provider and elects to enter into a contract with that assessor to provide both 
327.3 	assessment and treatment under circumstances specified in the county's contract, provided 
327.4 	the county retains responsibility for making placement decisions.
327.5 	(c) The county may contract with a hospital to conduct chemical assessments if the 
327.6 	requirements in subdivision 1a are met.
327.7 	An assessor under this paragraph may not place clients in treatment. The assessor shall 
327.8 	gather required information and provide it to the county along with any required 
327.9 	documentation. The county shall make all placement decisions for clients assessed by 
327.10 	assessors under this paragraph.
327.11 	(d) An eligible vendor under section 254B.05 conducting a comprehensive assessment 
327.12 	for an individual seeking treatment shall approve the nature, intensity level, and duration 
327.13 	of treatment service if a need for services is indicated, but the individual assessed can access 
327.14 	any enrolled provider that is licensed to provide the level of service authorized, including 
327.15 	the provider or program that completed the assessment. If an individual is enrolled in a 
327.16 	prepaid health plan, the individual must comply with any provider network requirements 
327.17 	or limitations.

327.18 	EFFECTIVE DATE. This section is effective January 1, 2018.

327.19 	Sec. 53. Minnesota Statutes 2016, section 254B.01, subdivision 3, is amended to read:
327.20 		Subd. 3.Chemical dependency Substance use disorder treatment services. "Chemical 
327.21 	dependency Substance use disorder treatment services" means a planned program of care 
327.22 	for the treatment of chemical dependency substance misuse or chemical abuse substance 
327.23 	use disorder to minimize or prevent further chemical abuse substance misuse by the person. 
327.24 	Diagnostic, evaluation, prevention, referral, detoxification, and aftercare services that are 
327.25 	not part of a program of care licensable as a residential or nonresidential chemical dependency
327.26 	substance use disorder treatment program are not chemical dependency substance use 
327.27 	disorder services for purposes of this section. For pregnant and postpartum women, chemical 
327.28 	dependency substance use disorder services include halfway house services, aftercare 
327.29 	services, psychological services, and case management.

327.30 	EFFECTIVE DATE. This section is effective January 1, 2018.

328.1 	Sec. 54. Minnesota Statutes 2016, section 254B.01, is amended by adding a subdivision 
328.2 	to read:
328.3 		Subd. 8.Recovery community organization. "Recovery community organization" 
328.4 	means an independent organization led and governed by representatives of local communities 
328.5 	of recovery. A recovery community organization mobilizes resources within and outside 
328.6 	of the recovery community to increase the prevalence and quality of long-term recovery 
328.7 	from alcohol and other drug addiction. Recovery community organizations provide 
328.8 	peer-based recovery support activities such as training of recovery peers. Recovery 
328.9 	community organizations provide mentorship and ongoing support to individuals dealing 
328.10 	with a substance use disorder and connect them with the resources that can support each 
328.11 	person's recovery. A recovery community organization also promotes a recovery-focused 
328.12 	orientation in community education and outreach programming, and organize 
328.13 	recovery-focused policy advocacy activities to foster healthy communities and reduce the 
328.14 	stigma of substance use disorder.

328.15 	EFFECTIVE DATE. This section is effective January 1, 2018.

328.16 	Sec. 55. Minnesota Statutes 2016, section 254B.03, subdivision 2, is amended to read:
328.17 		Subd. 2.Chemical dependency fund payment. (a) Payment from the chemical 
328.18 	dependency fund is limited to payments for services other than detoxification licensed under 
328.19 	Minnesota Rules, parts 9530.6510 to 9530.6590, that, if located outside of federally 
328.20 	recognized tribal lands, would be required to be licensed by the commissioner as a chemical 
328.21 	dependency treatment or rehabilitation program under sections 245A.01 to 245A.16, and 
328.22 	services other than detoxification provided in another state that would be required to be 
328.23 	licensed as a chemical dependency program if the program were in the state. Out of state 
328.24 	vendors must also provide the commissioner with assurances that the program complies 
328.25 	substantially with state licensing requirements and possesses all licenses and certifications 
328.26 	required by the host state to provide chemical dependency treatment. Except for chemical 
328.27 	dependency transitional rehabilitation programs, Vendors receiving payments from the 
328.28 	chemical dependency fund must not require co-payment from a recipient of benefits for 
328.29 	services provided under this subdivision. The vendor is prohibited from using the client's 
328.30 	public benefits to offset the cost of services paid under this section. The vendor shall not 
328.31 	require the client to use public benefits for room or board costs. This includes but is not 
328.32 	limited to cash assistance benefits under chapters 119B, 256D, and 256J, or SNAP benefits. 
328.33 	Retention of SNAP benefits is a right of a client receiving services through the consolidated 
328.34 	chemical dependency treatment fund or through state contracted managed care entities. 
329.1 	Payment from the chemical dependency fund shall be made for necessary room and board 
329.2 	costs provided by vendors certified according to section 254B.05, or in a community hospital 
329.3 	licensed by the commissioner of health according to sections 144.50 to 144.56 to a client 
329.4 	who is:
329.5 	(1) determined to meet the criteria for placement in a residential chemical dependency 
329.6 	treatment program according to rules adopted under section 254A.03, subdivision 3; and
329.7 	(2) concurrently receiving a chemical dependency treatment service in a program licensed 
329.8 	by the commissioner and reimbursed by the chemical dependency fund.
329.9 	(b) A county may, from its own resources, provide chemical dependency services for 
329.10 	which state payments are not made. A county may elect to use the same invoice procedures 
329.11 	and obtain the same state payment services as are used for chemical dependency services 
329.12 	for which state payments are made under this section if county payments are made to the 
329.13 	state in advance of state payments to vendors. When a county uses the state system for 
329.14 	payment, the commissioner shall make monthly billings to the county using the most recent 
329.15 	available information to determine the anticipated services for which payments will be made 
329.16 	in the coming month. Adjustment of any overestimate or underestimate based on actual 
329.17 	expenditures shall be made by the state agency by adjusting the estimate for any succeeding 
329.18 	month.
329.19 	(c) The commissioner shall coordinate chemical dependency services and determine 
329.20 	whether there is a need for any proposed expansion of chemical dependency treatment 
329.21 	services. The commissioner shall deny vendor certification to any provider that has not 
329.22 	received prior approval from the commissioner for the creation of new programs or the 
329.23 	expansion of existing program capacity. The commissioner shall consider the provider's 
329.24 	capacity to obtain clients from outside the state based on plans, agreements, and previous 
329.25 	utilization history, when determining the need for new treatment services.

329.26 	EFFECTIVE DATE. This section is effective January 1, 2018.

329.27 	Sec. 56. Minnesota Statutes 2016, section 254B.04, subdivision 1, is amended to read:
329.28 		Subdivision 1.Eligibility. (a) Persons eligible for benefits under Code of Federal 
329.29 	Regulations, title 25, part 20, and persons eligible for medical assistance benefits under 
329.30 	sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 5, and 6, or who meet the 
329.31 	income standards of section 256B.056, subdivision 4, are entitled to chemical dependency 
329.32 	fund services. State money appropriated for this paragraph must be placed in a separate 
329.33 	account established for this purpose.
330.1 	Persons with dependent children who are determined to be in need of chemical 
330.2 	dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or 
330.3 	a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the 
330.4 	local agency to access needed treatment services. Treatment services must be appropriate 
330.5 	for the individual or family, which may include long-term care treatment or treatment in a 
330.6 	facility that allows the dependent children to stay in the treatment facility. The county shall 
330.7 	pay for out-of-home placement costs, if applicable.
330.8 	(b) A person not entitled to services under paragraph (a), but with family income that 
330.9 	is less than 215 percent of the federal poverty guidelines for the applicable family size, shall 
330.10 	be eligible to receive chemical dependency fund services within the limit of funds 
330.11 	appropriated for this group for the fiscal year. If notified by the state agency of limited 
330.12 	funds, a county must give preferential treatment to persons with dependent children who 
330.13 	are in need of chemical dependency treatment pursuant to an assessment under section 
330.14 	626.556, subdivision 10, or a case plan under section 260C.201, subdivision 6, or 260C.212. 
330.15 	A county may spend money from its own sources to serve persons under this paragraph. 
330.16 	State money appropriated for this paragraph must be placed in a separate account established 
330.17 	for this purpose.
330.18 	(c) Persons whose income is between 215 percent and 412 percent of the federal poverty 
330.19 	guidelines for the applicable family size shall be eligible for chemical dependency services 
330.20 	on a sliding fee basis, within the limit of funds appropriated for this group for the fiscal 
330.21 	year. Persons eligible under this paragraph must contribute to the cost of services according 
330.22 	to the sliding fee scale established under subdivision 3. A county may spend money from 
330.23 	its own sources to provide services to persons under this paragraph. State money appropriated 
330.24 	for this paragraph must be placed in a separate account established for this purpose.

330.25 	EFFECTIVE DATE. This section is effective January 1, 2018.

330.26 	Sec. 57. Minnesota Statutes 2016, section 254B.04, subdivision 2b, is amended to read:
330.27 		Subd. 2b.Eligibility for placement in opioid treatment programs. (a) Notwithstanding 
330.28 	provisions of Minnesota Rules, part 9530.6622, subpart 5, related to a placement authority's 
330.29 	requirement to authorize services or service coordination in a program that complies with 
330.30 	Minnesota Rules, part 9530.6500, or Code of Federal Regulations, title 42, part 8, and after 
330.31 	taking into account an individual's preference for placement in an opioid treatment program, 
330.32 	a placement authority may, but is not required to, authorize services or service coordination 
330.33 	or otherwise place an individual in an opioid treatment program. Prior to making a 
331.1 	determination of placement for an individual, the placing authority must consult with the 
331.2 	current treatment provider, if any.
331.3 	(b) Prior to placement of an individual who is determined by the assessor to require 
331.4 	treatment for opioid addiction, the assessor must provide educational information concerning 
331.5 	treatment options for opioid addiction, including the use of a medication for the use of 
331.6 	opioid addiction. The commissioner shall develop educational materials supported by 
331.7 	research and updated periodically that must be used by assessors to comply with this 
331.8 	requirement.

331.9 	EFFECTIVE DATE. This section is effective January 1, 2018.

331.10 	Sec. 58. Minnesota Statutes 2016, section 254B.05, subdivision 1, is amended to read:
331.11 		Subdivision 1.Licensure required. (a) Programs licensed by the commissioner are 
331.12 	eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors, 
331.13 	notwithstanding the provisions of section 245A.03. American Indian programs that provide 
331.14 	chemical dependency primary substance use disorder treatment, extended care, transitional 
331.15 	residence, or outpatient treatment services, and are licensed by tribal government are eligible 
331.16 	vendors.
331.17 	(b) On July 1, 2018, or upon federal approval, whichever is later, a licensed professional 
331.18 	in private practice who meets the requirements of section 245G.11, subdivisions 1 and 4, 
331.19 	is an eligible vendor of a comprehensive assessment and assessment summary provided 
331.20 	according to section 245G.05, and treatment services provided according to sections 245G.06 
331.21 	and 245G.07, subdivision 1, paragraphs (a), clauses (1) to (5), and (b); and subdivision 2.
331.22 	(c) On July 1, 2018, or upon federal approval, whichever is later, a county is an eligible 
331.23 	vendor for a comprehensive assessment and assessment summary when provided by an 
331.24 	individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 4, and 
331.25 	completed according to the requirements of section 245G.05. A county is an eligible vendor 
331.26 	of care coordination services when provided by an individual who meets the staffing 
331.27 	credentials of section 245G.11, subdivisions 1 and 7, and provided according to the 
331.28 	requirements of section 245G.07, subdivision 1, clause (7).
331.29 	(d) On July 1, 2018, or upon federal approval, whichever is later, a recovery community 
331.30 	organization that meets certification requirements identified by the commissioner is an 
331.31 	eligible vendor of peer support services.
331.32 	(e) Detoxification programs licensed under Minnesota Rules, parts 9530.6510 to 
331.33 	9530.6590, are not eligible vendors. Programs that are not licensed as a chemical dependency
332.1 	residential or nonresidential substance use disorder treatment or withdrawal management 
332.2 	program by the commissioner or by tribal government or do not meet the requirements of 
332.3 	subdivisions 1a and 1b are not eligible vendors.

332.4 	EFFECTIVE DATE. This section is effective January 1, 2018.

332.5 	Sec. 59. Minnesota Statutes 2016, section 254B.05, subdivision 1a, is amended to read:
332.6 		Subd. 1a.Room and board provider requirements. (a) Effective January 1, 2000, 
332.7 	vendors of room and board are eligible for chemical dependency fund payment if the vendor:
332.8 	(1) has rules prohibiting residents bringing chemicals into the facility or using chemicals 
332.9 	while residing in the facility and provide consequences for infractions of those rules;
332.10 	(2) is determined to meet applicable health and safety requirements;
332.11 	(3) is not a jail or prison;
332.12 	(4) is not concurrently receiving funds under chapter 256I for the recipient;
332.13 	(5) admits individuals who are 18 years of age or older;
332.14 	(6) is registered as a board and lodging or lodging establishment according to section 
332.15 	157.17;
332.16 	(7) has awake staff on site 24 hours per day;
332.17 	(8) has staff who are at least 18 years of age and meet the requirements of Minnesota 
332.18 	Rules, part 9530.6450, subpart 1, item A section 245G.11, subdivision 1, paragraph (a);
332.19 	(9) has emergency behavioral procedures that meet the requirements of Minnesota Rules, 
332.20 	part 9530.6475 section 245G.16;
332.21 	(10) meets the requirements of Minnesota Rules, part 9530.6435, subparts 3 and 4, items 
332.22 	A and B section 245G.08, subdivision 5, if administering medications to clients;
332.23 	(11) meets the abuse prevention requirements of section 245A.65, including a policy on 
332.24 	fraternization and the mandatory reporting requirements of section 626.557;
332.25 	(12) documents coordination with the treatment provider to ensure compliance with 
332.26 	section 254B.03, subdivision 2;
332.27 	(13) protects client funds and ensures freedom from exploitation by meeting the 
332.28 	provisions of section 245A.04, subdivision 13;
332.29 	(14) has a grievance procedure that meets the requirements of Minnesota Rules, part 
332.30 	9530.6470, subpart 2 section 245G.15, subdivision 2; and
333.1 	(15) has sleeping and bathroom facilities for men and women separated by a door that 
333.2 	is locked, has an alarm, or is supervised by awake staff.
333.3 	(b) Programs licensed according to Minnesota Rules, chapter 2960, are exempt from 
333.4 	paragraph (a), clauses (5) to (15).

333.5 	EFFECTIVE DATE. This section is effective January 1, 2018.

333.6 	Sec. 60. Minnesota Statutes 2016, section 254B.05, subdivision 5, is amended to read:
333.7 		Subd. 5.Rate requirements. (a) The commissioner shall establish rates for chemical 
333.8 	dependencysubstance use disorder services and service enhancements funded under this 
333.9 	chapter.
333.10 	(b) Eligible chemical dependency substance use disorder treatment services include:
333.11 	(1) outpatient treatment services that are licensed according to Minnesota Rules, parts 
333.12 	9530.6405 to 9530.6480 sections 245G.01 to 245G.17, or applicable tribal license;
333.13 	(2) on July 1, 2018, or upon federal approval, whichever is later, comprehensive 
333.14 	assessments provided according to sections 245.4863, paragraph (a), and 245G.05, and 
333.15 	Minnesota Rules, part 9530.6422;
333.16 	(3) on July 1, 2018, or upon federal approval, whichever is later, care coordination 
333.17 	services provided according to section 245G.07, subdivision 1, paragraph (a), clause (6);
333.18 	(4) on July 1, 2018, or upon federal approval, whichever is later, peer recovery support 
333.19 	services provided according to section 245G.07, subdivision 1, paragraph (a), clause (5);
333.20 	(5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management 
333.21 	services provided according to chapter 245F;
333.22 	(2) (6) medication-assisted therapy services that are licensed according to Minnesota 
333.23 	Rules, parts 9530.6405 to 9530.6480 and 9530.6500 section 245G.07, subdivision 1, or 
333.24 	applicable tribal license;
333.25 	(3) (7) medication-assisted therapy plus enhanced treatment services that meet the 
333.26 	requirements of clause (2) (6) and provide nine hours of clinical services each week;
333.27 	(4) (8) high, medium, and low intensity residential treatment services that are licensed 
333.28 	according to Minnesota Rules, parts 9530.6405 to 9530.6480 and 9530.6505, sections 
333.29 	245G.01 to 245G.17 and 245G.21 or applicable tribal license which provide, respectively, 
333.30 	30, 15, and five hours of clinical services each week;
334.1 	(5) (9) hospital-based treatment services that are licensed according to Minnesota Rules, 
334.2 	parts 9530.6405 to 9530.6480,sections 245G.01 to 245G.17 or applicable tribal license and 
334.3 	licensed as a hospital under sections 144.50 to 144.56;
334.4 	(6) (10) adolescent treatment programs that are licensed as outpatient treatment programs 
334.5 	according to Minnesota Rules, parts 9530.6405 to 9530.6485, sections 245G.01 to 245G.18
334.6 	or as residential treatment programs according to Minnesota Rules, parts 2960.0010 to 
334.7 	2960.0220, and 2960.0430 to 2960.0490, or applicable tribal license;
334.8 	(7) (11) high-intensity residential treatment services that are licensed according to 
334.9 	Minnesota Rules, parts 9530.6405 to 9530.6480 and 9530.6505, sections 245G.01 to 245G.17 
334.10 	and 245G.21 or applicable tribal license, which provide 30 hours of clinical services each 
334.11 	week provided by a state-operated vendor or to clients who have been civilly committed to 
334.12 	the commissioner, present the most complex and difficult care needs, and are a potential 
334.13 	threat to the community; and
334.14 	(8) (12) room and board facilities that meet the requirements of subdivision 1a.
334.15 	(c) The commissioner shall establish higher rates for programs that meet the requirements 
334.16 	of paragraph (b) and one of the following additional requirements:
334.17 	(1) programs that serve parents with their children if the program:
334.18 	(i) provides on-site child care during the hours of treatment activity that:
334.19 	(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter 
334.20 	9503; or
334.21 	(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph 
334.22 	(a), clause (6), and meets the requirements under Minnesota Rules, part 9530.6490, subpart 
334.23 	4 section 245G.19, subdivision 4; or
334.24 	(ii) arranges for off-site child care during hours of treatment activity at a facility that is 
334.25 	licensed under chapter 245A as:
334.26 	(A) a child care center under Minnesota Rules, chapter 9503; or
334.27 	(B) a family child care home under Minnesota Rules, chapter 9502;
334.28 	(2) culturally specific programs as defined in section 254B.01, subdivision 4a, or 
334.29 	programs or subprograms serving special populations, if the program or subprogram meets 
334.30 	the following requirements:
334.31 	(i) is designed to address the unique needs of individuals who share a common language, 
334.32 	racial, ethnic, or social background;
335.1 	(ii) is governed with significant input from individuals of that specific background; and
335.2 	(iii) employs individuals to provide individual or group therapy, at least 50 percent of 
335.3 	whom are of that specific background, except when the common social background of the 
335.4 	individuals served is a traumatic brain injury or cognitive disability and the program employs 
335.5 	treatment staff who have the necessary professional training, as approved by the 
335.6 	commissioner, to serve clients with the specific disabilities that the program is designed to 
335.7 	serve;
335.8 	(3) programs that offer medical services delivered by appropriately credentialed health 
335.9 	care staff in an amount equal to two hours per client per week if the medical needs of the 
335.10 	client and the nature and provision of any medical services provided are documented in the 
335.11 	client file; and
335.12 	(4) programs that offer services to individuals with co-occurring mental health and 
335.13 	chemical dependency problems if:
335.14 	(i) the program meets the co-occurring requirements in Minnesota Rules, part 9530.6495
335.15 	section 245G.20;
335.16 	(ii) 25 percent of the counseling staff are licensed mental health professionals, as defined 
335.17 	in section 245.462, subdivision 18, clauses (1) to (6), or are students or licensing candidates 
335.18 	under the supervision of a licensed alcohol and drug counselor supervisor and licensed 
335.19 	mental health professional, except that no more than 50 percent of the mental health staff 
335.20 	may be students or licensing candidates with time documented to be directly related to 
335.21 	provisions of co-occurring services;
335.22 	(iii) clients scoring positive on a standardized mental health screen receive a mental 
335.23 	health diagnostic assessment within ten days of admission;
335.24 	(iv) the program has standards for multidisciplinary case review that include a monthly 
335.25 	review for each client that, at a minimum, includes a licensed mental health professional 
335.26 	and licensed alcohol and drug counselor, and their involvement in the review is documented;
335.27 	(v) family education is offered that addresses mental health and substance abuse disorders 
335.28 	and the interaction between the two; and
335.29 	(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder 
335.30 	training annually.
335.31 	(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program 
335.32 	that provides arrangements for off-site child care must maintain current documentation at 
335.33 	the chemical dependency facility of the child care provider's current licensure to provide 
336.1 	child care services. Programs that provide child care according to paragraph (c), clause (1), 
336.2 	must be deemed in compliance with the licensing requirements in Minnesota Rules, part 
336.3 	9530.6490 section 245G.19.
336.4 	(e) Adolescent residential programs that meet the requirements of Minnesota Rules, 
336.5 	parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements 
336.6 	in paragraph (c), clause (4), items (i) to (iv).
336.7 	(f) Subject to federal approval, chemical dependency services that are otherwise covered 
336.8 	as direct face-to-face services may be provided via two-way interactive video. The use of 
336.9 	two-way interactive video must be medically appropriate to the condition and needs of the 
336.10 	person being served. Reimbursement shall be at the same rates and under the same conditions 
336.11 	that would otherwise apply to direct face-to-face services. The interactive video equipment 
336.12 	and connection must comply with Medicare standards in effect at the time the service is 
336.13 	provided.

336.14 	EFFECTIVE DATE. This section is effective January 1, 2018.

336.15 	Sec. 61. Minnesota Statutes 2016, section 254B.051, is amended to read:
336.16 	254B.051 SUBSTANCE ABUSE USE DISORDER TREATMENT 
336.17 	EFFECTIVENESS.
336.18 	In addition to the substance abuse use disorder treatment program performance outcome 
336.19 	measures that the commissioner of human services collects annually from treatment providers, 
336.20 	the commissioner shall request additional data from programs that receive appropriations 
336.21 	from the consolidated chemical dependency treatment fund. This data shall include number 
336.22 	of client readmissions six months after release from inpatient treatment, and the cost of 
336.23 	treatment per person for each program receiving consolidated chemical dependency treatment 
336.24 	funds. The commissioner may post this data on the department Web site.

336.25 	EFFECTIVE DATE. This section is effective January 1, 2018.

336.26 	Sec. 62. Minnesota Statutes 2016, section 254B.07, is amended to read:
336.27 	254B.07 THIRD-PARTY LIABILITY.
336.28 	The state agency provision and payment of, or liability for, chemical dependency
336.29 	substance use disorder medical care is the same as in section 256B.042.

336.30 	EFFECTIVE DATE. This section is effective January 1, 2018.

337.1 	Sec. 63. Minnesota Statutes 2016, section 254B.08, is amended to read:
337.2 	254B.08 FEDERAL WAIVERS.
337.3 	The commissioner shall apply for any federal waivers necessary to secure, to the extent 
337.4 	allowed by law, federal financial participation for the provision of services to persons who 
337.5 	need chemical dependency substance use disorder services. The commissioner may seek 
337.6 	amendments to the waivers or apply for additional waivers to contain costs. The 
337.7 	commissioner shall ensure that payment for the cost of providing chemical dependency
337.8 	substance use disorder services under the federal waiver plan does not exceed the cost of 
337.9 	chemical dependency substance use disorder services that would have been provided without 
337.10 	the waivered services.

337.11 	EFFECTIVE DATE. This section is effective January 1, 2018.

337.12 	Sec. 64. Minnesota Statutes 2016, section 254B.09, is amended to read:
337.13 	254B.09 INDIAN RESERVATION ALLOCATION OF CHEMICAL 
337.14 	DEPENDENCY FUND.
337.15 		Subdivision 1.Vendor payments. The commissioner shall pay eligible vendors for 
337.16 	chemical dependency substance use disorder services to American Indians on the same 
337.17 	basis as other payments, except that no local match is required when an invoice is submitted 
337.18 	by the governing authority of a federally recognized American Indian tribal body or a county 
337.19 	if the tribal governing body has not entered into an agreement under subdivision 2 on behalf 
337.20 	of a current resident of the reservation under this section.
337.21 		Subd. 2.American Indian agreements. The commissioner may enter into agreements 
337.22 	with federally recognized tribal units to pay for chemical dependency substance use disorder
337.23 	treatment services provided under Laws 1986, chapter 394, sections 8 to 20. The agreements 
337.24 	must clarify how the governing body of the tribal unit fulfills local agency responsibilities 
337.25 	regarding:
337.26 	(1) the form and manner of invoicing; and
337.27 	(2) provide that only invoices for eligible vendors according to section 254B.05 will be 
337.28 	included in invoices sent to the commissioner for payment, to the extent that money allocated 
337.29 	under subdivisions 4 and 5 is used.
337.30 		Subd. 6.American Indian tribal placements. After entering into an agreement under 
337.31 	subdivision 2, the governing authority of each reservation may submit invoices to the state 
337.32 	for the cost of providing chemical dependency substance use disorder services to residents 
338.1 	of the reservation according to the placement rules governing county placements, except 
338.2 	that local match requirements are waived. The governing body may designate an agency to 
338.3 	act on its behalf to provide placement services and manage invoices by written notice to 
338.4 	the commissioner and evidence of agreement by the agency designated.
338.5 		Subd. 8.Payments to improve services to American Indians. The commissioner may 
338.6 	set rates for chemical dependency substance use disorder services to American Indians 
338.7 	according to the American Indian Health Improvement Act, Public Law 94-437, for eligible 
338.8 	vendors. These rates shall supersede rates set in county purchase of service agreements 
338.9 	when payments are made on behalf of clients eligible according to Public Law 94-437.

338.10 	EFFECTIVE DATE. This section is effective January 1, 2018.

338.11 	Sec. 65. Minnesota Statutes 2016, section 254B.12, subdivision 2, is amended to read:
338.12 		Subd. 2.Payment methodology for highly specialized vendors. Notwithstanding 
338.13 	subdivision 1, the commissioner shall seek federal authority to develop separate payment 
338.14 	methodologies for chemical dependency substance use disorder treatment services provided 
338.15 	under the consolidated chemical dependency treatment fund: (1) by a state-operated vendor; 
338.16 	or (2) for persons who have been civilly committed to the commissioner, present the most 
338.17 	complex and difficult care needs, and are a potential threat to the community. A payment 
338.18 	methodology under this subdivision is effective for services provided on or after October 
338.19 	1, 2015, or on or after the receipt of federal approval, whichever is later.

338.20 	EFFECTIVE DATE. This section is effective January 1, 2018.

338.21 	Sec. 66. Minnesota Statutes 2016, section 254B.12, is amended by adding a subdivision 
338.22 	to read:
338.23 		Subd. 3.Chemical dependency provider rate increase. For the chemical dependency 
338.24 	services listed in section 254B.05, subdivision 5, and provided on or after July 1, 2017, 
338.25 	payment rates shall be increased by one percent over the rates in effect on January 1, 2017, 
338.26 	for vendors who meet the requirements of section 254B.05.

338.27 	Sec. 67. Minnesota Statutes 2016, section 254B.13, subdivision 2a, is amended to read:
338.28 		Subd. 2a.Eligibility for navigator pilot program. (a) To be considered for participation 
338.29 	in a navigator pilot program, an individual must:
338.30 	(1) be a resident of a county with an approved navigator program;
338.31 	(2) be eligible for consolidated chemical dependency treatment fund services;
339.1 	(3) be a voluntary participant in the navigator program;
339.2 	(4) satisfy one of the following items:
339.3 	(i) have at least one severity rating of three or above in dimension four, five, or six in a 
339.4 	comprehensive assessment under Minnesota Rules, part 9530.6422 section 245G.05, 
339.5 	paragraph (c), clauses (4) to (6); or
339.6 	(ii) have at least one severity rating of two or above in dimension four, five, or six in a 
339.7 	comprehensive assessment under Minnesota Rules, part 9530.6422, section 245G.05, 
339.8 	paragraph (c), clauses (4) to (6), and be currently participating in a Rule 31 treatment program 
339.9 	under Minnesota Rules, parts 9530.6405 to 9530.6505, chapter 245G or be within 60 days 
339.10 	following discharge after participation in a Rule 31 treatment program; and
339.11 	(5) have had at least two treatment episodes in the past two years, not limited to episodes 
339.12 	reimbursed by the consolidated chemical dependency treatment funds. An admission to an 
339.13 	emergency room, a detoxification program, or a hospital may be substituted for one treatment 
339.14 	episode if it resulted from the individual's substance use disorder.
339.15 	(b) New eligibility criteria may be added as mutually agreed upon by the commissioner 
339.16 	and participating navigator programs.

339.17 	EFFECTIVE DATE. This section is effective January 1, 2018.

339.18 	Sec. 68. Minnesota Statutes 2016, section 256B.0625, subdivision 45a, is amended to 
339.19 	read:
339.20 		Subd. 45a.Psychiatric residential treatment facility services for persons under 21 
339.21 	years of age. (a) Medical assistance covers psychiatric residential treatment facility services, 
339.22 	according to section 256B.0941, for persons under younger than 21 years of age. Individuals 
339.23 	who reach age 21 at the time they are receiving services are eligible to continue receiving 
339.24 	services until they no longer require services or until they reach age 22, whichever occurs 
339.25 	first.
339.26 	(b) For purposes of this subdivision, "psychiatric residential treatment facility" means 
339.27 	a facility other than a hospital that provides psychiatric services, as described in Code of 
339.28 	Federal Regulations, title 42, sections 441.151 to 441.182, to individuals under age 21 in 
339.29 	an inpatient setting.
339.30 	(c) The commissioner shall develop admissions and discharge procedures and establish 
339.31 	rates consistent with guidelines from the federal Centers for Medicare and Medicaid Services.
340.1 	(d) The commissioner shall enroll up to 150 certified psychiatric residential treatment 
340.2 	facility services beds at up to six sites. The commissioner shall select psychiatric residential 
340.3 	treatment facility services providers through a request for proposals process. Providers of 
340.4 	state-operated services may respond to the request for proposals.

340.5 	EFFECTIVE DATE. This section is effective the day following final enactment.

340.6 	Sec. 69. [256B.0941] PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY 
340.7 	FOR PERSONS UNDER 21 YEARS OF AGE.
340.8 		Subdivision 1.Eligibility. (a) An individual who is eligible for mental health treatment 
340.9 	services in a psychiatric residential treatment facility must meet all of the following criteria:
340.10 	(1) before admission, services are determined to be medically necessary by the state's 
340.11 	medical review agent according to Code of Federal Regulations, title 42, section 441.152;
340.12 	(2) is younger than 21 years of age at the time of admission. Services may continue until 
340.13 	the individual meets criteria for discharge or reaches 22 years of age, whichever occurs 
340.14 	first;
340.15 	(3) has a mental health diagnosis as defined in the most recent edition of the Diagnostic 
340.16 	and Statistical Manual for Mental Disorders, as well as clinical evidence of severe aggression, 
340.17 	or a finding that the individual is a risk to self or others;
340.18 	(4) has functional impairment and a history of difficulty in functioning safely and 
340.19 	successfully in the community, school, home, or job; an inability to adequately care for 
340.20 	one's physical needs; or caregivers, guardians, or family members are unable to safely fulfill 
340.21 	the individual's needs;
340.22 	(5) requires psychiatric residential treatment under the direction of a physician to improve 
340.23 	the individual's condition or prevent further regression so that services will no longer be 
340.24 	needed;
340.25 	(6) utilized and exhausted other community-based mental health services, or clinical 
340.26 	evidence indicates that such services cannot provide the level of care needed; and
340.27 	(7) was referred for treatment in a psychiatric residential treatment facility by a qualified 
340.28 	mental health professional licensed as defined in section 245.4871, subdivision 27, clauses 
340.29 	(1) to (6).
340.30 	(b) A mental health professional making a referral shall submit documentation to the 
340.31 	state's medical review agent containing all information necessary to determine medical 
340.32 	necessity, including a standard diagnostic assessment completed within 180 days of the 
341.1 	individual's admission. Documentation shall include evidence of family participation in the 
341.2 	individual's treatment planning and signed consent for services.
341.3 		Subd. 2.Services. Psychiatric residential treatment facility service providers must offer 
341.4 	and have the capacity to provide the following services:
341.5 	(1) development of the individual plan of care, review of the individual plan of care 
341.6 	every 30 days, and discharge planning by required members of the treatment team according 
341.7 	to Code of Federal Regulations, title 42, sections 441.155 to 441.156;
341.8 	(2) any services provided by a psychiatrist or physician for development of an individual 
341.9 	plan of care, conducting a review of the individual plan of care every 30 days, and discharge 
341.10 	planning by required members of the treatment team according to Code of Federal 
341.11 	Regulations, title 42, sections 441.155 to 441.156;
341.12 	(3) active treatment seven days per week that may include individual, family, or group 
341.13 	therapy as determined by the individual care plan;
341.14 	(4) individual therapy, provided a minimum of twice per week;
341.15 	(5) family engagement activities, provided a minimum of once per week;
341.16 	(6) consultation with other professionals, including case managers, primary care 
341.17 	professionals, community-based mental health providers, school staff, or other support 
341.18 	planners;
341.19 	(7) coordination of educational services between local and resident school districts and 
341.20 	the facility;
341.21 	(8) 24-hour nursing; and
341.22 	(9) direct care and supervision, supportive services for daily living and safety, and 
341.23 	positive behavior management.
341.24 		Subd. 3.Per diem rate. (a) The commissioner shall establish a statewide per diem rate 
341.25 	for psychiatric residential treatment facility services for individuals 21 years of age or 
341.26 	younger. The rate for a provider must not exceed the rate charged by that provider for the 
341.27 	same service to other payers. Payment must not be made to more than one entity for each 
341.28 	individual for services provided under this section on a given day. The commissioner shall 
341.29 	set rates prospectively for the annual rate period. The commissioner shall require providers 
341.30 	to submit annual cost reports on a uniform cost reporting form and shall use submitted cost 
341.31 	reports to inform the rate-setting process. The cost reporting shall be done according to 
341.32 	federal requirements for Medicare cost reports.
342.1 	(b) The following are included in the rate:
342.2 	(1) costs necessary for licensure and accreditation, meeting all staffing standards for 
342.3 	participation, meeting all service standards for participation, meeting all requirements for 
342.4 	active treatment, maintaining medical records, conducting utilization review, meeting 
342.5 	inspection of care, and discharge planning. The direct services costs must be determined 
342.6 	using the actual cost of salaries, benefits, payroll taxes, and training of direct services staff 
342.7 	and service-related transportation; and
342.8 	(2) payment for room and board provided by facilities meeting all accreditation and 
342.9 	licensing requirements for participation.
342.10 	(c) A facility may submit a claim for payment outside of the per diem for professional 
342.11 	services arranged by and provided at the facility by an appropriately licensed professional 
342.12 	who is enrolled as a provider with Minnesota health care programs. Arranged services must 
342.13 	be billed by the facility on a separate claim, and the facility shall be responsible for payment 
342.14 	to the provider. These services must be included in the individual plan of care and are subject 
342.15 	to prior authorization by the state's medical review agent.
342.16 	(d) Medicaid shall reimburse for concurrent services as approved by the commissioner 
342.17 	to support continuity of care and successful discharge from the facility. "Concurrent services" 
342.18 	means services provided by another entity or provider while the individual is admitted to a 
342.19 	psychiatric residential treatment facility. Payment for concurrent services may be limited 
342.20 	and these services are subject to prior authorization by the state's medical review agent. 
342.21 	Concurrent services may include targeted case management, assertive community treatment, 
342.22 	clinical care consultation, team consultation, and treatment planning.
342.23 	(e) Payment rates under this subdivision shall not include the costs of providing the 
342.24 	following services:
342.25 	(1) educational services;
342.26 	(2) acute medical care or specialty services for other medical conditions;
342.27 	(3) dental services; and
342.28 	(4) pharmacy drug costs.
342.29 	(f) For purposes of this section, "actual cost" means costs that are allowable, allocable, 
342.30 	reasonable, and consistent with federal reimbursement requirements in Code of Federal 
342.31 	Regulations, title 48, chapter 1, part 31, relating to for-profit entities, and the Office of 
342.32 	Management and Budget Circular Number A-122, relating to nonprofit entities.
343.1 		Subd. 4.Leave days. (a) Medical assistance covers therapeutic and hospital leave days, 
343.2 	provided the recipient was not discharged from the psychiatric residential treatment facility 
343.3 	and is expected to return to the psychiatric residential treatment facility. A reserved bed 
343.4 	must be held for a recipient on hospital leave or therapeutic leave.
343.5 	(b) A therapeutic leave day to home shall be used to prepare for discharge and 
343.6 	reintegration and shall be included in the individual plan of care. The state shall reimburse 
343.7 	75 percent of the per diem rate for a reserve bed day while the recipient is on therapeutic 
343.8 	leave. A therapeutic leave visit may not exceed three days without prior authorization.
343.9 	(c) A hospital leave day shall be a day for which a recipient has been admitted to a 
343.10 	hospital for medical or acute psychiatric care and is temporarily absent from the psychiatric 
343.11 	residential treatment facility. The state shall reimburse 50 percent of the per diem rate for 
343.12 	a reserve bed day while the recipient is receiving medical or psychiatric care in a hospital.

343.13 	EFFECTIVE DATE. This section is effective the day following final enactment.

343.14 	Sec. 70. Minnesota Statutes 2016, section 256B.0943, subdivision 13, is amended to read:
343.15 		Subd. 13.Exception to excluded services. Notwithstanding subdivision 12, up to 15 
343.16 	hours of children's therapeutic services and supports provided within a six-month period to 
343.17 	a child with severe emotional disturbance who is residing in a hospital; a group home as 
343.18 	defined in Minnesota Rules, parts 2960.0130 to 2960.0220; a residential treatment facility 
343.19 	licensed under Minnesota Rules, parts 2960.0580 to 2960.0690; a psychiatric residential 
343.20 	treatment facility under section 256B.0625, subdivision 45a; a regional treatment center; 
343.21 	or other institutional group setting or who is participating in a program of partial 
343.22 	hospitalization are eligible for medical assistance payment if part of the discharge plan.

343.23 	EFFECTIVE DATE. This section is effective the day following final enactment.

343.24 	Sec. 71. Minnesota Statutes 2016, section 256B.0945, subdivision 2, is amended to read:
343.25 		Subd. 2.Covered services. All services must be included in a child's individualized 
343.26 	treatment or multiagency plan of care as defined in chapter 245.
343.27 	For facilities that are not institutions for mental diseases according to federal statute and 
343.28 	regulation, medical assistance covers mental health-related services that are required to be 
343.29 	provided by a residential facility under section 245.4882 and administrative rules promulgated 
343.30 	thereunder, except for room and board. For residential facilities determined by the federal 
343.31 	Centers for Medicare and Medicaid Services to be an institution for mental diseases, medical 
344.1 	assistance covers medically necessary mental health services provided by the facility 
344.2 	according to section 256B.055, subdivision 13, except for room and board.

344.3 	EFFECTIVE DATE. This section is effective for services provided on July 1, 2017, 
344.4 	through April 30, 2019, and expires May 1, 2019.

344.5 	Sec. 72. Minnesota Statutes 2016, section 256B.0945, subdivision 4, is amended to read:
344.6 		Subd. 4.Payment rates. (a) Notwithstanding sections 256B.19 and 256B.041, payments 
344.7 	to counties for residential services provided under this section by a residential facility shall:
344.8 	(1) for services provided by a residential facility that is not an institution for mental 
344.9 	diseases, only be made of federal earnings for services provided under this section, and the 
344.10 	nonfederal share of costs for services provided under this section shall be paid by the county 
344.11 	from sources other than federal funds or funds used to match other federal funds. Payment 
344.12 	to counties for services provided according to this section shall be a proportion of the per 
344.13 	day contract rate that relates to rehabilitative mental health services and shall not include 
344.14 	payment for costs or services that are billed to the IV-E program as room and board.; and
344.15 	(2) for services provided by a residential facility that is determined to be an institution 
344.16 	for mental diseases, be equivalent to the federal share of the payment that would have been 
344.17 	made if the residential facility were not an institution for mental diseases. The portion of 
344.18 	the payment representing what would be the nonfederal shares shall be paid by the county. 
344.19 	Payment to counties for services provided according to this section shall be a proportion of 
344.20 	the per day contract rate that relates to rehabilitative mental health services and shall not 
344.21 	include payment for costs or services that are billed to the IV-E program as room and board.
344.22 	(b) Per diem rates paid to providers under this section by prepaid plans shall be the 
344.23 	proportion of the per-day contract rate that relates to rehabilitative mental health services 
344.24 	and shall not include payment for group foster care costs or services that are billed to the 
344.25 	county of financial responsibility. Services provided in facilities located in bordering states 
344.26 	are eligible for reimbursement on a fee-for-service basis only as described in paragraph (a) 
344.27 	and are not covered under prepaid health plans.
344.28 	(c) Payment for mental health rehabilitative services provided under this section by or 
344.29 	under contract with an American Indian tribe or tribal organization or by agencies operated 
344.30 	by or under contract with an American Indian tribe or tribal organization must be made 
344.31 	according to section 256B.0625, subdivision 34, or other relevant federally approved 
344.32 	rate-setting methodology.
345.1 	(d) The commissioner shall set aside a portion not to exceed five percent of the federal 
345.2 	funds earned for county expenditures under this section to cover the state costs of 
345.3 	administering this section. Any unexpended funds from the set-aside shall be distributed to 
345.4 	the counties in proportion to their earnings under this section.

345.5 	EFFECTIVE DATE. This section is effective for services provided on July 1, 2017, 
345.6 	through April 30, 2019, and expires May 1, 2019.

345.7 	Sec. 73. Minnesota Statutes 2016, section 256B.763, is amended to read:
345.8 	256B.763 CRITICAL ACCESS MENTAL HEALTH RATE INCREASE.
345.9 	(a) For services defined in paragraph (b) and rendered on or after July 1, 2007, payment 
345.10 	rates shall be increased by 23.7 percent over the rates in effect on January 1, 2006, for:
345.11 	(1) psychiatrists and advanced practice registered nurses with a psychiatric specialty;
345.12 	(2) community mental health centers under section 256B.0625, subdivision 5; and
345.13 	(3) mental health clinics and centers certified under Minnesota Rules, parts 9520.0750
345.14 	to 9520.0870, or hospital outpatient psychiatric departments that are designated as essential 
345.15 	community providers under section 62Q.19.
345.16 	(b) This increase applies to group skills training when provided as a component of 
345.17 	children's therapeutic services and support, psychotherapy, medication management, 
345.18 	evaluation and management, diagnostic assessment, explanation of findings, psychological 
345.19 	testing, neuropsychological services, direction of behavioral aides, and inpatient consultation.
345.20 	(c) This increase does not apply to rates that are governed by section 256B.0625, 
345.21 	subdivision 30, or 256B.761, paragraph (b), other cost-based rates, rates that are negotiated 
345.22 	with the county, rates that are established by the federal government, or rates that increased 
345.23 	between January 1, 2004, and January 1, 2005.
345.24 	(d) The commissioner shall adjust rates paid to prepaid health plans under contract with 
345.25 	the commissioner to reflect the rate increases provided in paragraphs (a), (e), and (f). The 
345.26 	prepaid health plan must pass this rate increase to the providers identified in paragraphs (a), 
345.27 	(e), (f), and (g).
345.28 	(e) Payment rates shall be increased by 23.7 percent over the rates in effect on December 
345.29 	31, 2007, for:
345.30 	(1) medication education services provided on or after January 1, 2008, by adult 
345.31 	rehabilitative mental health services providers certified under section 256B.0623; and
346.1 	(2) mental health behavioral aide services provided on or after January 1, 2008, by 
346.2 	children's therapeutic services and support providers certified under section 256B.0943.
346.3 	(f) For services defined in paragraph (b) and rendered on or after January 1, 2008, by 
346.4 	children's therapeutic services and support providers certified under section 256B.0943 and 
346.5 	not already included in paragraph (a), payment rates shall be increased by 23.7 percent over 
346.6 	the rates in effect on December 31, 2007.
346.7 	(g) Payment rates shall be increased by 2.3 percent over the rates in effect on December 
346.8 	31, 2007, for individual and family skills training provided on or after January 1, 2008, by 
346.9 	children's therapeutic services and support providers certified under section 256B.0943.
346.10 	(h) For services described in paragraphs (b), (e), and (g) and rendered on or after July 
346.11 	1, 2017, payment rates for mental health clinics and centers certified under Minnesota Rules, 
346.12 	parts 9520.0750 to 9520.0870, that are not designated as essential community providers 
346.13 	under section 62Q.19 shall be equal to payment rates for mental health clinics and centers 
346.14 	certified under Minnesota Rules, parts 9520.0750 to 9520.0870, that are designated as 
346.15 	essential community providers under section 62Q.19. In order to receive increased payment 
346.16 	rates under this paragraph, a provider must demonstrate a commitment to serve low-income 
346.17 	and underserved populations by:
346.18 	(1) charging for services on a sliding-fee schedule based on current poverty income 
346.19 	guidelines; and
346.20 	(2) not restricting access or services because of a client's financial limitation.

346.21 	Sec. 74. CHILDREN'S MENTAL HEALTH REPORT AND RECOMMENDATIONS.
 346.22 	The commissioner of human services shall conduct a comprehensive analysis of 
346.23 	Minnesota's continuum of intensive mental health services and shall develop 
346.24 	recommendations for a sustainable and community-driven continuum of care for children 
346.25 	with serious mental health needs, including children currently being served in residential 
346.26 	treatment. The commissioner's analysis shall include, but not be limited to:
346.27 	(1) data related to access, utilization, efficacy, and outcomes for Minnesota's current 
346.28 	system of residential mental health treatment for a child with a severe emotional disturbance;
346.29 	(2) potential expansion of the state's psychiatric residential treatment facility (PRTF) 
346.30 	capacity, including increasing the number of PRTF beds and conversion of existing children's 
346.31 	mental health residential treatment programs into PRTFs;
347.1 	(3) the capacity need for PRTF and other group settings within the state if adequate 
347.2 	community-based alternatives are accessible, equitable, and effective statewide;
347.3 	(4) recommendations for expanding alternative community-based service models to 
347.4 	meet the needs of a child with a serious mental health disorder who would otherwise require 
347.5 	residential treatment and potential service models that could be utilized, including data 
347.6 	related to access, utilization, efficacy, and outcomes;
347.7 	(5) models of care used in other states; and
347.8 	(6) analysis and specific recommendations for the design and implementation of new 
347.9 	service models, including analysis to inform rate setting as necessary.
347.10 	The analysis shall be supported and informed by extensive stakeholder engagement. 
347.11 	Stakeholders include individuals who receive services, family members of individuals who 
347.12 	receive services, providers, counties, health plans, advocates, and others. Stakeholder 
347.13 	engagement shall include interviews with key stakeholders, intentional outreach to individuals 
347.14 	who receive services and the individual's family members, and regional listening sessions.
347.15 	The commissioner shall provide a report with specific recommendations and timelines 
347.16 	for implementation to the legislative committees with jurisdiction over children's mental 
347.17 	health policy and finance by November 15, 2018.

347.18 	Sec. 75. RESIDENTIAL TREATMENT AND PAYMENT RATE REFORM.
 347.19 	The commissioner shall contract with an outside expert to identify recommendations 
347.20 	for the development of a substance use disorder residential treatment program model and 
347.21 	payment structure that is not subject to the federal institutions for mental diseases exclusion 
347.22 	and that is financially sustainable for providers, while incentivizing best practices and 
347.23 	improved treatment outcomes. The analysis must include recommendations and a timeline 
347.24 	for supporting providers to transition to the new models of care delivery. No later than 
347.25 	December 15, 2018, the commissioner shall deliver a report with recommendations to the 
347.26 	chairs and ranking minority members of the legislative committees with jurisdiction over 
347.27 	health and human services policy and finance.

347.28 	Sec. 76. REVISOR'S INSTRUCTION.
 347.29 	In Minnesota Statutes and Minnesota Rules, the revisor of statutes, in consultation with 
347.30 	the with the Department of Human Services, shall make necessary cross-reference changes 
347.31 	that are needed as a result of the enactment of sections 12 to 35 and 75. The revisor shall 
347.32 	make any necessary technical and grammatical changes to preserve the meaning of the text.

348.1 	EFFECTIVE DATE. This section is effective the day following final enactment.

348.2 	Sec. 77.  REPEALER.
 348.3 	(a) Minnesota Statutes 2016, sections 245A.1915; 245A.192; and 254A.02, subdivision 
348.4 	4, are repealed.
348.5 	(b) Minnesota Rules, parts 9530.6405, subparts 1, 1a, 2, 3, 4, 5, 6, 7, 7a, 8, 9, 10, 11, 
348.6 	12, 13, 14, 14a, 15, 15a, 16, 17, 17a, 17b, 17c, 18, 20, and 21; 9530.6410; 9530.6415; 
348.7 	9530.6420; 9530.6422; 9530.6425; 9530.6430; 9530.6435; 9530.6440; 9530.6445; 
348.8 	9530.6450; 9530.6455; 9530.6460; 9530.6465; 9530.6470; 9530.6475; 9530.6480; 
348.9 	9530.6485; 9530.6490; 9530.6495; 9530.6500; and 9530.6505, are repealed.
348.10 	(c) Minnesota Statutes 2016, section 256B.7631, is repealed.

348.11 	EFFECTIVE DATE. Paragraphs (a) and (b) are effective January 1, 2018. Paragraph 
348.12 	(c) is effective the day following final enactment.

348.13 	ARTICLE 9
348.14 	OPERATIONS

348.15 	Section 1. Minnesota Statutes 2016, section 245A.02, subdivision 2b, is amended to read:
348.16 		Subd. 2b.Annual or annually. With the exception of subdivision 2c, "annual" or 
348.17 	"annually" means prior to or within the same month of the subsequent calendar year.

348.18 	Sec. 2. Minnesota Statutes 2016, section 245A.02, is amended by adding a subdivision to 
348.19 	read:
348.20 		Subd. 2c.Annual or annually; family child care training requirements. For the 
348.21 	purposes of section 245A.50, subdivisions 1 to 9, "annual" or "annually" means the 12-month 
348.22 	period beginning on the license effective date or the annual anniversary of the effective date 
348.23 	and ending on the day prior to the annual anniversary of the license effective date.

348.24 	Sec. 3. Minnesota Statutes 2016, section 245A.04, subdivision 4, is amended to read:
348.25 		Subd. 4.Inspections; waiver. (a) Before issuing an initial license, the commissioner 
348.26 	shall conduct an inspection of the program. The inspection must include but is not limited 
348.27 	to:
348.28 	(1) an inspection of the physical plant;
348.29 	(2) an inspection of records and documents;
349.1 	(3) an evaluation of the program by consumers of the program; and
349.2 	(4) observation of the program in operation.
349.3 	For the purposes of this subdivision, "consumer" means a person who receives the 
349.4 	services of a licensed program, the person's legal guardian, or the parent or individual having 
349.5 	legal custody of a child who receives the services of a licensed program.
349.6 	(b) The evaluation required in paragraph (a), clause (3), or the observation in paragraph 
349.7 	(a), clause (4), is not required prior to issuing an initial license under subdivision 7. If the 
349.8 	commissioner issues an initial license under subdivision 7, these requirements must be 
349.9 	completed within one year after the issuance of an initial license.
349.10 	(c) Before completing a licensing inspection in a family child care program or child care 
349.11 	center, the licensing agency must offer the license holder an exit interview to discuss 
349.12 	violations of law or rule observed during the inspection and offer technical assistance on 
349.13 	how to comply with applicable laws and rules. Nothing in this paragraph limits the ability 
349.14 	of the commissioner to issue a correction order or negative action for violations of law or 
349.15 	rule not discussed in an exit interview or in the event that a license holder chooses not to 
349.16 	participate in an exit interview.

349.17 	EFFECTIVE DATE. This section is effective October 1, 2017.

349.18 	Sec. 4. Minnesota Statutes 2016, section 245A.06, subdivision 2, is amended to read:
349.19 		Subd. 2.Reconsideration of correction orders. (a) If the applicant or license holder 
349.20 	believes that the contents of the commissioner's correction order are in error, the applicant 
349.21 	or license holder may ask the Department of Human Services to reconsider the parts of the 
349.22 	correction order that are alleged to be in error. The request for reconsideration must be made 
349.23 	in writing and must be postmarked and sent to the commissioner within 20 calendar days 
349.24 	after receipt of the correction order by the applicant or license holder, and:
349.25 	(1) specify the parts of the correction order that are alleged to be in error;
349.26 	(2) explain why they are in error; and
349.27 	(3) include documentation to support the allegation of error.
349.28 	A request for reconsideration does not stay any provisions or requirements of the 
349.29 	correction order. The commissioner's disposition of a request for reconsideration is final 
349.30 	and not subject to appeal under chapter 14.
349.31 	(b) This paragraph applies only to licensed family child care providers. A licensed family 
349.32 	child care provider who requests reconsideration of a correction order under paragraph (a) 
350.1 	may also request, on a form and in the manner prescribed by the commissioner, that the 
350.2 	commissioner expedite the review if:
350.3 	(1) the provider is challenging a violation and provides a description of how complying 
350.4 	with the corrective action for that violation would require the substantial expenditure of 
350.5 	funds or a significant change to their program; and
350.6 	(2) describes what actions the provider will take in lieu of the corrective action ordered 
350.7 	to ensure the health and safety of children in care pending the commissioner's review of the 
350.8 	correction order.

350.9 	Sec. 5. Minnesota Statutes 2016, section 245A.06, subdivision 8, is amended to read:
350.10 		Subd. 8.Requirement to post correction order. (a) For licensed family child care 
350.11 	providers and child care centers, upon receipt of any correction order or order of conditional 
350.12 	license issued by the commissioner under this section, and notwithstanding a pending request 
350.13 	for reconsideration of the correction order or order of conditional license by the license 
350.14 	holder, the license holder shall post the correction order or order of conditional license in 
350.15 	a place that is conspicuous to the people receiving services and all visitors to the facility 
350.16 	for two years. When the correction order or order of conditional license is accompanied by 
350.17 	a maltreatment investigation memorandum prepared under section 626.556 or 626.557, the 
350.18 	investigation memoranda must be posted with the correction order or order of conditional 
350.19 	license.
350.20 	(b) If the commissioner reverses or rescinds a violation in a correction order upon 
350.21 	reconsideration under subdivision 2, the commissioner shall issue an amended correction 
350.22 	order and the license holder shall post the amended order according to paragraph (a).
350.23 	(c) If the correction order is rescinded or reversed in full upon reconsideration under 
350.24 	subdivision 2, the license holder shall remove the original correction order posted according 
350.25 	to paragraph (a).

350.26 	Sec. 6. Minnesota Statutes 2016, section 245A.06, is amended by adding a subdivision to 
350.27 	read:
350.28 		Subd. 9.Child care correction order quotas prohibited. The commissioner and county 
350.29 	licensing agencies shall not order, mandate, require, or suggest to any person responsible 
350.30 	for licensing or inspecting a licensed family child care provider or child care center a quota 
350.31 	for the issuance of correction orders on a daily, weekly, monthly, quarterly, or yearly basis.

351.1 	Sec. 7. [245A.065] CHILD CARE FIX-IT TICKET.
351.2 	(a) In lieu of a correction order under section 245A.06, the commissioner shall issue a 
351.3 	fix-it ticket to a family child care or child care center license holder if the commissioner 
351.4 	finds that:
351.5 	(1) the license holder has failed to comply with a requirement in this chapter or Minnesota 
351.6 	Rules, chapter 9502 or 9503, that the commissioner determines to be eligible for a fix-it 
351.7 	ticket;
351.8 	(2) the violation does not imminently endanger the health, safety, or rights of the persons 
351.9 	served by the program;
351.10 	(3) the license holder did not receive a fix-it ticket or correction order for the violation 
351.11 	at the license holder's last licensing inspection;
351.12 	(4) the violation can be corrected at the time of inspection or within 48 hours, excluding 
351.13 	Saturdays, Sundays, and holidays; and
351.14 	(5) the license holder corrects the violation at the time of inspection or agrees to correct 
351.15 	the violation within 48 hours, excluding Saturdays, Sundays, and holidays.
351.16 	(b) The fix-it ticket must state:
351.17 	(1) the conditions that constitute a violation of the law or rule;
351.18 	(2) the specific law or rule violated; and
351.19 	(3) that the violation was corrected at the time of inspection or must be corrected within 
351.20 	48 hours, excluding Saturdays, Sundays, and holidays.
351.21 	(c) The commissioner shall not publicly publish a fix-it ticket on the department's Web 
351.22 	site.
351.23 	(d) Within 48 hours, excluding Saturdays, Sundays, and holidays, of receiving a fix-it 
351.24 	ticket, the license holder must correct the violation and within one week submit evidence 
351.25 	to the licensing agency that the violation was corrected.
351.26 	(e) If the violation is not corrected at the time of inspection or within 48 hours, excluding 
351.27 	Saturdays, Sundays, and holidays, or the evidence submitted is insufficient to establish that 
351.28 	the license holder corrected the violation, the commissioner must issue a correction order 
351.29 	for the violation of Minnesota law or rule identified in the fix-it ticket according to section 
351.30 	245A.06.
352.1 	(f) The commissioner shall, following consultation with family child care license holders, 
352.2 	child care center license holders, and county agencies, issue a report by October 1, 2017, 
352.3 	that identifies the violations of this chapter and Minnesota Rules, chapters 9502 and 9503, 
352.4 	that are eligible for a fix-it ticket. The commissioner shall provide the report to county 
352.5 	agencies and the chairs and ranking minority members of the legislative committees with 
352.6 	jurisdiction over child care, and shall post the report to the department's Web site.

352.7 	EFFECTIVE DATE. This section is effective October 1, 2017.

352.8 	Sec. 8. Minnesota Statutes 2016, section 245A.07, subdivision 3, is amended to read:
352.9 		Subd. 3.License suspension, revocation, or fine. (a) The commissioner may suspend 
352.10 	or revoke a license, or impose a fine if:
352.11 	(1) a license holder fails to comply fully with applicable laws or rules;
352.12 	(2) a license holder, a controlling individual, or an individual living in the household 
352.13 	where the licensed services are provided or is otherwise subject to a background study has 
352.14 	a disqualification which has not been set aside under section 245C.22;
352.15 	(3) a license holder knowingly withholds relevant information from or gives false or 
352.16 	misleading information to the commissioner in connection with an application for a license, 
352.17 	in connection with the background study status of an individual, during an investigation, 
352.18 	or regarding compliance with applicable laws or rules; or
352.19 	(4) after July 1, 2012, and upon request by the commissioner, a license holder fails to 
352.20 	submit the information required of an applicant under section 245A.04, subdivision 1, 
352.21 	paragraph (f) or (g).
352.22 	A license holder who has had a license suspended, revoked, or has been ordered to pay 
352.23 	a fine must be given notice of the action by certified mail or personal service. If mailed, the 
352.24 	notice must be mailed to the address shown on the application or the last known address of 
352.25 	the license holder. The notice must state the reasons the license was suspended, revoked, 
352.26 	or a fine was ordered.
352.27 	(b) If the license was suspended or revoked, the notice must inform the license holder 
352.28 	of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts 
352.29 	1400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking 
352.30 	a license. The appeal of an order suspending or revoking a license must be made in writing 
352.31 	by certified mail or personal service. If mailed, the appeal must be postmarked and sent to 
352.32 	the commissioner within ten calendar days after the license holder receives notice that the 
352.33 	license has been suspended or revoked. If a request is made by personal service, it must be 
353.1 	received by the commissioner within ten calendar days after the license holder received the 
353.2 	order. Except as provided in subdivision 2a, paragraph (c), if a license holder submits a 
353.3 	timely appeal of an order suspending or revoking a license, the license holder may continue 
353.4 	to operate the program as provided in section 245A.04, subdivision 7, paragraphs (g) and 
353.5 	(h), until the commissioner issues a final order on the suspension or revocation.
353.6 	(c)(1) If the license holder was ordered to pay a fine, the notice must inform the license 
353.7 	holder of the responsibility for payment of fines and the right to a contested case hearing 
353.8 	under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal of an 
353.9 	order to pay a fine must be made in writing by certified mail or personal service. If mailed, 
353.10 	the appeal must be postmarked and sent to the commissioner within ten calendar days after 
353.11 	the license holder receives notice that the fine has been ordered. If a request is made by 
353.12 	personal service, it must be received by the commissioner within ten calendar days after 
353.13 	the license holder received the order.
353.14 	(2) The license holder shall pay the fines assessed on or before the payment date specified. 
353.15 	If the license holder fails to fully comply with the order, the commissioner may issue a 
353.16 	second fine or suspend the license until the license holder complies. If the license holder 
353.17 	receives state funds, the state, county, or municipal agencies or departments responsible for 
353.18 	administering the funds shall withhold payments and recover any payments made while the 
353.19 	license is suspended for failure to pay a fine. A timely appeal shall stay payment of the fine 
353.20 	until the commissioner issues a final order.
353.21 	(3) A license holder shall promptly notify the commissioner of human services, in writing, 
353.22 	when a violation specified in the order to forfeit a fine is corrected. If upon reinspection the 
353.23 	commissioner determines that a violation has not been corrected as indicated by the order 
353.24 	to forfeit a fine, the commissioner may issue a second fine. The commissioner shall notify 
353.25 	the license holder by certified mail or personal service that a second fine has been assessed. 
353.26 	The license holder may appeal the second fine as provided under this subdivision.
353.27 	(4) Fines shall be assessed as follows:
353.28 	(i) the license holder shall forfeit $1,000 for each determination of maltreatment of a 
353.29 	child under section 626.556 or the maltreatment of a vulnerable adult under section 626.557
353.30 	for which the license holder is determined responsible for the maltreatment under section 
353.31 	626.556, subdivision 10e, paragraph (i), or 626.557, subdivision 9c, paragraph (c);
353.32 	(ii) if the commissioner determines that a determination of maltreatment for which the 
353.33 	license holder is responsible is the result of maltreatment that meets the definition of serious 
354.1 	maltreatment as defined in section 245C.02, subdivision 18, the license holder shall forfeit 
354.2 	$5,000;
354.3 	(iii) for a program that operates out of the license holder's home and a program licensed 
354.4 	under Minnesota Rules, parts 9502.0300 to 9502.0495, the fine assessed against the license 
354.5 	holder shall not exceed $1,000 for each determination of maltreatment;
354.6 	(iv) the license holder shall forfeit $200 for each occurrence of a violation of law or rule 
354.7 	governing matters of health, safety, or supervision, including but not limited to the provision 
354.8 	of adequate staff-to-child or adult ratios, and failure to comply with background study 
354.9 	requirements under chapter 245C; and
354.10 	(v) the license holder shall forfeit $100 for each occurrence of a violation of law or rule 
354.11 	other than those subject to a $5,000, $1,000, or $200 fine above in items (i) to (iv).
354.12 	For purposes of this section, "occurrence" means each violation identified in the 
354.13 	commissioner's fine order. Fines assessed against a license holder that holds a license to 
354.14 	provide home and community-based services, as identified in section 245D.03, subdivision 
354.15 	1, and a community residential setting or day services facility license under chapter 245D 
354.16 	where the services are provided, may be assessed against both licenses for the same 
354.17 	occurrence, but the combined amount of the fines shall not exceed the amount specified in 
354.18 	this clause for that occurrence.
354.19 	(5) When a fine has been assessed, the license holder may not avoid payment by closing, 
354.20 	selling, or otherwise transferring the licensed program to a third party. In such an event, the 
354.21 	license holder will be personally liable for payment. In the case of a corporation, each 
354.22 	controlling individual is personally and jointly liable for payment.
354.23 	(d) Except for background study violations involving the failure to comply with an order 
354.24 	to immediately remove an individual or an order to provide continuous, direct supervision, 
354.25 	the commissioner shall not issue a fine under paragraph (c) relating to a background study 
354.26 	violation to a license holder who self-corrects a background study violation before the 
354.27 	commissioner discovers the violation. A license holder who has previously exercised the 
354.28 	provisions of this paragraph to avoid a fine for a background study violation may not avoid 
354.29 	a fine for a subsequent background study violation unless at least 365 days have passed 
354.30 	since the license holder self-corrected the earlier background study violation.

354.31 	EFFECTIVE DATE. This section is effective August 1, 2017.

355.1 	Sec. 9. [245A.1434] INFORMATION FOR CHILD CARE LICENSE HOLDERS.
355.2 	The commissioner shall inform family child care and child care center license holders 
355.3 	on a timely basis of changes to state and federal statute, rule, regulation, and policy relating 
355.4 	to the provision of licensed child care, the child care assistance program under chapter 119B, 
355.5 	the quality rating and improvement system under section 124D.142, and child care licensing 
355.6 	functions delegated to counties. Communications under this section shall include information 
355.7 	to promote license holder compliance with identified changes. Communications under this 
355.8 	section may be accomplished by electronic means and shall be made available to the public 
355.9 	online.

355.10 	Sec. 10. [245A.153] REPORT TO LEGISLATURE ON THE STATUS OF CHILD 
355.11 	CARE.
355.12 		Subdivision 1.Reporting requirements. Beginning on February 1, 2018, and no later 
355.13 	than February 1 of each year thereafter, the commissioner of human services shall provide 
355.14 	a report on the status of child care in Minnesota to the chairs and ranking minority members 
355.15 	of the legislative committees with jurisdiction over child care.
355.16 		Subd. 2.Contents of report. (a) The report must include the following:
355.17 	(1) summary data on trends in child care center and family child care capacity and 
355.18 	availability throughout the state, including the number of centers and programs that have 
355.19 	opened and closed and the geographic locations of those centers and programs;
355.20 	(2) a description of any changes to statutes, administrative rules, or agency policies and 
355.21 	procedures that were implemented in the year preceding the report;
355.22 	(3) a description of the actions the department has taken to address or implement the 
355.23 	recommendations from the Legislative Task Force on Access to Affordable Child Care 
355.24 	Report dated January 15, 2017, including but not limited to actions taken in the areas of:
355.25 	(i) encouraging uniformity in implementing and interpreting statutes, administrative 
355.26 	rules, and agency policies and procedures relating to child care licensing and access;
355.27 	(ii) improving communication with county licensors and child care providers regarding 
355.28 	changes to statutes, administrative rules, and agency policies and procedures, ensuring that 
355.29 	information is directly and regularly transmitted;
355.30 	(iii) providing notice to child care providers before issuing correction orders or negative 
355.31 	actions relating to recent changes to statutes, administrative rules, and agency policies and 
355.32 	procedures;
356.1 	(iv) implementing confidential, anonymous communication processes for child care 
356.2 	providers to ask questions and receive prompt, clear answers from the department;
356.3 	(v) streamlining processes to reduce duplication or overlap in paperwork and training 
356.4 	requirements for child care providers; and
356.5 	(vi) compiling and distributing information detailing trends in the violations for which 
356.6 	correction orders and negative actions are issued;
356.7 	(4) a description of the department's efforts to cooperate with counties while addressing 
356.8 	and implementing the task force recommendations;
356.9 	(5) summary data on child care assistance programs including but not limited to state 
356.10 	funding and numbers of families served; and
356.11 	(6) summary data on family child care correction orders, including:
356.12 	(i) the number of licensed family child care provider appeals or requests for 
356.13 	reconsideration of correction orders to the Department of Human Services;
356.14 	(ii) the number of family child care correction order appeals or requests for 
356.15 	reconsideration that the Department of Human Services grants; and
356.16 	(iii) the number of family child care correction order appeals or requests for 
356.17 	reconsideration that the Department of Human Services denies.
356.18 	(b) The commissioner may offer recommendations for legislative action.
356.19 		Subd. 3.Sunset. This section expires February 2, 2020.

356.20 	Sec. 11. Minnesota Statutes 2016, section 626.556, subdivision 3c, is amended to read:
356.21 		Subd. 3c.Local welfare agency, Department of Human Services or Department of 
356.22 	Health responsible for assessing or investigating reports of maltreatment. (a) The county
356.23 	local welfare agency is the agency responsible for assessing or investigating allegations of 
356.24 	maltreatment in child foster care, family child care, legally unlicensed nonlicensed child 
356.25 	care, juvenile correctional facilities licensed under section 241.021 located in the local 
356.26 	welfare agency's county, and reports involving children served by an unlicensed personal 
356.27 	care provider organization under section 256B.0659. Copies of findings related to personal 
356.28 	care provider organizations under section 256B.0659 must be forwarded to the Department 
356.29 	of Human Services provider enrollment.
356.30 	(b) The Department of Human Services is the agency responsible for assessing or 
356.31 	investigating allegations of maltreatment in juvenile correctional facilities listed under 
357.1 	section 241.021 located in the local welfare agency's county and in facilities licensed or 
357.2 	certified under chapters 245A and 245D, except for child foster care and family child care.
357.3 	(c) The Department of Health is the agency responsible for assessing or investigating 
357.4 	allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58 and 
357.5 	144A.43 to 144A.482.

357.6 	ARTICLE 10
357.7 	HEALTH DEPARTMENT

357.8 	Section 1. Minnesota Statutes 2016, section 103I.005, subdivision 2, is amended to read:
357.9 		Subd. 2.Boring. "Boring" means a hole or excavation that is not used to extract water 
357.10 	and includes exploratory borings, environmental bore holes, bored geothermal heat 
357.11 	exchangers, and elevator shafts borings.

357.12 	Sec. 2. Minnesota Statutes 2016, section 103I.005, subdivision 2a, is amended to read:
357.13 		Subd. 2a.Certified representative. "Certified representative" means a person certified 
357.14 	by the commissioner to represent a well contractor, limited well/boring contractor, monitoring
357.15 	environmental well contractor, or elevator boring contractor.

357.16 	Sec. 3. Minnesota Statutes 2016, section 103I.005, is amended by adding a subdivision 
357.17 	to read:
357.18 		Subd. 8a.Environmental well. "Environmental well" means an excavation 15 or more 
357.19 	feet in depth that is drilled, cored, bored, washed, driven, dug, jetted, or otherwise constructed 
357.20 	to:
357.21 	(1) conduct physical, chemical, or biological testing of groundwater, and includes a 
357.22 	groundwater quality monitoring or sampling well;
357.23 	(2) lower a groundwater level to control or remove contamination in groundwater, and 
357.24 	includes a remedial well and excludes horizontal trenches; or
357.25 	(3) monitor or measure physical, chemical, radiological, or biological parameters of the 
357.26 	earth and earth fluids, or for vapor recovery or venting systems. An environmental well 
357.27 	includes an excavation used to:
357.28 	(i) measure groundwater levels, including a piezometer;
357.29 	(ii) determine groundwater flow direction or velocity;
358.1 	(iii) measure earth properties such as hydraulic conductivity, bearing capacity, or 
358.2 	resistance;
358.3 	(iv) obtain samples of geologic materials for testing or classification; or
358.4 	(v) remove or remediate pollution or contamination from groundwater or soil through 
358.5 	the use of a vent, vapor recovery system, or sparge point.

358.6 	Sec. 4. Minnesota Statutes 2016, section 103I.005, is amended by adding a subdivision 
358.7 	to read:
358.8 		Subd. 8b.Environmental well contractor. "Environmental well contractor" means a 
358.9 	person with an environmental well contractor's license issued by the commissioner.

358.10 	Sec. 5. Minnesota Statutes 2016, section 103I.005, subdivision 12, is amended to read:
358.11 		Subd. 12.Limited well/boring contractor. "Limited well/boring contractor" means a 
358.12 	person with a limited well/boring contractor's license issued by the commissioner. Limited 
358.13 	well/boring contractor's licenses are issued for:
358.14 	(1) constructing, repairing, and sealing bored geothermal heat exchangers;
358.15 	(2) installing, repairing, and modifying pitless units and pitless adaptors, well casings 
358.16 	above the pitless unit or pitless adaptor, well screens, or well diameters; constructing, 
358.17 	repairing, and sealing drive point wells or dug wells, and well pumps and pumping 
358.18 	equipment;
358.19 	(3) constructing, repairing, and sealing dewatering wells; and
358.20 	(4) sealing wells; and installing well pumps or pumping equipment and borings.

358.21 	Sec. 6. Minnesota Statutes 2016, section 103I.005, is amended by adding a subdivision 
358.22 	to read:
358.23 		Subd. 17a.Temporary environmental well. "Temporary environmental well" means 
358.24 	an environmental well as defined in section 103I.005, subdivision 8a, that is sealed within 
358.25 	72 hours of the time construction on the well begins.

358.26 	Sec. 7. Minnesota Statutes 2016, section 103I.005, subdivision 20a, is amended to read:
358.27 		Subd. 20a.Water supply well. "Water supply well" means a well that is not a dewatering 
358.28 	well or monitoring environmental well and includes wells used:
358.29 	(1) for potable water supply;
359.1 	(2) for irrigation;
359.2 	(3) for agricultural, commercial, or industrial water supply;
359.3 	(4) for heating or cooling; and
359.4 	(5) as a remedial well; and
359.5 	(6) for testing water yield for irrigation, commercial or industrial uses, residential supply, 
359.6 	or public water supply.

359.7 	Sec. 8. Minnesota Statutes 2016, section 103I.005, subdivision 21, is amended to read:
359.8 		Subd. 21.Well. "Well" means an excavation that is drilled, cored, bored, washed, driven, 
359.9 	dug, jetted, or otherwise constructed if the excavation is intended for the location, diversion, 
359.10 	artificial recharge, monitoring, testing, remediation, or acquisition of groundwater. Well 
359.11 	includes monitoring environmental wells, drive point wells, and dewatering wells. "Well" 
359.12 	does not include:
359.13 	(1) an excavation by backhoe, or otherwise for temporary dewatering of groundwater 
359.14 	for nonpotable use during construction, if the depth of the excavation is 25 feet or less;
359.15 	(2) an excavation made to obtain or prospect for oil, natural gas, minerals, or products 
359.16 	of mining or quarrying;
359.17 	(3) an excavation to insert media to repressure oil or natural gas bearing formations or 
359.18 	to store petroleum, natural gas, or other products;
359.19 	(4) an excavation for nonpotable use for wildfire suppression activities; or
359.20 	(5) borings.

359.21 	Sec. 9. Minnesota Statutes 2016, section 103I.101, subdivision 2, is amended to read:
359.22 		Subd. 2.Duties. The commissioner shall:
359.23 	(1) regulate the drilling, construction, modification, repair, and sealing of wells and 
359.24 	borings;
359.25 	(2) examine and license:
359.26 	(i) well contractors;
359.27 	(ii) persons constructing, repairing, and sealing bored geothermal heat exchangers;
360.1 	(iii) persons modifying or repairing well casings above the pitless unit or adaptor, well 
360.2 	screens, or well diameters; persons constructing, repairing, and sealing drive point wells or 
360.3 	dug wells, and installing well pumps or pumping equipment;
360.4 	(iv) persons constructing, repairing, and sealing dewatering wells;
360.5 	(v) persons sealing wells; persons installing well pumps or pumping equipment or 
360.6 	borings; and
360.7 	(vi) persons excavating or drilling holes for the installation of elevator borings or 
360.8 	hydraulic cylinders;
360.9 	(3) register examine and examine monitoring license environmental well contractors;
360.10 	(4) license explorers engaged in exploratory boring and examine individuals who 
360.11 	supervise or oversee exploratory boring;
360.12 	(5) after consultation with the commissioner of natural resources and the Pollution 
360.13 	Control Agency, establish standards for the design, location, construction, repair, and sealing 
360.14 	of wells and borings within the state; and
360.15 	(6) issue permits for wells, groundwater thermal devices, bored geothermal heat 
360.16 	exchangers, and elevator borings.

360.17 	Sec. 10. Minnesota Statutes 2016, section 103I.101, subdivision 5, is amended to read:
360.18 		Subd. 5.Commissioner to adopt rules. The commissioner shall adopt rules including:
360.19 	(1) issuance of licenses for:
360.20 	(i) qualified well contractors, persons modifying or repairing well casings, well screens, 
360.21 	or well diameters;
360.22 	(ii) persons constructing, repairing, and sealing drive point wells or dug wells;
360.23 	(iii) persons constructing, repairing, and sealing dewatering wells;
360.24 	(iv) (iii) persons sealing wells or borings;
360.25 	(v) (iv) persons installing, modifying, or repairing well casings, well screens, well 
360.26 	diameters, and well pumps or pumping equipment;
360.27 	(vi) (v) persons constructing, repairing, and sealing bored geothermal heat exchangers; 
360.28 	and
360.29 	(vii) (vi) persons constructing, repairing, and sealing elevator borings; and
360.30 	(vii) persons constructing, repairing, and sealing environmental wells;
361.1 	(2) issuance of registration for monitoring well contractors;
361.2 	(3) establishment of conditions for examination and review of applications for license 
361.3 	and registration certification;
361.4 	(4) (3) establishment of conditions for revocation and suspension of license and 
361.5 	registration certification;
361.6 	(5) (4) establishment of minimum standards for design, location, construction, repair, 
361.7 	and sealing of wells and borings to implement the purpose and intent of this chapter;
361.8 	(6) (5) establishment of a system for reporting on wells and borings drilled and sealed;
361.9 	(7) (6) establishment of standards for the construction, maintenance, sealing, and water 
361.10 	quality monitoring of wells in areas of known or suspected contamination;
361.11 	(8) (7) establishment of wellhead protection measures for wells serving public water 
361.12 	supplies;
361.13 	(9) (8) establishment of procedures to coordinate collection of well and boring data with 
361.14 	other state and local governmental agencies;
361.15 	(10) (9) establishment of criteria and procedures for submission of well and boring logs, 
361.16 	formation samples or well or boring cuttings, water samples, or other special information 
361.17 	required for and water resource mapping; and
361.18 	(11) (10) establishment of minimum standards for design, location, construction, 
361.19 	maintenance, repair, sealing, safety, and resource conservation related to borings, including 
361.20 	exploratory borings as defined in section 103I.005, subdivision 9.

361.21 	Sec. 11. Minnesota Statutes 2016, section 103I.101, subdivision 6, is amended to read:
361.22 		Subd. 6.Fees for variances. The commissioner shall charge a nonrefundable application 
361.23 	fee of $235 $275 to cover the administrative cost of processing a request for a variance or 
361.24 	modification of rules adopted by the commissioner under this chapter.

361.25 	Sec. 12. Minnesota Statutes 2016, section 103I.105, is amended to read:
361.26 	103I.105 ADVISORY COUNCIL ON WELLS AND BORINGS.
361.27 	(a) The Advisory Council on Wells and Borings is established as an advisory council 
361.28 	to the commissioner. The advisory council shall consist of 18 voting members. Of the 18 
361.29 	voting members:
362.1 	(1) one member must be from the Department of Health, appointed by the commissioner 
362.2 	of health;
362.3 	(2) one member must be from the Department of Natural Resources, appointed by the 
362.4 	commissioner of natural resources;
362.5 	(3) one member must be a member of the Minnesota Geological Survey of the University 
362.6 	of Minnesota, appointed by the director;
362.7 	(4) one member must be a responsible individual for a licensed explorer;
362.8 	(5) one member must be a certified representative of a licensed elevator boring contractor;
362.9 	(6) two members must be members of the public who are not connected with the boring 
362.10 	or well drilling industry;
362.11 	(7) one member must be from the Pollution Control Agency, appointed by the 
362.12 	commissioner of the Pollution Control Agency;
362.13 	(8) one member must be from the Department of Transportation, appointed by the 
362.14 	commissioner of transportation;
362.15 	(9) one member must be from the Board of Water and Soil Resources appointed by its 
362.16 	chair;
362.17 	(10) one member must be a certified representative of a monitoring an environmental
362.18 	well contractor;
362.19 	(11) six members must be residents of this state appointed by the commissioner, who 
362.20 	are certified representatives of licensed well contractors, with not more than two from the 
362.21 	seven-county metropolitan area and at least four from other areas of the state who represent 
362.22 	different geographical regions; and
362.23 	(12) one member must be a certified representative of a licensed bored geothermal heat 
362.24 	exchanger contractor.
362.25 	(b) An appointee of the well drilling industry may not serve more than two consecutive 
362.26 	terms.
362.27 	(c) The appointees to the advisory council from the well drilling industry must:
362.28 	(1) have been residents of this state for at least three years before appointment; and
362.29 	(2) have at least five years' experience in the well drilling business.
362.30 	(d) The terms of the appointed members and the compensation and removal of all 
362.31 	members are governed by section 15.059.

363.1 	Sec. 13. Minnesota Statutes 2016, section 103I.111, subdivision 6, is amended to read:
363.2 		Subd. 6.Unsealed wells and borings are public health nuisances. A well or boring 
363.3 	that is required to be sealed under section 103I.301 but is not sealed is a public health 
363.4 	nuisance. A county may abate the unsealed well or boring with the same authority of a 
363.5 	community health board to abate a public health nuisance under section 145A.04, subdivision 
363.6 	8.

363.7 	Sec. 14. Minnesota Statutes 2016, section 103I.111, subdivision 8, is amended to read:
363.8 		Subd. 8.Municipal regulation of drilling. A municipality may regulate all drilling, 
363.9 	except well, elevator shaft boring, and exploratory drilling that is subject to the provisions 
363.10 	of this chapter, above, in, through, and adjacent to subsurface areas designated for mined 
363.11 	underground space development and existing mined underground space. The regulations 
363.12 	may prohibit, restrict, control, and require permits for the drilling.

363.13 	Sec. 15. Minnesota Statutes 2016, section 103I.205, subdivision 1, is amended to read:
363.14 		Subdivision 1.Notification required. (a) Except as provided in paragraphs paragraph
363.15 	(d) and (e), a person may not construct a water-supply, dewatering, or environmental well 
363.16 	until a notification of the proposed well on a form prescribed by the commissioner is filed 
363.17 	with the commissioner with the filing fee in section 103I.208, and, when applicable, the 
363.18 	person has met the requirements of paragraph (f) (e). If after filing the well notification an 
363.19 	attempt to construct a well is unsuccessful, a new notification is not required unless the 
363.20 	information relating to the successful well has substantially changed. A notification is not 
363.21 	required prior to construction of a temporary environmental well.
363.22 	(b) The property owner, the property owner's agent, or the well licensed contractor where 
363.23 	a well is to be located must file the well notification with the commissioner.
363.24 	(c) The well notification under this subdivision preempts local permits and notifications, 
363.25 	and counties or home rule charter or statutory cities may not require a permit or notification 
363.26 	for wells unless the commissioner has delegated the permitting or notification authority 
363.27 	under section 103I.111.
363.28 	(d) A person who is an individual that constructs a drive point water-supply well on 
363.29 	property owned or leased by the individual for farming or agricultural purposes or as the 
363.30 	individual's place of abode must notify the commissioner of the installation and location of 
363.31 	the well. The person must complete the notification form prescribed by the commissioner 
363.32 	and mail it to the commissioner by ten days after the well is completed. A fee may not be 
364.1 	charged for the notification. A person who sells drive point wells at retail must provide 
364.2 	buyers with notification forms and informational materials including requirements regarding 
364.3 	wells, their location, construction, and disclosure. The commissioner must provide the 
364.4 	notification forms and informational materials to the sellers.
364.5 	(e) A person may not construct a monitoring well until a permit is issued by the 
364.6 	commissioner for the construction. If after obtaining a permit an attempt to construct a well 
364.7 	is unsuccessful, a new permit is not required as long as the initial permit is modified to 
364.8 	indicate the location of the successful well.
364.9 	(f) (e) When the operation of a well will require an appropriation permit from the 
364.10 	commissioner of natural resources, a person may not begin construction of the well until 
364.11 	the person submits the following information to the commissioner of natural resources:
364.12 	(1) the location of the well;
364.13 	(2) the formation or aquifer that will serve as the water source;
364.14 	(3) the maximum daily, seasonal, and annual pumpage rates and volumes that will be 
364.15 	requested in the appropriation permit; and
364.16 	(4) other information requested by the commissioner of natural resources that is necessary 
364.17 	to conduct the preliminary assessment required under section 103G.287, subdivision 1, 
364.18 	paragraph (c).
364.19 	The person may begin construction after receiving preliminary approval from the 
364.20 	commissioner of natural resources.

364.21 	Sec. 16. Minnesota Statutes 2016, section 103I.205, subdivision 2, is amended to read:
364.22 		Subd. 2.Emergency permit and notification exemptions. The commissioner may 
364.23 	adopt rules that modify the procedures for filing a well notification or well or boring permit 
364.24 	if conditions occur that:
364.25 	(1) endanger the public health and welfare or cause a need to protect the groundwater; 
364.26 	or
364.27 	(2) require the monitoring environmental well contractor, limited well/boring contractor, 
364.28 	or well contractor to begin constructing a well or boring before obtaining a permit or 
364.29 	notification.

365.1 	Sec. 17. Minnesota Statutes 2016, section 103I.205, subdivision 3, is amended to read:
365.2 		Subd. 3.Maintenance permit. (a) Except as provided under paragraph (b), a well that 
365.3 	is not in use must be sealed or have a maintenance permit.
365.4 	(b) If a monitoring an environmental well or a dewatering well is not sealed by 14 months 
365.5 	after completion of construction, the owner of the property on which the well is located 
365.6 	must obtain and annually renew a maintenance permit from the commissioner.

365.7 	Sec. 18. Minnesota Statutes 2016, section 103I.205, subdivision 4, is amended to read:
365.8 		Subd. 4.License required. (a) Except as provided in paragraph (b), (c), (d), or (e), 
365.9 	section 103I.401, subdivision 2, or 103I.601, subdivision 2, a person may not drill, construct, 
365.10 	repair, or seal a well or boring unless the person has a well contractor's license in possession.
365.11 	(b) A person may construct, repair, and seal a monitoring an environmental well if the 
365.12 	person:
365.13 	(1) is a professional engineer licensed under sections 326.02 to 326.15 in the branches 
365.14 	of civil or geological engineering;
365.15 	(2) is a hydrologist or hydrogeologist certified by the American Institute of Hydrology;
365.16 	(3) is a professional geoscientist licensed under sections 326.02 to 326.15;
365.17 	(4) is a geologist certified by the American Institute of Professional Geologists; or
365.18 	(5) meets the qualifications established by the commissioner in rule.
365.19 	A person must register with be licensed by the commissioner as a monitoring an 
365.20 	environmental well contractor on forms provided by the commissioner.
365.21 	(c) A person may do the following work with a limited well/boring contractor's license 
365.22 	in possession. A separate license is required for each of the six four activities:
365.23 	(1) installing or, repairing, and modifying well screens or, pitless units or and pitless 
365.24 	adaptors, well pumps and pumping equipment, and well casings from the pitless adaptor or 
365.25 	pitless unit to the upper termination of the well casing;
365.26 	(2) constructing, repairing, and sealing drive point wells or dug wells;
365.27 	(3) installing well pumps or pumping equipment;
365.28 	(4) sealing wells and borings;
365.29 	(5) (3) constructing, repairing, or and sealing dewatering wells; or
365.30 	(6) (4) constructing, repairing, or and sealing bored geothermal heat exchangers.
366.1 	(d) A person may construct, repair, and seal an elevator boring with an elevator boring 
366.2 	contractor's license.
366.3 	(e) Notwithstanding other provisions of this chapter requiring a license or registration, 
366.4 	a license or registration is not required for a person who complies with the other provisions 
366.5 	of this chapter if the person is:
366.6 	(1) an individual who constructs a water-supply well on land that is owned or leased by 
366.7 	the individual and is used by the individual for farming or agricultural purposes or as the 
366.8 	individual's place of abode;
366.9 	(2) an individual who performs labor or services for a contractor licensed or registered
366.10 	under the provisions of this chapter in connection with the construction, sealing, or repair 
366.11 	of a well or boring at the direction and under the personal supervision of a contractor licensed 
366.12 	or registered under the provisions of this chapter; or
366.13 	(3) a licensed plumber who is repairing submersible pumps or water pipes associated 
366.14 	with well water systems if: (i) the repair location is within an area where there is no licensed 
366.15 	or registered well contractor within 50 miles, and (ii) the licensed plumber complies with 
366.16 	all relevant sections of the plumbing code.

366.17 	Sec. 19. Minnesota Statutes 2016, section 103I.205, subdivision 5, is amended to read:
366.18 		Subd. 5.At-grade monitoring environmental wells. At-grade monitoring environmental
366.19 	wells are authorized without variance and may be installed for the purpose of evaluating 
366.20 	groundwater conditions or for use as a leak detection device. An at-grade monitoring
366.21 	environmental well must be installed in accordance with the rules of the commissioner. The 
366.22 	at-grade monitoring environmental wells must be installed with an impermeable double 
366.23 	locking cap approved by the commissioner and must be labeled environmental or monitoring 
366.24 	wells.

366.25 	Sec. 20. Minnesota Statutes 2016, section 103I.205, subdivision 6, is amended to read:
366.26 		Subd. 6.Distance requirements for sources of contamination, buildings, gas pipes, 
366.27 	liquid propane tanks, and electric lines. (a) A person may not place, construct, or install 
366.28 	an actual or potential source of contamination, building, gas pipe, liquid propane tank, or 
366.29 	electric line any closer to a well or boring than the isolation distances prescribed by the 
366.30 	commissioner by rule unless a variance has been prescribed by rule.
367.1 	(b) The commissioner shall establish by rule reduced isolation distances for facilities 
367.2 	which have safeguards in accordance with sections 18B.01, subdivision 26, and 18C.005, 
367.3 	subdivision 29.

367.4 	Sec. 21. Minnesota Statutes 2016, section 103I.208, subdivision 1, is amended to read:
367.5 		Subdivision 1.Well notification fee. The well notification fee to be paid by a property 
367.6 	owner is:
367.7 	(1) for construction of a new water supply well, $235 $275, which includes the state 
367.8 	core function fee;
367.9 	(2) for a well sealing, $65 $75 for each well, which includes the state core function fee, 
367.10 	except that a single fee of $75 is required for monitoring all temporary environmental wells 
367.11 	constructed on recorded on the sealing notification for a single property, having depths 
367.12 	within a 25 foot range, and sealed within 48 72 hours of start of construction, a single fee 
367.13 	of $65; and
367.14 	(3) for construction of a dewatering well, $235 $275, which includes the state core 
367.15 	function fee, for each dewatering well except a dewatering project comprising five or more 
367.16 	dewatering wells shall be assessed a single fee of $1,175 $1,375 for the dewatering wells 
367.17 	recorded on the notification.; and
367.18 	(4) for construction of an environmental well, $275, which includes the state core function 
367.19 	fee, except that a single fee of $275 is required for all environmental wells recorded on the 
367.20 	notification that are located on a single property, and except that no fee is required for 
367.21 	construction of a temporary environmental well.

367.22 	Sec. 22. Minnesota Statutes 2016, section 103I.208, subdivision 2, is amended to read:
367.23 		Subd. 2.Permit fee. The permit fee to be paid by a property owner is:
367.24 	(1) for a water supply well that is not in use under a maintenance permit, $175 annually;
367.25 	(2) for construction of a monitoring well, $235, which includes the state core function 
367.26 	fee;
367.27 	(3) for a monitoring an environmental well that is unsealed under a maintenance permit, 
367.28 	$175 annually except no fee is required for an environmental well owned by a federal 
367.29 	agency, state agency, or local unit of government that is unsealed under a maintenance 
367.30 	permit. "Local unit of government" means a statutory or home rule charter city, town, county, 
367.31 	or soil and water conservation district, watershed district, an organization formed for the 
368.1 	joint exercise of powers under section 471.59, a community health board, or other special 
368.2 	purpose district or authority with local jurisdiction in water and related land resources 
368.3 	management;
368.4 	(4) for a monitoring well owned by a federal agency, state agency, or local unit of 
368.5 	government that is unsealed under a maintenance permit, $50 annually. "Local unit of 
368.6 	government" means a statutory or home rule charter city, town, county, or soil and water 
368.7 	conservation district, watershed district, an organization formed for the joint exercise of 
368.8 	powers under section 471.59, a community health board, or other special purpose district 
368.9 	or authority with local jurisdiction in water and related land resources management;
368.10 	(5) (3) for monitoring environmental wells used as a leak detection device at a single 
368.11 	motor fuel retail outlet, a single petroleum bulk storage site excluding tank farms, or a single 
368.12 	agricultural chemical facility site, the construction permit fee is $235, which includes the 
368.13 	state core function fee, per site regardless of the number of wells constructed on the site, 
368.14 	and the annual fee for that are unsealed under a maintenance permit for unsealed monitoring 
368.15 	wells is, $175 annually per site regardless of the number of monitoring environmental wells 
368.16 	located on site;
368.17 	(6) (4) for a groundwater thermal exchange device, in addition to the notification fee 
368.18 	for water supply wells, $235 $275, which includes the state core function fee;
368.19 	(7) (5) for a bored geothermal heat exchanger with less than ten tons of heating/cooling 
368.20 	capacity, $235 $275;
368.21 	(8) (6) for a bored geothermal heat exchanger with ten to 50 tons of heating/cooling 
368.22 	capacity, $475 $515;
368.23 	(9) (7) for a bored geothermal heat exchanger with greater than 50 tons of heating/cooling 
368.24 	capacity, $700 $740;
368.25 	(10) (8) for a dewatering well that is unsealed under a maintenance permit, $175 annually 
368.26 	for each dewatering well, except a dewatering project comprising more than five dewatering 
368.27 	wells shall be issued a single permit for $875 annually for dewatering wells recorded on 
368.28 	the permit; and
368.29 	(11) (9) for an elevator boring, $235 $275 for each boring.

369.1 	Sec. 23. Minnesota Statutes 2016, section 103I.235, is amended by adding a subdivision 
369.2 	to read:
369.3 		Subd. 3.Temporary environmental well and unsuccessful well exemption. This 
369.4 	section does not apply to temporary environmental wells or unsuccessful wells that have 
369.5 	been sealed by a licensed contractor in compliance with this chapter.

369.6 	Sec. 24. Minnesota Statutes 2016, section 103I.301, subdivision 1, is amended to read:
369.7 		Subdivision 1.Wells and borings. (a) A property owner must have a well or boring 
369.8 	sealed if:
369.9 	(1) the well or boring is contaminated or may contribute to the spread of contamination;
369.10 	(2) the well or boring was attempted to be sealed but was not sealed according to the 
369.11 	provisions of this chapter; or
369.12 	(3) the well or boring is located, constructed, or maintained in a manner that its continued 
369.13 	use or existence endangers groundwater quality or is a safety or health hazard.
369.14 	(b) A well or boring that is not in use must be sealed unless the property owner has a 
369.15 	maintenance permit for the well.
369.16 	(c) The property owner must have a well or boring sealed by a registered or licensed 
369.17 	person authorized to seal the well or boring, consistent with provisions of this chapter.

369.18 	Sec. 25. Minnesota Statutes 2016, section 103I.301, subdivision 2, is amended to read:
369.19 		Subd. 2.MonitoringEnvironmental wells. The owner of the property where a 
369.20 	monitoring an environmental well is located must have the monitoring environmental well 
369.21 	sealed when the well is no longer in use. The owner must have a well contractor, limited 
369.22 	well/boring sealing contractor, or a monitoring an environmental well contractor seal the 
369.23 	monitoring environmental well.

369.24 	Sec. 26. Minnesota Statutes 2016, section 103I.315, subdivision 1, is amended to read:
369.25 		Subdivision 1.Order to seal well or boring. The commissioner may order a property 
369.26 	owner to seal a well or boring if:
369.27 	(1) the commissioner determines that without being sealed the well or boring is an 
369.28 	imminent threat to public health or public safety;
369.29 	(2) the well or boring is required to be sealed under section 103I.301; or
370.1 	(3) a well is a monitoring an environmental well or dewatering well and by 14 months 
370.2 	after construction of the well, the owner has not obtained a maintenance permit, or after a 
370.3 	maintenance permit has been issued the owner has not renewed a maintenance permit.

370.4 	Sec. 27. Minnesota Statutes 2016, section 103I.501, is amended to read:
370.5 	103I.501 LICENSING AND REGULATION OF WELLS AND BORINGS.
370.6 	(a) The commissioner shall regulate and license:
370.7 	(1) drilling, constructing, and repair of wells;
370.8 	(2) sealing of wells;
370.9 	(3) installing of well pumps and pumping equipment;
370.10 	(4) excavating, drilling, repairing, and sealing of elevator borings;
370.11 	(5) construction, repair, and sealing of environmental bore holes wells; and
370.12 	(6) construction, repair, and sealing of bored geothermal heat exchangers.
370.13 	(b) The commissioner shall examine and license well contractors, limited well/boring 
370.14 	contractors, and elevator boring contractors, and examine and register monitoring
370.15 	environmental well contractors.
370.16 	(c) The commissioner shall license explorers engaged in exploratory boring and shall 
370.17 	examine persons who supervise or oversee exploratory boring.

370.18 	Sec. 28. Minnesota Statutes 2016, section 103I.505, subdivision 1, is amended to read:
370.19 		Subdivision 1.Reciprocity authorized. The commissioner may issue a license or register
370.20 	certify a person under this chapter, without giving an examination, if the person is licensed 
370.21 	or registered certified in another state and:
370.22 	(1) the requirements for licensing or registration certification under which the well or 
370.23 	boring contractor was licensed or registered person was certified do not conflict with this 
370.24 	chapter;
370.25 	(2) the requirements are of a standard not lower than that specified by the rules adopted 
370.26 	under this chapter; and
370.27 	(3) equal reciprocal privileges are granted to licensees or registrants certified persons
370.28 	of this state.

371.1 	Sec. 29. Minnesota Statutes 2016, section 103I.505, subdivision 2, is amended to read:
371.2 		Subd. 2.Fees required. A well or boring contractor or certified person must apply for 
371.3 	the license or registration certification and pay the fees under the provisions of this chapter 
371.4 	to receive a license or registration certification under this section.

371.5 	Sec. 30. Minnesota Statutes 2016, section 103I.515, is amended to read:
371.6 	103I.515 LICENSES NOT TRANSFERABLE.
371.7 	A license or registration certification issued under this chapter is not transferable.

371.8 	Sec. 31. Minnesota Statutes 2016, section 103I.525, subdivision 1, is amended to read:
371.9 		Subdivision 1.Certification application. (a) A person must file an application and 
371.10 	application fee with the commissioner to represent a well contractor.
371.11 	(b) The application must state the applicant's qualifications for certification as a 
371.12 	representative, and other information required by the commissioner. The application must 
371.13 	be on forms prescribed by the commissioner.
371.14 	(c) A person may apply as an individual if the person:
371.15 	(1) is not representing a firm, sole proprietorship, partnership, association, corporation, 
371.16 	or other entity including the United States government, any interstate body, the state, and 
371.17 	an agency, department, or political subdivision of the state; and
371.18 	(2) meets the well contractor certification and license requirements under this chapter.

371.19 	Sec. 32. Minnesota Statutes 2016, section 103I.525, subdivision 2, is amended to read:
371.20 		Subd. 2.Certification fee. (a) The application fee for certification as a representative 
371.21 	of a well contractor is $75. The commissioner may not act on an application until the 
371.22 	application fee is paid.
371.23 	(b) The renewal fee for certification as a representative of a well contractor is $75. The 
371.24 	commissioner may not renew a certification until the renewal fee is paid.
371.25 	(c) A certified representative must file an application and a renewal application fee to 
371.26 	renew the certification by the date stated in the certification. The renewal application must 
371.27 	include information that the certified representative has met continuing education 
371.28 	requirements established by the commissioner by rule.

372.1 	Sec. 33. Minnesota Statutes 2016, section 103I.525, subdivision 5, is amended to read:
372.2 		Subd. 5.Bond. (a) As a condition of being issued a well contractor's license, the applicant, 
372.3 	except a person applying for an individual well contractor's license, must submit a corporate 
372.4 	surety bond for $25,000 approved by the commissioner. The bond must be conditioned to 
372.5 	pay the state on performance of work in this state that is not in compliance with this chapter 
372.6 	or rules adopted under this chapter. The bond is in lieu of other license bonds required by 
372.7 	a political subdivision of the state.
372.8 	(b) From proceeds of the bond, the commissioner may compensate persons injured or 
372.9 	suffering financial loss because of a failure of the applicant to perform work or duties in 
372.10 	compliance with this chapter or rules adopted under this chapter.

372.11 	Sec. 34. Minnesota Statutes 2016, section 103I.525, subdivision 6, is amended to read:
372.12 		Subd. 6.License fee. The fee for a well contractor's license is $250, except the fee for 
372.13 	an individual well contractor's license is $75.

372.14 	Sec. 35. Minnesota Statutes 2016, section 103I.525, subdivision 8, is amended to read:
372.15 		Subd. 8.Renewal. (a) A licensee must file an application and a renewal application fee 
372.16 	to renew the license by the date stated in the license.
372.17 	(b) The renewal application fee for a well contractor's license is $250, except the fee for 
372.18 	an individual well contractor's license is $75.
372.19 	(c) The renewal application must include information that the certified representative 
372.20 	of the applicant has met continuing education requirements established by the commissioner 
372.21 	by rule.
372.22 	(d) At the time of the renewal, the commissioner must have on file all properly completed 
372.23 	well and boring construction reports, well and boring sealing reports, reports of elevator 
372.24 	borings, water sample analysis reports, well and boring permits, and well notifications for 
372.25 	work conducted by the licensee since the last license renewal.

372.26 	Sec. 36. Minnesota Statutes 2016, section 103I.531, subdivision 2, is amended to read:
372.27 		Subd. 2.Certification fee. (a) The application fee for certification as a representative 
372.28 	of a limited well/boring contractor is $75. The commissioner may not act on an application 
372.29 	until the application fee is paid.
372.30 	(b) The renewal fee for certification as a representative of a limited well/boring contractor 
372.31 	is $75. The commissioner may not renew a certification until the renewal fee is paid.
373.1 	(c) The fee for three or more limited well/boring contractor certifications is $225.
373.2 	(d) A certified representative must file an application and a renewal application fee to 
373.3 	renew the certification by the date stated in the certification. The renewal application must 
373.4 	include information that the certified representative has met continuing education 
373.5 	requirements established by the commissioner by rule.

373.6 	Sec. 37. Minnesota Statutes 2016, section 103I.531, subdivision 5, is amended to read:
373.7 		Subd. 5.Bond. (a) As a condition of being issued a limited well/boring contractor's 
373.8 	license for constructing, repairing, and sealing drive point wells or dug wells, sealing wells 
373.9 	or and borings, constructing, repairing, and sealing dewatering wells, or constructing, 
373.10 	repairing, and sealing bored geothermal heat exchangers, the applicant must submit a 
373.11 	corporate surety bond for $10,000 approved by the commissioner. As a condition of being 
373.12 	issued a limited well/boring contractor's license for installing or, repairing, and modifying 
373.13 	well pumps and pumping equipment, well screens or, pitless units or and pitless adaptors,
373.14 	and well casings from the pitless adaptor or pitless unit to the upper termination of the well 
373.15 	casing, or installing well pumps or pumping equipment, the applicant must submit a corporate 
373.16 	surety bond for $2,000 approved by the commissioner. The bonds required in this paragraph 
373.17 	must be conditioned to pay the state on performance of work in this state that is not in 
373.18 	compliance with this chapter or rules adopted under this chapter. The bonds are in lieu of 
373.19 	other license bonds required by a political subdivision of the state.
373.20 	(b) From proceeds of a bond required in paragraph (a), the commissioner may compensate 
373.21 	persons injured or suffering financial loss because of a failure of the applicant to perform 
373.22 	work or duties in compliance with this chapter or rules adopted under this chapter.

373.23 	Sec. 38. Minnesota Statutes 2016, section 103I.535, subdivision 2, is amended to read:
373.24 		Subd. 2.Certification fee. (a) The application fee for certification as a representative 
373.25 	of an elevator boring contractor is $75. The commissioner may not act on an application 
373.26 	until the application fee is paid.
373.27 	(b) The renewal fee for certification as a representative of an elevator boring contractor 
373.28 	is $75. The commissioner may not renew a certification until the renewal fee is paid.
373.29 	(c) A certified representative must file an application and a renewal application fee to 
373.30 	renew the certification by the date stated in the certification. The renewal application must 
373.31 	include information that the certified representative has met continuing education 
373.32 	requirements established by the commissioner by rule.

374.1 	Sec. 39. Minnesota Statutes 2016, section 103I.535, subdivision 6, is amended to read:
374.2 		Subd. 6.License fee. The fee for an elevator shaft boring contractor's license is $75.

374.3 	Sec. 40. Minnesota Statutes 2016, section 103I.541, subdivision 1, is amended to read:
374.4 		Subdivision 1.Registration Certification. A person seeking registration as a monitoring
374.5 	certification to represent an environmental well contractor must meet examination and 
374.6 	experience requirements adopted by the commissioner by rule.

374.7 	Sec. 41. Minnesota Statutes 2016, section 103I.541, subdivision 2, is amended to read:
374.8 		Subd. 2.Validity. A monitoring An environmental well contractor's registration
374.9 	certification is valid until the date prescribed in the registration certification by the 
374.10 	commissioner.

374.11 	Sec. 42. Minnesota Statutes 2016, section 103I.541, subdivision 2a, is amended to read:
374.12 		Subd. 2a.Certification application. (a) An individual must submit an application and 
374.13 	application fee to the commissioner to apply for certification as a representative of a 
374.14 	monitoring an environmental well contractor.
374.15 	(b) The application must be on forms prescribed by the commissioner. The application 
374.16 	must state the applicant's qualifications for the certification, and other information required 
374.17 	by the commissioner.

374.18 	Sec. 43. Minnesota Statutes 2016, section 103I.541, subdivision 2b, is amended to read:
374.19 		Subd. 2b.Issuance of registration license. If a person employs a certified representative, 
374.20 	submits the bond under subdivision 3, and pays the registration license fee of $75 for a 
374.21 	monitoring an environmental well contractor registration license, the commissioner shall 
374.22 	issue a monitoring an environmental well contractor registration license to the applicant. 
374.23 	The fee for an individual registration is $75. The commissioner may not act on an application 
374.24 	until the application fee is paid.

374.25 	Sec. 44. Minnesota Statutes 2016, section 103I.541, subdivision 2c, is amended to read:
374.26 		Subd. 2c.Certification fee. (a) The application fee for certification as a representative 
374.27 	of a monitoring an environmental well contractor is $75. The commissioner may not act on 
374.28 	an application until the application fee is paid.
375.1 	(b) The renewal fee for certification as a representative of a monitoring an environmental
375.2 	well contractor is $75. The commissioner may not renew a certification until the renewal 
375.3 	fee is paid.
375.4 	(c) A certified representative must file an application and a renewal application fee to 
375.5 	renew the certification by the date stated in the certification. The renewal application must 
375.6 	include information that the certified representative has met continuing education 
375.7 	requirements established by the commissioner by rule.

375.8 	Sec. 45. Minnesota Statutes 2016, section 103I.541, subdivision 2e, is amended to read:
375.9 		Subd. 2e.Issuance of certification. If the applicant meets the experience requirements 
375.10 	established by rule and passes the examination as determined by the commissioner, the 
375.11 	commissioner shall issue the applicant a certification to represent a monitoring an 
375.12 	environmental well contractor.

375.13 	Sec. 46. Minnesota Statutes 2016, section 103I.541, subdivision 3, is amended to read:
375.14 		Subd. 3.Bond. (a) As a condition of being issued a monitoring an environmental well 
375.15 	contractor's registration license, the applicant must submit a corporate surety bond for 
375.16 	$10,000 approved by the commissioner. The bond must be conditioned to pay the state on 
375.17 	performance of work in this state that is not in compliance with this chapter or rules adopted 
375.18 	under this chapter. The bond is in lieu of other license bonds required by a political 
375.19 	subdivision of the state.
375.20 	(b) From proceeds of the bond, the commissioner may compensate persons injured or 
375.21 	suffering financial loss because of a failure of the applicant to perform work or duties in 
375.22 	compliance with this chapter or rules adopted under this chapter.

375.23 	Sec. 47. Minnesota Statutes 2016, section 103I.541, subdivision 4, is amended to read:
375.24 		Subd. 4.License renewal. (a) A person must file an application and a renewal application 
375.25 	fee to renew the registration license by the date stated in the registration license.
375.26 	(b) The renewal application fee for a monitoring an environmental  well contractor's 
375.27 	registration license is $75.
375.28 	(c) The renewal application must include information that the certified representative 
375.29 	of the applicant has met continuing education requirements established by the commissioner 
375.30 	by rule.
376.1 	(d) At the time of the renewal, the commissioner must have on file all well and boring 
376.2 	construction reports, well and boring sealing reports, well permits, and notifications for 
376.3 	work conducted by the registered licensed person since the last registration license renewal.

376.4 	Sec. 48. Minnesota Statutes 2016, section 103I.541, subdivision 5, is amended to read:
376.5 		Subd. 5.Incomplete or late renewal. If a registered licensed person submits a renewal 
376.6 	application after the required renewal date:
376.7 	(1) the registered licensed person must include a late fee of $75; and
376.8 	(2) the registered licensed person may not conduct activities authorized by the monitoring
376.9 	environmental well contractor's registration license until the renewal application, renewal 
376.10 	application fee, late fee, and all other information required in subdivision 4 are submitted.

376.11 	Sec. 49. Minnesota Statutes 2016, section 103I.545, is amended to read:
376.12 	103I.545 REGISTRATION OF DRILLING MACHINES AND HOISTS 
376.13 	REQUIRED.
376.14 		Subdivision 1.Drilling machine. (a) A person may not use a drilling machine such as 
376.15 	a cable tool, rotary tool, hollow rod tool, or auger for a drilling activity requiring a license 
376.16 	or registration under this chapter unless the drilling machine is registered with the 
376.17 	commissioner.
376.18 	(b) A person must apply for the registration on forms prescribed by the commissioner 
376.19 	and submit a $75 registration fee.
376.20 	(c) A registration is valid for one year.
376.21 		Subd. 2.Hoist. (a) A person may not use a machine such as a hoist for an activity 
376.22 	requiring a license or registration under this chapter to repair wells or borings, seal wells 
376.23 	or borings, or install pumps unless the machine is registered with the commissioner.
376.24 	(b) A person must apply for the registration on forms prescribed by the commissioner 
376.25 	and submit a $75 registration fee.
376.26 	(c) A registration is valid for one year.

376.27 	Sec. 50. [103I.550] LIMITED PUMP, PITLESS, OR DUG WELL/DRIVE POINT 
376.28 	CONTRACTOR.
376.29 		Subdivision 1.Limited pump or pitless license or certification. A person with a limited 
376.30 	well/boring contractor's license or certification to install well pumps and pumping equipment; 
377.1 	or a person with a limited well/boring contractor's license or certification to install, repair, 
377.2 	and modify pitless units and pitless adapters, well casings above the pitless unit or pitless 
377.3 	adapter, and well screens and well diameters, will be issued a combined license or 
377.4 	certification to: (1) install well pumps and pumping equipment; and (2) install, repair, and 
377.5 	modify pitless units and pitless adapters, well casings above the pitless unit or pitless adapter, 
377.6 	well screens, and well diameters.
377.7 		Subd. 2.Limited dug well/drive point license or certification. A person with a limited 
377.8 	well/boring contractor's license or certification to construct, repair, and seal drive point 
377.9 	wells and dug wells will be issued a well contractor's license or certification.

377.10 	Sec. 51. Minnesota Statutes 2016, section 103I.601, subdivision 2, is amended to read:
377.11 		Subd. 2.License required to make borings. (a) Except as provided in paragraph (d), 
377.12 	a person must not make an exploratory boring without an explorer's license. The fee for an 
377.13 	explorer's license is $75. The explorer's license is valid until the date prescribed in the license 
377.14 	by the commissioner.
377.15 	(b) A person must file an application and renewal application fee to renew the explorer's 
377.16 	license by the date stated in the license. The renewal application fee is $75.
377.17 	(c) If the licensee submits an application fee after the required renewal date, the licensee:
377.18 	(1) must include a late fee of $75; and
377.19 	(2) may not conduct activities authorized by an explorer's license until the renewal 
377.20 	application, renewal application fee, late fee, and sealing reports required in subdivision 9 
377.21 	are submitted.
377.22 	(d) An explorer must designate a responsible individual to supervise and oversee the 
377.23 	making of exploratory borings.
377.24 	(1) Before an individual supervises or oversees an exploratory boring, the individual 
377.25 	must file an application and application fee of $75 to qualify as a certified responsible 
377.26 	individual.
377.27 	(2) The individual must take and pass an examination relating to construction, location, 
377.28 	and sealing of exploratory borings. A professional engineer or geoscientist licensed under 
377.29 	sections 326.02 to 326.15 or a professional geologist certified by the American Institute of 
377.30 	Professional Geologists is not required to take the examination required in this subdivision, 
377.31 	but must be certified as a responsible individual to supervise an exploratory boring.
378.1 	(3) The individual must file an application and a renewal fee of $75 to renew the 
378.2 	responsible individual's certification by the date stated in the certification. If the certified 
378.3 	responsible individual submits an application fee after the renewal date, the certified 
378.4 	responsible individual must include a late fee of $75 and may not supervise or oversee 
378.5 	exploratory borings until the renewal application, application fee, and late fee are submitted.

378.6 	Sec. 52. Minnesota Statutes 2016, section 103I.601, subdivision 4, is amended to read:
378.7 		Subd. 4.Notification and map of borings. (a) By ten days before beginning exploratory 
378.8 	boring, an explorer must submit to the commissioner of health a notification of the proposed 
378.9 	boring on a form prescribed by the commissioner, and a fee of $275 for each exploratory 
378.10 	boring.
378.11 	(b) By ten days before beginning exploratory boring, an explorer must submit to the 
378.12 	commissioners of health and natural resources a county road map having a scale of one-half 
378.13 	inch equal to one mile, as prepared by the Department of Transportation, or a 7.5 minute 
378.14 	series topographic map (1:24,000 scale), as prepared by the United States Geological Survey, 
378.15 	showing the location of each proposed exploratory boring to the nearest estimated 40 acre 
378.16 	parcel. Exploratory boring that is proposed on the map may not be commenced later than 
378.17 	180 days after submission of the map, unless a new map is submitted.

378.18 	Sec. 53. Minnesota Statutes 2016, section 103I.711, subdivision 1, is amended to read:
378.19 		Subdivision 1.Impoundment. The commissioner may apply to district court for a 
378.20 	warrant authorizing seizure and impoundment of all drilling machines or hoists owned or 
378.21 	used by a person. The court shall issue an impoundment order upon the commissioner's 
378.22 	showing that a person is constructing, repairing, or sealing wells or borings or installing 
378.23 	pumps or pumping equipment or excavating holes for installing elevator shafts borings
378.24 	without a license or registration as required under this chapter. A sheriff on receipt of the 
378.25 	warrant must seize and impound all drilling machines and hoists owned or used by the 
378.26 	person. A person from whom equipment is seized under this subdivision may file an action 
378.27 	in district court for the purpose of establishing that the equipment was wrongfully seized.

378.28 	Sec. 54. Minnesota Statutes 2016, section 103I.715, subdivision 2, is amended to read:
378.29 		Subd. 2.Gross misdemeanors. A person is guilty of a gross misdemeanor who:
378.30 	(1) willfully violates a provision of this chapter or order of the commissioner;
379.1 	(2) engages in the business of drilling or making wells, sealing wells, installing pumps 
379.2 	or pumping equipment, or constructing elevator shafts borings without a license required 
379.3 	by this chapter; or
379.4 	(3) engages in the business of exploratory boring without an exploratory borer's license 
379.5 	under this chapter.

379.6 	Sec. 55. [137.67] MINNESOTA BIOMEDICINE AND BIOETHICS INNOVATION 
379.7 	GRANTS.
379.8 		Subdivision 1.Grants. (a) The steering committee of the University of Minnesota and 
379.9 	Mayo Foundation partnership shall award grants to entities that apply for a grant under this 
379.10 	subdivision to fund innovations and research in biomedicine and bioethics. Grant funds 
379.11 	must be used to fund biomedical and bioethical research, and related clinical translation 
379.12 	and commercialization activities in this state. Entities must apply for a grant in a form and 
379.13 	manner specified by the steering committee. The steering committee shall use the following 
379.14 	criteria to award grants under this subdivision:
379.15 	(1) the likelihood that the research will lead to a new discovery;
379.16 	(2) the prospects for commercialization of the research;
379.17 	(3) the likelihood that the research will strengthen Minnesota's economy through the 
379.18 	creation of new businesses, increased public or private funding for research in Minnesota, 
379.19 	or attracting additional clinicians and researchers to Minnesota; and
379.20 	(4) whether the proposed research includes a bioethics research plan to ensure the research 
379.21 	is conducted using ethical research practices.
379.22 	(b) Projects that include the acquisition or use of human fetal tissue are not eligible for 
379.23 	grants under this subdivision. For purposes of this paragraph, "human fetal tissue" has the 
379.24 	meaning given in United States Code, title 42, section 289g-1(f).
379.25 		Subd. 2.Consultation. In awarding grants under subdivision 1, the steering committee 
379.26 	may consult with interested parties who are able to provide technical information, advice, 
379.27 	and recommendations on grant projects and awards. Interested parties with whom the steering 
379.28 	committee may consult include but are not limited to representatives of  private industries 
379.29 	with expertise in biomedical research, bioethical research, clinical translation, 
379.30 	commercialization, and medical venture financing.

380.1 	Sec. 56. [144.0572] CRIMINAL HISTORY BACKGROUND CHECKS ON 
380.2 	APPLICANTS, LICENSEES, AND OTHER OCCUPATIONS REGULATED BY 
380.3 	COMMISSIONER OF HEALTH.
380.4 		Subdivision 1.Criminal history background check requirements. (a) Beginning 
380.5 	January 1, 2018, an applicant for initial licensure, temporary licensure, or relicensure after 
380.6 	a lapse in licensure as an audiologist or speech-language pathologist, or an applicant for 
380.7 	initial certification as a hearing instrument dispenser, must submit to a criminal history 
380.8 	records check of state data completed by the Bureau of Criminal Apprehension (BCA) and 
380.9 	a national criminal history records check, including a search of the records of the Federal 
380.10 	Bureau of Investigation (FBI).
380.11 	(b) Beginning January 1, 2020, an applicant for a renewal license or certificate as an 
380.12 	audiologist, speech-language pathologist, or hearing instrument dispenser who was licensed 
380.13 	or obtained a certificate before January 1, 2018, must submit to a criminal history records 
380.14 	check of state data completed by the BCA and a national criminal history records check, 
380.15 	including a search of the records of the FBI.
380.16 	(c) An applicant must submit to a background study under chapter 245C.
380.17 	(d) The criminal history records check must be structured so that any new crimes that 
380.18 	an applicant or licensee or certificate holder commits after the initial background check are 
380.19 	flagged in the BCA's or FBI's database and reported back to the commissioner of human 
380.20 	services.
380.21 		Subd. 2.Procedures. (a) The commissioner shall contract with the Department of Human 
380.22 	Services to process the criminal history background check requirements through NETStudy 
380.23 	2.0, as defined in section 245C.02.
380.24 	(b) The Department of Human Services shall conduct the criminal history background 
380.25 	checks according to section 144.057, except that:
380.26 	(1) all applicants must submit to a fingerprint-based criminal history records check of 
380.27 	state data completed by the BCA and a national criminal history records check, including 
380.28 	a search of the records of the FBI;
380.29 	(2) the Department of Human Services shall complete the check and the study and notify 
380.30 	the commissioner of health if the applicant, licensee, or certificate holder has a criminal 
380.31 	history as defined in section 245C.15; and
380.32 	(3) the Department of Human Services shall simultaneously conduct a background study 
380.33 	on each applicant according to chapter 245C.
381.1 	(c) When making a determination whether to issue a license, deny a license, or issue a 
381.2 	conditional license or other credential to practice an occupation regulated by the Department 
381.3 	of Health, the commissioner or the commissioner's designee shall evaluate a criminal 
381.4 	conviction, guilty plea, Alford plea, judicial determination, or preponderance of evidence 
381.5 	to determine an applicant's risk of harm using the criteria in section 364.03.
381.6 	(d) Before taking disciplinary action against an applicant or a licensee based on a criminal 
381.7 	conviction, judicial determination, admission in court, Alford plea, or preponderance of 
381.8 	evidence, the commissioner of health shall provide the applicant or licensee an opportunity 
381.9 	to complete or challenge the accuracy of the criminal history information. The applicant or 
381.10 	licensee shall have 30 calendar days following notice from the commissioner of the intent 
381.11 	to deny licensure or take disciplinary action to request an opportunity to correct or complete 
381.12 	the record prior to the commissioner taking disciplinary action. The commissioner shall 
381.13 	provide the applicant up to 180 days to challenge the accuracy or completeness of the report 
381.14 	with the agency responsible for the record. This subdivision does not affect the right of the 
381.15 	subject of the data to contest the accuracy or completeness under section 13.04, subdivision 
381.16 	4.
381.17 	(e) The checks and studies must be structured so that any new crimes that an applicant 
381.18 	or licensee commits after the initial background check are flagged in the BCA's or FBI's 
381.19 	database and reported back to the commissioner of human services.
381.20 		Subd. 3.Applicant, licensee, or other regulated individual's responsibilities. (a) 
381.21 	Applicants, licensees, and individuals seeking a credential to practice one of the public 
381.22 	health occupations listed in subdivision 1 must submit a complete criminal history records 
381.23 	check consent form, a complete background study consent form, and a full set of fingerprints 
381.24 	as required by the Department of Human Services in section 245C.05.
381.25 	(b) The applicant or license holder is responsible for paying to the Department of Human 
381.26 	Services all fees associated with the preparation of the fingerprints, the criminal records 
381.27 	check consent form, and the criminal background check.

381.28 	Sec. 57. [144.059] PALLIATIVE CARE ADVISORY COUNCIL.
381.29 		Subdivision 1.Membership. The Palliative Care Advisory Council shall consist of 18 
381.30 	public members.
381.31 		Subd. 2.Public members. (a) The commissioner shall appoint, in the manner provided 
381.32 	in section 15.0597, 18 public members, including the following:
382.1 	(1) two physicians, of which one is certified by the American Board of Hospice and 
382.2 	Palliative Medicine;
382.3 	(2) two registered nurses or advanced practice registered nurses, of which one is certified 
382.4 	by the National Board for Certification of Hospice and Palliative Nurses;
382.5 	(3) one care coordinator experienced in working with people with serious or chronic 
382.6 	illness and their families;
382.7 	(4) one spiritual counselor experienced in working with people with serious or chronic 
382.8 	illness and their families;
382.9 	(5) three licensed health professionals, such as complementary and alternative health 
382.10 	care practitioners, dietitians or nutritionists, pharmacists, or physical therapists, who are 
382.11 	neither physicians nor nurses, but who have experience as members of a palliative care 
382.12 	interdisciplinary team working with people with serious or chronic illness and their families;
382.13 	(6) one licensed social worker experienced in working with people with serious or chronic 
382.14 	illness and their families;
382.15 	(7) four patients or personal caregivers experienced with serious or chronic illness;
382.16 	(8) one representative of a health plan company;
382.17 	(9) one physician assistant that is a member of the American Academy of Hospice and 
382.18 	Palliative Medicine; and
382.19 	(10) two members from any of the categories described in clauses (1) to (9).
382.20 	(b) Council membership must include, where possible, representation that is racially, 
382.21 	culturally, linguistically, geographically, and economically diverse.
382.22 	(c) The council must include at least six members who reside outside Anoka, Carver, 
382.23 	Chisago, Dakota, Hennepin, Isanti, Mille Lacs, Ramsey, Scott, Sherburne, Sibley, Stearns, 
382.24 	Washington, or Wright Counties.
382.25 	(d) To the extent possible, council membership must include persons who have experience 
382.26 	in palliative care research, palliative care instruction in a medical or nursing school setting, 
382.27 	palliative care services for veterans as a provider or recipient, or pediatric care.
382.28 	(e) Council membership must include health professionals who have palliative care work 
382.29 	experience or expertise in palliative care delivery models in a variety of inpatient, outpatient, 
382.30 	and community settings, including acute care, long-term care, or hospice, with a variety of 
382.31 	populations, including pediatric, youth, and adult patients.
383.1 		Subd. 3.Term. Members of the council shall serve for a term of three years and may 
383.2 	be reappointed. Members shall serve until their successors have been appointed.
383.3 		Subd. 4.Administration. The commissioner or the commissioner's designee shall 
383.4 	provide meeting space and administrative services for the council.
383.5 		Subd. 5.Chairs. At the council's first meeting, and biannually thereafter, the members 
383.6 	shall elect a chair and a vice-chair whose duties shall be established by the council.
383.7 		Subd. 6.Meeting. The council shall meet at least twice yearly.
383.8 		Subd. 7.No compensation. Public members of the council serve without compensation 
383.9 	or reimbursement for expenses.
383.10 		Subd. 8.Duties. (a) The council shall consult with and advise the commissioner on 
383.11 	matters related to the establishment, maintenance, operation, and outcomes evaluation of 
383.12 	palliative care initiatives in the state.
383.13 	(b) By February 15 of each year, the council shall submit to the chairs and ranking 
383.14 	minority members of the committees of the senate and the house of representatives with 
383.15 	primary jurisdiction over health care a report containing:
383.16 	(1) the advisory council's assessment of the availability of palliative care in the state;
383.17 	(2) the advisory council's analysis of barriers to greater access to palliative care; and
383.18 	(3) recommendations for legislative action, with draft legislation to implement the 
383.19 	recommendations.
383.20 	(c) The Department of Health shall publish the report each year on the department's Web 
383.21 	site.
383.22 		Subd. 9.Open meetings. The council is subject to the requirements of chapter 13D.
383.23 		Subd. 10.Sunset. The council shall sunset January 1, 2025.

383.24 	Sec. 58. [144.1215] AUTHORIZATION TO USE HANDHELD DENTAL X-RAY 
383.25 	EQUIPMENT.
383.26 		Subdivision 1.Definition; handheld dental x-ray equipment. For purposes of this 
383.27 	section, "handheld dental x-ray equipment" means x-ray equipment that is used to take 
383.28 	dental radiographs, is designed to be handheld during operation, and is operated by an 
383.29 	individual authorized to take dental radiographs under chapter 150A.
384.1 		Subd. 2.Use authorized. (a) Handheld dental x-ray equipment may be used if the 
384.2 	equipment:
384.3 	(1) has been approved for human use by the United States Food and Drug Administration 
384.4 	and is being used in a manner consistent with that approval; and
384.5 	(2) utilizes a backscatter shield that:
384.6 	(i) is composed of a leaded polymer or a substance with a substantially equivalent 
384.7 	protective capacity;
384.8 	(ii) has at least 0.25 millimeters of lead or lead-shielding equivalent; and
384.9 	(iii) is permanently affixed to the handheld dental x-ray equipment.
384.10 	(b) The use of handheld dental x-ray equipment is prohibited if the equipment's 
384.11 	backscatter shield is broken or not permanently affixed to the system.
384.12 	(c) The use of handheld dental x-ray equipment shall not be limited to situations in which 
384.13 	it is impractical to transfer the patient to a stationary x-ray system.
384.14 	(d) Handheld dental x-ray equipment must be stored when not in use, by being secured 
384.15 	in a restricted, locked area of the facility.
384.16 	(e) Handheld dental x-ray equipment must be calibrated initially and at intervals that 
384.17 	must not exceed 24 months. Calibration must include the test specified in Minnesota Rules, 
384.18 	part 4732.1100, subpart 11.
384.19 	(f) Notwithstanding Minnesota Rules, part 4732.0880, subpart 2, item C, the tube housing 
384.20 	and the position-indicating device of handheld dental x-ray equipment may be handheld 
384.21 	during an exposure.
384.22 		Subd. 3.Exemptions from certain shielding requirements. Handheld dental x-ray 
384.23 	equipment used according to this section and according to manufacturer instructions is 
384.24 	exempt from the following requirements for the equipment:
384.25 	(1) shielding requirements in Minnesota Rules, part 4732.0365, item B; and
384.26 	(2) requirements for the location of the x-ray control console or utilization of a protective 
384.27 	barrier in Minnesota Rules, part 4732.0800, subpart 2, item B, subitems (2) and (3), provided 
384.28 	the equipment utilizes a backscatter shield that satisfies the requirements in subdivision 2, 
384.29 	paragraph (a), clause (2).
384.30 		Subd. 4.Compliance with rules. A registrant using handheld dental x-ray equipment 
384.31 	shall otherwise comply with Minnesota Rules, chapter 4732.

385.1 	Sec. 59. Minnesota Statutes 2016, section 144.122, is amended to read:
385.2 	144.122 LICENSE, PERMIT, AND SURVEY FEES.
385.3 	(a) The state commissioner of health, by rule, may prescribe procedures and fees for 
385.4 	filing with the commissioner as prescribed by statute and for the issuance of original and 
385.5 	renewal permits, licenses, registrations, and certifications issued under authority of the 
385.6 	commissioner. The expiration dates of the various licenses, permits, registrations, and 
385.7 	certifications as prescribed by the rules shall be plainly marked thereon. Fees may include 
385.8 	application and examination fees and a penalty fee for renewal applications submitted after 
385.9 	the expiration date of the previously issued permit, license, registration, and certification. 
385.10 	The commissioner may also prescribe, by rule, reduced fees for permits, licenses, 
385.11 	registrations, and certifications when the application therefor is submitted during the last 
385.12 	three months of the permit, license, registration, or certification period. Fees proposed to 
385.13 	be prescribed in the rules shall be first approved by the Department of Management and 
385.14 	Budget. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be 
385.15 	in an amount so that the total fees collected by the commissioner will, where practical, 
385.16 	approximate the cost to the commissioner in administering the program. All fees collected 
385.17 	shall be deposited in the state treasury and credited to the state government special revenue 
385.18 	fund unless otherwise specifically appropriated by law for specific purposes.
385.19 	(b) The commissioner may charge a fee for voluntary certification of medical laboratories 
385.20 	and environmental laboratories, and for environmental and medical laboratory services 
385.21 	provided by the department, without complying with paragraph (a) or chapter 14. Fees 
385.22 	charged for environment and medical laboratory services provided by the department must 
385.23 	be approximately equal to the costs of providing the services.
385.24 	(c) The commissioner may develop a schedule of fees for diagnostic evaluations 
385.25 	conducted at clinics held by the services for children with disabilities program. All receipts 
385.26 	generated by the program are annually appropriated to the commissioner for use in the 
385.27 	maternal and child health program.
385.28 	(d) The commissioner shall set license fees for hospitals and nursing homes that are not 
385.29 	boarding care homes at the following levels:

385.30
385.31
385.32
385.33	Joint Commission on Accreditation of 
Healthcare Organizations (JCAHO) and 
American Osteopathic Association (AOA) 
hospitals
	$7,655 plus $16 per bed
	
385.34	Non-JCAHO and non-AOA hospitals
	$5,280 plus $250 per bed
	
385.35385.36
386.1
386.2	Nursing home
	$183 plus $91 per bed until June 30, 2018. 
$183 plus $100 per bed between July 1, 2018, 
and June 30, 2020. $183 plus $105 per bed 
beginning July 1, 2020.
	
386.3 	The commissioner shall set license fees for outpatient surgical centers, boarding care 
386.4 	homes, and supervised living facilities at the following levels:

386.5	Outpatient surgical centers
	$3,712
	
386.6	Boarding care homes
	$183 plus $91 per bed
	
386.7	Supervised living facilities
	$183 plus $91 per bed.
	
386.8 	Fees collected under this paragraph are nonrefundable. The fees are nonrefundable even if 
386.9 	received before July 1, 2017, for licenses or registrations being issued effective July 1, 2017, 
386.10 	or later.
386.11 	(e) Unless prohibited by federal law, the commissioner of health shall charge applicants 
386.12 	the following fees to cover the cost of any initial certification surveys required to determine 
386.13 	a provider's eligibility to participate in the Medicare or Medicaid program:

386.14	Prospective payment surveys for hospitals
	$
	900
	
386.15	Swing bed surveys for nursing homes
	$
	1,200
	
386.16	Psychiatric hospitals
	$
	1,400
	
386.17	Rural health facilities
	$
	1,100
	
386.18	Portable x-ray providers
	$
	500
	
386.19	Home health agencies
	$
	1,800
	
386.20	Outpatient therapy agencies
	$
	800
	
386.21	End stage renal dialysis providers
	$
	2,100
	
386.22	Independent therapists
	$
	800
	
386.23	Comprehensive rehabilitation outpatient facilities
	$
	1,200
	
386.24	Hospice providers
	$
	1,700
	
386.25	Ambulatory surgical providers
	$
	1,800
	
386.26	Hospitals
	$
	4,200
	
386.27
386.28
386.29	Other provider categories or additional
resurveys required to complete initial
certification
	Actual surveyor costs: average 
surveyor cost x number of hours for 
the survey process.
	
386.30 	These fees shall be submitted at the time of the application for federal certification and 
386.31 	shall not be refunded. All fees collected after the date that the imposition of fees is not 
386.32 	prohibited by federal law shall be deposited in the state treasury and credited to the state 
386.33 	government special revenue fund.

387.1 	Sec. 60. Minnesota Statutes 2016, section 144.1501, subdivision 2, is amended to read:
387.2 		Subd. 2.Creation of account. (a) A health professional education loan forgiveness 
387.3 	program account is established. The commissioner of health shall use money from the 
387.4 	account to establish a loan forgiveness program:
387.5 	(1) for medical residents and mental health professionals agreeing to practice in designated 
387.6 	rural areas or underserved urban communities or specializing in the area of pediatric 
387.7 	psychiatry;
387.8 	(2) for midlevel practitioners agreeing to practice in designated rural areas or to teach 
387.9 	at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary program 
387.10 	at the undergraduate level or the equivalent at the graduate level;
387.11 	(3) for nurses who agree to practice in a Minnesota nursing home; an intermediate care 
387.12 	facility for persons with developmental disability; or a hospital if the hospital owns and 
387.13 	operates a Minnesota nursing home and a minimum of 50 percent of the hours worked by 
387.14 	the nurse is in the nursing home; a housing with services establishment as defined in section 
387.15 	144D.01, subdivision 4; or for a home care provider as defined in section 144A.43, 
387.16 	subdivision 4; or agree to teach at least 12 credit hours, or 720 hours per year in the nursing 
387.17 	field in a postsecondary program at the undergraduate level or the equivalent at the graduate 
387.18 	level;
387.19 	(4) for other health care technicians agreeing to teach at least 12 credit hours, or 720 
387.20 	hours per year in their designated field in a postsecondary program at the undergraduate 
387.21 	level or the equivalent at the graduate level. The commissioner, in consultation with the 
387.22 	Healthcare Education-Industry Partnership, shall determine the health care fields where the 
387.23 	need is the greatest, including, but not limited to, respiratory therapy, clinical laboratory 
387.24 	technology, radiologic technology, and surgical technology;
387.25 	(5) for pharmacists, advanced dental therapists, dental therapists, and public health nurses 
387.26 	who agree to practice in designated rural areas; and
387.27 	(6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient 
387.28 	encounters to state public program enrollees or patients receiving sliding fee schedule 
387.29 	discounts through a formal sliding fee schedule meeting the standards established by the 
387.30 	United States Department of Health and Human Services under Code of Federal Regulations, 
387.31 	title 42, section 51, chapter 303.
387.32 	(b) Appropriations made to the account do not cancel and are available until expended, 
387.33 	except that at the end of each biennium, any remaining balance in the account that is not 
388.1 	committed by contract and not needed to fulfill existing commitments shall cancel to the 
388.2 	fund.

388.3 	Sec. 61. [144.1505] HEALTH PROFESSIONALS CLINICAL TRAINING 
388.4 	EXPANSION GRANT PROGRAM.
388.5 		Subdivision 1.Definitions. For purposes of this section, the following definitions apply:
388.6 	(1) "eligible advanced practice registered nurse program" means a program that is located 
388.7 	in Minnesota and is currently accredited as a master's, doctoral, or postgraduate level 
388.8 	advanced practice registered nurse program by the Commission on Collegiate Nursing 
388.9 	Education or by the Accreditation Commission for Education in Nursing, or is a candidate 
388.10 	for accreditation;
388.11 	(2) "eligible dental therapy program" means a dental therapy education program or 
388.12 	advanced dental therapy education program that is located in Minnesota and is either:
388.13 	(i) approved by the Board of Dentistry; or
388.14 	(ii) currently accredited by the Commission on Dental Accreditation;
388.15 	(3) "eligible mental health professional program" means a program that is located in 
388.16 	Minnesota and is listed as a mental health professional program by the appropriate accrediting 
388.17 	body for clinical social work, psychology, marriage and family therapy, or licensed 
388.18 	professional clinical counseling, or is a candidate for accreditation;
388.19 	(4) "eligible pharmacy program" means a program that is located in Minnesota and is 
388.20 	currently accredited as a doctor of pharmacy program by the Accreditation Council on 
388.21 	Pharmacy Education;
388.22 	(5) "eligible physician assistant program" means a program that is located in Minnesota 
388.23 	and is currently accredited as a physician assistant program by the Accreditation Review 
388.24 	Commission on Education for the Physician Assistant, or is a candidate for accreditation;
388.25 	(6) "mental health professional" means an individual providing clinical services in the 
388.26 	treatment of mental illness who meets one of the qualifications under section 245.462, 
388.27 	subdivision 18; and
388.28 	(7) "project" means a project to establish or expand clinical training for physician 
388.29 	assistants, advanced practice registered nurses, pharmacists, dental therapists, advanced 
388.30 	dental therapists, or mental health professionals in Minnesota.
388.31 		Subd. 2.Program. (a) The commissioner of health shall award health professional 
388.32 	training site grants to eligible physician assistant, advanced practice registered nurse, 
389.1 	pharmacy, dental therapy, and mental health professional programs to plan and implement 
389.2 	expanded clinical training. A planning grant shall not exceed $75,000, and a training grant 
389.3 	shall not exceed $150,000 for the first year, $100,000 for the second year, and $50,000 for 
389.4 	the third year per program.
389.5 	(b) Funds may be used for:
389.6 	(1) establishing or expanding clinical training for physician assistants, advanced practice 
389.7 	registered nurses, pharmacists, dental therapists, advanced dental therapists, and mental 
389.8 	health professionals in Minnesota;
389.9 	(2) recruitment, training, and retention of students and faculty;
389.10 	(3) connecting students with appropriate clinical training sites, internships, practicums, 
389.11 	or externship activities;
389.12 	(4) travel and lodging for students;
389.13 	(5) faculty, student, and preceptor salaries, incentives, or other financial support;
389.14 	(6) development and implementation of cultural competency training;
389.15 	(7) evaluations;
389.16 	(8) training site improvements, fees, equipment, and supplies required to establish, 
389.17 	maintain, or expand a physician assistant, advanced practice registered nurse, pharmacy, 
389.18 	dental therapy, or mental health professional training program; and
389.19 	(9) supporting clinical education in which trainees are part of a primary care team model.
389.20 		Subd. 3.Applications. Eligible physician assistant, advanced practice registered nurse, 
389.21 	pharmacy, dental therapy, and mental health professional programs seeking a grant shall 
389.22 	apply to the commissioner. Applications must include a description of the number of 
389.23 	additional students who will be trained using grant funds; attestation that funding will be 
389.24 	used to support an increase in the number of clinical training slots; a description of the 
389.25 	problem that the proposed project will address; a description of the project, including all 
389.26 	costs associated with the project, sources of funds for the project, detailed uses of all funds 
389.27 	for the project, and the results expected; and a plan to maintain or operate any component 
389.28 	included in the project after the grant period. The applicant must describe achievable 
389.29 	objectives, a timetable, and roles and capabilities of responsible individuals in the 
389.30 	organization.
389.31 		Subd. 4.Consideration of applications. The commissioner shall review each application 
389.32 	to determine whether or not the application is complete and whether the program and the 
390.1 	project are eligible for a grant. In evaluating applications, the commissioner shall score each 
390.2 	application based on factors including, but not limited to, the applicant's clarity and 
390.3 	thoroughness in describing the project and the problems to be addressed, the extent to which 
390.4 	the applicant has demonstrated that the applicant has made adequate provisions to ensure 
390.5 	proper and efficient operation of the training program once the grant project is completed, 
390.6 	the extent to which the proposed project is consistent with the goal of increasing access to 
390.7 	primary care and mental health services for rural and underserved urban communities, the 
390.8 	extent to which the proposed project incorporates team-based primary care, and project 
390.9 	costs and use of funds.
390.10 		Subd. 5.Program oversight. The commissioner shall determine the amount of a grant 
390.11 	to be given to an eligible program based on the relative score of each eligible program's 
390.12 	application, other relevant factors discussed during the review, and the funds available to 
390.13 	the commissioner. Appropriations made to the program do not cancel and are available until 
390.14 	expended. During the grant period, the commissioner may require and collect from programs 
390.15 	receiving grants any information necessary to evaluate the program.

390.16 	Sec. 62. [144.4199] PUBLIC HEALTH RESPONSE CONTINGENCY ACCOUNT.
390.17 		Subdivision 1.Public health response contingency account. A public health response 
390.18 	contingency account is created in the special revenue fund in the state treasury. Money in 
390.19 	the public health response contingency account does not cancel and is appropriated to the 
390.20 	commissioner of health for the purposes specified in subdivision 4 when the determination 
390.21 	criteria in subdivision 3 and the requirements in subdivisions 5, paragraph (a), and 7, are 
390.22 	satisfied.
390.23 		Subd. 2.Definition. For purposes of this section, "public health response" means 
390.24 	immediate public health activities required to protect the health and safety of the public due 
390.25 	to pandemic influenza or an outbreak of a communicable or infectious disease.
390.26 		Subd. 3.Determination criteria. The commissioner may make expenditures from the 
390.27 	public health response contingency account only if:
390.28 	(1) the commissioner determines the pandemic influenza or outbreak of a communicable 
390.29 	or infectious disease requires a public health response;
390.30 	(2) the commissioner determines that the public health response is reasonably expected 
390.31 	to require supplies, equipment, personnel, and other resources in excess of the resources 
390.32 	available for public health response and preparedness activities in the affected jurisdictions; 
390.33 	and
391.1 	(3) the commissioner has notified the relevant federal agency that the pandemic influenza 
391.2 	or communicable or infectious disease:
391.3 	(i) is reasonably expected to require the evacuation of the impacted population, relocation 
391.4 	of seriously ill or injured persons to temporary care facilities, or the provision of replacement 
391.5 	essential community services;
391.6 	(ii) poses a probability of a large number of deaths, serious injuries, or long-term 
391.7 	disabilities in the affected population;
391.8 	(iii) involves widespread exposure to an infectious agent that poses a significant risk of 
391.9 	substantial future harm to a large number of people in the affected area; or
391.10 	(iv) poses a significant risk of harm to a large number of people or a high rate of morbidity 
391.11 	or mortality in the affected population.
391.12 		Subd. 4.Uses of funds. (a) When the determination criteria in subdivision 3 are satisfied 
391.13 	and the commissioner has complied with subdivisions 5, paragraph (a), and 7, the 
391.14 	commissioner may make expenditures from the public health response contingency account 
391.15 	for the following purposes attributable to a public health response:
391.16 	(1) staffing;
391.17 	(2) information technology;
391.18 	(3) supplies, equipment, and services to protect people in the affected area or population, 
391.19 	health care providers, and public safety workers;
391.20 	(4) training for and coordination with local public health departments and health care 
391.21 	providers;
391.22 	(5) communication with and outreach to affected areas or populations;
391.23 	(6) to provide a state match for federal assistance obtained for the public health response;
391.24 	(7) laboratory testing, including enhancements to laboratory capacity necessary to conduct 
391.25 	testing related to the event, and supplies, equipment, shipping, and security;
391.26 	(8) the purchase of vaccines, antibiotics, antivirals, and other medical resources to prevent 
391.27 	the spread of the pandemic influenza or communicable or infectious disease or to treat 
391.28 	related medical conditions;
391.29 	(9) reimbursement to community health boards or other local units of government for 
391.30 	incurred costs for the goods and services listed in clauses (1) to (8) that are attributable to 
391.31 	the public health response;
392.1 	(10) reimbursement to health care organizations and health care providers for incurred 
392.2 	costs that are attributable to the public health response; and
392.3 	(11) funding to support other state agencies for costs incurred by those agencies that are 
392.4 	attributable to the public health response.
392.5 	(b) Money in the account must not be used to increase the total number of full-time 
392.6 	equivalent permanent employees at the Department of Health, unless expressly authorized 
392.7 	by law. Money in the account shall be used only for public health response activities to 
392.8 	protect the health and safety of the public.
392.9 		Subd. 5.Assistance from other sources. (a) As a condition of making expenditures 
392.10 	from the public health response contingency account, the commissioner must seek any 
392.11 	appropriate assistance from other available sources, including the federal government, to 
392.12 	assist with costs attributable to the public health response.
392.13 	(b) If the commissioner recovers eligible costs for the public health response from a 
392.14 	nonstate source after making expenditures from the public health response contingency 
392.15 	account, the commissioner shall reimburse the public health response contingency account 
392.16 	for those costs, up to the amount recovered for eligible costs from the nonstate source.
392.17 		Subd. 6.Emergency management authority. Nothing in this section shall be construed 
392.18 	to limit the emergency management authority of the governor or any local or county 
392.19 	organization for emergency management under chapter 12 or other law.
392.20 		Subd. 7.Notice and expenditure review. (a) For pandemic influenza or an outbreak of 
392.21 	a communicable or infectious disease that begins on or after July 1, 2017, if the commissioner 
392.22 	determines that a public health response to pandemic influenza or an outbreak of a 
392.23 	communicable or infectious disease may require the diversion of Department of Health staff 
392.24 	or resources, the commissioner shall provide written notice to the chairs and ranking minority 
392.25 	members of the legislative committees with jurisdiction over health and human services 
392.26 	policy and finance with information on the event requiring the public health response, the 
392.27 	public health response that may be required, and estimates of the staff hours and resources 
392.28 	that the commissioner may need to divert to provide the public health response. For pandemic 
392.29 	influenza or an outbreak of a communicable or infectious disease that begins prior to July 
392.30 	1, 2017, the commissioner must provide the notice required by this paragraph no later than 
392.31 	July 10, 2017.
392.32 	(b) Prior to authorizing expenditures from the public health response contingency account, 
392.33 	the commissioner shall seek review and recommendation from the Legislative Advisory 
392.34 	Commission according to the procedures in section 3.3005, subdivision 5, that would 
393.1 	otherwise apply if the funds were federal funds. The commissioner is prohibited from seeking 
393.2 	review and recommendation for any expenditures for public health response activities that 
393.3 	were made before the commissioner provided the notice required in paragraph (a).
393.4 		Subd. 8.Report. By January 15 of each year, the commissioner shall submit a report to 
393.5 	the chairs and ranking minority members of the house of representatives Ways and Means 
393.6 	Committee, the senate Finance Committee, and the house of representatives and senate 
393.7 	committees with jurisdiction over health and human services finance, detailing expenditures 
393.8 	made in the previous calendar year from the public health response contingency account.

393.9 	Sec. 63. Minnesota Statutes 2016, section 144.4961, subdivision 3, is amended to read:
393.10 		Subd. 3.Rulemaking. The commissioner of health shall adopt rules establishing licensure 
393.11 	requirements and work standards relating to indoor radon in dwellings and other buildings, 
393.12 	with the exception of newly constructed Minnesota homes according to section 326B.106, 
393.13 	subdivision 6. The commissioner shall coordinate, oversee, and implement all state functions 
393.14 	in matters concerning the presence, effects, measurement, and mitigation of risks of radon 
393.15 	in dwellings and other buildings. Rules adopted by the commissioner under this subdivision 
393.16 	are effective beginning January 1, 2019.

393.17 	Sec. 64. Minnesota Statutes 2016, section 144.4961, subdivision 4, is amended to read:
393.18 		Subd. 4.System tag. All radon mitigation systems installed in Minnesota on or after 
393.19 	January 1, 2018 2019, must have a radon mitigation system tag provided by the 
393.20 	commissioner. A radon mitigation professional must attach the tag to the radon mitigation 
393.21 	system in a visible location.

393.22 	Sec. 65. Minnesota Statutes 2016, section 144.4961, subdivision 5, is amended to read:
393.23 		Subd. 5.License required annually. Effective January 1, 2018 2019, a license is required 
393.24 	annually for every person, firm, or corporation that performs a service for compensation to 
393.25 	detect the presence of radon in the indoor atmosphere, performs laboratory analysis, or 
393.26 	performs a service to mitigate radon in the indoor atmosphere.

393.27 	Sec. 66. Minnesota Statutes 2016, section 144.551, subdivision 1, is amended to read:
393.28 		Subdivision 1.Restricted construction or modification. (a) The following construction 
393.29 	or modification may not be commenced:
393.30 	(1) any erection, building, alteration, reconstruction, modernization, improvement, 
393.31 	extension, lease, or other acquisition by or on behalf of a hospital that increases the bed 
394.1 	capacity of a hospital, relocates hospital beds from one physical facility, complex, or site 
394.2 	to another, or otherwise results in an increase or redistribution of hospital beds within the 
394.3 	state; and
394.4 	(2) the establishment of a new hospital.
394.5 	(b) This section does not apply to:
394.6 	(1) construction or relocation within a county by a hospital, clinic, or other health care 
394.7 	facility that is a national referral center engaged in substantial programs of patient care, 
394.8 	medical research, and medical education meeting state and national needs that receives more 
394.9 	than 40 percent of its patients from outside the state of Minnesota;
394.10 	(2) a project for construction or modification for which a health care facility held an 
394.11 	approved certificate of need on May 1, 1984, regardless of the date of expiration of the 
394.12 	certificate;
394.13 	(3) a project for which a certificate of need was denied before July 1, 1990, if a timely 
394.14 	appeal results in an order reversing the denial;
394.15 	(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200, 
394.16 	section 2;
394.17 	(5) a project involving consolidation of pediatric specialty hospital services within the 
394.18 	Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number 
394.19 	of pediatric specialty hospital beds among the hospitals being consolidated;
394.20 	(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to 
394.21 	an existing licensed hospital that will allow for the reconstruction of a new philanthropic, 
394.22 	pediatric-orthopedic hospital on an existing site and that will not result in a net increase in 
394.23 	the number of hospital beds. Upon completion of the reconstruction, the licenses of both 
394.24 	hospitals must be reinstated at the capacity that existed on each site before the relocation;
394.25 	(7) the relocation or redistribution of hospital beds within a hospital building or 
394.26 	identifiable complex of buildings provided the relocation or redistribution does not result 
394.27 	in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from 
394.28 	one physical site or complex to another; or (iii) redistribution of hospital beds within the 
394.29 	state or a region of the state;
394.30 	(8) relocation or redistribution of hospital beds within a hospital corporate system that 
394.31 	involves the transfer of beds from a closed facility site or complex to an existing site or 
394.32 	complex provided that: (i) no more than 50 percent of the capacity of the closed facility is 
394.33 	transferred; (ii) the capacity of the site or complex to which the beds are transferred does 
395.1 	not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal 
395.2 	health systems agency boundary in place on July 1, 1983; and (iv) the relocation or 
395.3 	redistribution does not involve the construction of a new hospital building;
395.4 	(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice 
395.5 	County that primarily serves adolescents and that receives more than 70 percent of its 
395.6 	patients from outside the state of Minnesota;
395.7 	(10) a project to replace a hospital or hospitals with a combined licensed capacity of 
395.8 	130 beds or less if: (i) the new hospital site is located within five miles of the current site; 
395.9 	and (ii) the total licensed capacity of the replacement hospital, either at the time of 
395.10 	construction of the initial building or as the result of future expansion, will not exceed 70 
395.11 	licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;
395.12 	(11) the relocation of licensed hospital beds from an existing state facility operated by 
395.13 	the commissioner of human services to a new or existing facility, building, or complex 
395.14 	operated by the commissioner of human services; from one regional treatment center site 
395.15 	to another; or from one building or site to a new or existing building or site on the same 
395.16 	campus;
395.17 	(12) the construction or relocation of hospital beds operated by a hospital having a 
395.18 	statutory obligation to provide hospital and medical services for the indigent that does not 
395.19 	result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27 
395.20 	beds, of which 12 serve mental health needs, may be transferred from Hennepin County 
395.21 	Medical Center to Regions Hospital under this clause;
395.22 	(13) a construction project involving the addition of up to 31 new beds in an existing 
395.23 	nonfederal hospital in Beltrami County;
395.24 	(14) a construction project involving the addition of up to eight new beds in an existing 
395.25 	nonfederal hospital in Otter Tail County with 100 licensed acute care beds;
395.26 	(15) a construction project involving the addition of 20 new hospital beds used for 
395.27 	rehabilitation services in an existing hospital in Carver County serving the southwest 
395.28 	suburban metropolitan area. Beds constructed under this clause shall not be eligible for 
395.29 	reimbursement under medical assistance or MinnesotaCare;
395.30 	(16) a project for the construction or relocation of up to 20 hospital beds for the operation 
395.31 	of up to two psychiatric facilities or units for children provided that the operation of the 
395.32 	facilities or units have received the approval of the commissioner of human services;
396.1 	(17) a project involving the addition of 14 new hospital beds to be used for rehabilitation 
396.2 	services in an existing hospital in Itasca County;
396.3 	(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin County 
396.4 	that closed 20 rehabilitation beds in 2002, provided that the beds are used only for 
396.5 	rehabilitation in the hospital's current rehabilitation building. If the beds are used for another 
396.6 	purpose or moved to another location, the hospital's licensed capacity is reduced by 20 beds;
396.7 	(19) a critical access hospital established under section 144.1483, clause (9), and section 
396.8 	1820 of the federal Social Security Act, United States Code, title 42, section 1395i-4, that 
396.9 	delicensed beds since enactment of the Balanced Budget Act of 1997, Public Law 105-33, 
396.10 	to the extent that the critical access hospital does not seek to exceed the maximum number 
396.11 	of beds permitted such hospital under federal law;
396.12 	(20) notwithstanding section 144.552, a project for the construction of a new hospital 
396.13 	in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:
396.14 	(i) the project, including each hospital or health system that will own or control the entity 
396.15 	that will hold the new hospital license, is approved by a resolution of the Maple Grove City 
396.16 	Council as of March 1, 2006;
396.17 	(ii) the entity that will hold the new hospital license will be owned or controlled by one 
396.18 	or more not-for-profit hospitals or health systems that have previously submitted a plan or 
396.19 	plans for a project in Maple Grove as required under section 144.552, and the plan or plans 
396.20 	have been found to be in the public interest by the commissioner of health as of April 1, 
396.21 	2005;
396.22 	(iii) the new hospital's initial inpatient services must include, but are not limited to, 
396.23 	medical and surgical services, obstetrical and gynecological services, intensive care services, 
396.24 	orthopedic services, pediatric services, noninvasive cardiac diagnostics, behavioral health 
396.25 	services, and emergency room services;
396.26 	(iv) the new hospital:
396.27 	(A) will have the ability to provide and staff sufficient new beds to meet the growing 
396.28 	needs of the Maple Grove service area and the surrounding communities currently being 
396.29 	served by the hospital or health system that will own or control the entity that will hold the 
396.30 	new hospital license;
396.31 	(B) will provide uncompensated care;
396.32 	(C) will provide mental health services, including inpatient beds;
397.1 	(D) will be a site for workforce development for a broad spectrum of health-care-related 
397.2 	occupations and have a commitment to providing clinical training programs for physicians 
397.3 	and other health care providers;
397.4 	(E) will demonstrate a commitment to quality care and patient safety;
397.5 	(F) will have an electronic medical records system, including physician order entry;
397.6 	(G) will provide a broad range of senior services;
397.7 	(H) will provide emergency medical services that will coordinate care with regional 
397.8 	providers of trauma services and licensed emergency ambulance services in order to enhance 
397.9 	the continuity of care for emergency medical patients; and
397.10 	(I) will be completed by December 31, 2009, unless delayed by circumstances beyond 
397.11 	the control of the entity holding the new hospital license; and
397.12 	(v) as of 30 days following submission of a written plan, the commissioner of health 
397.13 	has not determined that the hospitals or health systems that will own or control the entity 
397.14 	that will hold the new hospital license are unable to meet the criteria of this clause;
397.15 	(21) a project approved under section 144.553;
397.16 	(22) a project for the construction of a hospital with up to 25 beds in Cass County within 
397.17 	a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's license holder 
397.18 	is approved by the Cass County Board;
397.19 	(23) a project for an acute care hospital in Fergus Falls that will increase the bed capacity 
397.20 	from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 and closing 
397.21 	a separately licensed 13-bed skilled nursing facility;
397.22 	(24) notwithstanding section 144.552, a project for the construction and expansion of a 
397.23 	specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for patients 
397.24 	who are under 21 years of age on the date of admission. The commissioner conducted a 
397.25 	public interest review of the mental health needs of Minnesota and the Twin Cities 
397.26 	metropolitan area in 2008. No further public interest review shall be conducted for the 
397.27 	construction or expansion project under this clause;
397.28 	(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if the 
397.29 	commissioner finds the project is in the public interest after the public interest review 
397.30 	conducted under section 144.552 is complete; or
397.31 	(26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the city 
397.32 	of Maple Grove, exclusively for patients who are under 21 years of age on the date of 
398.1 	admission, if the commissioner finds the project is in the public interest after the public 
398.2 	interest review conducted under section 144.552 is complete;
398.3 	(ii) this project shall serve patients in the continuing care benefit program under section 
398.4 	256.9693. The project may also serve patients not in the continuing care benefit program; 
398.5 	and
398.6 	(iii) if the project ceases to participate in the continuing care benefit program, the 
398.7 	commissioner must complete a subsequent public interest review under section 144.552. If 
398.8 	the project is found not to be in the public interest, the license must be terminated six months 
398.9 	from the date of that finding. If the commissioner of human services terminates the contract 
398.10 	without cause or reduces per diem payment rates for patients under the continuing care 
398.11 	benefit program below the rates in effect for services provided on December 31, 2015, the 
398.12 	project may cease to participate in the continuing care benefit program and continue to 
398.13 	operate without a subsequent public interest review; or
398.14 	(27) a project involving the addition of 21 new beds in an existing psychiatric hospital 
398.15 	in Hennepin County that is exclusively for patients who are under 21 years of age on the 
398.16 	date of admission.

398.17 	EFFECTIVE DATE. This section is effective the day following final enactment.

398.18 	Sec. 67. Minnesota Statutes 2016, section 144.99, subdivision 1, is amended to read:
398.19 		Subdivision 1.Remedies available. The provisions of chapters 103I and 157 and sections 
398.20 	115.71 to 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), (14), 
398.21 	and (15); 144.1201 to 144.1204; 144.121; 144.1215;144.1222; 144.35; 144.381 to 144.385; 
398.22 	144.411 to 144.417; 144.495; 144.71 to 144.74; 144.9501 to 144.9512; 144.97 to 144.98; 
398.23 	144.992; 326.70 to 326.785; 327.10 to 327.131; and 327.14 to 327.28 and all rules, orders, 
398.24 	stipulation agreements, settlements, compliance agreements, licenses, registrations, 
398.25 	certificates, and permits adopted or issued by the department or under any other law now 
398.26 	in force or later enacted for the preservation of public health may, in addition to provisions 
398.27 	in other statutes, be enforced under this section.

398.28 	Sec. 68. Minnesota Statutes 2016, section 144A.472, subdivision 7, is amended to read:
398.29 		Subd. 7.Fees; application, change of ownership, and renewal. (a) An initial applicant 
398.30 	seeking temporary home care licensure must submit the following application fee to the 
398.31 	commissioner along with a completed application:
398.32 	(1) for a basic home care provider, $2,100; or
399.1 	(2) for a comprehensive home care provider, $4,200.
399.2 	(b) A home care provider who is filing a change of ownership as required under 
399.3 	subdivision 5 must submit the following application fee to the commissioner, along with 
399.4 	the documentation required for the change of ownership:
399.5 	(1) for a basic home care provider, $2,100; or
399.6 	(2) for a comprehensive home care provider, $4,200.
399.7 	(c) For the period ending June 30, 2018, a home care provider who is seeking to renew 
399.8 	the provider's license shall pay a fee to the commissioner based on revenues derived from 
399.9 	the provision of home care services during the calendar year prior to the year in which the 
399.10 	application is submitted, according to the following schedule:
399.11 	License Renewal Fee

399.12	Provider Annual Revenue
	Fee
		
399.13	greater than $1,500,000
	$6,625
		
399.14
399.15	greater than $1,275,000 and no more than 
$1,500,000
	$5,797
		
399.16
399.17	greater than $1,100,000 and no more than 
$1,275,000
	$4,969
		
399.18
399.19	greater than $950,000 and no more than 
$1,100,000
	$4,141
		
399.20	greater than $850,000 and no more than $950,000
	$3,727
		
399.21	greater than $750,000 and no more than $850,000
	$3,313
		
399.22	greater than $650,000 and no more than $750,000
	$2,898
		
399.23	greater than $550,000 and no more than $650,000
	$2,485
		
399.24	greater than $450,000 and no more than $550,000
	$2,070
		
399.25	greater than $350,000 and no more than $450,000
	$1,656
		
399.26	greater than $250,000 and no more than $350,000
	$1,242
		
399.27	greater than $100,000 and no more than $250,000
	$828
		
399.28	greater than $50,000 and no more than $100,000
	$500
		
399.29	greater than $25,000 and no more than $50,000
	$400
		
399.30	no more than $25,000
	$200
		
399.31 	(d) For the period between July 1, 2018, and June 30, 2020, a home care provider who 
399.32 	is seeking to renew the provider's license shall pay a fee to the commissioner in an amount 
399.33 	that is ten percent higher than the applicable fee in paragraph (c). A home care provider's 
399.34 	fee shall be based on revenues derived from the provision of home care services during the 
399.35 	calendar year prior to the year in which the application is submitted.
400.1 	(e) Beginning July 1, 2020, a home care provider who is seeking to renew the provider's 
400.2 	license shall pay a fee to the commissioner based on revenues derived from the provision 
400.3 	of home care services during the calendar year prior to the year in which the application is 
400.4 	submitted, according to the following schedule:
400.5 	License Renewal Fee

400.6	Provider Annual Revenue
	Fee
		
400.7	greater than $1,500,000
	$7,651
		
400.8
400.9	greater than $1,275,000 and no more than 
$1,500,000
	$6,695
		
400.10
400.11	greater than $1,100,000 and no more than 
$1,275,000
	$5,739
		
400.12
400.13	greater than $950,000 and no more than 
$1,100,000
	$4,783
		
400.14	greater than $850,000 and no more than $950,000
	$4,304
		
400.15	greater than $750,000 and no more than $850,000
	$3,826
		
400.16	greater than $650,000 and no more than $750,000
	$3,347
		
400.17	greater than $550,000 and no more than $650,000
	$2,870
		
400.18	greater than $450,000 and no more than $550,000
	$2,391
		
400.19	greater than $350,000 and no more than $450,000
	$1,913
		
400.20	greater than $250,000 and no more than $350,000
	$1,434
		
400.21	greater than $100,000 and no more than $250,000
	$957
		
400.22	greater than $50,000 and no more than $100,000
	$577
		
400.23	greater than $25,000 and no more than $50,000
	$462
		
400.24	no more than $25,000
	$231
		
400.25 	(d) (f) If requested, the home care provider shall provide the commissioner information 
400.26 	to verify the provider's annual revenues or other information as needed, including copies 
400.27 	of documents submitted to the Department of Revenue.
400.28 	(e) (g) At each annual renewal, a home care provider may elect to pay the highest renewal 
400.29 	fee for its license category, and not provide annual revenue information to the commissioner.
400.30 	(f) (h) A temporary license or license applicant, or temporary licensee or licensee that 
400.31 	knowingly provides the commissioner incorrect revenue amounts for the purpose of paying 
400.32 	a lower license fee, shall be subject to a civil penalty in the amount of double the fee the 
400.33 	provider should have paid.
400.34 	(g) (i) Fees and penalties collected under this section shall be deposited in the state 
400.35 	treasury and credited to the state government special revenue fund. All fees are 
400.36 	nonrefundable. Fees collected under paragraphs (c), (d), and (e) are nonrefundable even if 
401.1 	received before July 1, 2017, for temporary licenses or licenses being issued effective July 
401.2 	1, 2017, or later.
401.3 	(h) The license renewal fee schedule in this subdivision is effective July 1, 2016.

401.4 	Sec. 69. Minnesota Statutes 2016, section 144A.474, subdivision 11, is amended to read:
401.5 		Subd. 11.Fines. (a) Fines and enforcement actions under this subdivision may be assessed 
401.6 	based on the level and scope of the violations described in paragraph (c) as follows:
401.7 	(1) Level 1, no fines or enforcement;
401.8 	(2) Level 2, fines ranging from $0 to $500, in addition to any of the enforcement 
401.9 	mechanisms authorized in section 144A.475 for widespread violations;
401.10 	(3) Level 3, fines ranging from $500 to $1,000, in addition to any of the enforcement 
401.11 	mechanisms authorized in section 144A.475; and
401.12 	(4) Level 4, fines ranging from $1,000 to $5,000, in addition to any of the enforcement 
401.13 	mechanisms authorized in section 144A.475.
401.14 	(b) Correction orders for violations are categorized by both level and scope and fines 
401.15 	shall be assessed as follows:
401.16 	(1) level of violation:
401.17 	(i) Level 1 is a violation that has no potential to cause more than a minimal impact on 
401.18 	the client and does not affect health or safety;
401.19 	(ii) Level 2 is a violation that did not harm a client's health or safety but had the potential 
401.20 	to have harmed a client's health or safety, but was not likely to cause serious injury, 
401.21 	impairment, or death;
401.22 	(iii) Level 3 is a violation that harmed a client's health or safety, not including serious 
401.23 	injury, impairment, or death, or a violation that has the potential to lead to serious injury, 
401.24 	impairment, or death; and
401.25 	(iv) Level 4 is a violation that results in serious injury, impairment, or death.
401.26 	(2) scope of violation:
401.27 	(i) isolated, when one or a limited number of clients are affected or one or a limited 
401.28 	number of staff are involved or the situation has occurred only occasionally;
402.1 	(ii) pattern, when more than a limited number of clients are affected, more than a limited 
402.2 	number of staff are involved, or the situation has occurred repeatedly but is not found to be 
402.3 	pervasive; and
402.4 	(iii) widespread, when problems are pervasive or represent a systemic failure that has 
402.5 	affected or has the potential to affect a large portion or all of the clients.
402.6 	(c) If the commissioner finds that the applicant or a home care provider required to be 
402.7 	licensed under sections 144A.43 to 144A.482 has not corrected violations by the date 
402.8 	specified in the correction order or conditional license resulting from a survey or complaint 
402.9 	investigation, the commissioner may impose a fine. A notice of noncompliance with a 
402.10 	correction order must be mailed to the applicant's or provider's last known address. The 
402.11 	noncompliance notice must list the violations not corrected.
402.12 	(d) The license holder must pay the fines assessed on or before the payment date specified. 
402.13 	If the license holder fails to fully comply with the order, the commissioner may issue a 
402.14 	second fine or suspend the license until the license holder complies by paying the fine. A 
402.15 	timely appeal shall stay payment of the fine until the commissioner issues a final order.
402.16 	(e) A license holder shall promptly notify the commissioner in writing when a violation 
402.17 	specified in the order is corrected. If upon reinspection the commissioner determines that 
402.18 	a violation has not been corrected as indicated by the order, the commissioner may issue a 
402.19 	second fine. The commissioner shall notify the license holder by mail to the last known 
402.20 	address in the licensing record that a second fine has been assessed. The license holder may 
402.21 	appeal the second fine as provided under this subdivision.
402.22 	(f) A home care provider that has been assessed a fine under this subdivision has a right 
402.23 	to a reconsideration or a hearing under this section and chapter 14.
402.24 	(g) When a fine has been assessed, the license holder may not avoid payment by closing, 
402.25 	selling, or otherwise transferring the licensed program to a third party. In such an event, the 
402.26 	license holder shall be liable for payment of the fine.
402.27 	(h) In addition to any fine imposed under this section, the commissioner may assess 
402.28 	costs related to an investigation that results in a final order assessing a fine or other 
402.29 	enforcement action authorized by this chapter.
402.30 	(i) Fines collected under this subdivision shall be deposited in the state government 
402.31 	special revenue fund and credited to an account separate from the revenue collected under 
402.32 	section 144A.472. Subject to an appropriation by the legislature, the revenue from the fines 
403.1 	collected may must be used by the commissioner for special projects to improve home care 
403.2 	in Minnesota as recommended by the advisory council established in section 144A.4799.

403.3 	Sec. 70. Minnesota Statutes 2016, section 144A.4799, subdivision 3, is amended to read:
403.4 		Subd. 3.Duties. (a) At the commissioner's request, the advisory council shall provide 
403.5 	advice regarding regulations of Department of Health licensed home care providers in this 
403.6 	chapter, including advice on the following:
403.7 	(1) community standards for home care practices;
403.8 	(2) enforcement of licensing standards and whether certain disciplinary actions are 
403.9 	appropriate;
403.10 	(3) ways of distributing information to licensees and consumers of home care;
403.11 	(4) training standards;
403.12 	(5) identifying emerging issues and opportunities in the home care field, including the 
403.13 	use of technology in home and telehealth capabilities;
403.14 	(6) allowable home care licensing modifications and exemptions, including a method 
403.15 	for an integrated license with an existing license for rural licensed nursing homes to provide 
403.16 	limited home care services in an adjacent independent living apartment building owned by 
403.17 	the licensed nursing home; and
403.18 	(7) recommendations for studies using the data in section 62U.04, subdivision 4, including 
403.19 	but not limited to studies concerning costs related to dementia and chronic disease among 
403.20 	an elderly population over 60 and additional long-term care costs, as described in section 
403.21 	62U.10, subdivision 6.
403.22 	(b) The advisory council shall perform other duties as directed by the commissioner.
403.23 	(c) The advisory council shall annually review the balance of the account in the state 
403.24 	government special revenue fund described in section 144A.474, subdivision 11, paragraph 
403.25 	(i), and make annual recommendations by January 15 directly to the chairs and ranking 
403.26 	minority members of the legislative committees with jurisdiction over health and human 
403.27 	services regarding appropriations to the commissioner for the purposes in section 144A.474, 
403.28 	subdivision 11, paragraph (i).

404.1 	Sec. 71. Minnesota Statutes 2016, section 144A.70, is amended by adding a subdivision 
404.2 	to read:
404.3 		Subd. 4a.Nurse. "Nurse" means a licensed practical nurse as defined in section 148.171, 
404.4 	subdivision 8, or a registered nurse as defined in section 148.171, subdivision 20.

404.5 	EFFECTIVE DATE. This section is effective the day following final enactment.

404.6 	Sec. 72. Minnesota Statutes 2016, section 144A.70, subdivision 6, is amended to read:
404.7 		Subd. 6.Supplemental nursing services agency. "Supplemental nursing services 
404.8 	agency" means a person, firm, corporation, partnership, or association engaged for hire in 
404.9 	the business of providing or procuring temporary employment in health care facilities for 
404.10 	nurses, nursing assistants, nurse aides, and orderlies, and other licensed health professionals. 
404.11 	Supplemental nursing services agency does not include an individual who only engages in 
404.12 	providing the individual's services on a temporary basis to health care facilities. Supplemental 
404.13 	nursing services agency does not include a professional home care agency licensed under 
404.14 	section 144A.471 that only provides staff to other home care providers.

404.15 	EFFECTIVE DATE. This section is effective the day following final enactment.

404.16 	Sec. 73. Minnesota Statutes 2016, section 144D.04, subdivision 2, is amended to read:
404.17 		Subd. 2.Contents of contract.  A housing with services contract, which need not be 
404.18 	entitled as such to comply with this section, shall include at least the following elements in 
404.19 	itself or through supporting documents or attachments:
404.20 	(1) the name, street address, and mailing address of the establishment;
404.21 	(2) the name and mailing address of the owner or owners of the establishment and, if 
404.22 	the owner or owners is not a natural person, identification of the type of business entity of 
404.23 	the owner or owners;
404.24 	(3) the name and mailing address of the managing agent, through management agreement 
404.25 	or lease agreement, of the establishment, if different from the owner or owners;
404.26 	(4) the name and address of at least one natural person who is authorized to accept service 
404.27 	of process on behalf of the owner or owners and managing agent;
404.28 	(5) a statement describing the registration and licensure status of the establishment and 
404.29 	any provider providing health-related or supportive services under an arrangement with the 
404.30 	establishment;
404.31 	(6) the term of the contract;
405.1 	(7) a description of the services to be provided to the resident in the base rate to be paid 
405.2 	by resident, including a delineation of the portion of the base rate that constitutes rent and 
405.3 	a delineation of charges for each service included in the base rate;
405.4 	(8) a description of any additional services, including home care services, available for 
405.5 	an additional fee from the establishment directly or through arrangements with the 
405.6 	establishment, and a schedule of fees charged for these services;
405.7 	(9) a description conspicuous notice informing the tenant of the policy concerning the 
405.8 	conditions under which and the process through which the contract may be modified, 
405.9 	amended, or terminated, including whether a move to a different room or sharing a room 
405.10 	would be required in the event that the tenant can no longer pay the current rent;
405.11 	(10) a description of the establishment's complaint resolution process available to residents 
405.12 	including the toll-free complaint line for the Office of Ombudsman for Long-Term Care;
405.13 	(11) the resident's designated representative, if any;
405.14 	(12) the establishment's referral procedures if the contract is terminated;
405.15 	(13) requirements of residency used by the establishment to determine who may reside 
405.16 	or continue to reside in the housing with services establishment;
405.17 	(14) billing and payment procedures and requirements;
405.18 	(15) a statement regarding the ability of residents to receive services from service 
405.19 	providers with whom the establishment does not have an arrangement;
405.20 	(16) a statement regarding the availability of public funds for payment for residence or 
405.21 	services in the establishment; and
405.22 	(17) a statement regarding the availability of and contact information for long-term care 
405.23 	consultation services under section 256B.0911 in the county in which the establishment is 
405.24 	located.

405.25 	Sec. 74. Minnesota Statutes 2016, section 144D.06, is amended to read:
405.26 	144D.06 OTHER LAWS.
405.27 	In addition to registration under this chapter, a housing with services establishment must 
405.28 	comply with chapter 504B and the provisions of section 325F.72, and shall obtain and 
405.29 	maintain all other licenses, permits, registrations, or other governmental approvals required 
405.30 	of it in addition to registration under this chapter. A housing with services establishment is 
406.1 	subject to the provisions of section 325F.72 and chapter 504B not required to obtain a 
406.2 	lodging license under chapter 157 and related rules.

406.3 	EFFECTIVE DATE. This section is effective August 1, 2017.

406.4 	Sec. 75. [144H.01] DEFINITIONS.
406.5 		Subdivision 1.Application. The terms defined in this section apply to this chapter.
406.6 		Subd. 2.Basic services. "Basic services" includes but is not limited to:
406.7 	(1) the development, implementation, and monitoring of a comprehensive protocol of 
406.8 	care that is developed in conjunction with the parent or guardian of a medically complex 
406.9 	or technologically dependent child and that specifies the medical, nursing, psychosocial, 
406.10 	and developmental therapies required by the medically complex or technologically dependent 
406.11 	child; and
406.12 	(2) the caregiver training needs of the child's parent or guardian.
406.13 		Subd. 3.Commissioner. "Commissioner" means the commissioner of health.
406.14 		Subd. 4.Licensee. "Licensee" means an owner of a prescribed pediatric extended care 
406.15 	(PPEC) center licensed under this chapter.
406.16 		Subd. 5.Medically complex or technologically dependent child. "Medically complex 
406.17 	or technologically dependent child" means a child under 21 years of age who, because of 
406.18 	a medical condition, requires continuous therapeutic interventions or skilled nursing 
406.19 	supervision which must be prescribed by a licensed physician and administered by, or under 
406.20 	the direct supervision of, a licensed registered nurse.
406.21 		Subd. 6.Owner. "Owner" means an individual whose ownership interest provides 
406.22 	sufficient authority or control to affect or change decisions regarding the operation of the 
406.23 	PPEC center. An owner includes a sole proprietor, a general partner, or any other individual 
406.24 	whose ownership interest has the ability to affect the management and direction of the PPEC 
406.25 	center's policies.
406.26 		Subd. 7.Prescribed pediatric extended care center, PPEC center, or center.
 406.27 	"Prescribed pediatric extended care center," "PPEC center," or "center" means any facility 
406.28 	that provides nonresidential basic services to three or more medically complex or 
406.29 	technologically dependent children who require such services and who are not related to 
406.30 	the owner by blood, marriage, or adoption.
407.1 		Subd. 8.Supportive services or contracted services. "Supportive services or contracted 
407.2 	services" include but are not limited to speech therapy, occupational therapy, physical 
407.3 	therapy, social work services, developmental services, child life services, and psychology 
407.4 	services.

407.5 	Sec. 76. [144H.02] LICENSURE REQUIRED.
407.6 	A person may not own or operate a prescribed pediatric extended care center in this state 
407.7 	unless the person holds a temporary or current license issued under this chapter. A separate 
407.8 	license must be obtained for each PPEC center maintained on separate premises, even if 
407.9 	the same management operates the PPEC centers. Separate licenses are not required for 
407.10 	separate buildings on the same grounds. A center shall not be operated on the same grounds 
407.11 	as a child care center licensed under Minnesota Rules, chapter 9503.

407.12 	Sec. 77. [144H.03] EXEMPTIONS.
407.13 	This chapter does not apply to:
407.14 	(1) a facility operated by the United States government or a federal agency; or
407.15 	(2) a health care facility licensed under chapter 144 or 144A.

407.16 	Sec. 78. [144H.04] LICENSE APPLICATION AND RENEWAL.
407.17 		Subdivision 1.Licenses. A person seeking licensure for a PPEC center must submit a 
407.18 	completed application for licensure to the commissioner, in a form and manner determined 
407.19 	by the commissioner. The applicant must also submit the application fee, in the amount 
407.20 	specified in section 144H.05, subdivision 1. Effective January 1, 2018, the commissioner 
407.21 	shall issue a license for a PPEC center if the commissioner determines that the applicant 
407.22 	and center meet the requirements of this chapter and rules that apply to PPEC centers. A 
407.23 	license issued under this subdivision is valid for two years.
407.24 		Subd. 2.License renewal. A license issued under subdivision 1 may be renewed for a 
407.25 	period of two years if the licensee:
407.26 	(1) submits an application for renewal in a form and manner determined by the 
407.27 	commissioner, at least 30 days before the license expires. An application for renewal 
407.28 	submitted after the renewal deadline date must be accompanied by a late fee in the amount 
407.29 	specified in section 144H.05, subdivision 3;
407.30 	(2) submits the renewal fee in the amount specified in section 144H.05, subdivision 2;
408.1 	(3) demonstrates that the licensee has provided basic services at the PPEC center within 
408.2 	the past two years;
408.3 	(4) provides evidence that the applicant meets the requirements for licensure; and
408.4 	(5) provides other information required by the commissioner.
408.5 		Subd. 3.License not transferable. A PPEC center license issued under this section is 
408.6 	not transferable to another party. Before acquiring ownership of a PPEC center, a prospective 
408.7 	applicant must apply to the commissioner for a new license.

408.8 	Sec. 79. [144H.05] FEES.
408.9 		Subdivision 1.Initial application fee. The initial application fee for PPEC center 
408.10 	licensure is $3,820.
408.11 		Subd. 2.License renewal. The fee for renewal of a PPEC center license is $1,800.
408.12 		Subd. 3.Late fee. The fee for late submission of an application to renew a PPEC center 
408.13 	license is $25.
408.14 		Subd. 4.Change of ownership. The fee for change of ownership of a PPEC center is 
408.15 	$4,200.
408.16 		Subd. 5.Nonrefundable; state government special revenue fund. All fees collected 
408.17 	under this chapter are nonrefundable and must be deposited in the state treasury and credited 
408.18 	to the state government special revenue fund.

408.19 	Sec. 80. [144H.06] APPLICATION OF RULES FOR HOSPICE SERVICES AND 
408.20 	RESIDENTIAL HOSPICE FACILITIES.
408.21 	Minnesota Rules, chapter 4664, shall apply to PPEC centers licensed under this chapter, 
408.22 	except that the following parts, subparts, items, and subitems do not apply:
408.23 	(1) Minnesota Rules, part 4664.0003, subparts 2, 6, 7, 11, 12, 13, 14, and 38;
408.24 	(2) Minnesota Rules, part 4664.0008;
408.25 	(3) Minnesota Rules, part 4664.0010, subparts 3; 4, items A, subitem (6), and B; and 8;
408.26 	(4) Minnesota Rules, part 4664.0020, subpart 13;
408.27 	(5) Minnesota Rules, part 4664.0370, subpart 1;
408.28 	(6) Minnesota Rules, part 4664.0390, subpart 1, items A, C, and E;
408.29 	(7) Minnesota Rules, part 4664.0420;
409.1 	(8) Minnesota Rules, part 4664.0425, subparts 3, item A; 4; and 6;
409.2 	(9) Minnesota Rules, part 4664.0430, subparts 3, 4, 5, 7, 8, 9, 10, 11, and 12;
409.3 	(10) Minnesota Rules, part 4664.0490; and
409.4 	(11) Minnesota Rules, part 4664.0520.

409.5 	Sec. 81. [144H.07] SERVICES; LIMITATIONS.
409.6 		Subdivision 1.Services. A PPEC center must provide basic services to medically complex 
409.7 	or technologically dependent children, based on a protocol of care established for each child. 
409.8 	A PPEC center may provide services up to 14 hours a day and up to six days a week.
409.9 		Subd. 2.Limitations. A PPEC center must comply with the following standards related 
409.10 	to services:
409.11 	(1) a child is prohibited from attending a PPEC center for more than 14 hours within a 
409.12 	24-hour period;
409.13 	(2) a PPEC center is prohibited from providing services other than those provided to 
409.14 	medically complex or technologically dependent children; and
409.15 	(3) the maximum capacity for medically complex or technologically dependent children 
409.16 	at a center shall not exceed 45 children.

409.17 	Sec. 82. [144H.08] ADMINISTRATION AND MANAGEMENT.
409.18 		Subdivision 1.Duties of owner. (a) The owner of a PPEC center shall have full legal 
409.19 	authority and responsibility for the operation of the center. A PPEC center must be organized 
409.20 	according to a written table of organization, describing the lines of authority and 
409.21 	communication to the child care level. The organizational structure must be designed to 
409.22 	ensure an integrated continuum of services for the children served.
409.23 	(b) The owner must designate one person as a center administrator, who is responsible 
409.24 	and accountable for overall management of the center.
409.25 		Subd. 2.Duties of administrator. The center administrator is responsible and accountable 
409.26 	for overall management of the center. The administrator must:
409.27 	(1) designate in writing a person to be responsible for the center when the administrator 
409.28 	is absent from the center for more than 24 hours;
409.29 	(2) maintain the following written records, in a place and form and using a system that 
409.30 	allows for inspection of the records by the commissioner during normal business hours:
410.1 	(i) a daily census record, which indicates the number of children currently receiving 
410.2 	services at the center;
410.3 	(ii) a record of all accidents or unusual incidents involving any child or staff member 
410.4 	that caused, or had the potential to cause, injury or harm to a person at the center or to center 
410.5 	property;
410.6 	(iii) copies of all current agreements with providers of supportive services or contracted 
410.7 	services;
410.8 	(iv) copies of all current agreements with consultants employed by the center, 
410.9 	documentation of each consultant's visits, and written, dated reports; and
410.10 	(v) a personnel record for each employee, which must include an application for 
410.11 	employment, references, employment history for the preceding five years, and copies of all 
410.12 	performance evaluations;
410.13 	(3) develop and maintain a current job description for each employee;
410.14 	(4) provide necessary qualified personnel and ancillary services to ensure the health, 
410.15 	safety, and proper care for each child; and
410.16 	(5) develop and implement infection control policies that comply with rules adopted by 
410.17 	the commissioner regarding infection control.

410.18 	Sec. 83. [144H.09] ADMISSION, TRANSFER, AND DISCHARGE POLICIES; 
410.19 	CONSENT FORM.
410.20 		Subdivision 1.Written policies. A PPEC center must have written policies and 
410.21 	procedures governing the admission, transfer, and discharge of children.
410.22 		Subd. 2.Notice of discharge. At least ten days prior to a child's discharge from a PPEC 
410.23 	center, the PPEC center shall provide notice of the discharge to the child's parent or guardian.
410.24 		Subd. 3.Consent form. A parent or guardian must sign a consent form outlining the 
410.25 	purpose of a PPEC center, specifying family responsibilities, authorizing treatment and 
410.26 	services, providing appropriate liability releases, and specifying emergency disposition 
410.27 	plans, before the child's admission to the center. The center must provide the child's parents 
410.28 	or guardians with a copy of the consent form and must maintain the consent form in the 
410.29 	child's medical record.

411.1 	Sec. 84. [144H.10] MEDICAL DIRECTOR.
411.2 	A PPEC center must have a medical director who is a physician licensed in Minnesota 
411.3 	and certified by the American Board of Pediatrics.

411.4 	Sec. 85. [144H.11] NURSING SERVICES.
411.5 		Subdivision 1.Nursing director. A PPEC center must have a nursing director who is 
411.6 	a registered nurse licensed in Minnesota, holds a current certification in cardiopulmonary 
411.7 	resuscitation, and has at least four years of general pediatric nursing experience, at least 
411.8 	one year of which must have been spent caring for medically fragile infants or children in 
411.9 	a pediatric intensive care, neonatal intensive care, PPEC center, or home care setting during 
411.10 	the previous five years. The nursing director is responsible for the daily operation of the 
411.11 	PPEC center.
411.12 		Subd. 2.Registered nurses. A registered nurse employed by a PPEC center must be a 
411.13 	registered nurse licensed in Minnesota, hold a current certification in cardiopulmonary 
411.14 	resuscitation, and have experience in the previous 24 months in being responsible for the 
411.15 	care of acutely ill or chronically ill children.
411.16 		Subd. 3.Licensed practical nurses. A licensed practical nurse employed by a PPEC 
411.17 	center must be supervised by a registered nurse and must be a licensed practical nurse 
411.18 	licensed in Minnesota, have at least two years of experience in pediatrics, and hold a current 
411.19 	certification in cardiopulmonary resuscitation.
411.20 		Subd. 4.Other direct care personnel. (a) Direct care personnel governed by this 
411.21 	subdivision include nursing assistants and individuals with training and experience in the 
411.22 	field of education, social services, or child care.
411.23 	(b) All direct care personnel employed by a PPEC center must work under the supervision 
411.24 	of a registered nurse and are responsible for providing direct care to children at the center. 
411.25 	Direct care personnel must have extensive, documented education and skills training in 
411.26 	providing care to infants and toddlers, provide employment references documenting skill 
411.27 	in the care of infants and children, and hold a current certification in cardiopulmonary 
411.28 	resuscitation.

412.1 	Sec. 86. [144H.12] TOTAL STAFFING FOR NURSING SERVICES AND DIRECT 
412.2 	CARE PERSONNEL.
412.3 	A PPEC center must provide total staffing for nursing services and direct care personnel 
412.4 	at a ratio of one staff person for every three children at the center. The staffing ratio required 
412.5 	in this section is the minimum staffing permitted.

412.6 	Sec. 87. [144H.13] MEDICAL RECORD; PROTOCOL OF CARE.
412.7 	A medical record and an individualized nursing protocol of care must be developed for 
412.8 	each child admitted to a PPEC center, must be maintained for each child, and must be signed 
412.9 	by authorized personnel.

412.10 	Sec. 88. [144H.14] QUALITY ASSURANCE PROGRAM.
412.11 	A PPEC center must have a quality assurance program, in which quarterly reviews are 
412.12 	conducted of the PPEC center's medical records and protocols of care for at least half of 
412.13 	the children served by the PPEC center. The quarterly review sample must be randomly 
412.14 	selected so each child at the center has an equal opportunity to be included in the review. 
412.15 	The committee conducting quality assurance reviews must include the medical director, 
412.16 	administrator, nursing director, and three other committee members determined by the PPEC 
412.17 	center.

412.18 	Sec. 89. [144H.15] INSPECTIONS.
412.19 	(a) The commissioner may inspect a PPEC center, including records held at the center, 
412.20 	at reasonable times as necessary to ensure compliance with this chapter and the rules that 
412.21 	apply to PPEC centers. During an inspection, a center must provide the commissioner with 
412.22 	access to all center records.
412.23 	(b) The commissioner must inspect a PPEC center before issuing or renewing a license 
412.24 	under this chapter.

412.25 	Sec. 90. [144H.16] COMPLIANCE WITH OTHER LAWS.
412.26 		Subdivision 1.Reporting of maltreatment of minors. A PPEC center must develop 
412.27 	policies and procedures for reporting suspected child maltreatment that fulfill the 
412.28 	requirements of section 626.556. The policies and procedures must include the telephone 
412.29 	numbers of the local county child protection agency for reporting suspected maltreatment. 
412.30 	The policies and procedures specified in this subdivision must be provided to the parents 
413.1 	or guardians of all children at the time of admission to the PPEC center and must be available 
413.2 	upon request.
413.3 		Subd. 2.Crib safety requirements. A PPEC center must comply with the crib safety 
413.4 	requirements in section 245A.146, to the extent they are applicable.

413.5 	Sec. 91. [144H.17] DENIAL, SUSPENSION, REVOCATION, REFUSAL TO RENEW 
413.6 	A LICENSE.
413.7 	(a) The commissioner may deny, suspend, revoke, or refuse to renew a license issued 
413.8 	under this chapter for:
413.9 	(1) a violation of this chapter or rules adopted that apply to PPEC centers; or
413.10 	(2) an intentional or negligent act by an employee or contractor at the center that 
413.11 	detrimentally affects the health or safety of children at the PPEC center.
413.12 	(b) Prior to any suspension, revocation, or refusal to renew a license, a licensee shall be 
413.13 	entitled to a hearing and review as provided in sections 14.57 to 14.69.

413.14 	Sec. 92. [144H.18] FINES; CORRECTIVE ACTION PLANS.
413.15 		Subdivision 1.Corrective action plans. If the commissioner determines that a PPEC 
413.16 	center is not in compliance with this chapter or rules that apply to PPEC centers, the 
413.17 	commissioner may require the center to submit a corrective action plan that demonstrates 
413.18 	a good-faith effort to remedy each violation by a specific date, subject to approval by the 
413.19 	commissioner.
413.20 		Subd. 2.Fines. The commissioner may issue a fine to a PPEC center, employee, or 
413.21 	contractor if the commissioner determines the center, employee, or contractor violated this 
413.22 	chapter or rules that apply to PPEC centers. The fine amount shall not exceed an amount 
413.23 	for each violation and an aggregate amount established by the commissioner. The failure 
413.24 	to correct a violation by the date set by the commissioner, or a failure to comply with an 
413.25 	approved corrective action plan, constitutes a separate violation for each day the failure 
413.26 	continues, unless the commissioner approves an extension to a specific date. In determining 
413.27 	if a fine is to be imposed and establishing the amount of the fine, the commissioner shall 
413.28 	consider:
413.29 	(1) the gravity of the violation, including the probability that death or serious physical 
413.30 	or emotional harm to a child will result or has resulted, the severity of the actual or potential 
413.31 	harm, and the extent to which the applicable laws were violated;
414.1 	(2) actions taken by the owner or administrator to correct violations;
414.2 	(3) any previous violations; and
414.3 	(4) the financial benefit to the PPEC center of committing or continuing the violation.
414.4 		Subd. 3.Fines for violations of other statutes. The commissioner shall impose a fine 
414.5 	of $250 on a PPEC center, employee, or contractor for each violation by that PPEC center, 
414.6 	employee, or contractor of section 144H.16, subdivision 2, or 626.556.

414.7 	Sec. 93. [144H.19] CLOSING A PPEC CENTER.
414.8 	When a PPEC center voluntarily closes, it must, at least 30 days before closure, inform 
414.9 	each child's parents or guardians of the closure and when the closure will occur.

414.10 	Sec. 94. [144H.20] PHYSICAL ENVIRONMENT.
414.11 		Subdivision 1.General requirements. A PPEC center shall conform with or exceed 
414.12 	the physical environment requirements in this section and the physical environment 
414.13 	requirements for day care facilities in Minnesota Rules, part 9502.0425. If the physical 
414.14 	environment requirements in this section differ from the physical environment requirements 
414.15 	for day care facilities in Minnesota Rules, part 9502.0425, the requirements in this section 
414.16 	shall prevail. A PPEC center must have sufficient indoor and outdoor space to accommodate 
414.17 	at least six medically complex or technologically dependent children.
414.18 		Subd. 2.Specific requirements. (a) The entrance to a PPEC center must be barrier-free, 
414.19 	have a wheelchair ramp, provide for traffic flow with a driveway area for entering and 
414.20 	exiting, and have storage space for supplies from home.
414.21 	(b) A PPEC center must have a treatment room with a medication preparation area. The 
414.22 	medication preparation area must contain a work counter, refrigerator, sink with hot and 
414.23 	cold running water, and locked storage for biologicals and prescription drugs.
414.24 	(c) A PPEC center must develop isolation procedures to prevent cross-infections and 
414.25 	must have an isolation room with at least one glass area for observation of a child in the 
414.26 	isolation room. The isolation room must be at least 100 square feet in size.
414.27 	(d) A PPEC center must have:
414.28 	(1) an outdoor play space adjacent to the center of at least 35 square feet per child in 
414.29 	attendance at the center, for regular use; or
414.30 	(2) a park, playground, or play space within 1,500 feet of the center.
415.1 	(e) A PPEC center must have at least 50 square feet of usable indoor space per child in 
415.2 	attendance at the center.
415.3 	(f) Notwithstanding the Minnesota State Building Code and the Minnesota State Fire 
415.4 	Code, a new construction PPEC center or an existing building converted into a PPEC center 
415.5 	must meet the requirements of the International Building Code in Minnesota Rules, chapter 
415.6 	1305, for:
415.7 	(1) Group R, Division 4 occupancy, if serving 12 or fewer children; or
415.8 	(2) Group E, Division 4 occupancy or Group I, Division 4 occupancy, if serving 13 or 
415.9 	more children.

415.10 	Sec. 95. Minnesota Statutes 2016, section 145.4131, subdivision 1, is amended to read:
415.11 		Subdivision 1.Forms. (a) Within 90 days of July 1, 1998, the commissioner shall prepare 
415.12 	a reporting form for use by physicians or facilities performing abortions. A copy of this 
415.13 	section shall be attached to the form. A physician or facility performing an abortion shall 
415.14 	obtain a form from the commissioner.
415.15 	(b) The form shall require the following information:
415.16 	(1) the number of abortions performed by the physician in the previous calendar year, 
415.17 	reported by month;
415.18 	(2) the method used for each abortion;
415.19 	(3) the approximate gestational age expressed in one of the following increments:
415.20 	(i) less than nine weeks;
415.21 	(ii) nine to ten weeks;
415.22 	(iii) 11 to 12 weeks;
415.23 	(iv) 13 to 15 weeks;
415.24 	(v) 16 to 20 weeks;
415.25 	(vi) 21 to 24 weeks;
415.26 	(vii) 25 to 30 weeks;
415.27 	(viii) 31 to 36 weeks; or
415.28 	(ix) 37 weeks to term;
415.29 	(4) the age of the woman at the time the abortion was performed;
416.1 	(5) the specific reason for the abortion, including, but not limited to, the following:
416.2 	(i) the pregnancy was a result of rape;
416.3 	(ii) the pregnancy was a result of incest;
416.4 	(iii) economic reasons;
416.5 	(iv) the woman does not want children at this time;
416.6 	(v) the woman's emotional health is at stake;
416.7 	(vi) the woman's physical health is at stake;
416.8 	(vii) the woman will suffer substantial and irreversible impairment of a major bodily 
416.9 	function if the pregnancy continues;
416.10 	(viii) the pregnancy resulted in fetal anomalies; or
416.11 	(ix) unknown or the woman refused to answer;
416.12 	(6) the number of prior induced abortions;
416.13 	(7) the number of prior spontaneous abortions;
416.14 	(8) whether the abortion was paid for by:
416.15 	(i) private coverage;
416.16 	(ii) public assistance health coverage; or
416.17 	(iii) self-pay;
416.18 	(9) whether coverage was under:
416.19 	(i) a fee-for-service plan;
416.20 	(ii) a capitated private plan; or
416.21 	(iii) other;
416.22 	(10) complications, if any, for each abortion and for the aftermath of each abortion. 
416.23 	Space for a description of any complications shall be available on the form;
416.24 	(11) the medical specialty of the physician performing the abortion; and
416.25 	(12) if the abortion was performed via telemedicine, the facility code for the patient and 
416.26 	the facility code for the physician; and
416.27 	(12) (13) whether the abortion resulted in a born alive infant, as defined in section 
416.28 	145.423, subdivision 4, and:
417.1 	(i) any medical actions taken to preserve the life of the born alive infant;
417.2 	(ii) whether the born alive infant survived; and
417.3 	(iii) the status of the born alive infant, should the infant survive, if known.

417.4 	EFFECTIVE DATE. This section is effective January 1, 2018.

417.5 	Sec. 96. Minnesota Statutes 2016, section 145.4716, subdivision 2, is amended to read:
417.6 		Subd. 2.Duties of director. The director of child sex trafficking prevention is responsible 
417.7 	for the following:
417.8 	(1) developing and providing comprehensive training on sexual exploitation of youth 
417.9 	for social service professionals, medical professionals, public health workers, and criminal 
417.10 	justice professionals;
417.11 	(2) collecting, organizing, maintaining, and disseminating information on sexual 
417.12 	exploitation and services across the state, including maintaining a list of resources on the 
417.13 	Department of Health Web site;
417.14 	(3) monitoring and applying for federal funding for antitrafficking efforts that may 
417.15 	benefit victims in the state;
417.16 	(4) managing grant programs established under sections 145.4716 to 145.4718, and;
417.17 	609.3241, paragraph (c), clause (3); and 609.5315, subdivision 5c, clause (3);
417.18 	(5) managing the request for proposals for grants for comprehensive services, including 
417.19 	trauma-informed, culturally specific services;
417.20 	(6) identifying best practices in serving sexually exploited youth, as defined in section 
417.21 	260C.007, subdivision 31;
417.22 	(7) providing oversight of and technical support to regional navigators pursuant to section 
417.23 	145.4717;
417.24 	(8) conducting a comprehensive evaluation of the statewide program for safe harbor of 
417.25 	sexually exploited youth; and
417.26 	(9) developing a policy consistent with the requirements of chapter 13 for sharing data 
417.27 	related to sexually exploited youth, as defined in section 260C.007, subdivision 31, among 
417.28 	regional navigators and community-based advocates.

418.1 	Sec. 97. Minnesota Statutes 2016, section 145.928, subdivision 13, is amended to read:
418.2 		Subd. 13.Reports. (a) The commissioner shall submit a biennial report to the legislature 
418.3 	on the local community projects, tribal government, and community health board prevention 
418.4 	activities funded under this section. These reports must include information on grant 
418.5 	recipients, activities that were conducted using grant funds, evaluation data, and outcome 
418.6 	measures, if available. These reports are due by January 15 of every other year, beginning 
418.7 	in the year 2003.
418.8 	(b) The commissioner shall release an annual report to the public and submit anthe 
418.9 	annual report to the chairs and ranking minority members of the house of representatives 
418.10 	and senate committees with jurisdiction over public health on grants made under subdivision 
418.11 	7 to decrease racial and ethnic disparities in infant mortality rates. The report must provide 
418.12 	specific information on the amount of each grant awarded to each agency or organization, 
418.13 	an itemized list submitted to the commissioner by each agency or organization awarded a 
418.14 	grant specifying all uses of grant funds and the amount expended for each use, the population 
418.15 	served by each agency or organization, outcomes of the programs funded by each grant, 
418.16 	and the amount of the appropriation retained by the commissioner for administrative and 
418.17 	associated expenses. The commissioner shall issue a report each January 15 for the previous 
418.18 	fiscal year beginning January 15, 2016.

418.19 	Sec. 98. Minnesota Statutes 2016, section 145.986, subdivision 1a, is amended to read:
418.20 		Subd. 1a.Grants to local communities. (a) Beginning July 1, 2009, the commissioner 
418.21 	of health shall award competitive grants to community health boards and tribal governments 
418.22 	to convene, coordinate, and implement evidence-based strategies targeted at reducing the 
418.23 	percentage of Minnesotans who are obese or overweight and to reduce the use of tobacco. 
418.24 	Grants shall be awarded to all community health boards and tribal governments whose 
418.25 	proposals demonstrate the ability to implement programs designed to achieve the purposes 
418.26 	in subdivision 1 and other requirements of this section.
418.27 	(b) Grantee activities shall:
418.28 	(1) be based on scientific evidence;
418.29 	(2) be based on community input;
418.30 	(3) address behavior change at the individual, community, and systems levels;
418.31 	(4) occur in community, school, work site, and health care settings;
419.1 	(5) be focused on policy, systems, and environmental changes that support healthy 
419.2 	behaviors; and
419.3 	(6) address the health disparities and inequities that exist in the grantee's community.
419.4 	(c) To receive a grant under this section, community health boards and tribal governments 
419.5 	must submit proposals to the commissioner. A local match of ten percent of the total funding 
419.6 	allocation is required. This local match may include funds donated by community partners.
419.7 	(d) In order to receive a grant, community health boards and tribal governments must 
419.8 	submit a health improvement plan to the commissioner of health for approval. The 
419.9 	commissioner may require the plan to identify a community leadership team, community 
419.10 	partners, and a community action plan that includes an assessment of area strengths and 
419.11 	needs, proposed action strategies, technical assistance needs, and a staffing plan.
419.12 	(e) The grant recipient must implement the health improvement plan, evaluate the 
419.13 	effectiveness of the strategies, and modify or discontinue strategies found to be ineffective.
419.14 	(f) Grant recipients shall report their activities and their progress toward the outcomes 
419.15 	established under subdivision 2 to the commissioner in a format and at a time specified by 
419.16 	the commissioner.
419.17 	(g) All grant recipients shall be held accountable for making progress toward the 
419.18 	measurable outcomes established in subdivision 2. The commissioner shall require a 
419.19 	corrective action plan and may reduce the funding level of grant recipients that do not make 
419.20 	adequate progress toward the measurable outcomes.
419.21 	(h) Beginning November 1, 2015, the commissioner shall offer grant recipients the 
419.22 	option of using a grant awarded under this subdivision to implement health improvement 
419.23 	strategies that improve the health status, delay the expression of dementia, or slow the 
419.24 	progression of dementia, for a targeted population at risk for dementia and shall award at 
419.25 	least two of the grants awarded on November 1, 2015, for these purposes. The grants must 
419.26 	meet all other requirements of this section. The commissioner shall coordinate grant planning 
419.27 	activities with the commissioner of human services, the Minnesota Board on Aging, and 
419.28 	community-based organizations with a focus on dementia. Each grant must include selected 
419.29 	outcomes and evaluation measures related to the incidence or progression of dementia 
419.30 	among the targeted population using the procedure described in subdivision 2.
419.31 	(i) Beginning July 1, 2017, the commissioner shall offer grant recipients the option of 
419.32 	using a grant awarded under this subdivision to confront the opioid addiction and overdose 
419.33 	epidemic, and shall award at least two of the grants awarded on or after July 1, 2017, for 
420.1 	these purposes. The grants awarded under this paragraph must meet all other requirements 
420.2 	of this section. The commissioner shall coordinate grant planning activities with the 
420.3 	commissioner of human services. Each grant shall include selected outcomes and evaluation 
420.4 	measures related to addressing the opioid epidemic.

420.5 	Sec. 99. Minnesota Statutes 2016, section 146B.02, subdivision 2, is amended to read:
420.6 		Subd. 2.Requirements and term of license. (a) Each application for an initial mobile 
420.7 	or fixed-site establishment license and for renewal must be submitted to the commissioner 
420.8 	on a form provided by the commissioner accompanied with the applicable fee required 
420.9 	under section 146B.10. The application must contain:
420.10 	(1) the name(s) of the owner(s) and operator(s) of the establishment;
420.11 	(2) the location of the establishment;
420.12 	(3) verification of compliance with all applicable local and state codes;
420.13 	(4) a description of the general nature of the business; and
420.14 	(5) any other relevant information deemed necessary by the commissioner.
420.15 	(b) If the information submitted is complete and complies with the requirements of this 
420.16 	chapter, the commissioner shall issue a provisional establishment license. The provisional 
420.17 	license is effective until the commissioner determines, after inspection, that the applicant 
420.18 	has met the requirements of this chapter. Upon approval, the commissioner shall issue a 
420.19 	body art establishment license effective for three years.
420.20 	(c) An establishment license must be renewed every two years.

420.21 	Sec. 100. Minnesota Statutes 2016, section 146B.02, subdivision 3, is amended to read:
420.22 		Subd. 3.Inspection. (a) Within the period of the provisional establishment license, and 
420.23 	The commissioner must inspect an establishment issued a provisional license within one 
420.24 	year of the date the license was issued. Thereafter at least one time during each three-year
420.25 	two-year licensure period, the commissioner shall conduct an inspection of the body art 
420.26 	establishment and a review of any records necessary to ensure that the standards required 
420.27 	under this chapter are met.
420.28 	(b) The commissioner shall have the authority to enter a premises to make an inspection. 
420.29 	Refusal to permit an inspection constitutes valid grounds for licensure denial or revocation.
420.30 	(c) If the establishment seeking licensure is new construction or if a licensed establishment 
420.31 	is remodeling, the establishment must meet all local building and zoning codes.

421.1 	Sec. 101. Minnesota Statutes 2016, section 146B.02, subdivision 5, is amended to read:
421.2 		Subd. 5.Transfer of ownership, relocation, and display of license. (a) A body art 
421.3 	establishment license must be issued to a specific person and location and is not transferable. 
421.4 	A license must be prominently displayed in a public area of the establishment.
421.5 	(b) An owner who has purchased a body art establishment licensed under the previous 
421.6 	owner must submit an application to license the establishment within two weeks of the date 
421.7 	of sale. Notwithstanding subdivision 1, the new owner may continue to operate for 60 days 
421.8 	after the sale while waiting for a new license to be issued.
421.9 	(c) An owner of a licensed body art establishment who is relocating the establishment 
421.10 	must submit an application for the new location. The owner may request that the new 
421.11 	application become effective at a specified date in the future. If the relocation is not 
421.12 	accomplished by the date expected, and the license at the existing location expires, the 
421.13 	owner may apply for a temporary event permit to continue to operate at the old location. 
421.14 	The owner may apply for no more than four temporary event permits to continue operating 
421.15 	at the old location.

421.16 	Sec. 102. Minnesota Statutes 2016, section 146B.02, is amended by adding a subdivision 
421.17 	to read:
421.18 		Subd. 7a.Supervisors. (a) Only a technician who has been licensed as a body artist for 
421.19 	at least two years in Minnesota or in a jurisdiction with which Minnesota has reciprocity 
421.20 	may supervise a temporary technician.
421.21 	(b) Any technician who agrees to supervise more than two temporary technicians during 
421.22 	the same time period must provide to the commissioner a supervisory plan that describes 
421.23 	how the technician will provide supervision to each temporary technician in accordance 
421.24 	with section 146B.01, subdivision 28.
421.25 	(c) The commissioner may refuse to approve as a supervisor a technician who has been 
421.26 	disciplined in Minnesota or in another jurisdiction after considering the criteria described 
421.27 	in subdivision 10, paragraph (b).

421.28 	Sec. 103. Minnesota Statutes 2016, section 146B.02, subdivision 8, is amended to read:
421.29 		Subd. 8.Temporary events event permit. (a) An owner or operator of a applicant for 
421.30 	a permit to hold a temporary body art establishment event shall submit an application for a 
421.31 	temporary events permit to the commissioner. The application must be received at least 14 
421.32 	days before the start of the event. The application must include the specific days and hours 
422.1 	of operation. The owner or operator An applicant issued a temporary event permit shall 
422.2 	comply with the requirements of this chapter.
422.3 	(b) Applications received less than 14 days prior to the start of the event may be processed 
422.4 	if the commissioner determines it is possible to conduct the all required work, including an 
422.5 	inspection.
422.6 	(c) The temporary events event permit must be prominently displayed in a public area 
422.7 	at the location.
422.8 	(d) The temporary events event permit, if approved, is valid for the specified dates and 
422.9 	hours listed on the application. No temporary events permit shall be issued for longer than 
422.10 	a 21-day period, and may not be extended.
422.11 	(e) No individual who does not hold a current body art establishment license may be 
422.12 	issued a temporary event permit more than four times within the same calendar year.
422.13 	(f) No individual who has been disciplined for a serious violation of this chapter within 
422.14 	three years preceding the intended start date of a temporary event may be issued a license 
422.15 	for a temporary event. Violations that preclude issuance of a temporary event permit include 
422.16 	unlicensed practice; practice in an unlicensed location; any of the conditions listed in section 
422.17 	146B.05, clauses (1) to (8), (12), or (13); 146B.08, subdivision 3, clauses (4), (5), and (10) 
422.18 	to (12); or any other violation that places the health or safety of a client at risk.

422.19 	Sec. 104. Minnesota Statutes 2016, section 146B.02, is amended by adding a subdivision 
422.20 	to read:
422.21 		Subd. 10.Licensure precluded. (a) The commissioner may choose to deny a body art 
422.22 	establishment license to an applicant who has been disciplined for a serious violation under 
422.23 	this chapter. Violations that constitute grounds for denial of license are any of the conditions 
422.24 	listed in section 146B.05, subdivision 1, clauses (1) to (8), (12), or (13); 146B.08, subdivision 
422.25 	3, clauses (4), (5), or (10) to (12); or any other violation that places the health or safety of 
422.26 	a client at risk.
422.27 	(b) In considering whether to grant a license to an applicant who has been disciplined 
422.28 	for a violation described in this subdivision, the commissioner shall consider evidence of 
422.29 	rehabilitation, including the nature and seriousness of the violation, circumstances relative 
422.30 	to the violation, the length of time elapsed since the violation, and evidence that demonstrates 
422.31 	that the applicant has maintained safe, ethical, and responsible body art practice since the 
422.32 	time of the most recent violation.

423.1 	Sec. 105. Minnesota Statutes 2016, section 146B.02, is amended by adding a subdivision 
423.2 	to read:
423.3 		Subd. 11.Penalties. Any person who violates the provisions of subdivision 1 or who 
423.4 	performs body art in an unlicensed location is guilty of a gross misdemeanor.

423.5 	Sec. 106. Minnesota Statutes 2016, section 146B.03, subdivision 6, is amended to read:
423.6 		Subd. 6.Licensure term; renewal. (a) A technician's license is valid for two years from 
423.7 	the date of issuance and may be renewed upon payment of the renewal fee established under 
423.8 	section 146B.10.
423.9 	(b) At renewal, a licensee must submit proof of continuing education approved by the 
423.10 	commissioner in the areas identified in subdivision 4.
423.11 	(c) The commissioner shall notify the technician of the pending expiration of a technician 
423.12 	license at least 60 days prior to license expiration.
423.13 	(d) A technician previously licensed in Minnesota whose license has lapsed for less than 
423.14 	six years may apply to renew. A technician previously licensed in Minnesota whose license 
423.15 	has lapsed for less than ten years and who was licensed in another jurisdiction or jurisdictions 
423.16 	during the entire time of lapse may apply to renew, but must submit proof of licensure in 
423.17 	good standing in all other jurisdictions in which the technician was licensed as a body artist 
423.18 	during the time of lapse. A technician previously licensed in Minnesota whose license has 
423.19 	lapsed for more than six years and who was not continuously licensed in another jurisdiction 
423.20 	during the period of Minnesota lapse must reapply for licensure under subdivision 4.

423.21 	Sec. 107. Minnesota Statutes 2016, section 146B.03, subdivision 7, as amended by Laws 
423.22 	2017, chapter 40, article 1, section 34, is amended to read:
423.23 		Subd. 7.Temporary licensure. (a) The commissioner may issue a temporary license 
423.24 	to an applicant who submits to the commissioner on a form provided by the commissioner:
423.25 	(1) proof that the applicant is over the age of 18;
423.26 	(2) all fees required under section 146B.10; and
423.27 	(3) a letter from a licensed technician who has agreed to provide the supervision to meet 
423.28 	the supervised experience requirement under subdivision 4.
423.29 	(b) Upon completion of the required supervised experience, the temporary licensee shall 
423.30 	submit documentation of satisfactorily completing the requirements under subdivision 4, 
424.1 	and the applicable fee under section 146B.10. The commissioner shall issue a new license 
424.2 	in accordance with subdivision 4.
424.3 	(c) A temporary license issued under this subdivision is valid for one year and may be 
424.4 	renewed for one additional year twice.

424.5 	Sec. 108. Minnesota Statutes 2016, section 146B.07, subdivision 2, is amended to read:
424.6 		Subd. 2.Parent or legal guardian consent; prohibitions. (a) A technician may perform 
424.7 	body piercings on an individual under the age of 18 if:
424.8 	(1) the individual's parent or legal guardian is present;
424.9 	(2) the individual's parent or legal guardian provides personal identification by using 
424.10 	one of the methods described in subdivision 1, paragraph (a), clauses (1) to (5), and provides 
424.11 	documentation that reasonably establishes that the individual is the parent or legal guardian 
424.12 	of the individual who is seeking the body piercing;
424.13 	(3) the individual seeking the body piercing provides proof of identification by using 
424.14 	one of the methods described in subdivision 1, paragraph (a), clauses (1) to (5), a current 
424.15 	student identification, or another official source that includes the name and a photograph 
424.16 	of the individual;
424.17 	(4) a consent form and the authorization form under subdivision 1, paragraph (b) is 
424.18 	signed by the parent or legal guardian in the presence of the technician; and
424.19 	(5) the piercing is not prohibited under paragraph (c).
424.20 	(b) No technician shall tattoo any Tattooing an individual under the age of 18 is a gross 
424.21 	misdemeanor, regardless of parental or guardian consent.
424.22 	(c) No nipple or genital piercing, branding, scarification, suspension, subdermal 
424.23 	implantation, microdermal, or tongue bifurcation shall be performed by any technician on 
424.24 	any individual under the age of 18 regardless of parental or guardian consent.
424.25 	(d) No technician shall perform body art procedures on any individual who appears to 
424.26 	be under the influence of alcohol, controlled substances as defined in section 152.01, 
424.27 	subdivision 4, or hazardous substances as defined in rules adopted under chapter 182.
424.28 	(e) No technician shall perform body art procedures while under the influence of alcohol, 
424.29 	controlled substances as defined under section 152.01, subdivision 4, or hazardous substances 
424.30 	as defined in the rules adopted under chapter 182.
424.31 	(f) No technician shall administer anesthetic injections or other medications.

425.1 	Sec. 109. Minnesota Statutes 2016, section 146B.10, subdivision 1, is amended to read:
425.2 		Subdivision 1. Licensing fees. (a) The fee for the initial technician licensure and biennial 
425.3 	licensure renewal is $100 $420.
425.4 	(b) The fee for temporary technician licensure is $100 $240.
425.5 	(c) The fee for the temporary guest artist license is $50 $140.
425.6 	(d) The fee for a dual body art technician license is $100 $420.
425.7 	(e) The fee for a provisional establishment license is $1,000 $1,500.
425.8 	(f) The fee for an initial establishment license and the three-year two-year license renewal 
425.9 	period required in section 146B.02, subdivision 2, paragraph (b), is $1,000 $1,500.
425.10 	(g) The fee for a temporary body art establishment event permit is $75 $200.
425.11 	(h) The commissioner shall prorate the initial two-year technician license fee and the 
425.12 	initial three-year body art establishment license fee based on the number of months in the 
425.13 	initial licensure period. The commissioner shall prorate the first renewal fee for the 
425.14 	establishment license based on the number of months from issuance of the provisional 
425.15 	license to the first renewal.
425.16 	(i) The fee for verification of licensure to other states is $25.
425.17 	(j) The fee to reissue a provisional establishment license that relocates prior to inspection 
425.18 	and removal of provisional status is $350. The expiration date of the provisional license 
425.19 	does not change.
425.20 	(k) The fee to change an establishment name or establishment type, such as tattoo, 
425.21 	piercing, or dual, is $50.

425.22 	Sec. 110. Minnesota Statutes 2016, section 146B.10, subdivision 2, is amended to read:
425.23 		Subd. 2.Penalty for Late renewals renewal fee. (a) The penalty fee for late submission 
425.24 	forof a technician renewal applications application is $75 $150.
425.25 	(b) The fee for late submission of an establishment renewal application is $300.

425.26 	Sec. 111. Minnesota Statutes 2016, section 146B.10, is amended by adding a subdivision 
425.27 	to read:
425.28 		Subd. 2a.Technical violation fee for practice after lapse. (a) The technical violation 
425.29 	fee for practicing body art after a body art license has expired and before it is renewed is 
426.1 	$200 for any part of the first month, plus $200 for any part of any subsequent month up to 
426.2 	one year. Continued practice or operation after one year becomes a disciplinary violation.
426.3 	(b) The technical violation fee for practicing body art after a temporary body art license 
426.4 	has expired and before it is renewed is $100 for any part of the first month, plus $100 for 
426.5 	any part of any subsequent month up to six months. Continued practice or operation after 
426.6 	six months becomes a disciplinary violation.
426.7 	(c) The technical violation fee for operating a body art establishment after the license 
426.8 	has expired and before it is renewed is $300 for any part of the first month, plus $300 for 
426.9 	any part of any subsequent month up to six months. Continued practice or operation after 
426.10 	six months becomes a disciplinary violation.

426.11 	Sec. 112. Minnesota Statutes 2016, section 148.514, subdivision 1, is amended to read:
426.12 		Subdivision 1.General licensure procedures. An applicant for licensure must:
426.13 	(1) submit an application as required under section 148.519, subdivision 1; and
426.14 	(2) submit all fees required under section 148.5194.; and
426.15 	(3) consent to a fingerprint-based background check as required under section 148.519.

426.16 	Sec. 113. Minnesota Statutes 2016, section 148.519, subdivision 1, is amended to read:
426.17 		Subdivision 1.Applications for licensure. (a) An applicant for licensure must:
426.18 	(1) submit a completed application for licensure on forms provided by the commissioner. 
426.19 	The application must include the applicant's name, certification number under chapter 153A, 
426.20 	if applicable, business address and telephone number, or home address and telephone number 
426.21 	if the applicant practices speech-language pathology or audiology out of the home, and a 
426.22 	description of the applicant's education, training, and experience, including previous work 
426.23 	history for the five years immediately preceding the date of application. The commissioner 
426.24 	may ask the applicant to provide additional information necessary to clarify information 
426.25 	submitted in the application; and
426.26 	(2) submit documentation of the certificate of clinical competence issued by the American 
426.27 	Speech-Language-Hearing Association, board certification by the American Board of 
426.28 	Audiology, or satisfy the following requirements:
426.29 	(i) submit a transcript showing the completion of a master's or doctoral degree or its 
426.30 	equivalent meeting the requirements of section 148.515, subdivision 2;
426.31 	(ii) submit documentation of the required hours of supervised clinical training;
427.1 	(iii) submit documentation of the postgraduate clinical or doctoral clinical experience 
427.2 	meeting the requirements of section 148.515, subdivision 4; and
427.3 	(iv) submit documentation of receiving a qualifying score on an examination meeting 
427.4 	the requirements of section 148.515, subdivision 6.
427.5 	(b) In addition, an applicant must:
427.6 	(1) sign a statement that the information in the application is true and correct to the best 
427.7 	of the applicant's knowledge and belief;
427.8 	(2) submit with the application all fees required by section 148.5194; and
427.9 	(3) sign a waiver authorizing the commissioner to obtain access to the applicant's records 
427.10 	in this or any other state in which the applicant has engaged in the practice of speech-language 
427.11 	pathology or audiology.; and
427.12 	(4) consent to a fingerprint-based criminal history background check as required under 
427.13 	section 144.0572, pay all required fees, and cooperate with all requests for information. An 
427.14 	applicant must complete a new criminal history background check if more than one year 
427.15 	has elapsed since the applicant last applied for a license.

427.16 	Sec. 114. Minnesota Statutes 2016, section 148.519, subdivision 2, is amended to read:
427.17 		Subd. 2.Action on applications for licensure. (a) The commissioner shall act on an 
427.18 	application for licensure according to paragraphs (b) to (d) (e).
427.19 	(b) The commissioner shall determine if the applicant meets the requirements for 
427.20 	licensure. The commissioner or advisory council may investigate information provided by 
427.21 	an applicant to determine whether the information is accurate and complete.
427.22 	(c) The commissioner shall not issue a license to an applicant who refuses to consent to 
427.23 	a background study within 90 days after submission of an application or fails to submit 
427.24 	fingerprints to the Department of Human Services. Any fees paid by the applicant to the 
427.25 	Department of Health shall be forfeited if the applicant refuses to consent to the background 
427.26 	study.
427.27 	(c) (d) The commissioner shall notify an applicant, via certified mail, of action taken on 
427.28 	the application and of the grounds for denying licensure if licensure is denied.
427.29 	(d) (e) An applicant denied licensure may make a written request to the commissioner, 
427.30 	within 30 days of the date of notification to the applicant, for reconsideration of the denial. 
427.31 	Individuals requesting reconsideration may submit information that the applicant wants 
427.32 	considered in the reconsideration. After reconsideration of the commissioner's determination 
428.1 	to deny licensure, the commissioner shall determine whether the original determination 
428.2 	should be affirmed or modified. An applicant may make only one request in any one biennial 
428.3 	license period for reconsideration of the commissioner's determination to deny licensure.

428.4 	Sec. 115. Minnesota Statutes 2016, section 148.5194, subdivision 2, is amended to read:
428.5 		Subd. 2.Speech-language pathologist biennial licensure fee fees. (a) The fee for initial 
428.6 	licensure and biennial licensure, clinical fellowship licensure, temporary licensure, or 
428.7 	renewal for a speech-language pathologist is $200 $210.50.
428.8 	(b) The fee for clinical fellowship licensure, doctoral externship, temporary license, or 
428.9 	renewal for a speech-language pathologist is $200.

428.10 	Sec. 116. Minnesota Statutes 2016, section 148.5194, subdivision 3, is amended to read:
428.11 		Subd. 3.Biennial Licensure fee fees for dual licensure as a speech-language 
428.12 	pathologist and audiologist. (a) The fee for initial dual licensure and biennial licensure, 
428.13 	clinical fellowship licensure, doctoral externship, temporary license, or renewal as a 
428.14 	speech-language pathologist and audiologist is $435 $523.
428.15 	(b) The fee for clinical fellowship licensure, doctoral externship, temporary license, or 
428.16 	renewal for dual licensure as a speech-language pathologist and audiologist is $510.

428.17 	Sec. 117. Minnesota Statutes 2016, section 148.5194, subdivision 4, is amended to read:
428.18 		Subd. 4.Penalty fee for late renewals. The penalty fee for late submission of a renewal 
428.19 	application is $45 $60.

428.20 	Sec. 118. Minnesota Statutes 2016, section 148.5194, subdivision 7, is amended to read:
428.21 		Subd. 7.Audiologist biennial licensure fee. (a) The licensure fee for initial applicants 
428.22 	is $523. The biennial licensure fee for audiologists for clinical fellowship, doctoral externship, 
428.23 	temporary, initial applicants, and renewal licensees licenses is $435 $510.
428.24 	(b) The audiologist fee is for practical examination costs greater than audiologist exam 
428.25 	fee receipts and for complaint investigation, enforcement action, and consumer information 
428.26 	and assistance expenditures related to hearing instrument dispensing.

429.1 	Sec. 119. Minnesota Statutes 2016, section 148.5194, is amended by adding a subdivision 
429.2 	to read:
429.3 		Subd. 7a.Surcharge. Speech-language pathologists who were licensed prior to January 
429.4 	1, 2018, shall pay a onetime surcharge of $10.50 to renew when their license first expires 
429.5 	after January 1, 2020. Audiologists who were licensed before January 1, 2018, shall pay a 
429.6 	onetime surcharge of $13 to renew when their license first expires after January 1, 2020. 
429.7 	The surcharge shall cover the commissioner's costs associated with criminal background 
429.8 	checks.

429.9 	Sec. 120. Minnesota Statutes 2016, section 148.5195, subdivision 2, is amended to read:
429.10 		Subd. 2.Rights of applicants and licensees. The rights of an applicant denied licensure 
429.11 	are stated in section 148.519, subdivision 2, paragraph (d) (e). A licensee shall not be 
429.12 	subjected to disciplinary action under this section without first having an opportunity for a 
429.13 	contested case hearing under chapter 14.

429.14 	Sec. 121. Minnesota Statutes 2016, section 148.997, subdivision 1, is amended to read:
429.15 		Subdivision 1.Fees. (a) The application fee is $130 $185.
429.16 	(b) The criminal background check fee is $6 $15.

429.17 	Sec. 122. Minnesota Statutes 2016, section 152.25, subdivision 1, is amended to read:
429.18 		Subdivision 1.Medical cannabis manufacturer registration. (a) The commissioner 
429.19 	shall register two in-state manufacturers for the production of all medical cannabis within 
429.20 	the state by December 1, 2014, unless the commissioner obtains an adequate supply of 
429.21 	federally sourced medical cannabis by August 1, 2014. The commissioner shall register 
429.22 	new manufacturers or reregister the existing manufacturers by December 1 every two years, 
429.23 	using the factors described in paragraph (c) this subdivision. The commissioner shall continue 
429.24 	to accept applications after December 1, 2014, if two manufacturers that meet the 
429.25 	qualifications set forth in this subdivision do not apply before December 1, 2014 if one of 
429.26 	the manufacturers registered before December 1, 2014, ceases to be registered as a 
429.27 	manufacturer. The commissioner's determination that no manufacturer exists to fulfill the 
429.28 	duties under sections 152.22 to 152.37 is subject to judicial review in Ramsey County 
429.29 	District Court. Data submitted during the application process are private data on individuals 
429.30 	or nonpublic data as defined in section 13.02 until the manufacturer is registered under this 
429.31 	section. Data on a manufacturer that is registered are public data, unless the data are trade 
429.32 	secret or security information under section 13.37.
430.1 	(b) As a condition for registration, a manufacturer must agree to:
430.2 	(1) begin supplying medical cannabis to patients by July 1, 2015; and
430.3 	(2) comply with all requirements under sections 152.22 to 152.37.
430.4 	(c) The commissioner shall consider the following factors when determining which 
430.5 	manufacturer to register:
430.6 	(1) the technical expertise of the manufacturer in cultivating medical cannabis and 
430.7 	converting the medical cannabis into an acceptable delivery method under section 152.22, 
430.8 	subdivision 6;
430.9 	(2) the qualifications of the manufacturer's employees;
430.10 	(3) the long-term financial stability of the manufacturer;
430.11 	(4) the ability to provide appropriate security measures on the premises of the 
430.12 	manufacturer;
430.13 	(5) whether the manufacturer has demonstrated an ability to meet the medical cannabis 
430.14 	production needs required by sections 152.22 to 152.37; and
430.15 	(6) the manufacturer's projection and ongoing assessment of fees on patients with a 
430.16 	qualifying medical condition.
430.17 	(d) If an officer, director, or controlling person of the manufacturer pleads or is found 
430.18 	guilty of intentionally diverting medical cannabis to a person other than allowed by law 
430.19 	under section 152.33, subdivision 1, the commissioner may decide not to renew the 
430.20 	registration of the manufacturer, provided the violation occurred while the person was an 
430.21 	officer, director, or controlling person of the manufacturer.
430.22 	(d) (e) The commissioner shall require each medical cannabis manufacturer to contract 
430.23 	with an independent laboratory to test medical cannabis produced by the manufacturer. The 
430.24 	commissioner shall approve the laboratory chosen by each manufacturer and require that 
430.25 	the laboratory report testing results to the manufacturer in a manner determined by the 
430.26 	commissioner.

430.27 	EFFECTIVE DATE. This section is effective the day following final enactment.

430.28 	Sec. 123. Minnesota Statutes 2016, section 152.25, is amended by adding a subdivision 
430.29 	to read:
430.30 		Subd. 1a.Revocation, nonrenewal, or denial of consent to transfer a medical cannabis 
430.31 	manufacturer registration. If the commissioner intends to revoke, not renew, or deny 
431.1 	consent to transfer a registration issued under this section, the commissioner must first notify 
431.2 	in writing the manufacturer against whom the action is to be taken and provide the 
431.3 	manufacturer with an opportunity to request a hearing under the contested case provisions 
431.4 	of chapter 14. If the manufacturer does not request a hearing by notifying the commissioner 
431.5 	in writing within 20 days after receipt of the notice of proposed action, the commissioner 
431.6 	may proceed with the action without a hearing. For revocations, the registration of a 
431.7 	manufacturer is considered revoked on the date specified in the commissioner's written 
431.8 	notice of revocation.

431.9 	EFFECTIVE DATE. This section is effective the day following final enactment.

431.10 	Sec. 124. Minnesota Statutes 2016, section 152.25, is amended by adding a subdivision 
431.11 	to read:
431.12 		Subd. 1b.Temporary suspension proceedings. The commissioner may institute 
431.13 	proceedings to temporarily suspend the registration of a medical cannabis manufacturer for 
431.14 	a period of up to 90 days by notifying the manufacturer in writing if any action by an 
431.15 	employee, agent, officer, director, or controlling person of the manufacturer:
431.16 	(1) violates any of the requirements of sections 152.21 to 152.37 or the rules adopted 
431.17 	thereunder;
431.18 	(2) permits, aids, or abets the commission of any violation of state law at the 
431.19 	manufacturer's location for cultivation, harvesting, manufacturing, packaging, and processing 
431.20 	or at any site for distribution of medical cannabis;
431.21 	(3) performs any act contrary to the welfare of a registered patient or registered designated 
431.22 	caregiver; or
431.23 	(4) obtains, or attempts to obtain, a registration by fraudulent means or misrepresentation.

431.24 	EFFECTIVE DATE. This section is effective the day following final enactment.

431.25 	Sec. 125. Minnesota Statutes 2016, section 152.25, is amended by adding a subdivision 
431.26 	to read:
431.27 		Subd. 1c.Notice to patients. Upon the revocation or nonrenewal of a manufacturer's 
431.28 	registration under subdivision 1a or implementation of an enforcement action under 
431.29 	subdivision 1b that may affect the ability of a registered patient, registered designated 
431.30 	caregiver, or a registered patient's parent or legal guardian to obtain medical cannabis from 
431.31 	the manufacturer subject to the enforcement action, the commissioner shall notify in writing 
431.32 	each registered patient and the patient's registered designated caregiver or registered patient's 
432.1 	parent or legal guardian about the outcome of the proceeding and information regarding 
432.2 	alternative registered manufacturers. This notice must be provided two or more business 
432.3 	days prior to the effective date of the revocation, nonrenewal, or other enforcement action.

432.4 	EFFECTIVE DATE. This section is effective the day following final enactment.

432.5 	Sec. 126. Minnesota Statutes 2016, section 152.28, is amended by adding a subdivision 
432.6 	to read:
432.7 		Subd. 3.Advertising restrictions. (a) A health care practitioner shall not publish or 
432.8 	cause to be published any advertisement that:
432.9 	(1) contains false or misleading statements about medical cannabis or about the medical 
432.10 	cannabis registry program;
432.11 	(2) uses colloquial terms to refer to medical cannabis, such as pot, weed, or grass;
432.12 	(3) states or implies the health care practitioner is endorsed by the Department of Health 
432.13 	or by the medical cannabis registry program;
432.14 	(4) includes images of cannabis in its plant or leaf form or of cannabis-smoking 
432.15 	paraphernalia; or
432.16 	(5) contains medical symbols that could reasonably be confused with symbols of 
432.17 	established medical associations or groups.
432.18 	(b) A health care practitioner found by the commissioner to have violated this subdivision 
432.19 	is prohibited from certifying that patients have a qualifying medical condition for purposes 
432.20 	of patient participation in the registry program. The commissioner's decision that a health 
432.21 	care practitioner has violated this subdivision is a final decision of the commissioner and 
432.22 	is not subject to the contested case procedures in chapter 14.

432.23 	Sec. 127. Minnesota Statutes 2016, section 152.33, is amended by adding a subdivision 
432.24 	to read:
432.25 		Subd. 1a.Intentional diversion outside the state; penalties. (a) In addition to any other 
432.26 	applicable penalty in law, the commissioner may levy a fine of $250,000 against a 
432.27 	manufacturer and may immediately initiate proceedings to revoke the manufacturer's 
432.28 	registration, using the procedure in section 152.25, if:
432.29 	(1) an officer, director, or controlling person of the manufacturer pleads or is found 
432.30 	guilty under subdivision 1 of intentionally transferring medical cannabis, while the person 
433.1 	was an officer, director, or controlling person of the manufacturer, to a person other than 
433.2 	allowed by law; and
433.3 	(2) in intentionally transferring medical cannabis to a person other than allowed by law, 
433.4 	the officer, director, or controlling person transported or directed the transport of medical 
433.5 	cannabis outside of Minnesota.
433.6 	(b) All fines collected under this subdivision shall be deposited in the state government 
433.7 	special revenue fund.

433.8 	EFFECTIVE DATE. This section is effective the day following final enactment, and 
433.9 	applies to crimes committed on or after that date.

433.10 	Sec. 128. Minnesota Statutes 2016, section 153A.14, subdivision 1, is amended to read:
433.11 		Subdivision 1.Application for certificate. An applicant must:
433.12 	(1) be 21 years of age or older;
433.13 	(2) apply to the commissioner for a certificate to dispense hearing instruments on 
433.14 	application forms provided by the commissioner;
433.15 	(3) at a minimum, provide the applicant's name, Social Security number, business address 
433.16 	and phone number, employer, and information about the applicant's education, training, 
433.17 	and experience in testing human hearing and fitting hearing instruments;
433.18 	(4) include with the application a statement that the statements in the application are 
433.19 	true and correct to the best of the applicant's knowledge and belief;
433.20 	(5) include with the application a written and signed authorization that authorizes the 
433.21 	commissioner to make inquiries to appropriate regulatory agencies in this or any other state 
433.22 	where the applicant has sold hearing instruments;
433.23 	(6) submit certification to the commissioner that the applicant's audiometric equipment 
433.24 	has been calibrated to meet current ANSI standards within 12 months of the date of the 
433.25 	application;
433.26 	(7) submit evidence of continuing education credits, if required; and
433.27 	(8) submit all fees as required under section 153A.17.; and
433.28 	(9) consent to a fingerprint-based criminal history records check required under section 
433.29 	144.0572, pay all required fees, and cooperate with all requests for information. An applicant 
433.30 	must complete a new criminal background check if more than one year has elapsed since 
433.31 	the applicant last applied for a license.

434.1 	Sec. 129. Minnesota Statutes 2016, section 153A.14, subdivision 2, is amended to read:
434.2 		Subd. 2.Issuance of certificate. (a) The commissioner shall issue a certificate to each 
434.3 	dispenser of hearing instruments who applies under subdivision 1 if the commissioner 
434.4 	determines that the applicant is in compliance with this chapter, has passed an examination 
434.5 	administered by the commissioner, has met the continuing education requirements, if 
434.6 	required, and has paid the fee set by the commissioner. The commissioner may reject or 
434.7 	deny an application for a certificate if there is evidence of a violation or failure to comply 
434.8 	with this chapter.
434.9 	(b) The commissioner shall not issue a certificate to an applicant who refuses to consent 
434.10 	to a criminal history background check as required by section 144.0572 within 90 days after 
434.11 	submission of an application or fails to submit fingerprints to the Department of Human 
434.12 	Services. Any fees paid by the applicant to the Department of Health shall be forfeited if 
434.13 	the applicant refuses to consent to the background study.

434.14 	Sec. 130. Minnesota Statutes 2016, section 153A.17, is amended to read:
434.15 	153A.17 EXPENSES; FEES.
434.16 	(a) The expenses for administering the certification requirements, including the complaint 
434.17 	handling system for hearing aid dispensers in sections 153A.14 and 153A.15, and the 
434.18 	Consumer Information Center under section 153A.18, must be paid from initial application 
434.19 	and examination fees, renewal fees, penalties, and fines. The commissioner shall only use 
434.20 	fees collected under this section for the purposes of administering this chapter. The legislature 
434.21 	must not transfer money generated by these fees from the state government special revenue 
434.22 	fund to the general fund. Surcharges collected by the commissioner of health under section 
434.23 	16E.22 are not subject to this paragraph.
434.24 	(b) The fees are as follows:
434.25 	(1) the initial and annual renewal certification application fee is $600 $772.50;
434.26 	(2) the initial examination fee for the written portion is $500, and for each time it is 
434.27 	taken, thereafter the annual renewal certification application fee is $750;
434.28 	(3) the initial examination fee for the practical portion is $1,200, and $600 for each time 
434.29 	it is taken, thereafter; for individuals meeting the requirements of section 148.515, subdivision 
434.30 	2, the fee for the practical portion of the hearing instrument dispensing examination is $250
434.31 	$600 each time it is taken;
434.32 	(4) the trainee application fee is $200 $230;
435.1 	(5) the penalty fee for late submission of a renewal application is $200 $260; and
435.2 	(6) the fee for verification of certification to other jurisdictions or entities is $25.
435.3 	(c) The commissioner may prorate the certification fee for new applicants based on the 
435.4 	number of quarters remaining in the annual certification period.
435.5 	(d) All fees are nonrefundable. All fees, penalties, and fines received must be deposited 
435.6 	in the state government special revenue fund.
435.7 	(e) Beginning July 1, 2009, until June 30, 2016, a surcharge of $100 shall be paid at the 
435.8 	time of initial certification application or renewal to recover the commissioner's accumulated 
435.9 	direct expenditures for administering the requirements of this chapter. Hearing instrument 
435.10 	dispensers who were certified before January 1, 2018, shall pay a onetime surcharge of 
435.11 	$22.50 to renew their certification when it expires after October 31, 2020. The surcharge 
435.12 	shall cover the commissioner's costs associated with criminal background checks.

435.13 	Sec. 131. Minnesota Statutes 2016, section 157.16, subdivision 1, is amended to read:
435.14 		Subdivision 1.License required annually. A license is required annually for every 
435.15 	person, firm, or corporation engaged in the business of conducting a food and beverage 
435.16 	service establishment, youth camp, hotel, motel, lodging establishment, public pool, or 
435.17 	resort. Any person wishing to operate a place of business licensed in this section shall first 
435.18 	make application, pay the required fee specified in this section, and receive approval for 
435.19 	operation, including plan review approval. Special event food stands are not required to 
435.20 	submit plans. Nonprofit organizations operating a special event food stand with multiple 
435.21 	locations at an annual one-day event shall be issued only one license. Application shall be 
435.22 	made on forms provided by the commissioner and shall require the applicant to state the 
435.23 	full name and address of the owner of the building, structure, or enclosure, the lessee and 
435.24 	manager of the food and beverage service establishment, hotel, motel, lodging establishment, 
435.25 	public pool, or resort; the name under which the business is to be conducted; and any other 
435.26 	information as may be required by the commissioner to complete the application for license.
435.27 	All fees collected under this section shall be deposited in the state government special 
435.28 	revenue fund.

435.29 	Sec. 132. Minnesota Statutes 2016, section 157.16, subdivision 3, is amended to read:
435.30 		Subd. 3.Establishment fees; definitions. (a) The following fees are required for food 
435.31 	and beverage service establishments, youth camps, hotels, motels, lodging establishments, 
435.32 	public pools, and resorts licensed under this chapter. Food and beverage service 
436.1 	establishments must pay the highest applicable fee under paragraph (d), clause (1), (2), (3), 
436.2 	or (4), and establishments serving alcohol must pay the highest applicable fee under paragraph 
436.3 	(d), clause (6) or (7). The license fee for new operators previously licensed under this chapter 
436.4 	for the same calendar year is one-half of the appropriate annual license fee, plus any penalty 
436.5 	that may be required. The license fee for operators opening on or after October 1 is one-half 
436.6 	of the appropriate annual license fee, plus any penalty that may be required.
436.7 	(b) All food and beverage service establishments, except special event food stands, and 
436.8 	all hotels, motels, lodging establishments, public pools, and resorts shall pay an annual base 
436.9 	fee of $150 $165.
436.10 	(c) A special event food stand shall pay a flat fee of $50 $55 annually. "Special event 
436.11 	food stand" means a fee category where food is prepared or served in conjunction with 
436.12 	celebrations, county fairs, or special events from a special event food stand as defined in 
436.13 	section 157.15.
436.14 	(d) In addition to the base fee in paragraph (b), each food and beverage service 
436.15 	establishment, other than a special event food stand and a school concession stand, and each 
436.16 	hotel, motel, lodging establishment, public pool, and resort shall pay an additional annual 
436.17 	fee for each fee category, additional food service, or required additional inspection specified 
436.18 	in this paragraph:
436.19 	(1) Limited food menu selection, $60. "Limited food menu selection" Category 1 
436.20 	establishment, $110. "Category 1 establishment" means a fee category that provides one or 
436.21 	more of the following items or is one of the listed establishments or facilities:
436.22 	(i) serves prepackaged food that receives heat treatment and is served in the package;
436.23 	(ii) frozen pizza that is heated and served;
436.24 	(iii) serves a continental breakfast such as rolls, coffee, juice, milk, and cold cereal;
436.25 	(iv) (iii) serves soft drinks, coffee, or nonalcoholic beverages; or
436.26 	(v) (iv) provides cleaning for eating, drinking, or cooking utensils, when the only food 
436.27 	served is prepared off site.;
436.28 	(v) a food establishment where the method of food preparation meets the definition of 
436.29 	a low-risk establishment in section 157.20; or
436.30 	(vi) operates as a child care facility licensed under section 245A.03 and Minnesota Rules, 
436.31 	chapter 9503.
437.1 	(2) Small establishment, including boarding establishments, $120. "Small establishment" 
437.2 	means a fee category that has no salad bar and meets one or more of the following:
437.3 	(i) possesses food service equipment that consists of no more than a deep fat fryer, a 
437.4 	grill, two hot holding containers, and one or more microwave ovens;
437.5 	(ii) serves dipped ice cream or soft serve frozen desserts;
437.6 	(iii) serves breakfast in an owner-occupied bed and breakfast establishment;
437.7 	(iv) is a boarding establishment; or
437.8 	(v) meets the equipment criteria in clause (3), item (i) or (ii), and has a maximum patron 
437.9 	seating capacity of not more than 50.
437.10 	(3) Medium establishment, $310. "Medium establishment" (2) Category 2 establishment, 
437.11 	$245. "Category 2 establishment" means a fee category that meets one or more of the 
437.12 	following an establishment that is not a Category 1 establishment and is either:
437.13 	(i) possesses food service equipment that includes a range, oven, steam table, salad bar, 
437.14 	or salad preparation area; a food establishment where the method of food preparation meets 
437.15 	the definition of a medium-risk establishment in section 157.20; or
437.16 	(ii) possesses food service equipment that includes more than one deep fat fryer, one 
437.17 	grill, or two hot holding containers; or an elementary or secondary school as defined in 
437.18 	section 120A.05.
437.19 	(iii) is an establishment where food is prepared at one location and served at one or more 
437.20 	separate locations.
437.21 	Establishments meeting criteria in clause (2), item (v), are not included in this fee 
437.22 	category.
437.23 	(4) Large establishment, $540. "Large establishment" (3) Category 3 establishment, 
437.24 	$385. "Category 3 establishment" means an establishment that is not a Category 1 or Category 
437.25 	2 establishment and is either:
437.26 	(i) a fee category that (A) meets the criteria in clause (3), items (i) or (ii), for a medium 
437.27 	establishment, (B) seats more than 175 people, and (C) offers the full menu selection an 
437.28 	average of five or more days a week during the weeks of operation a food establishment 
437.29 	where the method of food preparation meets the definition of a high-risk establishment in 
437.30 	section 157.20; or
438.1 	(ii) a fee category that (A) meets the criteria in clause (3), item (iii), for a medium 
438.2 	establishment, and (B) prepares and serves 500 or more meals per day. an establishment 
438.3 	where 500 or more meals are prepared per day and served at one or more separate locations.
438.4 	(5) (4) Other food and beverage service, including food carts, mobile food units, seasonal 
438.5 	temporary food stands, and seasonal permanent food stands, $60 $85.
438.6 	(6) Beer or wine table service, $60. "Beer or wine table service" means a fee category 
438.7 	where the only alcoholic beverage service is beer or wine, served to customers seated at 
438.8 	tables.
438.9 	(7) Alcoholic beverage service, other than beer or wine table service, $165.
438.10 	"Alcohol beverage service, other than beer or wine table service" means a fee category 
438.11 	where alcoholic mixed drinks are served or where beer or wine are served from a bar.
438.12 	(8) (5) Lodging per sleeping accommodation unit, $10 $11, including hotels, motels, 
438.13 	lodging establishments, and resorts, up to a maximum of $1,000 $1,100. "Lodging per 
438.14 	sleeping accommodation unit" means a fee category including the number of guest rooms, 
438.15 	cottages, or other rental units of a hotel, motel, lodging establishment, or resort; or the 
438.16 	number of beds in a dormitory.
438.17 	(9) (6) First public pool, $325 $355; each additional public pool, $175 $200. "Public 
438.18 	pool" means a fee category that has the meaning given in section 144.1222, subdivision 4.
438.19 	(10) (7) First spa, $175 $200; each additional spa, $100 $110. "Spa pool" means a fee 
438.20 	category that has the meaning given in Minnesota Rules, part 4717.0250, subpart 9.
438.21 	(11) (8) Private sewer or water, $60. "Individual private water" means a fee category 
438.22 	with a water supply other than a community public water supply as defined in Minnesota 
438.23 	Rules, chapter 4720. "Individual private sewer" means a fee category with an individual 
438.24 	sewage treatment system which uses subsurface treatment and disposal.
438.25 	(12) (9) Additional food service, $150 $175. "Additional food service" means a location 
438.26 	at a food service establishment, other than the primary food preparation and service area, 
438.27 	used to prepare or serve beverages or food to the public. Additional food service does not 
438.28 	apply to school concession stands.
438.29 	(13) (10) Additional inspection fee, $360 $250. "Additional inspection fee" means a fee 
438.30 	to conduct the second inspection each year for elementary and secondary education facility 
438.31 	school lunch programs when required by the Richard B. Russell National School Lunch 
438.32 	Act.
439.1 	(11) HACCP verification, $175. "HACCP verification" means an annual fee category 
439.2 	for a business that performs one or more specialized process that requires an HACCP plan 
439.3 	as required in chapter 31 and Minnesota Rules, chapter 4626.
439.4 	(e) A fee for review of construction plans must accompany the initial license application 
439.5 	for restaurants, hotels, motels, lodging establishments, resorts, seasonal food stands, and 
439.6 	mobile food units. A fee for review of an HACCP plan for specialized processing must be 
439.7 	submitted and approved prior to preparing and serving the specialized processed food for 
439.8 	human consumption. The fee fees for this construction plan review is reviews and HACCP 
439.9 	plan reviews are as follows:

439.10	Service Area
	Type
	Fee
	
439.11	Food
	limited food menu
	$275
	
439.12		small category 1 establishment
	$400
	
439.13		medium category 2 establishment
	$450
	
439.14		large category 3 food establishment
	$500
	
439.16439.15
		additional food service
	$150
$250
	
439.17		HACCP Plan Review
	$500
	
439.18	Transient food service
	food cart
	$250
	
439.19		seasonal permanent food stand
	$250
	
439.20		seasonal temporary food stand
	$250
	
439.21		mobile food unit
	$350
	
439.22	Alcohol
	beer or wine table service
	$150
	
439.23		alcohol service from bar
	$250
	
439.24	Lodging
	less than 25 rooms
	$375
	
439.25		25 to less than 100 rooms
	$400
	
439.26		100 rooms or more
	$500
	
439.27		less than five cabins
	$350
	
439.28		five to less than ten cabins
	$400
	
439.29		ten cabins or more
	$450
	
439.30 	(f) When existing food and beverage service establishments, hotels, motels, lodging 
439.31 	establishments, resorts, seasonal food stands, and mobile food units are extensively 
439.32 	remodeled, a fee must be submitted with the remodeling plans. The fee for this construction 
439.33 	plan review is as follows:

439.34	Service Area
	Type
	Fee
	
439.35	Food
	limited food menu
	$250
	
439.36		small category 1 establishment
	$300
	
440.1		medium category 2 establishment
	$350
	
440.2		large food category 3 establishment
	$400
	
440.4440.3
		additional food service
	$150
$250
	
440.5	Transient food service
	food cart
	$250
	
440.6		seasonal permanent food stand
	$250
	
440.7		seasonal temporary food stand
	$250
	
440.8		mobile food unit
	$250
	
440.9	Alcohol
	beer or wine table service
	$150
	
440.10		alcohol service from bar
	$250
	
440.11	Lodging
	less than 25 rooms
	$250
	
440.12		25 to less than 100 rooms
	$300
	
440.13		100 rooms or more
	$450
	
440.14		less than five cabins
	$250
	
440.15		five to less than ten cabins
	$350
	
440.16		ten cabins or more
	$400
	
440.17 	(g) Special event food stands are not required to submit construction or remodeling plans 
440.18 	for review.
440.19 	(h) Youth camps shall pay an annual single fee for food and lodging as follows:
440.20 	(1) camps with up to 99 campers, $325;
440.21 	(2) camps with 100 to 199 campers, $550; and
440.22 	(3) camps with 200 or more campers, $750.
440.23 	(i) A youth camp which pays fees under paragraph (d) is not required to pay fees under 
440.24 	paragraph (h).

440.25 	Sec. 133. Minnesota Statutes 2016, section 157.16, subdivision 3a, is amended to read:
440.26 		Subd. 3a.Statewide hospitality fee. Every person, firm, or corporation that operates a 
440.27 	licensed boarding establishment, food and beverage service establishment, seasonal temporary 
440.28 	or permanent food stand, special event food stand, mobile food unit, food cart, resort, hotel, 
440.29 	motel, or lodging establishment in Minnesota must submit to the commissioner a $35 $40
440.30 	annual statewide hospitality fee for each licensed activity. The fee for establishments licensed 
440.31 	by the Department of Health is required at the same time the licensure fee is due. For 
440.32 	establishments licensed by local governments, the fee is due by July 1 of each year.

441.1 	Sec. 134. Minnesota Statutes 2016, section 245C.10, is amended by adding a subdivision 
441.2 	to read:
441.3 		Subd. 2a.Occupations regulated by commissioner of health. The commissioner shall 
441.4 	set fees to recover the cost of combined background studies and criminal background checks 
441.5 	initiated by applicants, licensees, and certified practitioners regulated under sections 148.511 
441.6 	to 148.5198 and chapter 153A. The fees collected under this subdivision shall be deposited 
441.7 	in the special revenue fund and are appropriated to the commissioner for the purpose of 
441.8 	conducting background studies and criminal background checks.

441.9 	Sec. 135. Minnesota Statutes 2016, section 327.15, subdivision 3, is amended to read:
441.10 		Subd. 3.Fees, manufactured home parks and recreational camping areas. (a) The 
441.11 	following fees are required for manufactured home parks and recreational camping areas 
441.12 	licensed under this chapter. Fees collected under this section shall be deposited in the state 
441.13 	government special revenue fund. Recreational camping areas and manufactured home 
441.14 	parks shall pay the highest applicable base fee under paragraph (b). The license fee for new 
441.15 	operators of a manufactured home park or recreational camping area previously licensed 
441.16 	under this chapter for the same calendar year is one-half of the appropriate annual license 
441.17 	fee, plus any penalty that may be required. The license fee for operators opening on or after 
441.18 	October 1 is one-half of the appropriate annual license fee, plus any penalty that may be 
441.19 	required.
441.20 	(b) All manufactured home parks and recreational camping areas shall pay the following 
441.21 	annual base fee:
441.22 	(1) a manufactured home park, $150 $165; and
441.23 	(2) a recreational camping area with:
441.24 	(i) 24 or less sites, $50 $55;
441.25 	(ii) 25 to 99 sites, $212 $230; and
441.26 	(iii) 100 or more sites, $300 $330.
441.27 	In addition to the base fee, manufactured home parks and recreational camping areas shall 
441.28 	pay $4 $5 for each licensed site. This paragraph does not apply to special event recreational 
441.29 	camping areas. Operators of a manufactured home park or a recreational camping area also 
441.30 	licensed under section 157.16 for the same location shall pay only one base fee, whichever 
441.31 	is the highest of the base fees found in this section or section 157.16.
442.1 	(c) In addition to the fee in paragraph (b), each manufactured home park or recreational 
442.2 	camping area shall pay an additional annual fee for each fee category specified in this 
442.3 	paragraph:
442.4 	(1) Manufactured home parks and recreational camping areas with public swimming 
442.5 	pools and spas shall pay the appropriate fees specified in section 157.16.
442.6 	(2) Individual private sewer or water, $60. "Individual private water" means a fee category 
442.7 	with a water supply other than a community public water supply as defined in Minnesota 
442.8 	Rules, chapter 4720. "Individual private sewer" means a fee category with a subsurface 
442.9 	sewage treatment system which uses subsurface treatment and disposal.
442.10 	(d) The following fees must accompany a plan review application for initial construction 
442.11 	of a manufactured home park or recreational camping area:
442.12 	(1) for initial construction of less than 25 sites, $375;
442.13 	(2) for initial construction of 25 to 99 sites, $400; and
442.14 	(3) for initial construction of 100 or more sites, $500.
442.15 	(e) The following fees must accompany a plan review application when an existing 
442.16 	manufactured home park or recreational camping area is expanded:
442.17 	(1) for expansion of less than 25 sites, $250;
442.18 	(2) for expansion of 25 to 99 sites, $300; and
442.19 	(3) for expansion of 100 or more sites, $450.

442.20 	Sec. 136. Minnesota Statutes 2016, section 364.09, is amended to read:
442.21 	364.09 EXCEPTIONS.
442.22 	(a) This chapter does not apply to the licensing process for peace officers; to law 
442.23 	enforcement agencies as defined in section 626.84, subdivision 1, paragraph (f); to fire 
442.24 	protection agencies; to eligibility for a private detective or protective agent license; to the 
442.25 	licensing and background study process under chapters 245A and 245C; to the licensing 
442.26 	and background investigation process under chapter 240; to eligibility for school bus driver 
442.27 	endorsements; to eligibility for special transportation service endorsements; to eligibility 
442.28 	for a commercial driver training instructor license, which is governed by section 171.35
442.29 	and rules adopted under that section; to emergency medical services personnel, or to the 
442.30 	licensing by political subdivisions of taxicab drivers, if the applicant for the license has 
443.1 	been discharged from sentence for a conviction within the ten years immediately preceding 
443.2 	application of a violation of any of the following:
443.3 	(1) sections 609.185 to 609.2114, 609.221 to 609.223, 609.342 to 609.3451, or 617.23, 
443.4 	subdivision 2 or 3; or Minnesota Statutes 2012, section 609.21;
443.5 	(2) any provision of chapter 152 that is punishable by a maximum sentence of 15 years 
443.6 	or more; or
443.7 	(3) a violation of chapter 169 or 169A involving driving under the influence, leaving 
443.8 	the scene of an accident, or reckless or careless driving.
443.9 	This chapter also shall not apply to eligibility for juvenile corrections employment, where 
443.10 	the offense involved child physical or sexual abuse or criminal sexual conduct.
443.11 	(b) This chapter does not apply to a school district or to eligibility for a license issued 
443.12 	or renewed by the Board of Teaching or the commissioner of education.
443.13 	(c) Nothing in this section precludes the Minnesota Police and Peace Officers Training 
443.14 	Board or the state fire marshal from recommending policies set forth in this chapter to the 
443.15 	attorney general for adoption in the attorney general's discretion to apply to law enforcement 
443.16 	or fire protection agencies.
443.17 	(d) This chapter does not apply to a license to practice medicine that has been denied or 
443.18 	revoked by the Board of Medical Practice pursuant to section 147.091, subdivision 1a.
443.19 	(e) This chapter does not apply to any person who has been denied a license to practice 
443.20 	chiropractic or whose license to practice chiropractic has been revoked by the board in 
443.21 	accordance with section 148.10, subdivision 7.
443.22 	(f) This chapter does not apply to any license, registration, or permit that has been denied 
443.23 	or revoked by the Board of Nursing in accordance with section 148.261, subdivision 1a.
443.24 	(g) This chapter does not apply to any license, registration, permit, or certificate that has 
443.25 	been denied or revoked by the commissioner of health according to section 148.5195, 
443.26 	subdivision 5; or 153A.15, subdivision 2.
443.27 	(g)(h) This chapter does not supersede a requirement under law to conduct a criminal 
443.28 	history background investigation or consider criminal history records in hiring for particular 
443.29 	types of employment.

444.1 	Sec. 137. Minnesota Statutes 2016, section 609.5315, subdivision 5c, is amended to read:
444.2 		Subd. 5c.Disposition of money; prostitution. Money forfeited under section 609.5312, 
444.3 	subdivision 1, paragraph (b), must be distributed as follows:
444.4 	(1) 40 percent must be forwarded to the appropriate agency for deposit as a supplement 
444.5 	to the agency's operating fund or similar fund for use in law enforcement;
444.6 	(2) 20 percent must be forwarded to the prosecuting authority that handled the forfeiture 
444.7 	for deposit as a supplement to its operating fund or similar fund for prosecutorial purposes; 
444.8 	and
444.9 	(3) the remaining 40 percent must be forwarded to the commissioner of public safety
444.10 	health to be deposited in the safe harbor for youth account in the special revenue fund and 
444.11 	is appropriated to the commissioner for distribution to crime victims services organizations 
444.12 	that provide services to sexually exploited youth, as defined in section 260C.007, subdivision 
444.13 	31.

444.14 	Sec. 138. Minnesota Statutes 2016, section 626.556, subdivision 2, is amended to read:
444.15 		Subd. 2.Definitions. As used in this section, the following terms have the meanings 
444.16 	given them unless the specific content indicates otherwise:
444.17 	(a) "Accidental" means a sudden, not reasonably foreseeable, and unexpected occurrence 
444.18 	or event which:
444.19 	(1) is not likely to occur and could not have been prevented by exercise of due care; and
444.20 	(2) if occurring while a child is receiving services from a facility, happens when the 
444.21 	facility and the employee or person providing services in the facility are in compliance with 
444.22 	the laws and rules relevant to the occurrence or event.
444.23 	(b) "Commissioner" means the commissioner of human services.
444.24 	(c) "Facility" means:
444.25 	(1) a licensed or unlicensed day care facility, residential facility, agency, hospital, 
444.26 	sanitarium, or other facility or institution required to be licensed under sections 144.50 to 
444.27 	144.58, 241.021, or 245A.01 to 245A.16, or chapter 144H or 245D;
444.28 	(2) a school as defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E; 
444.29 	or
444.30 	(3) a nonlicensed personal care provider organization as defined in section 256B.0625, 
444.31 	subdivision 19a.
445.1 	(d) "Family assessment" means a comprehensive assessment of child safety, risk of 
445.2 	subsequent child maltreatment, and family strengths and needs that is applied to a child 
445.3 	maltreatment report that does not allege sexual abuse or substantial child endangerment. 
445.4 	Family assessment does not include a determination as to whether child maltreatment 
445.5 	occurred but does determine the need for services to address the safety of family members 
445.6 	and the risk of subsequent maltreatment.
445.7 	(e) "Investigation" means fact gathering related to the current safety of a child and the 
445.8 	risk of subsequent maltreatment that determines whether child maltreatment occurred and 
445.9 	whether child protective services are needed. An investigation must be used when reports 
445.10 	involve sexual abuse or substantial child endangerment, and for reports of maltreatment in 
445.11 	facilities required to be licensed under chapter 245A or 245D; under sections 144.50 to 
445.12 	144.58 and 241.021; in a school as defined in section 120A.05, subdivisions 9, 11, and 13, 
445.13 	and chapter 124E; or in a nonlicensed personal care provider association as defined in section 
445.14 	256B.0625, subdivision 19a.
445.15 	(f) "Mental injury" means an injury to the psychological capacity or emotional stability 
445.16 	of a child as evidenced by an observable or substantial impairment in the child's ability to 
445.17 	function within a normal range of performance and behavior with due regard to the child's 
445.18 	culture.
445.19 	(g) "Neglect" means the commission or omission of any of the acts specified under 
445.20 	clauses (1) to (9), other than by accidental means:
445.21 	(1) failure by a person responsible for a child's care to supply a child with necessary 
445.22 	food, clothing, shelter, health, medical, or other care required for the child's physical or 
445.23 	mental health when reasonably able to do so;
445.24 	(2) failure to protect a child from conditions or actions that seriously endanger the child's 
445.25 	physical or mental health when reasonably able to do so, including a growth delay, which 
445.26 	may be referred to as a failure to thrive, that has been diagnosed by a physician and is due 
445.27 	to parental neglect;
445.28 	(3) failure to provide for necessary supervision or child care arrangements appropriate 
445.29 	for a child after considering factors as the child's age, mental ability, physical condition, 
445.30 	length of absence, or environment, when the child is unable to care for the child's own basic 
445.31 	needs or safety, or the basic needs or safety of another child in their care;
445.32 	(4) failure to ensure that the child is educated as defined in sections 120A.22 and 
445.33 	260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's 
446.1 	child with sympathomimetic medications, consistent with section 125A.091, subdivision 
446.2 	5;
446.3 	(5) nothing in this section shall be construed to mean that a child is neglected solely 
446.4 	because the child's parent, guardian, or other person responsible for the child's care in good 
446.5 	faith selects and depends upon spiritual means or prayer for treatment or care of disease or 
446.6 	remedial care of the child in lieu of medical care; except that a parent, guardian, or caretaker, 
446.7 	or a person mandated to report pursuant to subdivision 3, has a duty to report if a lack of 
446.8 	medical care may cause serious danger to the child's health. This section does not impose 
446.9 	upon persons, not otherwise legally responsible for providing a child with necessary food, 
446.10 	clothing, shelter, education, or medical care, a duty to provide that care;
446.11 	(6) prenatal exposure to a controlled substance, as defined in section 253B.02, subdivision 
446.12 	2, used by the mother for a nonmedical purpose, as evidenced by withdrawal symptoms in 
446.13 	the child at birth, results of a toxicology test performed on the mother at delivery or the 
446.14 	child at birth, medical effects or developmental delays during the child's first year of life 
446.15 	that medically indicate prenatal exposure to a controlled substance, or the presence of a 
446.16 	fetal alcohol spectrum disorder;
446.17 	(7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
446.18 	(8) chronic and severe use of alcohol or a controlled substance by a parent or person 
446.19 	responsible for the care of the child that adversely affects the child's basic needs and safety; 
446.20 	or
446.21 	(9) emotional harm from a pattern of behavior which contributes to impaired emotional 
446.22 	functioning of the child which may be demonstrated by a substantial and observable effect 
446.23 	in the child's behavior, emotional response, or cognition that is not within the normal range 
446.24 	for the child's age and stage of development, with due regard to the child's culture.
446.25 	(h) "Nonmaltreatment mistake" means:
446.26 	(1) at the time of the incident, the individual was performing duties identified in the 
446.27 	center's child care program plan required under Minnesota Rules, part 9503.0045;
446.28 	(2) the individual has not been determined responsible for a similar incident that resulted 
446.29 	in a finding of maltreatment for at least seven years;
446.30 	(3) the individual has not been determined to have committed a similar nonmaltreatment 
446.31 	mistake under this paragraph for at least four years;
447.1 	(4) any injury to a child resulting from the incident, if treated, is treated only with 
447.2 	remedies that are available over the counter, whether ordered by a medical professional or 
447.3 	not; and
447.4 	(5) except for the period when the incident occurred, the facility and the individual 
447.5 	providing services were both in compliance with all licensing requirements relevant to the 
447.6 	incident.
447.7 	This definition only applies to child care centers licensed under Minnesota Rules, chapter 
447.8 	9503. If clauses (1) to (5) apply, rather than making a determination of substantiated 
447.9 	maltreatment by the individual, the commissioner of human services shall determine that a 
447.10 	nonmaltreatment mistake was made by the individual.
447.11 	(i) "Operator" means an operator or agency as defined in section 245A.02.
447.12 	(j) "Person responsible for the child's care" means (1) an individual functioning within 
447.13 	the family unit and having responsibilities for the care of the child such as a parent, guardian, 
447.14 	or other person having similar care responsibilities, or (2) an individual functioning outside 
447.15 	the family unit and having responsibilities for the care of the child such as a teacher, school 
447.16 	administrator, other school employees or agents, or other lawful custodian of a child having 
447.17 	either full-time or short-term care responsibilities including, but not limited to, day care, 
447.18 	babysitting whether paid or unpaid, counseling, teaching, and coaching.
447.19 	(k) "Physical abuse" means any physical injury, mental injury, or threatened injury, 
447.20 	inflicted by a person responsible for the child's care on a child other than by accidental 
447.21 	means, or any physical or mental injury that cannot reasonably be explained by the child's 
447.22 	history of injuries, or any aversive or deprivation procedures, or regulated interventions, 
447.23 	that have not been authorized under section 125A.0942 or 245.825.
447.24 	Abuse does not include reasonable and moderate physical discipline of a child 
447.25 	administered by a parent or legal guardian which does not result in an injury. Abuse does 
447.26 	not include the use of reasonable force by a teacher, principal, or school employee as allowed 
447.27 	by section 121A.582. Actions which are not reasonable and moderate include, but are not 
447.28 	limited to, any of the following:
447.29 	(1) throwing, kicking, burning, biting, or cutting a child;
447.30 	(2) striking a child with a closed fist;
447.31 	(3) shaking a child under age three;
447.32 	(4) striking or other actions which result in any nonaccidental injury to a child under 18 
447.33 	months of age;
448.1 	(5) unreasonable interference with a child's breathing;
448.2 	(6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
448.3 	(7) striking a child under age one on the face or head;
448.4 	(8) striking a child who is at least age one but under age four on the face or head, which 
448.5 	results in an injury;
448.6 	(9) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled 
448.7 	substances which were not prescribed for the child by a practitioner, in order to control or 
448.8 	punish the child; or other substances that substantially affect the child's behavior, motor 
448.9 	coordination, or judgment or that results in sickness or internal injury, or subjects the child 
448.10 	to medical procedures that would be unnecessary if the child were not exposed to the 
448.11 	substances;
448.12 	(10) unreasonable physical confinement or restraint not permitted under section 609.379, 
448.13 	including but not limited to tying, caging, or chaining; or
448.14 	(11) in a school facility or school zone, an act by a person responsible for the child's 
448.15 	care that is a violation under section 121A.58.
448.16 	(l) "Practice of social services," for the purposes of subdivision 3, includes but is not 
448.17 	limited to employee assistance counseling and the provision of guardian ad litem and 
448.18 	parenting time expeditor services.
448.19 	(m) "Report" means any communication received by the local welfare agency, police 
448.20 	department, county sheriff, or agency responsible for child protection pursuant to this section 
448.21 	that describes neglect or physical or sexual abuse of a child and contains sufficient content 
448.22 	to identify the child and any person believed to be responsible for the neglect or abuse, if 
448.23 	known.
448.24 	(n) "Sexual abuse" means the subjection of a child by a person responsible for the child's 
448.25 	care, by a person who has a significant relationship to the child, as defined in section 609.341, 
448.26 	or by a person in a position of authority, as defined in section 609.341, subdivision 10, to 
448.27 	any act which constitutes a violation of section 609.342 (criminal sexual conduct in the first 
448.28 	degree), 609.343 (criminal sexual conduct in the second degree), 609.344 (criminal sexual 
448.29 	conduct in the third degree), 609.345 (criminal sexual conduct in the fourth degree), or 
448.30 	609.3451 (criminal sexual conduct in the fifth degree). Sexual abuse also includes any act 
448.31 	which involves a minor which constitutes a violation of prostitution offenses under sections 
448.32 	609.321 to 609.324 or 617.246. Effective May 29, 2017, sexual abuse includes all reports 
448.33 	of known or suspected child sex trafficking involving a child who is identified as a victim 
449.1 	of sex trafficking. Sexual abuse includes child sex trafficking as defined in section 609.321, 
449.2 	subdivisions 7a and 7b. Sexual abuse includes threatened sexual abuse which includes the 
449.3 	status of a parent or household member who has committed a violation which requires 
449.4 	registration as an offender under section 243.166, subdivision 1b, paragraph (a) or (b), or 
449.5 	required registration under section 243.166, subdivision 1b, paragraph (a) or (b).
449.6 	(o) "Substantial child endangerment" means a person responsible for a child's care, by 
449.7 	act or omission, commits or attempts to commit an act against a child under their care that 
449.8 	constitutes any of the following:
449.9 	(1) egregious harm as defined in section 260C.007, subdivision 14;
449.10 	(2) abandonment under section 260C.301, subdivision 2;
449.11 	(3) neglect as defined in paragraph (g), clause (2), that substantially endangers the child's 
449.12 	physical or mental health, including a growth delay, which may be referred to as failure to 
449.13 	thrive, that has been diagnosed by a physician and is due to parental neglect;
449.14 	(4) murder in the first, second, or third degree under section 609.185, 609.19, or 609.195;
449.15 	(5) manslaughter in the first or second degree under section 609.20 or 609.205;
449.16 	(6) assault in the first, second, or third degree under section 609.221, 609.222, or 609.223;
449.17 	(7) solicitation, inducement, and promotion of prostitution under section 609.322;
449.18 	(8) criminal sexual conduct under sections 609.342 to 609.3451;
449.19 	(9) solicitation of children to engage in sexual conduct under section 609.352;
449.20 	(10) malicious punishment or neglect or endangerment of a child under section 609.377
449.21 	or 609.378;
449.22 	(11) use of a minor in sexual performance under section 617.246; or
449.23 	(12) parental behavior, status, or condition which mandates that the county attorney file 
449.24 	a termination of parental rights petition under section 260C.503, subdivision 2.
449.25 	(p) "Threatened injury" means a statement, overt act, condition, or status that represents 
449.26 	a substantial risk of physical or sexual abuse or mental injury. Threatened injury includes, 
449.27 	but is not limited to, exposing a child to a person responsible for the child's care, as defined 
449.28 	in paragraph (j), clause (1), who has:
449.29 	(1) subjected a child to, or failed to protect a child from, an overt act or condition that 
449.30 	constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a similar law 
449.31 	of another jurisdiction;
450.1 	(2) been found to be palpably unfit under section 260C.301, subdivision 1, paragraph 
450.2 	(b), clause (4), or a similar law of another jurisdiction;
450.3 	(3) committed an act that has resulted in an involuntary termination of parental rights 
450.4 	under section 260C.301, or a similar law of another jurisdiction; or
450.5 	(4) committed an act that has resulted in the involuntary transfer of permanent legal and 
450.6 	physical custody of a child to a relative under Minnesota Statutes 2010, section 260C.201, 
450.7 	subdivision 11, paragraph (d), clause (1), section 260C.515, subdivision 4, or a similar law 
450.8 	of another jurisdiction.
450.9 	A child is the subject of a report of threatened injury when the responsible social services 
450.10 	agency receives birth match data under paragraph (q) from the Department of Human 
450.11 	Services.
450.12 	(q) Upon receiving data under section 144.225, subdivision 2b, contained in a birth 
450.13 	record or recognition of parentage identifying a child who is subject to threatened injury 
450.14 	under paragraph (p), the Department of Human Services shall send the data to the responsible 
450.15 	social services agency. The data is known as "birth match" data. Unless the responsible 
450.16 	social services agency has already begun an investigation or assessment of the report due 
450.17 	to the birth of the child or execution of the recognition of parentage and the parent's previous 
450.18 	history with child protection, the agency shall accept the birth match data as a report under 
450.19 	this section. The agency may use either a family assessment or investigation to determine 
450.20 	whether the child is safe. All of the provisions of this section apply. If the child is determined 
450.21 	to be safe, the agency shall consult with the county attorney to determine the appropriateness 
450.22 	of filing a petition alleging the child is in need of protection or services under section 
450.23 	260C.007, subdivision 6, clause (16), in order to deliver needed services. If the child is 
450.24 	determined not to be safe, the agency and the county attorney shall take appropriate action 
450.25 	as required under section 260C.503, subdivision 2.
450.26 	(r) Persons who conduct assessments or investigations under this section shall take into 
450.27 	account accepted child-rearing practices of the culture in which a child participates and 
450.28 	accepted teacher discipline practices, which are not injurious to the child's health, welfare, 
450.29 	and safety.

450.30 	Sec. 139. Minnesota Statutes 2016, section 626.556, subdivision 3, is amended to read:
450.31 		Subd. 3.Persons mandated to report; persons voluntarily reporting. (a) A person 
450.32 	who knows or has reason to believe a child is being neglected or physically or sexually 
450.33 	abused, as defined in subdivision 2, or has been neglected or physically or sexually abused 
451.1 	within the preceding three years, shall immediately report the information to the local welfare 
451.2 	agency, agency responsible for assessing or investigating the report, police department, 
451.3 	county sheriff, tribal social services agency, or tribal police department if the person is:
451.4 	(1) a professional or professional's delegate who is engaged in the practice of the healing 
451.5 	arts, social services, hospital administration, psychological or psychiatric treatment, child 
451.6 	care, education, correctional supervision, probation and correctional services, or law 
451.7 	enforcement; or
451.8 	(2) employed as a member of the clergy and received the information while engaged in 
451.9 	ministerial duties, provided that a member of the clergy is not required by this subdivision 
451.10 	to report information that is otherwise privileged under section 595.02, subdivision 1, 
451.11 	paragraph (c).
451.12 	(b) Any person may voluntarily report to the local welfare agency, agency responsible 
451.13 	for assessing or investigating the report, police department, county sheriff, tribal social 
451.14 	services agency, or tribal police department if the person knows, has reason to believe, or 
451.15 	suspects a child is being or has been neglected or subjected to physical or sexual abuse.
451.16 	(c) A person mandated to report physical or sexual child abuse or neglect occurring 
451.17 	within a licensed facility shall report the information to the agency responsible for licensing 
451.18 	the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or chapter 144H 
451.19 	or 245D; or a nonlicensed personal care provider organization as defined in section 
451.20 	256B.0625, subdivision 19 19a. A health or corrections agency receiving a report may 
451.21 	request the local welfare agency to provide assistance pursuant to subdivisions 10, 10a, and 
451.22 	10b. A board or other entity whose licensees perform work within a school facility, upon 
451.23 	receiving a complaint of alleged maltreatment, shall provide information about the 
451.24 	circumstances of the alleged maltreatment to the commissioner of education. Section 13.03, 
451.25 	subdivision 4, applies to data received by the commissioner of education from a licensing 
451.26 	entity.
451.27 	(d) Notification requirements under subdivision 10 apply to all reports received under 
451.28 	this section.
451.29 	(e) For purposes of this section, "immediately" means as soon as possible but in no event 
451.30 	longer than 24 hours.

451.31 	Sec. 140. Minnesota Statutes 2016, section 626.556, subdivision 3c, is amended to read:
451.32 		Subd. 3c.Local welfare agency, Department of Human Services or Department of 
451.33 	Health responsible for assessing or investigating reports of maltreatment. (a) The county 
452.1 	local welfare agency is the agency responsible for assessing or investigating allegations of 
452.2 	maltreatment in child foster care, family child care, legally unlicensed child care, juvenile 
452.3 	correctional facilities licensed under section 241.021 located in the local welfare agency's 
452.4 	county, and reports involving children served by an unlicensed personal care provider 
452.5 	organization under section 256B.0659. Copies of findings related to personal care provider 
452.6 	organizations under section 256B.0659 must be forwarded to the Department of Human 
452.7 	Services provider enrollment.
452.8 	(b) The Department of Human Services is the agency responsible for assessing or 
452.9 	investigating allegations of maltreatment in facilities licensed under chapters 245A and 
452.10 	245D, except for child foster care and family child care.
452.11 	(c) The Department of Health is the agency responsible for assessing or investigating 
452.12 	allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58 and 
452.13 	144A.43 to 144A.482 or chapter 144H.

452.14 	Sec. 141. Minnesota Statutes 2016, section 626.556, subdivision 10d, is amended to read:
452.15 		Subd. 10d.Notification of neglect or abuse in facility. (a) When a report is received 
452.16 	that alleges neglect, physical abuse, sexual abuse, or maltreatment of a child while in the 
452.17 	care of a licensed or unlicensed day care facility, residential facility, agency, hospital, 
452.18 	sanitarium, or other facility or institution required to be licensed according to sections 144.50
452.19 	to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 144H or 245D, or a school as defined 
452.20 	in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E; or a nonlicensed personal 
452.21 	care provider organization as defined in section 256B.0625, subdivision 19a, the 
452.22 	commissioner of the agency responsible for assessing or investigating the report or local 
452.23 	welfare agency investigating the report shall provide the following information to the parent, 
452.24 	guardian, or legal custodian of a child alleged to have been neglected, physically abused, 
452.25 	sexually abused, or the victim of maltreatment of a child in the facility: the name of the 
452.26 	facility; the fact that a report alleging neglect, physical abuse, sexual abuse, or maltreatment 
452.27 	of a child in the facility has been received; the nature of the alleged neglect, physical abuse, 
452.28 	sexual abuse, or maltreatment of a child in the facility; that the agency is conducting an 
452.29 	assessment or investigation; any protective or corrective measures being taken pending the 
452.30 	outcome of the investigation; and that a written memorandum will be provided when the 
452.31 	investigation is completed.
452.32 	(b) The commissioner of the agency responsible for assessing or investigating the report 
452.33 	or local welfare agency may also provide the information in paragraph (a) to the parent, 
452.34 	guardian, or legal custodian of any other child in the facility if the investigative agency 
453.1 	knows or has reason to believe the alleged neglect, physical abuse, sexual abuse, or 
453.2 	maltreatment of a child in the facility has occurred. In determining whether to exercise this 
453.3 	authority, the commissioner of the agency responsible for assessing or investigating the 
453.4 	report or local welfare agency shall consider the seriousness of the alleged neglect, physical 
453.5 	abuse, sexual abuse, or maltreatment of a child in the facility; the number of children 
453.6 	allegedly neglected, physically abused, sexually abused, or victims of maltreatment of a 
453.7 	child in the facility; the number of alleged perpetrators; and the length of the investigation. 
453.8 	The facility shall be notified whenever this discretion is exercised.
453.9 	(c) When the commissioner of the agency responsible for assessing or investigating the 
453.10 	report or local welfare agency has completed its investigation, every parent, guardian, or 
453.11 	legal custodian previously notified of the investigation by the commissioner or local welfare 
453.12 	agency shall be provided with the following information in a written memorandum: the 
453.13 	name of the facility investigated; the nature of the alleged neglect, physical abuse, sexual 
453.14 	abuse, or maltreatment of a child in the facility; the investigator's name; a summary of the 
453.15 	investigation findings; a statement whether maltreatment was found; and the protective or 
453.16 	corrective measures that are being or will be taken. The memorandum shall be written in a 
453.17 	manner that protects the identity of the reporter and the child and shall not contain the name, 
453.18 	or to the extent possible, reveal the identity of the alleged perpetrator or of those interviewed 
453.19 	during the investigation. If maltreatment is determined to exist, the commissioner or local 
453.20 	welfare agency shall also provide the written memorandum to the parent, guardian, or legal 
453.21 	custodian of each child in the facility who had contact with the individual responsible for 
453.22 	the maltreatment. When the facility is the responsible party for maltreatment, the 
453.23 	commissioner or local welfare agency shall also provide the written memorandum to the 
453.24 	parent, guardian, or legal custodian of each child who received services in the population 
453.25 	of the facility where the maltreatment occurred. This notification must be provided to the 
453.26 	parent, guardian, or legal custodian of each child receiving services from the time the 
453.27 	maltreatment occurred until either the individual responsible for maltreatment is no longer 
453.28 	in contact with a child or children in the facility or the conclusion of the investigation. In 
453.29 	the case of maltreatment within a school facility, as defined in section 120A.05, subdivisions 
453.30 	9, 11, and 13, and chapter 124E, the commissioner of education need not provide notification 
453.31 	to parents, guardians, or legal custodians of each child in the facility, but shall, within ten 
453.32 	days after the investigation is completed, provide written notification to the parent, guardian, 
453.33 	or legal custodian of any student alleged to have been maltreated. The commissioner of 
453.34 	education may notify the parent, guardian, or legal custodian of any student involved as a 
453.35 	witness to alleged maltreatment.

454.1 	Sec. 142. RECOMMENDATIONS FOR SAFETY AND QUALITY IMPROVEMENT 
454.2 	PRACTICES FOR LONG-TERM CARE SERVICES AND SUPPORTS.
 454.3 	The commissioner of health shall consult with interested stakeholders to consider:
454.4 	(1) systems improvements in processes used by the Office of Health Facility Complaints 
454.5 	to investigate reports of maltreatment of vulnerable adults received by the office and 
454.6 	processes used to report maltreatment to the office; and
454.7 	(2) options for implementing prevention strategies, alternative reporting approaches, 
454.8 	and proven patient safety and quality improvement practices and infrastructure for long-term 
454.9 	care services and supports.

454.10 	Sec. 143. STUDY AND REPORT ON HOME CARE NURSING WORKFORCE 
454.11 	SHORTAGE.
 454.12 	(a) The chair and ranking minority member of the senate Human Services Reform 
454.13 	Finance and Policy Committee and the chair and ranking minority member of the house of 
454.14 	representatives Health and Human Services Finance Committee shall convene a working 
454.15 	group to study and report on the shortage of registered nurses and licensed practical nurses 
454.16 	available to provide low-complexity regular home care services to clients in need of such 
454.17 	services, especially clients covered by medical assistance, and to provide recommendations 
454.18 	for ways to address the workforce shortage. The working group shall consist of 14 members 
454.19 	appointed as follows:
454.20 	(1) the chair of the senate Human Services Reform Finance and Policy Committee or a 
454.21 	designee;
454.22 	(2) the ranking minority member of the senate Human Services Reform Finance and 
454.23 	Policy Committee or a designee;
454.24 	(3) the chair of the house of representatives Health and Human Services Finance 
454.25 	Committee or a designee;
454.26 	(4) the ranking minority member of the house of representatives Health and Human 
454.27 	Services Finance Committee or a designee;
454.28 	(5) the commissioner of human services or a designee;
454.29 	(6) the commissioner of health or a designee;
454.30 	(7) one representative appointed by the Professional Home Care Coalition;
454.31 	(8) one representative appointed by the Minnesota Home Care Association;
455.1 	(9) one representative appointed by the Minnesota Board of Nursing;
455.2 	(10) one representative appointed by the Minnesota Nurses Association;
455.3 	(11) one representative appointed by the Minnesota Licensed Practical Nurses 
455.4 	Association;
455.5 	(12) one representative appointed by the Minnesota Society of Medical Assistants;
455.6 	(13) one client who receives regular home care nursing services and is covered by medical 
455.7 	assistance appointed by the commissioner of human services after consulting with the 
455.8 	appointing authorities identified in clauses (7) to (12); and
455.9 	(14) one assessor appointed by the commissioner of human services. The assessor must 
455.10 	be certified under Minnesota Statutes, section 256B.0911, and must be a registered nurse.
455.11 	(b) The appointing authorities must appoint members by August 1, 2017.
455.12 	(c) The convening authorities shall convene the first meeting of the working group no 
455.13 	later than August 15, 2017, and caucus staff shall provide support and meeting space for 
455.14 	the working group. The Department of Health and the Department of Human Services shall 
455.15 	provide technical assistance to the working group by providing existing data and analysis 
455.16 	documenting the current and projected workforce shortages in the area of regular home care 
455.17 	nursing. The home care and assisted living program advisory council established under 
455.18 	Minnesota Statutes, section 144A.4799, shall provide advice and recommendations to the 
455.19 	working group. Working group members shall serve without compensation and shall not 
455.20 	be reimbursed for expenses.
455.21 	(d) The working group shall:
455.22 	(1) quantify the number of low-complexity regular home care nursing hours that are 
455.23 	authorized but not provided to clients covered by medical assistance, due to the shortage 
455.24 	of registered nurses and licensed practical nurses available to provide these home care 
455.25 	services;
455.26 	(2) quantify the current and projected workforce shortages of registered nurses and 
455.27 	licensed practical nurses available to provide low-complexity regular home care nursing 
455.28 	services to clients, especially clients covered by medical assistance;
455.29 	(3) develop recommendations for actions to take in the next two years to address the 
455.30 	regular home care nursing workforce shortage, including identifying other health care 
455.31 	professionals who may be able to provide low-complexity regular home care nursing services 
456.1 	with additional training; what additional training may be necessary for these health care 
456.2 	professionals; and how to address scope of practice and licensing issues;
456.3 	(4) compile reimbursement rates for regular home care nursing from other states and 
456.4 	determine Minnesota's national ranking with respect to reimbursement for regular home 
456.5 	care nursing;
456.6 	(5) determine whether reimbursement rates for regular home care nursing fully reimburse 
456.7 	providers for the cost of providing the service and whether the discrepancy, if any, between 
456.8 	rates and costs contributes to lack of access to regular home care nursing; and
456.9 	(6) by January 15, 2018, report on the findings and recommendations of the working 
456.10 	group to the chairs and ranking minority members of the legislative committees with 
456.11 	jurisdiction over health and human services policy and finance. The working group's report 
456.12 	shall include draft legislation.
456.13 	(e) The working group shall elect a chair from among its members at its first meeting.
456.14 	(f) The meetings of the working group shall be open to the public.
456.15 	(g) This section expires January 16, 2018, or the day after submitting the report required 
456.16 	by this section, whichever is earlier.

456.17 	EFFECTIVE DATE. This section is effective the day following final enactment.

456.18 	Sec. 144. OPIOID ABUSE PREVENTION PILOT PROJECTS.
 456.19 	(a) The commissioner of health shall establish opioid abuse prevention pilot projects in 
456.20 	geographic areas throughout the state based on the most recently available data on opioid 
456.21 	overdose and abuse rates, to reduce opioid abuse through the use of controlled substance 
456.22 	care teams and community-wide coordination of abuse-prevention initiatives. The 
456.23 	commissioner shall award grants to health care providers, health plan companies, local units 
456.24 	of government, tribal governments, or other entities to establish pilot projects.
456.25 	(b) Each pilot project must:
456.26 	(1) be designed to reduce emergency room and other health care provider visits resulting 
456.27 	from opioid use or abuse, and reduce rates of opioid addiction in the community;
456.28 	(2) establish multidisciplinary controlled substance care teams, that may consist of 
456.29 	physicians, pharmacists, social workers, nurse care coordinators, and mental health 
456.30 	professionals;
457.1 	(3) deliver health care services and care coordination, through controlled substance care 
457.2 	teams, to reduce the inappropriate use of opioids by patients and rates of opioid addiction;
457.3 	(4) address any unmet social service needs that create barriers to managing pain 
457.4 	effectively and obtaining optimal health outcomes;
457.5 	(5) provide prescriber and dispenser education and assistance to reduce the inappropriate 
457.6 	prescribing and dispensing of opioids;
457.7 	(6) promote the adoption of best practices related to opioid disposal and reducing 
457.8 	opportunities for illegal access to opioids; and
457.9 	(7) engage partners outside of the health care system, including schools, law enforcement, 
457.10 	and social services, to address root causes of opioid abuse and addiction at the community 
457.11 	level.
457.12 	(c) The commissioner shall contract with an accountable community for health that 
457.13 	operates an opioid abuse prevention project, and can document success in reducing opioid 
457.14 	use through the use of controlled substance care teams, to assist the commissioner in 
457.15 	administering this section, and to provide technical assistance to the commissioner and to 
457.16 	entities selected to operate a pilot project.
457.17 	(d) The contract under paragraph (c) shall require the accountable community for health 
457.18 	to evaluate the extent to which the pilot projects were successful in reducing the inappropriate 
457.19 	use of opioids. The evaluation must analyze changes in the number of opioid prescriptions, 
457.20 	the number of emergency room visits related to opioid use, and other relevant measures. 
457.21 	The accountable community for health shall report evaluation results to the chairs and 
457.22 	ranking minority members of the legislative committees with jurisdiction over health and 
457.23 	human services policy and finance and public safety by December 15, 2019.
457.24 	(e) The commissioner may award one grant that, in addition to the other requirements 
457.25 	of this section, allows a root cause approach to reduce opioid abuse in an American Indian 
457.26 	community.

457.27 	Sec. 145. SAFE HARBOR FOR ALL; STATEWIDE SEX TRAFFICKING VICTIMS 
457.28 	STRATEGIC PLAN.
 457.29 	(a) By October 1, 2018, the commissioner of health, in consultation with the 
457.30 	commissioners of public safety and human services, shall adopt a comprehensive strategic 
457.31 	plan to address the needs of sex trafficking victims statewide.
458.1 	(b) The commissioner of health shall issue a request for proposals to select an organization 
458.2 	to develop the comprehensive strategic plan. The selected organization shall seek 
458.3 	recommendations from professionals, community members, and stakeholders from across 
458.4 	the state, with an emphasis on the communities most impacted by sex trafficking. At a 
458.5 	minimum, the selected organization must seek input from the following groups: sex 
458.6 	trafficking survivors and their family members, statewide crime victim services coalitions, 
458.7 	victim services providers, nonprofit organizations, task forces, prosecutors, public defenders, 
458.8 	tribal governments, public safety and corrections professionals, public health professionals, 
458.9 	human services professionals, and impacted community members. The strategic plan shall 
458.10 	include recommendations regarding the expansion of Minnesota's Safe Harbor Law to adult 
458.11 	victims of sex trafficking.
458.12 	(c) By January 15, 2019, the commissioner of health shall report to the chairs and ranking 
458.13 	minority members of the legislative committees with jurisdiction over health and human 
458.14 	services and criminal justice finance and policy on developing the statewide strategic plan, 
458.15 	including recommendations for additional legislation and funding.
458.16 	(d) As used in this section, "sex trafficking victim" has the meaning given in Minnesota 
458.17 	Statutes, section 609.321, subdivision 7b.

458.18 	Sec. 146. DIRECTION TO THE COMMISSIONER OF HEALTH.
 458.19 	The commissioner of health shall work with interested stakeholders to evaluate whether 
458.20 	existing laws, including laws governing housing with services establishments, board and 
458.21 	lodging establishments with special services, assisted living designations, and home care 
458.22 	providers, as well as building code requirements and landlord tenancy laws, sufficiently 
458.23 	protect the health and safety of persons diagnosed with Alzheimer's disease or a related 
458.24 	dementia.

458.25 	Sec. 147. PALLIATIVE CARE ADVISORY COUNCIL.
 458.26 	The appointing authorities shall appoint the first members of the Palliative Care Advisory 
458.27 	Council under Minnesota Statutes, section 144.059, by October 1, 2017. The commissioner 
458.28 	of health shall convene the first meeting by November 15, 2017, and the commissioner or 
458.29 	the commissioner's designee shall act as chair until the council elects a chair at its first 
458.30 	meeting.

459.1 	Sec. 148.  REPEALER.
 459.2 	Minnesota Statutes 2016, sections 103I.005, subdivisions 8, 14, and 15; 103I.451; and 
459.3 	144.0571, are repealed.

459.4 	ARTICLE 11
459.5 	HEALTH LICENSING BOARDS

459.6 	Section 1. Minnesota Statutes 2016, section 147.01, subdivision 7, is amended to read:
459.7 		Subd. 7.Physician application fee and license fees. (a) The board may charge a the 
459.8 	following nonrefundable application and license fees processed pursuant to sections 147.02, 
459.9 	147.03, 147.037, 147.0375, and 147.38:
459.10 	(1) physician application fee of, $200.;
459.11 	(2) physician annual registration renewal fee, $192;
459.12 	(3) physician endorsement to other states, $40;
459.13 	(4) physician emeritus license, $50;
459.14 	(5) physician temporary licenses, $60;
459.15 	(6) physician late fee, $60;
459.16 	(7) duplicate license fee, $20;
459.17 	(8) certification letter fee, $25;
459.18 	(9) education or training program approval fee, $100;
459.19 	(10) report creation and generation fee, $60;
459.20 	(11) examination administration fee (half day), $50;
459.21 	(12) examination administration fee (full day), $80; and
459.22 	(13) fees developed by the Interstate Commission for determining physician qualification 
459.23 	to register and participate in the interstate medical licensure compact, as established in rules 
459.24 	authorized in and pursuant to section 147.38, not to exceed $1,000.
459.25 	(b) The board may prorate the initial annual license fee. All licensees are required to 
459.26 	pay the full fee upon license renewal. The revenue generated from the fee must be deposited 
459.27 	in an account in the state government special revenue fund.

460.1 	Sec. 2. Minnesota Statutes 2016, section 147.02, subdivision 1, is amended to read:
460.2 		Subdivision 1.United States or Canadian medical school graduates. The board shall 
460.3 	issue a license to practice medicine to a person not currently licensed in another state or 
460.4 	Canada and who meets the requirements in paragraphs (a) to (i).
460.5 	(a) An applicant for a license shall file a written application on forms provided by the 
460.6 	board, showing to the board's satisfaction that the applicant is of good moral character and 
460.7 	satisfies the requirements of this section.
460.8 	(b) The applicant shall present evidence satisfactory to the board of being a graduate of 
460.9 	a medical or osteopathic medical school located in the United States, its territories or Canada, 
460.10 	and approved by the board based upon its faculty, curriculum, facilities, accreditation by a 
460.11 	recognized national accrediting organization approved by the board, and other relevant data, 
460.12 	or is currently enrolled in the final year of study at the school.
460.13 	(c) The applicant must have passed an examination as described in clause (1) or (2).
460.14 	(1) The applicant must have passed a comprehensive examination for initial licensure 
460.15 	prepared and graded by the National Board of Medical Examiners, the Federation of State 
460.16 	Medical Boards, the Medical Council of Canada, the National Board of Osteopathic 
460.17 	Examiners, or the appropriate state board that the board determines acceptable. The board 
460.18 	shall by rule determine what constitutes a passing score in the examination.
460.19 	(2) The applicant taking the United States Medical Licensing Examination (USMLE) 
460.20 	or Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) must 
460.21 	have passed steps or levels one, two, and three. Step or level three must be passed within 
460.22 	five years of passing step or level two, or before the end of residency training. The applicant 
460.23 	must pass each of steps or levels one, two, and three with passing scores as recommended 
460.24 	by the USMLE program or National Board of Osteopathic Medical Examiners within three 
460.25 	attempts. The applicant taking combinations of Federation of State Medical Boards, National 
460.26 	Board of Medical Examiners, and USMLE may be accepted only if the combination is 
460.27 	approved by the board as comparable to existing comparable examination sequences and 
460.28 	all examinations are completed prior to the year 2000.
460.29 	(d) The applicant shall present evidence satisfactory to the board of the completion of 
460.30 	one year of graduate, clinical medical training in a program accredited by a national 
460.31 	accrediting organization approved by the board or other graduate training approved in 
460.32 	advance by the board as meeting standards similar to those of a national accrediting 
460.33 	organization.
461.1 	(e) The applicant may make arrangements with the executive director to appear in person 
461.2 	before the board or its designated representative to show that the applicant satisfies the 
461.3 	requirements of this section. The board may establish as internal operating procedures the 
461.4 	procedures or requirements for the applicant's personal presentation.
461.5 	(f) The applicant shall pay a nonrefundable fee established by the board by rule. The 
461.6 	fee may not be refunded. Upon application or notice of license renewal, the board must 
461.7 	provide notice to the applicant and to the person whose license is scheduled to be issued or 
461.8 	renewed of any additional fees, surcharges, or other costs which the person is obligated to 
461.9 	pay as a condition of licensure. The notice must:
461.10 	(1) state the dollar amount of the additional costs; and
461.11 	(2) clearly identify to the applicant the payment schedule of additional costs.
461.12 	(g) The applicant must not be under license suspension or revocation by the licensing 
461.13 	board of the state or jurisdiction in which the conduct that caused the suspension or revocation 
461.14 	occurred.
461.15 	(h) The applicant must not have engaged in conduct warranting disciplinary action 
461.16 	against a licensee, or have been subject to disciplinary action other than as specified in 
461.17 	paragraph (g). If the applicant does not satisfy the requirements stated in this paragraph, 
461.18 	the board may issue a license only on the applicant's showing that the public will be protected 
461.19 	through issuance of a license with conditions and limitations the board considers appropriate.
461.20 	(i) If the examination in paragraph (c) was passed more than ten years ago, the applicant 
461.21 	must either:
461.22 	(1) pass the special purpose examination of the Federation of State Medical Boards with 
461.23 	a score of 75 or better within three attempts; or
461.24 	(2) have a current certification by a specialty board of the American Board of Medical 
461.25 	Specialties, of the American Osteopathic Association, the Royal College of Physicians and 
461.26 	Surgeons of Canada, or of the College of Family Physicians of Canada.

461.27 	Sec. 3. Minnesota Statutes 2016, section 147.03, subdivision 1, is amended to read:
461.28 		Subdivision 1.Endorsement; reciprocity. (a) The board may issue a license to practice 
461.29 	medicine to any person who satisfies the requirements in paragraphs (b) to (f)(e).
461.30 	(b) The applicant shall satisfy all the requirements established in section 147.02, 
461.31 	subdivision 1, paragraphs (a), (b), (d), (e), and (f).
461.32 	(c) The applicant shall:
462.1 	(1) have passed an examination prepared and graded by the Federation of State Medical 
462.2 	Boards, the National Board of Medical Examiners, or the United States Medical Licensing 
462.3 	Examination (USMLE) program in accordance with section 147.02, subdivision 1, paragraph 
462.4 	(c), clause (2); the National Board of Osteopathic Medical Examiners; or the Medical Council 
462.5 	of Canada; and
462.6 	(2) have a current license from the equivalent licensing agency in another state or Canada 
462.7 	and, if the examination in clause (1) was passed more than ten years ago, either:
462.8 	(i) pass the Special Purpose Examination of the Federation of State Medical Boards with 
462.9 	a score of 75 or better within three attempts; or
462.10 	(ii) have a current certification by a specialty board of the American Board of Medical 
462.11 	Specialties, of the American Osteopathic Association, the Royal College of Physicians and 
462.12 	Surgeons of Canada, or of the College of Family Physicians of Canada; or
462.13 	(3) if the applicant fails to meet the requirement established in section 147.02, subdivision 
462.14 	1, paragraph (c), clause (2), because the applicant failed to pass each of steps one, two, and 
462.15 	three of the USMLE within the required three attempts, the applicant may be granted a 
462.16 	license provided the applicant:
462.17 	(i) has passed each of steps one, two, and three with passing scores as recommended by 
462.18 	the USMLE program within no more than four attempts for any of the three steps;
462.19 	(ii) is currently licensed in another state; and
462.20 	(iii) has current certification by a specialty board of the American Board of Medical 
462.21 	Specialties, the American Osteopathic Association Bureau of Professional Education, the 
462.22 	Royal College of Physicians and Surgeons of Canada, or the College of Family Physicians 
462.23 	of Canada.
462.24 	(d) The applicant shall pay a fee established by the board by rule. The fee may not be 
462.25 	refunded.
462.26 	(e) (d) The applicant must not be under license suspension or revocation by the licensing 
462.27 	board of the state or jurisdiction in which the conduct that caused the suspension or revocation 
462.28 	occurred.
462.29 	(f) (e) The applicant must not have engaged in conduct warranting disciplinary action 
462.30 	against a licensee, or have been subject to disciplinary action other than as specified in 
462.31 	paragraph (e) (d). If an applicant does not satisfy the requirements stated in this paragraph, 
462.32 	the board may issue a license only on the applicant's showing that the public will be protected 
462.33 	through issuance of a license with conditions or limitations the board considers appropriate.
463.1 	(g) (f) Upon the request of an applicant, the board may conduct the final interview of 
463.2 	the applicant by teleconference.

463.3 	Sec. 4. [147A.28] PHYSICIAN ASSISTANT APPLICATION AND LICENSE FEES.
463.4 	(a) The board may charge the following nonrefundable fees:
463.5 	(1) physician assistant application fee, $120;
463.6 	(2) physician assistant annual registration renewal fee (prescribing authority), $135;
463.7 	(3) physician assistant annual registration renewal fee (no prescribing authority), $115;
463.8 	(4) physician assistant temporary registration, $115;
463.9 	(5) physician assistant temporary permit, $60;
463.10 	(6) physician assistant locum tenens permit, $25;
463.11 	(7) physician assistant late fee, $50;
463.12 	(8) duplicate license fee, $20;
463.13 	(9) certification letter fee, $25;
463.14 	(10) education or training program approval fee, $100; and
463.15 	(11) report creation and generation fee, $60.
463.16 	(b) The board may prorate the initial annual license fee. All licensees are required to 
463.17 	pay the full fee upon license renewal. The revenue generated from the fees must be deposited 
463.18 	in an account in the state government special revenue fund.

463.19 	Sec. 5. Minnesota Statutes 2016, section 147B.08, is amended by adding a subdivision to 
463.20 	read:
463.21 		Subd. 4.Acupuncturist application and license fees. (a) The board may charge the 
463.22 	following nonrefundable fees:
463.23 	(1) acupuncturist application fee, $150;
463.24 	(2) acupuncturist annual registration renewal fee, $150;
463.25 	(3) acupuncturist temporary registration fee, $60;
463.26 	(4) acupuncturist inactive status fee, $50;
463.27 	(5) acupuncturist late fee, $50;
463.28 	(6) duplicate license fee, $20;
464.1 	(7) certification letter fee, $25;
464.2 	(8) education or training program approval fee, $100; and
464.3 	(9) report creation and generation fee, $60.
464.4 	(b) The board may prorate the initial annual license fee. All licensees are required to 
464.5 	pay the full fee upon license renewal. The revenue generated from the fees must be deposited 
464.6 	in an account in the state government special revenue fund.

464.7 	Sec. 6. Minnesota Statutes 2016, section 147C.40, is amended by adding a subdivision to 
464.8 	read:
464.9 		Subd. 5.Respiratory therapist application and license fees. (a) The board may charge 
464.10 	the following nonrefundable fees:
464.11 	(1) respiratory therapist application fee, $100;
464.12 	(2) respiratory therapist annual registration renewal fee, $90;
464.13 	(3) respiratory therapist inactive status fee, $50;
464.14 	(4) respiratory therapist temporary registration fee, $90;
464.15 	(5) respiratory therapist temporary permit, $60;
464.16 	(6) respiratory therapist late fee, $50;
464.17 	(7) duplicate license fee, $20;
464.18 	(8) certification letter fee, $25;
464.19 	(9) education or training program approval fee, $100; and
464.20 	(10) report creation and generation fee, $60.
464.21 	(b) The board may prorate the initial annual license fee. All licensees are required to 
464.22 	pay the full fee upon license renewal. The revenue generated from the fees must be deposited 
464.23 	in an account in the state government special revenue fund.

464.24 	Sec. 7. Minnesota Statutes 2016, section 148.6402, subdivision 4, is amended to read:
464.25 		Subd. 4.Commissioner Board. "Commissioner Board" means the commissioner of 
464.26 	health or a designee Board of Occupational Therapy Practice established in section 148.6449.

464.27 	EFFECTIVE DATE. This section is effective January 1, 2018.

465.1 	Sec. 8. Minnesota Statutes 2016, section 148.6405, is amended to read:
465.2 	148.6405 LICENSURE APPLICATION REQUIREMENTS: PROCEDURES AND 
465.3 	QUALIFICATIONS.
465.4 	(a) An applicant for licensure must comply with the application requirements in section 
465.5 	148.6420. To qualify for licensure, an applicant must satisfy one of the requirements in 
465.6 	paragraphs (b) to (f) and not be subject to denial of licensure under section 148.6448.
465.7 	(b) A person who applies for licensure as an occupational therapist and who has not 
465.8 	been credentialed by the National Board for Certification in Occupational Therapy or another 
465.9 	jurisdiction must meet the requirements in section 148.6408.
465.10 	(c) A person who applies for licensure as an occupational therapy assistant and who has 
465.11 	not been credentialed by the National Board for Certification in Occupational Therapy or 
465.12 	another jurisdiction must meet the requirements in section 148.6410.
465.13 	(d) A person who is certified by the National Board for Certification in Occupational 
465.14 	Therapy may apply for licensure by equivalency and must meet the requirements in section 
465.15 	148.6412.
465.16 	(e) A person who is credentialed in another jurisdiction may apply for licensure by 
465.17 	reciprocity and must meet the requirements in section 148.6415.
465.18 	(f) A person who applies for temporary licensure must meet the requirements in section 
465.19 	148.6418.
465.20 	(g) A person who applies for licensure under paragraph (b), (c), or (f) more than two 
465.21 	and less than four years after meeting the requirements in section 148.6408 or 148.6410 
465.22 	must submit the following:
465.23 	(1) a completed and signed application for licensure on forms provided by the 
465.24 	commissioner board;
465.25 	(2) the license application fee required under section 148.6445;
465.26 	(3) if applying for occupational therapist licensure, proof of having met a minimum of 
465.27 	24 contact hours of continuing education in the two years preceding licensure application, 
465.28 	or if applying for occupational therapy assistant licensure, proof of having met a minimum 
465.29 	of 18 contact hours of continuing education in the two years preceding licensure application;
465.30 	(4) verified documentation of successful completion of 160 hours of supervised practice 
465.31 	approved by the commissioner board under a limited license specified in section 148.6425, 
465.32 	subdivision 3, paragraph (c); and
466.1 	(5) additional information as requested by the commissioner board to clarify information 
466.2 	in the application, including information to determine whether the individual has engaged 
466.3 	in conduct warranting disciplinary action under section 148.6448. The information must be 
466.4 	submitted within 30 days after the commissioner's board's request.
466.5 	(h) A person who applied for licensure under paragraph (b), (c), or (f) four years or more 
466.6 	after meeting the requirements in section 148.6408 or 148.6410 must meet all the 
466.7 	requirements in paragraph (g) except clauses (3) and (4), submit documentation of having 
466.8 	retaken and passed the credentialing examination for occupational therapist or occupational 
466.9 	therapy assistant, or of having completed an occupational therapy refresher program that 
466.10 	contains both a theoretical and clinical component approved by the commissioner board, 
466.11 	and verified documentation of successful completion of 480 hours of supervised practice 
466.12 	approved by the commissioner board under a limited license specified in section 148.6425, 
466.13 	subdivision 3, paragraph (c). The 480 hours of supervised practice must be completed in 
466.14 	six months and may be completed at the applicant's place of work. Only refresher courses 
466.15 	completed within one year prior to the date of application qualify for approval.

466.16 	EFFECTIVE DATE. This section is effective January 1, 2018.

466.17 	Sec. 9. Minnesota Statutes 2016, section 148.6408, subdivision 2, is amended to read:
466.18 		Subd. 2.Qualifying examination score required. (a) An applicant must achieve a 
466.19 	qualifying score on the credentialing examination for occupational therapist.
466.20 	(b) The commissioner board shall determine the qualifying score for the credentialing 
466.21 	examination for occupational therapist. In determining the qualifying score, the commissioner
466.22 	board shall consider the cut score recommended by the National Board for Certification in 
466.23 	Occupational Therapy, or other national credentialing organization approved by the 
466.24 	commissioner board, using the modified Angoff method for determining cut score or another 
466.25 	method for determining cut score that is recognized as appropriate and acceptable by industry 
466.26 	standards.
466.27 	(c) The applicant is responsible for:
466.28 	(1) making arrangements to take the credentialing examination for occupational therapist;
466.29 	(2) bearing all expenses associated with taking the examination; and
466.30 	(3) having the examination scores sent directly to the commissioner board from the 
466.31 	testing service that administers the examination.

466.32 	EFFECTIVE DATE. This section is effective January 1, 2018.

467.1 	Sec. 10. Minnesota Statutes 2016, section 148.6410, subdivision 2, is amended to read:
467.2 		Subd. 2.Qualifying examination score required. (a) An applicant for licensure must 
467.3 	achieve a qualifying score on the credentialing examination for occupational therapy 
467.4 	assistants.
467.5 	(b) The commissioner board shall determine the qualifying score for the credentialing 
467.6 	examination for occupational therapy assistants. In determining the qualifying score, the 
467.7 	commissioner board shall consider the cut score recommended by the National Board for 
467.8 	Certification in Occupational Therapy, or other national credentialing organization approved 
467.9 	by the commissioner board, using the modified Angoff method for determining cut score 
467.10 	or another method for determining cut score that is recognized as appropriate and acceptable 
467.11 	by industry standards.
467.12 	(c) The applicant is responsible for:
467.13 	(1) making all arrangements to take the credentialing examination for occupational 
467.14 	therapy assistants;
467.15 	(2) bearing all expense associated with taking the examination; and
467.16 	(3) having the examination scores sent directly to the commissioner board from the 
467.17 	testing service that administers the examination.

467.18 	EFFECTIVE DATE. This section is effective January 1, 2018.

467.19 	Sec. 11. Minnesota Statutes 2016, section 148.6412, subdivision 2, is amended to read:
467.20 		Subd. 2.Persons certified by National Board for Certification in Occupational 
467.21 	Therapy after June 17, 1996. The commissioner board may license any person certified 
467.22 	by the National Board for Certification in Occupational Therapy as an occupational therapist 
467.23 	after June 17, 1996, if the commissioner board determines the requirements for certification 
467.24 	are equivalent to or exceed the requirements for licensure as an occupational therapist under 
467.25 	section 148.6408. The commissioner board may license any person certified by the National 
467.26 	Board for Certification in Occupational Therapy as an occupational therapy assistant after 
467.27 	June 17, 1996, if the commissioner board determines the requirements for certification are 
467.28 	equivalent to or exceed the requirements for licensure as an occupational therapy assistant 
467.29 	under section 148.6410. Nothing in this section limits the commissioner's board's authority 
467.30 	to deny licensure based upon the grounds for discipline in sections 148.6401 to 148.6450
467.31 	148.6449.

467.32 	EFFECTIVE DATE. This section is effective January 1, 2018.

468.1 	Sec. 12. Minnesota Statutes 2016, section 148.6415, is amended to read:
468.2 	148.6415 LICENSURE BY RECIPROCITY.
468.3 	A person who holds a current credential as an occupational therapist in the District of 
468.4 	Columbia or a state or territory of the United States whose standards for credentialing are 
468.5 	determined by the commissioner board to be equivalent to or exceed the requirements for 
468.6 	licensure under section 148.6408 may be eligible for licensure by reciprocity as an 
468.7 	occupational therapist. A person who holds a current credential as an occupational therapy 
468.8 	assistant in the District of Columbia or a state or territory of the United States whose 
468.9 	standards for credentialing are determined by the commissioner board to be equivalent to 
468.10 	or exceed the requirements for licensure under section 148.6410 may be eligible for licensure 
468.11 	by reciprocity as an occupational therapy assistant. Nothing in this section limits the 
468.12 	commissioner's board's authority to deny licensure based upon the grounds for discipline 
468.13 	in sections 148.6401 to 148.6450 148.6449. An applicant must provide:
468.14 	(1) the application materials as required by section 148.6420, subdivisions 1, 3, and 4;
468.15 	(2) the fees required by section 148.6445;
468.16 	(3) a copy of a current and unrestricted credential for the practice of occupational therapy 
468.17 	as either an occupational therapist or occupational therapy assistant;
468.18 	(4) a letter from the jurisdiction that issued the credential describing the applicant's 
468.19 	qualifications that entitled the applicant to receive the credential; and
468.20 	(5) other information necessary to determine whether the credentialing standards of the 
468.21 	jurisdiction that issued the credential are equivalent to or exceed the requirements for 
468.22 	licensure under sections 148.6401 to 148.6450 148.6449.

468.23 	EFFECTIVE DATE. This section is effective January 1, 2018.

468.24 	Sec. 13. Minnesota Statutes 2016, section 148.6418, subdivision 1, is amended to read:
468.25 		Subdivision 1.Application. The commissioner board shall issue temporary licensure 
468.26 	as an occupational therapist or occupational therapy assistant to applicants who are not the 
468.27 	subject of a disciplinary action or past disciplinary action, nor disqualified on the basis of 
468.28 	items listed in section 148.6448, subdivision 1.

468.29 	EFFECTIVE DATE. This section is effective January 1, 2018.

469.1 	Sec. 14. Minnesota Statutes 2016, section 148.6418, subdivision 2, is amended to read:
469.2 		Subd. 2.Procedures. To be eligible for temporary licensure, an applicant must submit 
469.3 	a completed application for temporary licensure on forms provided by the commissioner
469.4 	board, the fees required by section 148.6445, and one of the following:
469.5 	(1) evidence of successful completion of the requirements in section 148.6408, 
469.6 	subdivision 1, or 148.6410, subdivision 1;
469.7 	(2) a copy of a current and unrestricted credential for the practice of occupational therapy 
469.8 	as either an occupational therapist or occupational therapy assistant in another jurisdiction; 
469.9 	or
469.10 	(3) a copy of a current and unrestricted certificate from the National Board for 
469.11 	Certification in Occupational Therapy stating that the applicant is certified as an occupational 
469.12 	therapist or occupational therapy assistant.

469.13 	EFFECTIVE DATE. This section is effective January 1, 2018.

469.14 	Sec. 15. Minnesota Statutes 2016, section 148.6418, subdivision 4, is amended to read:
469.15 		Subd. 4.Supervision required. An applicant who has graduated from an accredited 
469.16 	occupational therapy program, as required by section 148.6408, subdivision 1, or 148.6410, 
469.17 	subdivision 1, and who has not passed the examination required by section 148.6408, 
469.18 	subdivision 2, or 148.6410, subdivision 2, must practice under the supervision of a licensed 
469.19 	occupational therapist. The supervising therapist must, at a minimum, supervise the person 
469.20 	working under temporary licensure in the performance of the initial evaluation, determination 
469.21 	of the appropriate treatment plan, and periodic review and modification of the treatment 
469.22 	plan. The supervising therapist must observe the person working under temporary licensure 
469.23 	in order to assure service competency in carrying out evaluation, treatment planning, and 
469.24 	treatment implementation. The frequency of face-to-face collaboration between the person 
469.25 	working under temporary licensure and the supervising therapist must be based on the 
469.26 	condition of each patient or client, the complexity of treatment and evaluation procedures, 
469.27 	and the proficiencies of the person practicing under temporary licensure. The occupational 
469.28 	therapist or occupational therapy assistant working under temporary licensure must provide 
469.29 	verification of supervision on the application form provided by the commissioner board.

469.30 	EFFECTIVE DATE. This section is effective January 1, 2018.

470.1 	Sec. 16. Minnesota Statutes 2016, section 148.6418, subdivision 5, is amended to read:
470.2 		Subd. 5.Expiration of temporary licensure. A temporary license issued to a person 
470.3 	pursuant to subdivision 2, clause (1), expires six months from the date of issuance for 
470.4 	occupational therapists and occupational therapy assistants or on the date the commissioner
470.5 	board grants or denies licensure, whichever occurs first. A temporary license issued to a 
470.6 	person pursuant to subdivision 2, clause (2) or (3), expires 90 days after it is issued. Upon 
470.7 	application for renewal, a temporary license shall be renewed once to persons who have 
470.8 	not met the examination requirement under section 148.6408, subdivision 2, or 148.6410, 
470.9 	subdivision 2, within the initial temporary licensure period and who are not the subject of 
470.10 	a disciplinary action nor disqualified on the basis of items in section 148.6448, subdivision 
470.11 	1. Upon application for renewal, a temporary license shall be renewed once to persons who 
470.12 	are able to demonstrate good cause for failure to meet the requirements for licensure under 
470.13 	section 148.6412 or 148.6415 within the initial temporary licensure period and who are not 
470.14 	the subject of a disciplinary action nor disqualified on the basis of items in section 148.6448, 
470.15 	subdivision 1.

470.16 	EFFECTIVE DATE. This section is effective January 1, 2018.

470.17 	Sec. 17. Minnesota Statutes 2016, section 148.6420, subdivision 1, is amended to read:
470.18 		Subdivision 1.Applications for licensure. An applicant for licensure must:
470.19 	(1) submit a completed application for licensure on forms provided by the commissioner
470.20 	board and must supply the information requested on the application, including:
470.21 	(i) the applicant's name, business address and business telephone number, business 
470.22 	setting, and daytime telephone number;
470.23 	(ii) the name and location of the occupational therapy program the applicant completed;
470.24 	(iii) a description of the applicant's education and training, including a list of degrees 
470.25 	received from educational institutions;
470.26 	(iv) the applicant's work history for the six years preceding the application, including 
470.27 	the number of hours worked;
470.28 	(v) a list of all credentials currently and previously held in Minnesota and other 
470.29 	jurisdictions;
470.30 	(vi) a description of any jurisdiction's refusal to credential the applicant;
470.31 	(vii) a description of all professional disciplinary actions initiated against the applicant 
470.32 	in any jurisdiction;
471.1 	(viii) information on any physical or mental condition or chemical dependency that 
471.2 	impairs the person's ability to engage in the practice of occupational therapy with reasonable 
471.3 	judgment or safety;
471.4 	(ix) a description of any misdemeanor or felony conviction that relates to honesty or to 
471.5 	the practice of occupational therapy;
471.6 	(x) a description of any state or federal court order, including a conciliation court 
471.7 	judgment or a disciplinary order, related to the individual's occupational therapy practice; 
471.8 	and
471.9 	(xi) a statement indicating the physical agent modalities the applicant will use and 
471.10 	whether the applicant will use the modalities as an occupational therapist or an occupational 
471.11 	therapy assistant under direct supervision;
471.12 	(2) submit with the application all fees required by section 148.6445;
471.13 	(3) sign a statement that the information in the application is true and correct to the best 
471.14 	of the applicant's knowledge and belief;
471.15 	(4) sign a waiver authorizing the commissioner board to obtain access to the applicant's 
471.16 	records in this or any other state in which the applicant holds or previously held a credential 
471.17 	for the practice of an occupation, has completed an accredited occupational therapy education 
471.18 	program, or engaged in the practice of occupational therapy;
471.19 	(5) submit additional information as requested by the commissioner board; and
471.20 	(6) submit the additional information required for licensure by equivalency, licensure 
471.21 	by reciprocity, and temporary licensure as specified in sections 148.6408 to 148.6418.

471.22 	EFFECTIVE DATE. This section is effective January 1, 2018.

471.23 	Sec. 18. Minnesota Statutes 2016, section 148.6420, subdivision 3, is amended to read:
471.24 		Subd. 3.Applicants certified by National Board for Certification in Occupational 
471.25 	Therapy. An applicant who is certified by the National Board for Certification in 
471.26 	Occupational Therapy must provide the materials required in subdivision 1 and the following:
471.27 	(1) verified documentation from the National Board for Certification in Occupational 
471.28 	Therapy stating that the applicant is certified as an occupational therapist, registered or 
471.29 	certified occupational therapy assistant, the date certification was granted, and the applicant's 
471.30 	certification number. The document must also include a statement regarding disciplinary 
471.31 	actions. The applicant is responsible for obtaining this documentation by sending a form 
472.1 	provided by the commissioner board to the National Board for Certification in Occupational 
472.2 	Therapy; and
472.3 	(2) a waiver authorizing the commissioner board to obtain access to the applicant's 
472.4 	records maintained by the National Board for Certification in Occupational Therapy.

472.5 	EFFECTIVE DATE. This section is effective January 1, 2018.

472.6 	Sec. 19. Minnesota Statutes 2016, section 148.6420, subdivision 5, is amended to read:
472.7 		Subd. 5.Action on applications for licensure. (a) The commissioner board shall 
472.8 	approve, approve with conditions, or deny licensure. The commissioner board shall act on 
472.9 	an application for licensure according to paragraphs (b) to (d).
472.10 	(b) The commissioner board shall determine if the applicant meets the requirements for 
472.11 	licensure. The commissioner board, or the advisory council at the commissioner's board's
472.12 	request, may investigate information provided by an applicant to determine whether the 
472.13 	information is accurate and complete.
472.14 	(c) The commissioner board shall notify an applicant of action taken on the application 
472.15 	and, if licensure is denied or approved with conditions, the grounds for the commissioner's
472.16 	board's determination.
472.17 	(d) An applicant denied licensure or granted licensure with conditions may make a 
472.18 	written request to the commissioner board, within 30 days of the date of the commissioner's
472.19 	board's determination, for reconsideration of the commissioner's board's determination. 
472.20 	Individuals requesting reconsideration may submit information which the applicant wants 
472.21 	considered in the reconsideration. After reconsideration of the commissioner's board's
472.22 	determination to deny licensure or grant licensure with conditions, the commissioner board
472.23 	shall determine whether the original determination should be affirmed or modified. An 
472.24 	applicant is allowed no more than one request in any one biennial licensure period for 
472.25 	reconsideration of the commissioner's board's determination to deny licensure or approve 
472.26 	licensure with conditions.

472.27 	EFFECTIVE DATE. This section is effective January 1, 2018.

472.28 	Sec. 20. Minnesota Statutes 2016, section 148.6423, is amended to read:
472.29 	148.6423 LICENSURE RENEWAL.
472.30 		Subdivision 1.Renewal requirements. To be eligible for licensure renewal, a licensee 
472.31 	must:
473.1 	(1) submit a completed and signed application for licensure renewal on forms provided 
473.2 	by the commissioner board;
473.3 	(2) submit the renewal fee required under section 148.6445;
473.4 	(3) submit proof of having met the continuing education requirement of section 148.6443
473.5 	on forms provided by the commissioner board; and
473.6 	(4) submit additional information as requested by the commissioner board to clarify 
473.7 	information presented in the renewal application. The information must be submitted within 
473.8 	30 days after the commissioner's board's request.
473.9 		Subd. 2.Renewal deadline. (a) Except as provided in paragraph (c), licenses must be 
473.10 	renewed every two years. Licensees must comply with the following procedures in paragraphs 
473.11 	(b) to (e):
473.12 	(b) Each license must state an expiration date. An application for licensure renewal must 
473.13 	be received by the Department of Health board or postmarked at least 30 calendar days 
473.14 	before the expiration date. If the postmark is illegible, the application shall be considered 
473.15 	timely if received at least 21 calendar days before the expiration date.
473.16 	(c) If the commissioner board changes the renewal schedule and the expiration date is 
473.17 	less than two years, the fee and the continuing education contact hours to be reported at the 
473.18 	next renewal must be prorated.
473.19 	(d) An application for licensure renewal not received within the time required under 
473.20 	paragraph (b), but received on or before the expiration date, must be accompanied by a late 
473.21 	fee in addition to the renewal fee specified by section 148.6445.
473.22 	(e) Licensure renewals received after the expiration date shall not be accepted and persons 
473.23 	seeking licensed status must comply with the requirements of section 148.6425.
473.24 		Subd. 3.Licensure renewal notice. At least 60 calendar days before the expiration date 
473.25 	in subdivision 2, the commissioner board shall mail a renewal notice to the licensee's last 
473.26 	known address on file with the commissioner board. The notice must include an application 
473.27 	for licensure renewal and notice of fees required for renewal. The licensee's failure to receive 
473.28 	notice does not relieve the licensee of the obligation to meet the renewal deadline and other 
473.29 	requirements for licensure renewal.

473.30 	EFFECTIVE DATE. This section is effective January 1, 2018.

474.1 	Sec. 21. Minnesota Statutes 2016, section 148.6425, subdivision 2, is amended to read:
474.2 		Subd. 2.Licensure renewal after licensure expiration date. An individual whose 
474.3 	application for licensure renewal is received after the licensure expiration date must submit 
474.4 	the following:
474.5 	(1) a completed and signed application for licensure following lapse in licensed status 
474.6 	on forms provided by the commissioner board;
474.7 	(2) the renewal fee and the late fee required under section 148.6445;
474.8 	(3) proof of having met the continuing education requirements in section 148.6443, 
474.9 	subdivision 1; and
474.10 	(4) additional information as requested by the commissioner board to clarify information 
474.11 	in the application, including information to determine whether the individual has engaged 
474.12 	in conduct warranting disciplinary action as set forth in section 148.6448. The information 
474.13 	must be submitted within 30 days after the commissioner's board's request.

474.14 	EFFECTIVE DATE. This section is effective January 1, 2018.

474.15 	Sec. 22. Minnesota Statutes 2016, section 148.6425, subdivision 3, is amended to read:
474.16 		Subd. 3.Licensure renewal four years or more after licensure expiration date. (a) 
474.17 	An individual who requests licensure renewal four years or more after the licensure expiration 
474.18 	date must submit the following:
474.19 	(1) a completed and signed application for licensure on forms provided by the 
474.20 	commissioner board;
474.21 	(2) the renewal fee and the late fee required under section 148.6445 if renewal application 
474.22 	is based on paragraph (b), clause (1), (2), or (3), or the renewal fee required under section 
474.23 	148.6445 if renewal application is based on paragraph (b), clause (4);
474.24 	(3) proof of having met the continuing education requirement in section 148.6443, 
474.25 	subdivision 1, except the continuing education must be obtained in the two years immediately 
474.26 	preceding application renewal; and
474.27 	(4) at the time of the next licensure renewal, proof of having met the continuing education 
474.28 	requirement, which shall be prorated based on the number of months licensed during the 
474.29 	two-year licensure period.
474.30 	(b) In addition to the requirements in paragraph (a), the applicant must submit proof of 
474.31 	one of the following:
475.1 	(1) verified documentation of successful completion of 160 hours of supervised practice 
475.2 	approved by the commissioner board as described in paragraph (c);
475.3 	(2) verified documentation of having achieved a qualifying score on the credentialing 
475.4 	examination for occupational therapists or the credentialing examination for occupational 
475.5 	therapy assistants administered within the past year;
475.6 	(3) documentation of having completed a combination of occupational therapy courses 
475.7 	or an occupational therapy refresher program that contains both a theoretical and clinical 
475.8 	component approved by the commissioner board. Only courses completed within one year 
475.9 	preceding the date of the application or one year after the date of the application qualify for 
475.10 	approval; or
475.11 	(4) evidence that the applicant holds a current and unrestricted credential for the practice 
475.12 	of occupational therapy in another jurisdiction and that the applicant's credential from that 
475.13 	jurisdiction has been held in good standing during the period of lapse.
475.14 	(c) To participate in a supervised practice as described in paragraph (b), clause (1), the 
475.15 	applicant shall obtain limited licensure. To apply for limited licensure, the applicant shall 
475.16 	submit the completed limited licensure application, fees, and agreement for supervision of 
475.17 	an occupational therapist or occupational therapy assistant practicing under limited licensure 
475.18 	signed by the supervising therapist and the applicant. The supervising occupational therapist 
475.19 	shall state the proposed level of supervision on the supervision agreement form provided 
475.20 	by the commissioner board. The supervising therapist shall determine the frequency and 
475.21 	manner of supervision based on the condition of the patient or client, the complexity of the 
475.22 	procedure, and the proficiencies of the supervised occupational therapist. At a minimum, a 
475.23 	supervising occupational therapist shall be on the premises at all times that the person 
475.24 	practicing under limited licensure is working; be in the room ten percent of the hours worked 
475.25 	each week by the person practicing under limited licensure; and provide daily face-to-face 
475.26 	collaboration for the purpose of observing service competency of the occupational therapist 
475.27 	or occupational therapy assistant, discussing treatment procedures and each client's response 
475.28 	to treatment, and reviewing and modifying, as necessary, each treatment plan. The supervising 
475.29 	therapist shall document the supervision provided. The occupational therapist participating 
475.30 	in a supervised practice is responsible for obtaining the supervision required under this 
475.31 	paragraph and must comply with the commissioner's board's requirements for supervision 
475.32 	during the entire 160 hours of supervised practice. The supervised practice must be completed 
475.33 	in two months and may be completed at the applicant's place of work.
476.1 	(d) In addition to the requirements in paragraphs (a) and (b), the applicant must submit 
476.2 	additional information as requested by the commissioner board to clarify information in the 
476.3 	application, including information to determine whether the applicant has engaged in conduct 
476.4 	warranting disciplinary action as set forth in section 148.6448. The information must be 
476.5 	submitted within 30 days after the commissioner's board's request.

476.6 	EFFECTIVE DATE. This section is effective January 1, 2018.

476.7 	Sec. 23. Minnesota Statutes 2016, section 148.6428, is amended to read:
476.8 	148.6428 CHANGE OF NAME, ADDRESS, OR EMPLOYMENT.
476.9 	A licensee who changes a name, address, or employment must inform the commissioner
476.10 	board, in writing, of the change of name, address, employment, business address, or business 
476.11 	telephone number within 30 days. A change in name must be accompanied by a copy of a 
476.12 	marriage certificate or court order. All notices or other correspondence mailed to or served 
476.13 	on a licensee by the commissioner board at the licensee's address on file with the 
476.14 	commissioner board shall be considered as having been received by the licensee.

476.15 	EFFECTIVE DATE. This section is effective January 1, 2018.

476.16 	Sec. 24. Minnesota Statutes 2016, section 148.6443, subdivision 5, is amended to read:
476.17 		Subd. 5.Reporting continuing education contact hours. Within one month following 
476.18 	licensure expiration, each licensee shall submit verification that the licensee has met the 
476.19 	continuing education requirements of this section on the continuing education report form 
476.20 	provided by the commissioner board. The continuing education report form may require 
476.21 	the following information:
476.22 	(1) title of continuing education activity;
476.23 	(2) brief description of the continuing education activity;
476.24 	(3) sponsor, presenter, or author;
476.25 	(4) location and attendance dates;
476.26 	(5) number of contact hours; and
476.27 	(6) licensee's notarized affirmation that the information is true and correct.

476.28 	EFFECTIVE DATE. This section is effective January 1, 2018.

477.1 	Sec. 25. Minnesota Statutes 2016, section 148.6443, subdivision 6, is amended to read:
477.2 		Subd. 6.Auditing continuing education reports. (a) The commissioner board may 
477.3 	audit a percentage of the continuing education reports based on random selection. A licensee 
477.4 	shall maintain all documentation required by this section for two years after the last day of 
477.5 	the biennial licensure period in which the contact hours were earned.
477.6 	(b) All renewal applications that are received after the expiration date may be subject 
477.7 	to a continuing education report audit.
477.8 	(c) Any licensee against whom a complaint is filed may be subject to a continuing 
477.9 	education report audit.
477.10 	(d) The licensee shall make the following information available to the commissioner
477.11 	board for auditing purposes:
477.12 	(1) a copy of the completed continuing education report form for the continuing education 
477.13 	reporting period that is the subject of the audit including all supporting documentation 
477.14 	required by subdivision 5;
477.15 	(2) a description of the continuing education activity prepared by the presenter or sponsor 
477.16 	that includes the course title or subject matter, date, place, number of program contact hours, 
477.17 	presenters, and sponsors;
477.18 	(3) documentation of self-study programs by materials prepared by the presenter or 
477.19 	sponsor that includes the course title, course description, name of sponsor or author, and 
477.20 	the number of hours required to complete the program;
477.21 	(4) documentation of university, college, or vocational school courses by a course 
477.22 	syllabus, listing in a course bulletin, or equivalent documentation that includes the course 
477.23 	title, instructor's name, course dates, number of contact hours, and course content, objectives, 
477.24 	or goals; and
477.25 	(5) verification of attendance by:
477.26 	(i) a signature of the presenter or a designee at the continuing education activity on the 
477.27 	continuing education report form or a certificate of attendance with the course name, course 
477.28 	date, and licensee's name;
477.29 	(ii) a summary or outline of the educational content of an audio or video educational 
477.30 	activity to verify the licensee's participation in the activity if a designee is not available to 
477.31 	sign the continuing education report form;
478.1 	(iii) verification of self-study programs by a certificate of completion or other 
478.2 	documentation indicating that the individual has demonstrated knowledge and has 
478.3 	successfully completed the program; or
478.4 	(iv) verification of attendance at a university, college, or vocational course by an official 
478.5 	transcript.

478.6 	EFFECTIVE DATE. This section is effective January 1, 2018.

478.7 	Sec. 26. Minnesota Statutes 2016, section 148.6443, subdivision 7, is amended to read:
478.8 		Subd. 7.Waiver of continuing education requirements. The commissioner board may 
478.9 	grant a waiver of the requirements of this section in cases where the requirements would 
478.10 	impose an extreme hardship on the licensee. The request for a waiver must be in writing, 
478.11 	state the circumstances that constitute extreme hardship, state the period of time the licensee 
478.12 	wishes to have the continuing education requirement waived, and state the alternative 
478.13 	measures that will be taken if a waiver is granted. The commissioner board shall set forth, 
478.14 	in writing, the reasons for granting or denying the waiver. Waivers granted by the 
478.15 	commissioner board shall specify, in writing, the time limitation and required alternative 
478.16 	measures to be taken by the licensee. A request for waiver shall be denied if the commissioner
478.17 	board finds that the circumstances stated by the licensee do not support a claim of extreme 
478.18 	hardship, the requested time period for waiver is unreasonable, the alternative measures 
478.19 	proposed by the licensee are not equivalent to the continuing education activity being waived, 
478.20 	or the request for waiver is not submitted to the commissioner board within 60 days after 
478.21 	the expiration date.

478.22 	EFFECTIVE DATE. This section is effective January 1, 2018.

478.23 	Sec. 27. Minnesota Statutes 2016, section 148.6443, subdivision 8, is amended to read:
478.24 		Subd. 8.Penalties for noncompliance. The commissioner board shall refuse to renew 
478.25 	or grant, or shall suspend, condition, limit, or qualify the license of any person who the 
478.26 	commissioner board determines has failed to comply with the continuing education 
478.27 	requirements of this section. A licensee may request reconsideration of the commissioner's
478.28 	board's determination of noncompliance or the penalty imposed under this section by making 
478.29 	a written request to the commissioner board within 30 days of the date of notification to the 
478.30 	applicant. Individuals requesting reconsideration may submit information that the licensee 
478.31 	wants considered in the reconsideration.

478.32 	EFFECTIVE DATE. This section is effective January 1, 2018.

479.1 	Sec. 28. Minnesota Statutes 2016, section 148.6445, subdivision 1, is amended to read:
479.2 		Subdivision 1.Initial licensure fee. The initial licensure fee for occupational therapists 
479.3 	is $145. The initial licensure fee for occupational therapy assistants is $80. The commissioner
479.4 	board shall prorate fees based on the number of quarters remaining in the biennial licensure 
479.5 	period.

479.6 	EFFECTIVE DATE. This section is effective January 1, 2018.

479.7 	Sec. 29. Minnesota Statutes 2016, section 148.6445, subdivision 10, is amended to read:
479.8 		Subd. 10.Use of fees. All fees are nonrefundable. The commissioner board shall only 
479.9 	use fees collected under this section for the purposes of administering this chapter. The 
479.10 	legislature must not transfer money generated by these fees from the state government 
479.11 	special revenue fund to the general fund. Surcharges collected by the commissioner of health 
479.12 	under section 16E.22 are not subject to this subdivision.

479.13 	EFFECTIVE DATE. This section is effective January 1, 2018.

479.14 	Sec. 30. Minnesota Statutes 2016, section 148.6448, is amended to read:
479.15 	148.6448 GROUNDS FOR DENIAL OF LICENSURE OR DISCIPLINE; 
479.16 	INVESTIGATION PROCEDURES; DISCIPLINARY ACTIONS.
479.17 		Subdivision 1.Grounds for denial of licensure or discipline. The commissioner board
479.18 	may deny an application for licensure, may approve licensure with conditions, or may 
479.19 	discipline a licensee using any disciplinary actions listed in subdivision 3 on proof that the 
479.20 	individual has:
479.21 	(1) intentionally submitted false or misleading information to the commissioner board
479.22 	or the advisory council;
479.23 	(2) failed, within 30 days, to provide information in response to a written request by the 
479.24 	commissioner board or advisory council;
479.25 	(3) performed services of an occupational therapist or occupational therapy assistant in 
479.26 	an incompetent manner or in a manner that falls below the community standard of care;
479.27 	(4) failed to satisfactorily perform occupational therapy services during a period of 
479.28 	temporary licensure;
479.29 	(5) violated sections 148.6401 to 148.6450 148.6449;
480.1 	(6) failed to perform services with reasonable judgment, skill, or safety due to the use 
480.2 	of alcohol or drugs, or other physical or mental impairment;
480.3 	(7) been convicted of violating any state or federal law, rule, or regulation which directly 
480.4 	relates to the practice of occupational therapy;
480.5 	(8) aided or abetted another person in violating any provision of sections 148.6401 to 
480.6 	148.6450 148.6449;
480.7 	(9) been disciplined for conduct in the practice of an occupation by the state of Minnesota, 
480.8 	another jurisdiction, or a national professional association, if any of the grounds for discipline 
480.9 	are the same or substantially equivalent to those in sections 148.6401 to 148.6450 148.6449;
480.10 	(10) not cooperated with the commissioner or advisory council board in an investigation 
480.11 	conducted according to subdivision 2;
480.12 	(11) advertised in a manner that is false or misleading;
480.13 	(12) engaged in dishonest, unethical, or unprofessional conduct in connection with the 
480.14 	practice of occupational therapy that is likely to deceive, defraud, or harm the public;
480.15 	(13) demonstrated a willful or careless disregard for the health, welfare, or safety of a 
480.16 	client;
480.17 	(14) performed medical diagnosis or provided treatment, other than occupational therapy, 
480.18 	without being licensed to do so under the laws of this state;
480.19 	(15) paid or promised to pay a commission or part of a fee to any person who contacts 
480.20 	the occupational therapist for consultation or sends patients to the occupational therapist 
480.21 	for treatment;
480.22 	(16) engaged in an incentive payment arrangement, other than that prohibited by clause 
480.23 	(15), that promotes occupational therapy overutilization, whereby the referring person or 
480.24 	person who controls the availability of occupational therapy services to a client profits 
480.25 	unreasonably as a result of client treatment;
480.26 	(17) engaged in abusive or fraudulent billing practices, including violations of federal 
480.27 	Medicare and Medicaid laws, Food and Drug Administration regulations, or state medical 
480.28 	assistance laws;
480.29 	(18) obtained money, property, or services from a consumer through the use of undue 
480.30 	influence, high pressure sales tactics, harassment, duress, deception, or fraud;
480.31 	(19) performed services for a client who had no possibility of benefiting from the services;
481.1 	(20) failed to refer a client for medical evaluation when appropriate or when a client 
481.2 	indicated symptoms associated with diseases that could be medically or surgically treated;
481.3 	(21) engaged in conduct with a client that is sexual or may reasonably be interpreted by 
481.4 	the client as sexual, or in any verbal behavior that is seductive or sexually demeaning to a 
481.5 	patient;
481.6 	(22) violated a federal or state court order, including a conciliation court judgment, or 
481.7 	a disciplinary order issued by the commissioner board, related to the person's occupational 
481.8 	therapy practice; or
481.9 	(23) any other just cause related to the practice of occupational therapy.
481.10 		Subd. 2.Investigation of complaints. The commissioner, or the advisory council when 
481.11 	authorized by the commissioner, board may initiate an investigation upon receiving a 
481.12 	complaint or other oral or written communication that alleges or implies that a person has 
481.13 	violated sections 148.6401 to 148.6450 148.6449. In the receipt, investigation, and hearing 
481.14 	of a complaint that alleges or implies a person has violated sections 148.6401 to 148.6450
481.15 	148.6449, the commissioner board shall follow the procedures in section 214.10.
481.16 		Subd. 3.Disciplinary actions. If the commissioner board finds that an occupational 
481.17 	therapist or occupational therapy assistant should be disciplined according to subdivision 
481.18 	1, the commissioner board may take any one or more of the following actions:
481.19 	(1) refuse to grant or renew licensure;
481.20 	(2) approve licensure with conditions;
481.21 	(3) revoke licensure;
481.22 	(4) suspend licensure;
481.23 	(5) any reasonable lesser action including, but not limited to, reprimand or restriction 
481.24 	on licensure; or
481.25 	(6) any action authorized by statute.
481.26 		Subd. 4.Effect of specific disciplinary action on use of title. Upon notice from the 
481.27 	commissioner board denying licensure renewal or upon notice that disciplinary actions have 
481.28 	been imposed and the person is no longer entitled to practice occupational therapy and use 
481.29 	the occupational therapy and licensed titles, the person shall cease to practice occupational 
481.30 	therapy, to use titles protected by sections 148.6401 to 148.6450 148.6449, and to represent 
481.31 	to the public that the person is licensed by the commissioner board.
482.1 		Subd. 5.Reinstatement requirements after disciplinary action. A person who has 
482.2 	had licensure suspended may request and provide justification for reinstatement following 
482.3 	the period of suspension specified by the commissioner board. The requirements of sections 
482.4 	148.6423 and 148.6425 for renewing licensure and any other conditions imposed with the 
482.5 	suspension must be met before licensure may be reinstated.
482.6 		Subd. 6.Authority to contract.  The commissioner board shall contract with the health 
482.7 	professionals services program as authorized by sections 214.31 to 214.37 to provide these 
482.8 	services to practitioners under this chapter. The health professionals services program does 
482.9 	not affect the commissioner's board's authority to discipline violations of sections 148.6401
482.10 	to 148.6450 148.6449.

482.11 	EFFECTIVE DATE. This section is effective January 1, 2018.

482.12 	Sec. 31. [148.6449] BOARD OF OCCUPATIONAL THERAPY PRACTICE.
482.13 		Subdivision 1.Creation. The Board of Occupational Therapy Practice consists of 11 
482.14 	members appointed by the governor. The members are:
482.15 	(1) five occupational therapists licensed under sections 148.6401 to 148.6449;
482.16 	(2) three occupational therapy assistants licensed under sections 148.6401 to 148.6449; 
482.17 	and
482.18 	(3) three public members, including two members who have received occupational 
482.19 	therapy services or have a family member who has received occupational therapy services, 
482.20 	and one member who is a health care professional or health care provider licensed in 
482.21 	Minnesota.
482.22 		Subd. 2.Qualifications of board members. (a) The occupational therapy practitioners 
482.23 	appointed to the board must represent a variety of practice areas and settings.
482.24 	(b) At least two occupational therapy practitioners must be employed outside the 
482.25 	seven-county metropolitan area.
482.26 	(c) Board members shall serve for not more than two consecutive terms.
482.27 		Subd. 3.Recommendations for appointment. Prior to the end of the term of a member 
482.28 	of the board, or within 60 days after a position on the board becomes vacant, the Minnesota 
482.29 	Occupational Therapy Association and other interested persons and organizations may 
482.30 	recommend to the governor members qualified to serve on the board. The governor may 
482.31 	appoint members to the board from the list of persons recommended or from among other 
482.32 	qualified candidates.
483.1 		Subd. 4.Officers. The board shall biennially elect from its membership a chair, vice-chair, 
483.2 	and secretary-treasurer. Each officer shall serve until a successor is elected.
483.3 		Subd. 5.Executive director. The board shall appoint and employ an executive director 
483.4 	who is not a member of the board. The employment of the executive director shall be subject 
483.5 	to the terms described in section 214.04, subdivision 2a.
483.6 		Subd. 6.Terms; compensation; removal of members. Membership terms, compensation 
483.7 	of members, removal of members, the filling of membership vacancies, and fiscal year and 
483.8 	reporting requirements shall be as provided in chapter 214. The provision of staff, 
483.9 	administrative services, and office space; the review and processing of complaints; the 
483.10 	setting of board fees; and other activities relating to board operations shall be conducted 
483.11 	according to chapter 214.
483.12 		Subd. 7.Duties of the Board of Occupational Therapy Practice. (a) The board shall:
483.13 	(1) adopt and enforce rules and laws necessary for licensing occupational therapy 
483.14 	practitioners;
483.15 	(2) adopt and enforce rules for regulating the professional conduct of the practice of 
483.16 	occupational therapy;
483.17 	(3) issue licenses to qualified individuals in accordance with sections 148.6401 to 
483.18 	148.6449;
483.19 	(4) assess and collect fees for the issuance and renewal of licenses;
483.20 	(5) educate the public about the requirements for licensing occupational therapy 
483.21 	practitioners, educate occupational therapy practitioners about the rules of conduct, and 
483.22 	enable the public to file complaints against applicants and licensees who may have violated 
483.23 	sections 148.6401 to 148.6449; and
483.24 	(6) investigate individuals engaging in practices that violate sections 148.6401 to 
483.25 	148.6449 and take necessary disciplinary, corrective, or other action according to section 
483.26 	148.6448.
483.27 	(b) The board may adopt rules necessary to define standards or carry out the provisions 
483.28 	of sections 148.6401 to 148.6449. Rules shall be adopted according to chapter 14.

483.29 	EFFECTIVE DATE. This section is effective January 1, 2018.

483.30 	Sec. 32. Minnesota Statutes 2016, section 148.881, is amended to read:
483.31 	148.881 DECLARATION OF POLICY.
484.1 	The practice of psychology in Minnesota affects the public health, safety, and welfare. 
484.2 	The regulations in sections 148.88 to 148.98 the Minnesota Psychology Practice Act as 
484.3 	enforced by the Board of Psychology protect the public from the practice of psychology by 
484.4 	unqualified persons and from unethical or unprofessional conduct by persons licensed to 
484.5 	practice psychology through licensure and regulation to promote access to safe, ethical, and 
484.6 	competent psychological services.

484.7 	Sec. 33. Minnesota Statutes 2016, section 148.89, is amended to read:
484.8 	148.89 DEFINITIONS.
484.9 		Subdivision 1.Applicability. For the purposes of sections 148.88 to 148.98, the following 
484.10 	terms have the meanings given them.
484.11 		Subd. 2.Board of Psychology or board. "Board of Psychology" or "board" means the 
484.12 	board established under section 148.90.
484.13 		Subd. 2a.Client. "Client" means each individual or legal, religious, academic, 
484.14 	organizational, business, governmental, or other entity that receives, received, or should 
484.15 	have received, or arranged for another individual or entity to receive services from an 
484.16 	individual regulated under sections 148.88 to 148.98. Client also means an individual's 
484.17 	legally authorized representative, such as a parent or guardian. For the purposes of sections 
484.18 	148.88 to 148.98, "client" may include patient, resident, counselee, evaluatee, and, as limited 
484.19 	in the rules of conduct, student, supervisee, or research subject. In the case of dual clients, 
484.20 	the licensee or applicant for licensure must be aware of the responsibilities to each client, 
484.21 	and of the potential for divergent interests of each client a direct recipient of psychological 
484.22 	services within the context of a professional relationship that may include a child, adolescent, 
484.23 	adult, couple, family, group, organization, community, or other entity. The client may be 
484.24 	the person requesting the psychological services or the direct recipient of the services.
484.25 		Subd. 2b.Credentialed. "Credentialed" means having a license, certificate, charter, 
484.26 	registration, or similar authority to practice in an occupation regulated by a governmental 
484.27 	board or agency.
484.28 		Subd. 2c.Designated supervisor. "Designated supervisor" means a qualified individual 
484.29 	who is designated identified and assigned by the primary supervisor to provide additional 
484.30 	supervision and training to a licensed psychological practitioner or to an individual who is 
484.31 	obtaining required predegree supervised professional experience or postdegree supervised 
484.32 	psychological employment.
485.1 		Subd. 2d.Direct services. "Direct services" means the delivery of preventive, diagnostic, 
485.2 	assessment, or therapeutic intervention services where the primary purpose is to benefit a 
485.3 	client who is the direct recipient of the service.
485.4 		Subd. 2e.Full-time employment. "Full-time employment" means a minimum of 35 
485.5 	clock hours per week.
485.6 		Subd. 3.Independent practice. "Independent practice" means the practice of psychology 
485.7 	without supervision.
485.8 		Subd. 3a.Jurisdiction. "Jurisdiction" means the United States, United States territories, 
485.9 	or Canadian provinces or territories.
485.10 		Subd. 4.Licensee. "Licensee" means a person who is licensed by the board as a licensed 
485.11 	psychologist or as a licensed psychological practitioner.
485.12 		Subd. 4a.Provider or provider of services. "Provider" or "provider of services" means 
485.13 	any individual who is regulated by the board, and includes a licensed psychologist, a licensed 
485.14 	psychological practitioner, a licensee, or an applicant.
485.15 		Subd. 4b.Primary supervisor. "Primary supervisor" means a psychologist licensed in 
485.16 	Minnesota or other qualified individual who provides the principal supervision to a licensed 
485.17 	psychological practitioner or to an individual who is obtaining required predegree supervised 
485.18 	professional experience or postdegree supervised psychological employment.
485.19 		Subd. 5.Practice of psychology. "Practice of psychology" means the observation, 
485.20 	description, evaluation, interpretation, or prediction, or modification of human behavior by 
485.21 	the application of psychological principles, methods, or procedures for any reason, including 
485.22 	to prevent, eliminate, or manage the purpose of preventing, eliminating, evaluating, assessing, 
485.23 	or predicting symptomatic, maladaptive, or undesired behavior; applying psychological 
485.24 	principles in legal settings; and to enhance enhancing interpersonal relationships, work, life 
485.25 	and developmental adjustment, personal and organizational effectiveness, behavioral health, 
485.26 	and mental health. The practice of psychology includes, but is not limited to, the following 
485.27 	services, regardless of whether the provider receives payment for the services:
485.28 	(1) psychological research and teaching of psychology subject to the exemptions in 
485.29 	section 148.9075;
485.30 	(2) assessment, including psychological testing and other means of evaluating personal 
485.31 	characteristics such as intelligence, personality, abilities, interests, aptitudes, and 
485.32 	neuropsychological functioning psychological testing and the evaluation or assessment of 
486.1 	personal characteristics, such as intelligence, personality, cognitive, physical and emotional 
486.2 	abilities, skills, interests, aptitudes, and neuropsychological functioning;
486.3 	(3) a psychological report, whether written or oral, including testimony of a provider as 
486.4 	an expert witness, concerning the characteristics of an individual or entity counseling, 
486.5 	psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy;
486.6 	(4) psychotherapy, including but not limited to, categories such as behavioral, cognitive, 
486.7 	emotive, systems, psychophysiological, or insight-oriented therapies; counseling; hypnosis; 
486.8 	and diagnosis and treatment of:
486.9 	(i) mental and emotional disorder or disability;
486.10 	(ii) alcohol and substance dependence or abuse;
486.11 	(iii) disorders of habit or conduct;
486.12 	(iv) the psychological aspects of physical illness or condition, accident, injury, or 
486.13 	disability, including the psychological impact of medications;
486.14 	(v) life adjustment issues, including work-related and bereavement issues; and
486.15 	(vi) child, family, or relationship issues
486.16 	(4) diagnosis, treatment, and management of mental or emotional disorders or disabilities, 
486.17 	substance use disorders, disorders of habit or conduct, and the psychological aspects of 
486.18 	physical illness, accident, injury, or disability;
486.19 	(5) psychoeducational services and treatment psychoeducational evaluation, therapy, 
486.20 	and remediation; and
486.21 	(6) consultation and supervision with physicians, other health care professionals, and 
486.22 	clients regarding available treatment options, including medication, with respect to the 
486.23 	provision of care for a specific client;
486.24 	(7) provision of direct services to individuals or groups for the purpose of enhancing 
486.25 	individual and organizational effectiveness, using psychological principles, methods, and 
486.26 	procedures to assess and evaluate individuals on personal characteristics for individual 
486.27 	development or behavior change or for making decisions about the individual; and
486.28 	(8) supervision and consultation related to any of the services described in this 
486.29 	subdivision.
487.1 		Subd. 6.Telesupervision. "Telesupervision" means the clinical supervision of 
487.2 	psychological services through a synchronous audio and video format where the supervisor 
487.3 	is not physically in the same facility as the supervisee.

487.4 	Sec. 34. Minnesota Statutes 2016, section 148.90, subdivision 1, is amended to read:
487.5 		Subdivision 1.Board of Psychology. (a) The Board of Psychology is created with the 
487.6 	powers and duties described in this section. The board has 11 members who consist of:
487.7 	(1) three four individuals licensed as licensed psychologists who have doctoral degrees 
487.8 	in psychology;
487.9 	(2) two individuals licensed as licensed psychologists who have master's degrees in 
487.10 	psychology;
487.11 	(3) two psychologists, not necessarily licensed, one with a who have doctoral degree
487.12 	degrees in psychology and one with either a doctoral or master's degree in psychology
487.13 	representing different training programs in psychology;
487.14 	(4) one individual licensed or qualified to be licensed as: (i) through December 31, 2010, 
487.15 	a licensed psychological practitioner; and (ii) after December 31, 2010, a licensed 
487.16 	psychologist; and
487.17 	(5) (4) three public members.
487.18 	(b) After the date on which fewer than 30 percent of the individuals licensed by the 
487.19 	board as licensed psychologists qualify for licensure under section 148.907, subdivision 3, 
487.20 	paragraph (b), vacancies filled under paragraph (a), clause (2), shall be filled by an individual 
487.21 	with either a master's or doctoral degree in psychology licensed or qualified to be licensed 
487.22 	as a licensed psychologist.
487.23 	(c) After the date on which fewer than 15 percent of the individuals licensed by the board 
487.24 	as licensed psychologists qualify for licensure under section 148.907, subdivision 3, 
487.25 	paragraph (b), vacancies under paragraph (a), clause (2), shall be filled by an individual 
487.26 	with either a master's or doctoral degree in psychology licensed or qualified to be licensed 
487.27 	as a licensed psychologist.

487.28 	Sec. 35. Minnesota Statutes 2016, section 148.90, subdivision 2, is amended to read:
487.29 		Subd. 2.Members. (a) The members of the board shall:
487.30 	(1) be appointed by the governor;
487.31 	(2) be residents of the state;
488.1 	(3) serve for not more than two consecutive terms;
488.2 	(4) designate the officers of the board; and
488.3 	(5) administer oaths pertaining to the business of the board.
488.4 	(b) A public member of the board shall represent the public interest and shall not:
488.5 	(1) be a psychologist, psychological practitioner, or have engaged in the practice of 
488.6 	psychology;
488.7 	(2) be an applicant or former applicant for licensure;
488.8 	(3) be a member of another health profession and be licensed by a health-related licensing 
488.9 	board as defined under section 214.01, subdivision 2; the commissioner of health; or licensed, 
488.10 	certified, or registered by another jurisdiction;
488.11 	(4) be a member of a household that includes a psychologist or psychological practitioner; 
488.12 	or
488.13 	(5) have conflicts of interest or the appearance of conflicts with duties as a board member.

488.14 	Sec. 36. Minnesota Statutes 2016, section 148.905, subdivision 1, is amended to read:
488.15 		Subdivision 1.General. The board shall:
488.16 	(1) adopt and enforce rules for licensing psychologists and psychological practitioners
488.17 	and for regulating their professional conduct;
488.18 	(2) adopt and enforce rules of conduct governing the practice of psychology;
488.19 	(3) adopt and implement rules for examinations which shall be held at least once a year 
488.20 	to assess applicants' knowledge and skills. The examinations may be written or oral or both, 
488.21 	and may be administered by the board or by institutions or individuals designated by the 
488.22 	board;. Before the adoption and implementation of a new national examination, the board 
488.23 	must consider whether the examination:
488.24 	(i) demonstrates reasonable reliability and external validity;
488.25 	(ii) is normed on a reasonable representative and diverse national sample; and
488.26 	(iii) is intended to assess an applicant's education, training, and experience for the purpose 
488.27 	of public protection;
488.28 	(4) issue licenses to individuals qualified under sections 148.907and 148.908, 148.909, 
488.29 	148.915, and 148.916, according to the procedures for licensing in Minnesota Rules;
488.30 	(5) issue copies of the rules for licensing to all applicants;
489.1 	(6) establish and maintain annually a register of current licenses;
489.2 	(7) establish and collect fees for the issuance and renewal of licenses and other services 
489.3 	by the board. Fees shall be set to defray the cost of administering the provisions of sections 
489.4 	148.88 to 148.98 including costs for applications, examinations, enforcement, materials, 
489.5 	and the operations of the board;
489.6 	(8) educate the public about on the requirements for licensing of psychologists and of 
489.7 	psychological practitionerslicenses issued by the board and about on the rules of conduct, 
489.8 	to;
489.9 	(9) enable the public to file complaints against applicants or licensees who may have 
489.10 	violated the Psychology Practice Act; and
489.11 	(9) (10) adopt and implement requirements for continuing education; and
489.12 	(11) establish or approve programs that qualify for professional psychology continuing 
489.13 	educational credit. The board may hire consultants, agencies, or professional psychological 
489.14 	associations to establish and approve continuing education courses.

489.15 	Sec. 37. Minnesota Statutes 2016, section 148.907, subdivision 1, is amended to read:
489.16 		Subdivision 1.Effective date. After August 1, 1991, No person shall engage in the 
489.17 	independent practice of psychology unless that person is licensed as a licensed psychologist
489.18 	or is exempt under section 148.9075.

489.19 	Sec. 38. Minnesota Statutes 2016, section 148.907, subdivision 2, is amended to read:
489.20 		Subd. 2.Requirements for licensure as licensed psychologist. To become licensed 
489.21 	by the board as a licensed psychologist, an applicant shall comply with the following 
489.22 	requirements:
489.23 	(1) pass an examination in psychology;
489.24 	(2) pass a professional responsibility examination on the practice of psychology;
489.25 	(3) pass any other examinations as required by board rules;
489.26 	(4) pay nonrefundable fees to the board for applications, processing, testing, renewals, 
489.27 	and materials;
489.28 	(5) have attained the age of majority, be of good moral character, and have no unresolved 
489.29 	disciplinary action or complaints pending in the state of Minnesota or any other jurisdiction;
490.1 	(6) have earned a doctoral degree with a major in psychology from a regionally accredited 
490.2 	educational institution meeting the standards the board has established by rule; and
490.3 	(7) have completed at least one full year or the equivalent in part time of postdoctoral 
490.4 	supervised psychological employment in no less than 12 months and no more than 60 
490.5 	months. If the postdoctoral supervised psychological employment goes beyond 60 months, 
490.6 	the board may grant a variance to this requirement.

490.7 	Sec. 39. [148.9075] EXEMPTIONS TO LICENSE REQUIREMENT.
490.8 		Subdivision 1.General. (a) Nothing in sections 148.88 to 148.98 shall prevent members 
490.9 	of other professions or occupations from performing functions for which they are competent 
490.10 	and properly authorized by law. The following individuals are exempt from the licensure 
490.11 	requirements of the Minnesota Psychology Practice Act, provided they operate in compliance 
490.12 	with the stated exemption:
490.13 	(1) individuals licensed by a health-related licensing board as defined under section 
490.14 	214.01, subdivision 2, or by the commissioner of health;
490.15 	(2) individuals authorized as mental health practitioners as defined under section 245.462, 
490.16 	subdivision 17; and
490.17 	(3) individuals authorized as mental health professionals under section 245.462, 
490.18 	subdivision 18.
490.19 	(b) Any of these individuals must not hold themselves out to the public by any title or 
490.20 	description stating or implying they are licensed to engage in the practice of psychology 
490.21 	unless they are licensed under sections 148.88 to 148.98 or are using a title in compliance 
490.22 	with section 148.96.
490.23 		Subd. 2.Business or industrial organization. Nothing in sections 148.88 to 148.98 
490.24 	shall prevent the use of psychological techniques by a business or industrial organization 
490.25 	for its own personnel purposes or by an employment agency or state vocational rehabilitation 
490.26 	agency for the evaluation of the agency's clients prior to a recommendation for employment. 
490.27 	However, a representative of an industrial or business firm or corporation may not sell, 
490.28 	offer, or provide psychological services as specified in section 148.89, unless the services 
490.29 	are performed or supervised by an individual licensed under sections 148.88 to 148.98.
490.30 		Subd. 3.School psychologist. (a) Nothing in sections 148.88 to 148.98 shall be construed 
490.31 	to prevent a person who holds a license or certificate issued by the State Board of Teaching 
490.32 	in accordance with chapters 122A and 129 from practicing school psychology within the 
490.33 	scope of employment if authorized by a board of education or by a private school that meets 
491.1 	the standards prescribed by the State Board of Teaching, or from practicing as a school 
491.2 	psychologist within the scope of employment in a program for children with disabilities.
491.3 	(b) Any person exempted under this subdivision shall not offer psychological services 
491.4 	to any other individual, organization, or group for remuneration, monetary or otherwise, 
491.5 	unless the person is licensed by the Board of Psychology under sections 148.88 to 148.98.
491.6 		Subd. 4.Clergy or religious officials. Nothing in sections 148.88 to 148.98 shall be 
491.7 	construed to prevent recognized religious officials, including ministers, priests, rabbis, 
491.8 	imams, Christian Science practitioners, and other persons recognized by the board, from 
491.9 	conducting counseling activities that are within the scope of the performance of their regular 
491.10 	recognizable religious denomination or sect, as defined in current federal tax regulations, 
491.11 	if the religious official does not refer to the official's self as a psychologist and the official 
491.12 	remains accountable to the established authority of the religious denomination or sect.
491.13 		Subd. 5.Teaching and research. Nothing in sections 148.88 to 148.98 shall be construed 
491.14 	to prevent a person employed in a secondary, postsecondary, or graduate institution from 
491.15 	teaching and conducting research in psychology within an educational institution that is 
491.16 	recognized by a regional accrediting organization or by a federal, state, county, or local 
491.17 	government institution, agency, or research facility, so long as:
491.18 	(1) the institution, agency, or facility provides appropriate oversight mechanisms to 
491.19 	ensure public protections; and
491.20 	(2) the person is not providing direct clinical services to a client or clients as defined in 
491.21 	sections 148.88 to 148.98.
491.22 		Subd. 6.Psychologist in disaster or emergency relief. Nothing in sections 148.88 to 
491.23 	148.98 shall be construed to prevent a psychologist sent to this state for the sole purpose of 
491.24 	responding to a disaster or emergency relief effort of the state government, the federal 
491.25 	government, the American Red Cross, or other disaster or emergency relief organization as 
491.26 	long as the psychologist is not practicing in Minnesota longer than 30 days and the sponsoring 
491.27 	organization can certify the psychologist's assignment to this state. The board or its designee, 
491.28 	at its discretion, may grant an extension to the 30-day time limitation of this subdivision.
491.29 		Subd. 7.Psychological consultant. A license under sections 148.88 to 148.98 is not 
491.30 	required by a nonresident of the state, serving as an expert witness, organizational consultant, 
491.31 	presenter, or educator on a limited basis provided the person is appropriately trained, 
491.32 	educated, or has been issued a license, certificate, or registration by another jurisdiction.
492.1 		Subd. 8.Students. Nothing in sections 148.88 to 148.98 shall prohibit the practice of 
492.2 	psychology under qualified supervision by a practicum psychology student, a predoctoral 
492.3 	psychology intern, or an individual who has earned a doctoral degree in psychology and is 
492.4 	in the process of completing their postdoctoral supervised psychological employment. A 
492.5 	student trainee or intern shall use the titles as required under section 148.96, subdivision 3.
492.6 		Subd. 9.Other professions. Nothing in sections 148.88 to 148.98 shall be construed to 
492.7 	authorize a person licensed under sections 148.88 to 148.98 to engage in the practice of any 
492.8 	profession regulated under Minnesota law, unless the individual is duly licensed or registered 
492.9 	in that profession.

492.10 	Sec. 40. [148.9077] RELICENSURE.
492.11 	A former licensee may apply to the board for licensure after complying with all laws 
492.12 	and rules required for applicants for licensure that were in effect on the date the initial 
492.13 	Minnesota license was granted. The former licensee must verify to the board that the former 
492.14 	licensee has not engaged in the practice of psychology in this state since the last date of 
492.15 	active licensure, except as permitted under statutory licensure exemption, and must submit 
492.16 	a fee for relicensure.

492.17 	Sec. 41. Minnesota Statutes 2016, section 148.9105, subdivision 1, is amended to read:
492.18 		Subdivision 1.Application. Retired providers who are licensed or were formerly licensed 
492.19 	to practice psychology in the state according to the Minnesota Psychology Practice Act may 
492.20 	apply to the board for psychologist emeritus registration or psychological practitioner 
492.21 	emeritus registration if they declare that they are retired from the practice of psychology in 
492.22 	Minnesota, have not been the subject of disciplinary action in any jurisdiction, and have no 
492.23 	unresolved complaints in any jurisdiction. Retired providers shall complete the necessary 
492.24 	forms provided by the board and pay a onetime, nonrefundable fee of $150 at the time of 
492.25 	application.

492.26 	Sec. 42. Minnesota Statutes 2016, section 148.9105, subdivision 4, is amended to read:
492.27 		Subd. 4.Documentation of status. A provider granted emeritus registration shall receive 
492.28 	a document certifying that emeritus status has been granted by the board and that the 
492.29 	registrant has completed the registrant's active career as a psychologist or psychological 
492.30 	practitioner licensed in good standing with the board.

493.1 	Sec. 43. Minnesota Statutes 2016, section 148.9105, subdivision 5, is amended to read:
493.2 		Subd. 5.Representation to public. In addition to the descriptions allowed in section 
493.3 	148.96, subdivision 3, paragraph (e), former licensees who have been granted emeritus 
493.4 	registration may represent themselves as "psychologist emeritus" or "psychological 
493.5 	practitioner emeritus," but shall not represent themselves or allow themselves to be 
493.6 	represented to the public as "licensed" or otherwise as current licensees of the board.

493.7 	Sec. 44. Minnesota Statutes 2016, section 148.916, subdivision 1, is amended to read:
493.8 		Subdivision 1.Generally. If(a) A nonresident of the state of Minnesota, who is not 
493.9 	seeking licensure in this state, and who has been issued a license, certificate, or registration 
493.10 	by another jurisdiction to practice psychology at the doctoral level, wishes and who intends
493.11 	to practice in Minnesota for more than seven calendar 30 days, the person shall apply to the 
493.12 	board for guest licensure, provided that. The psychologist's practice in Minnesota is limited 
493.13 	to no more than nine consecutive months per calendar year. Application under this section 
493.14 	shall be made no less than 30 days prior to the expected date of practice in Minnesota and 
493.15 	shall be subject to approval by the board or its designee. The board shall charge a 
493.16 	nonrefundable fee for guest licensure. The board shall adopt rules to implement this section.
493.17 	(b) To be eligible for licensure under this section, the applicant must:
493.18 	(1) have a license, certification, or registration to practice psychology from another 
493.19 	jurisdiction;
493.20 	(2) have a doctoral degree in psychology from a regionally accredited institution;
493.21 	(3) be of good moral character;
493.22 	(4) have no pending complaints or active disciplinary or corrective actions in any 
493.23 	jurisdiction;
493.24 	(5) pass a professional responsibility examination designated by the board; and
493.25 	(6) pay a fee to the board.

493.26 	Sec. 45. Minnesota Statutes 2016, section 148.916, subdivision 1a, is amended to read:
493.27 		Subd. 1a.Applicants for licensure. (a) An applicant who is seeking licensure in this 
493.28 	state, and who, at the time of application, is licensed, certified, or registered to practice 
493.29 	psychology in another jurisdiction at the doctoral level may apply to the board for guest 
493.30 	licensure in order to begin practicing psychology in this state while their application is being 
494.1 	processed if the applicant is of good moral character and has no complaints, corrective, or 
494.2 	disciplinary action pending in any jurisdiction.
494.3 	(b) Application under this section subdivision shall be made no less than 30 days prior 
494.4 	to the expected date of practice in this state, and must be made concurrently or after 
494.5 	submission of an application for licensure as a licensed psychologist if applicable. 
494.6 	Applications under this section subdivision are subject to approval by the board or its 
494.7 	designee. The board shall charge a fee for guest licensure under this subdivision.
494.8 	(b) The board shall charge a nonrefundable fee for guest licensure under this subdivision.
494.9 	(c) A guest license issued under this subdivision shall be valid for one year from the 
494.10 	date of issuance, or until the board has either issued a license or has denied the applicant's 
494.11 	application for licensure, whichever is earlier. Guest licenses issued under this section
494.12 	subdivision may be renewed annually until the board has denied the applicant's application 
494.13 	for licensure.

494.14 	Sec. 46. Minnesota Statutes 2016, section 148.925, is amended to read:
494.15 	148.925 SUPERVISION.
494.16 		Subdivision 1.Supervision. For the purpose of meeting the requirements of this section
494.17 	the Minnesota Psychology Practice Act, supervision means documented in-person 
494.18 	consultation, which may include interactive, visual electronic communication, between 
494.19 	either: (1) a primary supervisor and a licensed psychological practitioner; or (2) athat 
494.20 	employs a collaborative relationship that has both facilitative and evaluative components 
494.21 	with the goal of enhancing the professional competence and science, and practice-informed 
494.22 	professional work of the supervisee. Supervision may include telesupervision between 
494.23 	primary or designated supervisorsupervisors and an applicant for licensure as a licensed 
494.24 	psychologist the supervisee. The supervision shall be adequate to assure the quality and 
494.25 	competence of the activities supervised. Supervisory consultation shall include discussions 
494.26 	on the nature and content of the practice of the supervisee, including, but not limited to, a 
494.27 	review of a representative sample of psychological services in the supervisee's practice.
494.28 		Subd. 2.Postdegree supervised psychological employment. Postdegree supervised 
494.29 	psychological employment means required paid or volunteer work experience and postdegree 
494.30 	training of an individual seeking to be licensed as a licensed psychologist that involves the 
494.31 	professional oversight by a primary supervisor and satisfies the supervision requirements 
494.32 	in subdivisions 3 and 5 the Minnesota Psychology Practice Act.
495.1 		Subd. 3.Individuals qualified to provide supervision. (a) Supervision of a master's 
495.2 	level applicant for licensure as a licensed psychologist shall be provided by an individual:
495.3 	(1) who is a psychologist licensed in Minnesota with competence both in supervision 
495.4 	in the practice of psychology and in the activities being supervised;
495.5 	(2) who has a doctoral degree with a major in psychology, who is employed by a 
495.6 	regionally accredited educational institution or employed by a federal, state, county, or local 
495.7 	government institution, agency, or research facility, and who has competence both in 
495.8 	supervision in the practice of psychology and in the activities being supervised, provided 
495.9 	the supervision is being provided and the activities being supervised occur within that 
495.10 	regionally accredited educational institution or federal, state, county, or local government 
495.11 	institution, agency, or research facility;
495.12 	(3) who is licensed or certified as a psychologist in another jurisdiction and who has 
495.13 	competence both in supervision in the practice of psychology and in the activities being 
495.14 	supervised; or
495.15 	(4) who, in the case of a designated supervisor, is a master's or doctorally prepared 
495.16 	mental health professional.
495.17 	(b) Supervision of a doctoral level an applicant for licensure as a licensed psychologist 
495.18 	shall be provided by an individual:
495.19 	(1) who is a psychologist licensed in Minnesota with a doctoral degree and competence 
495.20 	both in supervision in the practice of psychology and in the activities being supervised;
495.21 	(2) who has a doctoral degree with a major in psychology, who is employed by a 
495.22 	regionally accredited educational institution or is employed by a federal, state, county, or 
495.23 	local government institution, agency, or research facility, and who has competence both in 
495.24 	supervision in the practice of psychology and in the activities being supervised, provided 
495.25 	the supervision is being provided and the activities being supervised occur within that 
495.26 	regionally accredited educational institution or federal, state, county, or local government 
495.27 	institution, agency, or research facility;
495.28 	(3) who is licensed or certified as a psychologist in another jurisdiction and who has 
495.29 	competence both in supervision in the practice of psychology and in the activities being 
495.30 	supervised;
495.31 	(4) who is a psychologist licensed in Minnesota who was licensed before August 1, 
495.32 	1991, with competence both in supervision in the practice of psychology and in the activities 
495.33 	being supervised; or
496.1 	(5) who, in the case of a designated supervisor, is a master's or doctorally prepared 
496.2 	mental health professional.
496.3 		Subd. 4.Supervisory consultation for a licensed psychological practitioner.
 496.4 	Supervisory consultation between a supervising licensed psychologist and a supervised 
496.5 	licensed psychological practitioner shall be at least one hour in duration and shall occur on 
496.6 	an individual, in-person basis. A minimum of one hour of supervision per month is required 
496.7 	for the initial 20 or fewer hours of psychological services delivered per month. For each 
496.8 	additional 20 hours of psychological services delivered per month, an additional hour of 
496.9 	supervision per month is required. When more than 20 hours of psychological services are 
496.10 	provided in a week, no more than one hour of supervision is required per week.
496.11 		Subd. 5.Supervisory consultation for an applicant for licensure as a licensed 
496.12 	psychologist. Supervision of an applicant for licensure as a licensed psychologist shall 
496.13 	include at least two hours of regularly scheduled in-person consultations per week for 
496.14 	full-time employment, one hour of which shall be with the supervisor on an individual basis. 
496.15 	The remaining hour may be with a designated supervisor. The board may approve an 
496.16 	exception to the weekly supervision requirement for a week when the supervisor was ill or 
496.17 	otherwise unable to provide supervision. The board may prorate the two hours per week of 
496.18 	supervision for individuals preparing for licensure on a part-time basis. Supervised 
496.19 	psychological employment does not qualify for licensure when the supervisory consultation 
496.20 	is not adequate as described in subdivision 1, or in the board rules.
496.21 		Subd. 6.Supervisee duties. Individuals Applicants preparing for licensure as a licensed 
496.22 	psychologist during their postdegree supervised psychological employment may perform 
496.23 	as part of their training any functionsof the  services specified in section 148.89, subdivision 
496.24 	5, but only under qualified supervision.
496.25 		Subd. 7.Variance from supervision requirements. (a) An applicant for licensure as 
496.26 	a licensed psychologist who entered supervised employment before August 1, 1991, may 
496.27 	request a variance from the board from the supervision requirements in this section in order 
496.28 	to continue supervision under the board rules in effect before August 1, 1991.
496.29 	(b) After a licensed psychological practitioner has completed two full years, or the 
496.30 	equivalent, of supervised post-master's degree employment meeting the requirements of 
496.31 	subdivision 5 as it relates to preparation for licensure as a licensed psychologist, the board 
496.32 	shall grant a variance from the supervision requirements of subdivision 4 or 5 if the licensed 
496.33 	psychological practitioner presents evidence of:
497.1 	(1) endorsement for specific areas of competency by the licensed psychologist who 
497.2 	provided the two years of supervision;
497.3 	(2) employment by a hospital or by a community mental health center or nonprofit mental 
497.4 	health clinic or social service agency providing services as a part of the mental health service 
497.5 	plan required by the Comprehensive Mental Health Act;
497.6 	(3) the employer's acceptance of clinical responsibility for the care provided by the 
497.7 	licensed psychological practitioner; and
497.8 	(4) a plan for supervision that includes at least one hour of regularly scheduled individual 
497.9 	in-person consultations per week for full-time employment. The board may approve an 
497.10 	exception to the weekly supervision requirement for a week when the supervisor was ill or 
497.11 	otherwise unable to provide supervision.
497.12 	(c) Following the granting of a variance under paragraph (b), and completion of two 
497.13 	additional full years or the equivalent of supervision and post-master's degree employment 
497.14 	meeting the requirements of paragraph (b), the board shall grant a variance to a licensed 
497.15 	psychological practitioner who presents evidence of:
497.16 	(1) endorsement for specific areas of competency by the licensed psychologist who 
497.17 	provided the two years of supervision under paragraph (b);
497.18 	(2) employment by a hospital or by a community mental health center or nonprofit mental 
497.19 	health clinic or social service agency providing services as a part of the mental health service 
497.20 	plan required by the Comprehensive Mental Health Act;
497.21 	(3) the employer's acceptance of clinical responsibility for the care provided by the 
497.22 	licensed psychological practitioner; and
497.23 	(4) a plan for supervision which includes at least one hour of regularly scheduled 
497.24 	individual in-person supervision per month.
497.25 	(d) The variance allowed under this section must be deemed to have been granted to an 
497.26 	individual who previously received a variance under paragraph (b) or (c) and is seeking a 
497.27 	new variance because of a change of employment to a different employer or employment 
497.28 	setting. The deemed variance continues until the board either grants or denies the variance. 
497.29 	An individual who has been denied a variance under this section is entitled to seek 
497.30 	reconsideration by the board.

498.1 	Sec. 47. Minnesota Statutes 2016, section 148.96, subdivision 3, is amended to read:
498.2 		Subd. 3.Requirements for representations to public. (a) Unless licensed under sections 
498.3 	148.88 to 148.98, except as provided in paragraphs (b) through (e), persons shall not represent 
498.4 	themselves or permit themselves to be represented to the public by:
498.5 	(1) using any title or description of services incorporating the words "psychology," 
498.6 	"psychological," "psychological practitioner," or "psychologist"; or
498.7 	(2) representing that the person has expert qualifications in an area of psychology.
498.8 	(b) Psychologically trained individuals who are employed by an educational institution 
498.9 	recognized by a regional accrediting organization, by a federal, state, county, or local 
498.10 	government institution, agency, or research facility, may represent themselves by the title 
498.11 	designated by that organization provided that the title does not indicate that the individual 
498.12 	is credentialed by the board.
498.13 	(c) A psychologically trained individual from an institution described in paragraph (b) 
498.14 	may offer lecture services and is exempt from the provisions of this section.
498.15 	(d) A person who is preparing for the practice of psychology under supervision in 
498.16 	accordance with board statutes and rules may be designated as a "psychological intern," 
498.17 	"psychology fellow," "psychological trainee," or by other terms clearly describing the 
498.18 	person's training status.
498.19 	(e) Former licensees who are completely retired from the practice of psychology may 
498.20 	represent themselves using the descriptions in paragraph (a), clauses (1) and (2), but shall 
498.21 	not represent themselves or allow themselves to be represented as current licensees of the 
498.22 	board.
498.23 	(f) Nothing in this section shall be construed to prohibit the practice of school psychology 
498.24 	by a person licensed in accordance with chapters 122A and 129.

498.25 	Sec. 48. Minnesota Statutes 2016, section 148B.53, subdivision 1, is amended to read:
498.26 		Subdivision 1.General requirements. (a) To be licensed as a licensed professional 
498.27 	counselor (LPC), an applicant must provide evidence satisfactory to the board that the 
498.28 	applicant:
498.29 	(1) is at least 18 years of age;
498.30 	(2) is of good moral character;
499.1 	(3) has completed a master's or doctoral degree program in counseling or a related field, 
499.2 	as determined by the board based on the criteria in paragraph (b), that includes a minimum 
499.3 	of 48 semester hours or 72 quarter hours and a supervised field experience of not fewer than 
499.4 	700 hours that is counseling in nature;
499.5 	(4) has submitted to the board a plan for supervision during the first 2,000 hours of 
499.6 	professional practice or has submitted proof of supervised professional practice that is 
499.7 	acceptable to the board; and
499.8 	(5) has demonstrated competence in professional counseling by passing the National 
499.9 	Counseling Exam (NCE) administered by the National Board for Certified Counselors, Inc. 
499.10 	(NBCC) or an equivalent national examination as determined by the board, and ethical, 
499.11 	oral, and situational examinations if prescribed by the board.
499.12 	(b) The degree described in paragraph (a), clause (3), must be from a counseling program 
499.13 	recognized by the Council for Accreditation of Counseling and Related Education Programs 
499.14 	(CACREP) or from an institution of higher education that is accredited by a regional 
499.15 	accrediting organization recognized by the Council for Higher Education Accreditation 
499.16 	(CHEA). Specific academic course content and training must include course work in each 
499.17 	of the following subject areas:
499.18 	(1) the helping relationship, including counseling theory and practice;
499.19 	(2) human growth and development;
499.20 	(3) lifestyle and career development;
499.21 	(4) group dynamics, processes, counseling, and consulting;
499.22 	(5) assessment and appraisal;
499.23 	(6) social and cultural foundations, including multicultural issues;
499.24 	(7) principles of etiology, treatment planning, and prevention of mental and emotional 
499.25 	disorders and dysfunctional behavior;
499.26 	(8) family counseling and therapy;
499.27 	(9) research and evaluation; and
499.28 	(10) professional counseling orientation and ethics.
499.29 	(c) To be licensed as a professional counselor, a psychological practitioner licensed 
499.30 	under section 148.908 need only show evidence of licensure under that section and is not 
499.31 	required to comply with paragraph (a), clauses (1) to (3) and (5), or paragraph (b).
500.1 	(d) (c) To be licensed as a professional counselor, a Minnesota licensed psychologist 
500.2 	need only show evidence of licensure from the Minnesota Board of Psychology and is not 
500.3 	required to comply with paragraph (a) or (b).

500.4 	Sec. 49. Minnesota Statutes 2016, section 150A.06, subdivision 3, is amended to read:
500.5 		Subd. 3.Waiver of examination. (a) All or any part of the examination for dentists or,
500.6 	dental therapists, dental hygienists, or dental assistants, except that pertaining to the law of 
500.7 	Minnesota relating to dentistry and the rules of the board, may, at the discretion of the board, 
500.8 	be waived for an applicant who presents a certificate of having passed all components of 
500.9 	the National Board Dental Examinations or evidence of having maintained an adequate 
500.10 	scholastic standing as determined by the board, in dental school as to dentists, or dental 
500.11 	hygiene school as to dental hygienists.
500.12 	(b) The board shall waive the clinical examination required for licensure for any dentist 
500.13 	applicant who is a graduate of a dental school accredited by the Commission on Dental 
500.14 	Accreditation, who has passed all components of the National Board Dental Examinations, 
500.15 	and who has satisfactorily completed a Minnesota-based postdoctoral general dentistry 
500.16 	residency program (GPR) or an advanced education in general dentistry (AEGD) program 
500.17 	after January 1, 2004. The postdoctoral program must be accredited by the Commission on 
500.18 	Dental Accreditation, be of at least one year's duration, and include an outcome assessment 
500.19 	evaluation assessing the resident's competence to practice dentistry. The board may require 
500.20 	the applicant to submit any information deemed necessary by the board to determine whether 
500.21 	the waiver is applicable.

500.22 	Sec. 50. Minnesota Statutes 2016, section 150A.06, subdivision 8, is amended to read:
500.23 		Subd. 8.Licensure by credentials. (a) Any dental assistant may, upon application and 
500.24 	payment of a fee established by the board, apply for licensure based on an evaluation of the 
500.25 	applicant's education, experience, and performance record in lieu of completing a 
500.26 	board-approved dental assisting program for expanded functions as defined in rule, and 
500.27 	may be interviewed by the board to determine if the applicant:
500.28 	(1) has graduated from an accredited dental assisting program accredited by the 
500.29 	Commission on Dental Accreditation, or and is currently certified by the Dental Assisting 
500.30 	National Board;
500.31 	(2) is not subject to any pending or final disciplinary action in another state or Canadian 
500.32 	province, or if not currently certified or registered, previously had a certification or 
501.1 	registration in another state or Canadian province in good standing that was not subject to 
501.2 	any final or pending disciplinary action at the time of surrender;
501.3 	(3) is of good moral character and abides by professional ethical conduct requirements;
501.4 	(4) at board discretion, has passed a board-approved English proficiency test if English 
501.5 	is not the applicant's primary language; and
501.6 	(5) has met all expanded functions curriculum equivalency requirements of a Minnesota 
501.7 	board-approved dental assisting program.
501.8 	(b) The board, at its discretion, may waive specific licensure requirements in paragraph 
501.9 	(a).
501.10 	(c) An applicant who fulfills the conditions of this subdivision and demonstrates the 
501.11 	minimum knowledge in dental subjects required for licensure under subdivision 2a must 
501.12 	be licensed to practice the applicant's profession.
501.13 	(d) If the applicant does not demonstrate the minimum knowledge in dental subjects 
501.14 	required for licensure under subdivision 2a, the application must be denied. If licensure is 
501.15 	denied, the board may notify the applicant of any specific remedy that the applicant could 
501.16 	take which, when passed, would qualify the applicant for licensure. A denial does not 
501.17 	prohibit the applicant from applying for licensure under subdivision 2a.
501.18 	(e) A candidate whose application has been denied may appeal the decision to the board 
501.19 	according to subdivision 4a.

501.20 	Sec. 51. Minnesota Statutes 2016, section 150A.10, subdivision 4, is amended to read:
501.21 		Subd. 4.Restorative procedures. (a) Notwithstanding subdivisions 1, 1a, and 2, a 
501.22 	licensed dental hygienist or licensed dental assistant may perform the following restorative 
501.23 	procedures:
501.24 	(1) place, contour, and adjust amalgam restorations;
501.25 	(2) place, contour, and adjust glass ionomer;
501.26 	(3) adapt and cement stainless steel crowns; and
501.27 	(4) place, contour, and adjust class I and class V supragingival composite restorations 
501.28 	where the margins are entirely within the enamel; and
501.29 	(5) (4) place, contour, and adjust class I, II, and class V supragingival composite 
501.30 	restorations on primary teeth and permanent dentition.
501.31 	(b) The restorative procedures described in paragraph (a) may be performed only if:
502.1 	(1) the licensed dental hygienist or licensed dental assistant has completed a 
502.2 	board-approved course on the specific procedures;
502.3 	(2) the board-approved course includes a component that sufficiently prepares the licensed 
502.4 	dental hygienist or licensed dental assistant to adjust the occlusion on the newly placed 
502.5 	restoration;
502.6 	(3) a licensed dentist or licensed advanced dental therapist has authorized the procedure 
502.7 	to be performed; and
502.8 	(4) a licensed dentist or licensed advanced dental therapist is available in the clinic while 
502.9 	the procedure is being performed.
502.10 	(c) The dental faculty who teaches the educators of the board-approved courses specified 
502.11 	in paragraph (b) must have prior experience teaching these procedures in an accredited 
502.12 	dental education program.

502.13 	Sec. 52. Minnesota Statutes 2016, section 214.01, subdivision 2, is amended to read:
502.14 		Subd. 2.Health-related licensing board. "Health-related licensing board" means the 
502.15 	Board of Examiners of Nursing Home Administrators established pursuant to section 
502.16 	144A.19, the Office of Unlicensed Complementary and Alternative Health Care Practice 
502.17 	established pursuant to section 146A.02, the Board of Medical Practice created pursuant to 
502.18 	section 147.01, the Board of Nursing created pursuant to section 148.181, the Board of 
502.19 	Chiropractic Examiners established pursuant to section 148.02, the Board of Optometry 
502.20 	established pursuant to section 148.52, the Board of Occupational Therapy Practice 
502.21 	established pursuant to section 148.6449, the Board of Physical Therapy established pursuant 
502.22 	to section 148.67, the Board of Psychology established pursuant to section 148.90, the Board 
502.23 	of Social Work pursuant to section 148E.025, the Board of Marriage and Family Therapy 
502.24 	pursuant to section 148B.30, the Board of Behavioral Health and Therapy established by 
502.25 	section 148B.51, the Board of Dietetics and Nutrition Practice established under section 
502.26 	148.622, the Board of Dentistry established pursuant to section 150A.02, the Board of 
502.27 	Pharmacy established pursuant to section 151.02, the Board of Podiatric Medicine established 
502.28 	pursuant to section 153.02, and the Board of Veterinary Medicine established pursuant to 
502.29 	section 156.01.

502.30 	EFFECTIVE DATE. This section is effective January 1, 2018.

503.1 	Sec. 53. BOARD OF OCCUPATIONAL THERAPY PRACTICE.
 503.2 	The governor shall appoint all members to the Board of Occupational Therapy Practice 
503.3 	under Minnesota Statutes, section 148.6449, by October 1, 2017. The governor shall designate 
503.4 	one member of the board to convene the first meeting of the board by November 1, 2017. 
503.5 	The board shall elect officers at its first meeting.

503.6 	EFFECTIVE DATE. This section is effective July 1, 2017.

503.7 	Sec. 54. REVISOR'S INSTRUCTION.
 503.8 	In Minnesota Statutes and Minnesota Rules, the revisor of statutes shall replace references 
503.9 	to Minnesota Statutes, section 148.6450, with Minnesota Statutes, section 148.6449.

503.10 	EFFECTIVE DATE. This section is effective January 1, 2018.

503.11 	Sec. 55. REVISOR'S INSTRUCTION.
 503.12 	The revisor of statutes shall change the headnote of Minnesota Statutes, section 147.0375, 
503.13 	to read "LICENSURE OF EMINENT PHYSICIANS."

503.14 	EFFECTIVE DATE. This section is effective the day following final enactment.

503.15 	Sec. 56.  REPEALER.
 503.16 	(a) Minnesota Statutes 2016, sections 147A.21; 147B.08, subdivisions 1, 2, and 3; 
503.17 	147C.40, subdivisions 1, 2, 3, and 4; 148.906; 148.907, subdivision 5; 148.908; 148.909, 
503.18 	subdivision 7; and 148.96, subdivisions 4 and 5, are repealed.
503.19 	(b) Minnesota Statutes 2016, sections 148.6402, subdivision 2; and 148.6450, are 
503.20 	repealed.
503.21 	(c) Minnesota Rules, part 5600.2500, is repealed.

503.22 	EFFECTIVE DATE. Paragraphs (a) and (c) are effective July 1, 2017. Paragraph (b) 
503.23 	is effective January 1, 2018.

503.24 	ARTICLE 12
503.25 	OPIATE ABUSE PREVENTION

503.26 	Section 1. Minnesota Statutes 2016, section 151.212, subdivision 2, is amended to read:
503.27 		Subd. 2.Controlled substances. (a) In addition to the requirements of subdivision 1, 
503.28 	when the use of any drug containing a controlled substance, as defined in chapter 152, or 
503.29 	any other drug determined by the board, either alone or in conjunction with alcoholic 
504.1 	beverages, may impair the ability of the user to operate a motor vehicle, the board shall 
504.2 	require by rule that notice be prominently set forth on the label or container. Rules 
504.3 	promulgated by the board shall specify exemptions from this requirement when there is 
504.4 	evidence that the user will not operate a motor vehicle while using the drug.
504.5 	(b) In addition to the requirements of subdivision 1, whenever a prescription drug 
504.6 	containing an opiate is dispensed to a patient for outpatient use, the pharmacy or practitioner 
504.7 	dispensing the drug must prominently display on the label or container a notice that states 
504.8 	"Caution: Opioid. Risk of overdose and addiction."

504.9 	Sec. 2. Minnesota Statutes 2016, section 152.11, is amended by adding a subdivision to 
504.10 	read:
504.11 		Subd. 4.Limit on quantity of opiates prescribed for acute dental and ophthalmic 
504.12 	pain. (a) When used for the treatment of acute dental pain or acute pain associated with 
504.13 	refractive surgery, prescriptions for opiate or narcotic pain relievers listed in Schedules II 
504.14 	through IV of section 152.02 shall not exceed a four-day supply. The quantity prescribed 
504.15 	shall be consistent with the dosage listed in the professional labeling for the drug that has 
504.16 	been approved by the United States Food and Drug Administration.
504.17 	(b) For the purposes of this subdivision, "acute pain" means pain resulting from disease, 
504.18 	accidental or intentional trauma, surgery, or another cause, that the practitioner reasonably 
504.19 	expects to last only a short period of time. Acute pain does not include chronic pain or pain 
504.20 	being treated as part of cancer care, palliative care, or hospice or other end-of-life care.
504.21 	(c) Notwithstanding paragraph (a), if in the professional clinical judgment of a practitioner 
504.22 	more than a four-day supply of a prescription listed in Schedules II through IV of section 
504.23 	152.02 is required to treat a patient's acute pain, the practitioner may issue a prescription 
504.24 	for the quantity needed to treat such acute pain.

504.25 	Sec. 3. CHRONIC PAIN REHABILITATION THERAPY DEMONSTRATION 
504.26 	PROJECT.
 504.27 		Subdivision 1.Establishment. The commissioner of human services shall award a 
504.28 	two-year grant to a rehabilitation institute located in Minneapolis operated by a nonprofit 
504.29 	foundation to participate in a bundled payment arrangement for chronic pain rehabilitation 
504.30 	therapy for adults who are eligible for fee-for-service medical assistance under Minnesota 
504.31 	Statutes, section 256B.055. The chronic pain rehabilitation therapy demonstration project 
504.32 	must include: nonnarcotic medication management, including opioid tapering; 
504.33 	interdisciplinary care coordination; and group and individual therapy in cognitive behavioral 
505.1 	therapy and physical therapy. The project may include self-management education in 
505.2 	nutrition, stress, mental health, substance use, or other modalities, if clinically appropriate. 
505.3 	The commissioner shall award the grant on a sole-source basis and the program design must 
505.4 	be mutually agreed upon by the commissioner and the grant recipient. Grant funds are 
505.5 	available until expended.
505.6 		Subd. 2.Performance measures. The commissioner shall develop performance measures 
505.7 	to evaluate the demonstration project. These measures may include:
505.8 	(1) reduction in medications, including opioids, taken for pain;
505.9 	(2) reduction in emergency department and outpatient clinic utilization related to pain;
505.10 	(3) improved ability to return to work, job search, or school;
505.11 	(4) patient functional status and satisfaction; and
505.12 	(5) rate of program completion.
505.13 		Subd. 3.Eligibility. (a) To be eligible to participate in the demonstration project, an 
505.14 	individual must:
505.15 	(1) be 21 years of age or older;
505.16 	(2) be eligible for fee-for-service medical assistance under Minnesota Statutes, section 
505.17 	256B.055, and not have other health coverage; and
505.18 	(3) meet criteria appropriate for chronic pain rehabilitation.
505.19 	(b) In determining the criteria under paragraph (a), clause (3), the commissioner shall 
505.20 	consider, but is not required to include, the following:
505.21 	(1) moderate to severe pain lasting longer than four months;
505.22 	(2) an impairment in daily functioning, including work or activities of daily living;
505.23 	(3) a referral from a physician or other qualified medical professional indicating that all 
505.24 	reasonable medical and surgical options have been exhausted; and
505.25 	(4) willingness of the patient to engage in chronic pain rehabilitation therapies, including 
505.26 	opioid tapering.
505.27 		Subd. 4.Payment for services. The bundled payment shall be billed on a per-person, 
505.28 	per-day payment and only for days the patient receives services from the grant recipient. 
505.29 	The grant recipient shall not receive a bundled payment for services provided to the patient 
505.30 	if a nonbundled medical assistance payment for a service that is part of the bundle is received 
505.31 	for the same day of service.
506.1 		Subd. 5.Report. The rehabilitation institute, for the duration of the demonstration 
506.2 	project, must annually report on cost savings and performance indicators described in 
506.3 	subdivision 2 to the commissioner of human services. One year after the completion of the 
506.4 	demonstration project, the commissioner of human services shall submit a report to the 
506.5 	chairs and ranking minority members of the legislative committees with jurisdiction over 
506.6 	health care. The report shall include an evaluation of the demonstration project, based on 
506.7 	the performance measures developed under subdivision 2, and may also include 
506.8 	recommendations to increase individual access to chronic pain rehabilitation therapy through 
506.9 	Minnesota health care programs.

506.10 	Sec. 4. SUBSTANCE USE DISORDER PROVIDER CAPACITY GRANT 
506.11 	PROGRAM.
 506.12 	The commissioner of human services shall design and implement a grant program to 
506.13 	assist providers to purchase the first dose of a nonnarcotic injectable or implantable 
506.14 	medication to treat substance use disorder for medical assistance enrollees. Grants shall be 
506.15 	distributed between July 1, 2017, and June 30, 2019. The commissioner shall conduct 
506.16 	outreach to providers regarding the availability of this grant and ensure a simplified grant 
506.17 	application process. The commissioner shall provide technical assistance to assist providers 
506.18 	in building operational capacity to treat substance use disorders with nonnarcotic injectable 
506.19 	or implantable medications. The commissioner, in collaboration with stakeholders, shall 
506.20 	analyze the impact of the grant program under this section and the actual or perceived 
506.21 	barriers for providers to access and be reimbursed for nonnarcotic injectable or implantable 
506.22 	substance use disorder medications and develop recommendations for addressing identified 
506.23 	barriers. The commissioner shall provide a report to the chairs and ranking minority members 
506.24 	of the legislative committees with jurisdiction over health and human services policy and 
506.25 	finance by September 1, 2019.

506.26 	ARTICLE 13
506.27 	MISCELLANEOUS

506.28 	Section 1. Minnesota Statutes 2016, section 62K.15, is amended to read:
506.29 	62K.15 ANNUAL OPEN ENROLLMENT PERIODS; SPECIAL ENROLLMENT 
506.30 	PERIODS.
506.31 	(a) Health carriers offering individual health plans must limit annual enrollment in the 
506.32 	individual market to the annual open enrollment periods for MNsure. Nothing in this section 
507.1 	limits the application of special or limited open enrollment periods as defined under the 
507.2 	Affordable Care Act.
507.3 	(b) Health carriers offering individual health plans must inform all applicants at the time 
507.4 	of application and enrollees at least annually of the open and special enrollment periods as 
507.5 	defined under the Affordable Care Act.
507.6 	(c) Health carriers offering individual health plans must provide a special enrollment 
507.7 	period for enrollment in the individual market by employees of a small employer that offers 
507.8 	a qualified small employer health reimbursement arrangement in accordance with United 
507.9 	States Code, title 26, section 9831(d). The special enrollment period shall be available only 
507.10 	to employees newly hired by a small employer offering a qualified small employer health 
507.11 	reimbursement arrangement, and to employees employed by the small employer at the time 
507.12 	the small employer initially offers a qualified small employer health reimbursement 
507.13 	arrangement. For employees newly hired by the small employer, the special enrollment 
507.14 	period shall last for 30 days after the employee's first day of employment. For employees 
507.15 	employed by the small employer at the time the small employer initially offers a qualified 
507.16 	small employer health reimbursement arrangement, the special enrollment period shall last 
507.17 	for 30 days after the date the arrangement is initially offered to employees.
507.18 	(c) (d) The commissioner of commerce shall enforce this section.

507.19 	Sec. 2. Minnesota Statutes 2016, section 245A.02, subdivision 5a, is amended to read:
507.20 		Subd. 5a.Controlling individual. (a) "Controlling individual" means a public body, 
507.21 	governmental agency, business entity, officer, owner, or managerial official whose 
507.22 	responsibilities include the direction of the management or policies of a program. For 
507.23 	purposes of this subdivision, owner means an individual who has direct or indirect ownership 
507.24 	interest in a corporation, partnership, or other business association issued a license under 
507.25 	this chapter. For purposes of this subdivision, managerial official means those individuals 
507.26 	who have the decision-making authority related to the operation of the program, and the 
507.27 	responsibility for the ongoing management of or direction of the policies, services, or 
507.28 	employees of the program. A site director who has no ownership interest in the program is 
507.29 	not considered to be a managerial official for purposes of this definition. Controlling 
507.30 	individual does not include an owner of a program or service provider licensed under this 
507.31 	chapter and the following individuals, if applicable:
507.32 	(1) each officer of the organization, including the chief executive officer and chief 
507.33 	financial officer;
508.1 	(2) the individual designated as the authorized agent under section 245A.04, subdivision 
508.2 	1, paragraph (b);
508.3 	(3) the individual designated as the compliance officer under section 256B.04, subdivision 
508.4 	21, paragraph (b); and
508.5 	(4) each managerial official whose responsibilities include the direction of the 
508.6 	management or policies of a program.
508.7 	(b) Controlling individual does not include:
508.8 	(1) a bank, savings bank, trust company, savings association, credit union, industrial 
508.9 	loan and thrift company, investment banking firm, or insurance company unless the entity 
508.10 	operates a program directly or through a subsidiary;
508.11 	(2) an individual who is a state or federal official, or state or federal employee, or a 
508.12 	member or employee of the governing body of a political subdivision of the state or federal 
508.13 	government that operates one or more programs, unless the individual is also an officer, 
508.14 	owner, or managerial official of the program, receives remuneration from the program, or 
508.15 	owns any of the beneficial interests not excluded in this subdivision;
508.16 	(3) an individual who owns less than five percent of the outstanding common shares of 
508.17 	a corporation:
508.18 	(i) whose securities are exempt under section 80A.45, clause (6); or
508.19 	(ii) whose transactions are exempt under section 80A.46, clause (2); or
508.20 	(4) an individual who is a member of an organization exempt from taxation under section 
508.21 	290.05, unless the individual is also an officer, owner, or managerial official of the program 
508.22 	or owns any of the beneficial interests not excluded in this subdivision. This clause does 
508.23 	not exclude from the definition of controlling individual an organization that is exempt from 
508.24 	taxation.; or
508.25 	(5) an employee stock ownership plan trust, or a participant or board member of an 
508.26 	employee stock ownership plan, unless the participant or board member is a controlling 
508.27 	individual according to paragraph (a).
508.28 	(c) For purposes of this subdivision, "managerial official" means an individual who has 
508.29 	the decision-making authority related to the operation of the program, and the responsibility 
508.30 	for the ongoing management of or direction of the policies, services, or employees of the 
508.31 	program. A site director who has no ownership interest in the program is not considered to 
508.32 	be a managerial official for purposes of this definition.

509.1 	Sec. 3. Minnesota Statutes 2016, section 245A.02, is amended by adding a subdivision to 
509.2 	read:
509.3 		Subd. 10b.Owner. "Owner" means an individual or organization that has a direct or 
509.4 	indirect ownership interest of five percent or more in a program licensed under this chapter. 
509.5 	For purposes of this subdivision, "direct ownership interest" means the possession of equity 
509.6 	in capital, stock, or profits of an organization, and "indirect ownership interest" means a 
509.7 	direct ownership interest in an entity that has a direct or indirect ownership interest in a 
509.8 	licensed program. For purposes of this chapter, "owner of a nonprofit corporation" means 
509.9 	the president and treasurer of the board of directors or, for an entity owned by an employee 
509.10 	stock ownership plan, means the president and treasurer of the entity. A government entity 
509.11 	that is issued a license under this chapter shall be designated the owner.

509.12 	ARTICLE 14
509.13 	NURSING FACILITY TECHNICAL CORRECTIONS

509.14 	Section 1. Minnesota Statutes 2016, section 144.0722, subdivision 1, as amended by Laws 
509.15 	2017, chapter 40, article 1, section 18, is amended to read:
509.16 		Subdivision 1.Resident reimbursement classifications. The commissioner of health 
509.17 	shall establish resident reimbursement classifications based upon the assessments of residents 
509.18 	of nursing homes and boarding care homes conducted under section 144.0721, or under 
509.19 	rules established by the commissioner of human services under sections 256B.421 to 256B.48
509.20 	chapter 256R. The reimbursement classifications established by the commissioner must 
509.21 	conform to the rules established by the commissioner of human services.

509.22 	Sec. 2. Minnesota Statutes 2016, section 144A.071, subdivision 3, as amended by Laws 
509.23 	2017, chapter 40, article 1, section 22, is amended to read:
509.24 		Subd. 3.Exceptions authorizing increase in beds; hardship areas. (a) The 
509.25 	commissioner of health, in coordination with the commissioner of human services, may 
509.26 	approve the addition of new licensed and Medicare and Medicaid certified nursing home 
509.27 	beds, using the criteria and process set forth in this subdivision.
509.28 	(b) The commissioner, in cooperation with the commissioner of human services, shall 
509.29 	consider the following criteria when determining that an area of the state is a hardship area 
509.30 	with regard to access to nursing facility services:
509.31 	(1) a low number of beds per thousand in a specified area using as a standard the beds 
509.32 	per thousand people age 65 and older, in five year age groups, using data from the most 
510.1 	recent census and population projections, weighted by each group's most recent nursing 
510.2 	home utilization, of the county at the 20th percentile, as determined by the commissioner 
510.3 	of human services;
510.4 	(2) a high level of out-migration for nursing facility services associated with a described 
510.5 	area from the county or counties of residence to other Minnesota counties, as determined 
510.6 	by the commissioner of human services, using as a standard an amount greater than the 
510.7 	out-migration of the county ranked at the 50th percentile;
510.8 	(3) an adequate level of availability of noninstitutional long-term care services measured 
510.9 	as public spending for home and community-based long-term care services per individual 
510.10 	age 65 and older, in five year age groups, using data from the most recent census and 
510.11 	population projections, weighted by each group's most recent nursing home utilization, as 
510.12 	determined by the commissioner of human services using as a standard an amount greater 
510.13 	than the 50th percentile of counties;
510.14 	(4) there must be a declaration of hardship resulting from insufficient access to nursing 
510.15 	home beds by local county agencies and area agencies on aging; and
510.16 	(5) other factors that may demonstrate the need to add new nursing facility beds.
510.17 	(c) On August 15 of odd-numbered years, the commissioner, in cooperation with the 
510.18 	commissioner of human services, may publish in the State Register a request for information 
510.19 	in which interested parties, using the data provided under section 144A.351, along with any 
510.20 	other relevant data, demonstrate that a specified area is a hardship area with regard to access 
510.21 	to nursing facility services. For a response to be considered, the commissioner must receive 
510.22 	it by November 15. The commissioner shall make responses to the request for information 
510.23 	available to the public and shall allow 30 days for comment. The commissioner shall review 
510.24 	responses and comments and determine if any areas of the state are to be declared hardship 
510.25 	areas.
510.26 	(d) For each designated hardship area determined in paragraph (c), the commissioner 
510.27 	shall publish a request for proposals in accordance with section 144A.073 and Minnesota 
510.28 	Rules, parts 4655.1070 to 4655.1098. The request for proposals must be published in the 
510.29 	State Register by March 15 following receipt of responses to the request for information. 
510.30 	The request for proposals must specify the number of new beds which may be added in the 
510.31 	designated hardship area, which must not exceed the number which, if added to the existing 
510.32 	number of beds in the area, including beds in layaway status, would have prevented it from 
510.33 	being determined to be a hardship area under paragraph (b), clause (1). Beginning July 1, 
510.34 	2011, the number of new beds approved must not exceed 200 beds statewide per biennium. 
511.1 	After June 30, 2019, the number of new beds that may be approved in a biennium must not 
511.2 	exceed 300 statewide. For a proposal to be considered, the commissioner must receive it 
511.3 	within six months of the publication of the request for proposals. The commissioner shall 
511.4 	review responses to the request for proposals and shall approve or disapprove each proposal 
511.5 	by the following July 15, in accordance with section 144A.073 and Minnesota Rules, parts 
511.6 	4655.1070 to 4655.1098. The commissioner shall base approvals or disapprovals on a 
511.7 	comparison and ranking of proposals using only the criteria in subdivision 4a. Approval of 
511.8 	a proposal expires after 18 months unless the facility has added the new beds using existing 
511.9 	space, subject to approval by the commissioner, or has commenced construction as defined 
511.10 	in section 144A.071, subdivision 1a, paragraph (d). If, after the approved beds have been 
511.11 	added, fewer than 50 percent of the beds in a facility are newly licensed, the operating 
511.12 	payment rates previously in effect shall remain. If, after the approved beds have been added, 
511.13 	50 percent or more of the beds in a facility are newly licensed, operating payment rates shall 
511.14 	be determined according to Minnesota Rules, part 9549.0057, using the limits under chapter 
511.15 	256R sections 256R.23, subdivision 5, and 256R.24, subdivision 3. External fixed costs
511.16 	payment rates must be determined according to chapter 256R section 256R.25. Property 
511.17 	payment rates for facilities with beds added under this subdivision must be determined in 
511.18 	the same manner as rate determinations resulting from projects approved and completed 
511.19 	under section 144A.073.
511.20 	(e) The commissioner may:
511.21 	(1) certify or license new beds in a new facility that is to be operated by the commissioner 
511.22 	of veterans affairs or when the costs of constructing and operating the new beds are to be 
511.23 	reimbursed by the commissioner of veterans affairs or the United States Veterans 
511.24 	Administration; and
511.25 	(2) license or certify beds in a facility that has been involuntarily delicensed or decertified 
511.26 	for participation in the medical assistance program, provided that an application for 
511.27 	relicensure or recertification is submitted to the commissioner by an organization that is 
511.28 	not a related organization as defined in section 256R.02, subdivision 43, to the prior licensee 
511.29 	within 120 days after delicensure or decertification.

511.30 	Sec. 3. Minnesota Statutes 2016, section 144A.071, subdivision 4a, as amended by Laws 
511.31 	2017, chapter 40, article 1, section 23, is amended to read:
511.32 		Subd. 4a.Exceptions for replacement beds.  It is in the best interest of the state to 
511.33 	ensure that nursing homes and boarding care homes continue to meet the physical plant 
511.34 	licensing and certification requirements by permitting certain construction projects. Facilities 
512.1 	should be maintained in condition to satisfy the physical and emotional needs of residents 
512.2 	while allowing the state to maintain control over nursing home expenditure growth.
512.3 	The commissioner of health in coordination with the commissioner of human services, 
512.4 	may approve the renovation, replacement, upgrading, or relocation of a nursing home or 
512.5 	boarding care home, under the following conditions:
512.6 	(a) to license or certify beds in a new facility constructed to replace a facility or to make 
512.7 	repairs in an existing facility that was destroyed or damaged after June 30, 1987, by fire, 
512.8 	lightning, or other hazard provided:
512.9 	(i) destruction was not caused by the intentional act of or at the direction of a controlling 
512.10 	person of the facility;
512.11 	(ii) at the time the facility was destroyed or damaged the controlling persons of the 
512.12 	facility maintained insurance coverage for the type of hazard that occurred in an amount 
512.13 	that a reasonable person would conclude was adequate;
512.14 	(iii) the net proceeds from an insurance settlement for the damages caused by the hazard 
512.15 	are applied to the cost of the new facility or repairs;
512.16 	(iv) the number of licensed and certified beds in the new facility does not exceed the 
512.17 	number of licensed and certified beds in the destroyed facility; and
512.18 	(v) the commissioner determines that the replacement beds are needed to prevent an 
512.19 	inadequate supply of beds.
512.20 	Project construction costs incurred for repairs authorized under this clause shall not be 
512.21 	considered in the dollar threshold amount defined in subdivision 2;
512.22 	(b) to license or certify beds that are moved from one location to another within a nursing 
512.23 	home facility, provided the total costs of remodeling performed in conjunction with the 
512.24 	relocation of beds does not exceed $1,000,000;
512.25 	(c) to license or certify beds in a project recommended for approval under section 
512.26 	144A.073;
512.27 	(d) to license or certify beds that are moved from an existing state nursing home to a 
512.28 	different state facility, provided there is no net increase in the number of state nursing home 
512.29 	beds;
512.30 	(e) to certify and license as nursing home beds boarding care beds in a certified boarding 
512.31 	care facility if the beds meet the standards for nursing home licensure, or in a facility that 
512.32 	was granted an exception to the moratorium under section 144A.073, and if the cost of any 
513.1 	remodeling of the facility does not exceed $1,000,000. If boarding care beds are licensed 
513.2 	as nursing home beds, the number of boarding care beds in the facility must not increase 
513.3 	beyond the number remaining at the time of the upgrade in licensure. The provisions 
513.4 	contained in section 144A.073 regarding the upgrading of the facilities do not apply to 
513.5 	facilities that satisfy these requirements;
513.6 	(f) to license and certify up to 40 beds transferred from an existing facility owned and 
513.7 	operated by the Amherst H. Wilder Foundation in the city of St. Paul to a new unit at the 
513.8 	same location as the existing facility that will serve persons with Alzheimer's disease and 
513.9 	other related disorders. The transfer of beds may occur gradually or in stages, provided the 
513.10 	total number of beds transferred does not exceed 40. At the time of licensure and certification 
513.11 	of a bed or beds in the new unit, the commissioner of health shall delicense and decertify 
513.12 	the same number of beds in the existing facility. As a condition of receiving a license or 
513.13 	certification under this clause, the facility must make a written commitment to the 
513.14 	commissioner of human services that it will not seek to receive an increase in its 
513.15 	property-related payment rate as a result of the transfers allowed under this paragraph;
513.16 	(g) to license and certify nursing home beds to replace currently licensed and certified 
513.17 	boarding care beds which may be located either in a remodeled or renovated boarding care 
513.18 	or nursing home facility or in a remodeled, renovated, newly constructed, or replacement 
513.19 	nursing home facility within the identifiable complex of health care facilities in which the 
513.20 	currently licensed boarding care beds are presently located, provided that the number of 
513.21 	boarding care beds in the facility or complex are decreased by the number to be licensed as 
513.22 	nursing home beds and further provided that, if the total costs of new construction, 
513.23 	replacement, remodeling, or renovation exceed ten percent of the appraised value of the 
513.24 	facility or $200,000, whichever is less, the facility makes a written commitment to the 
513.25 	commissioner of human services that it will not seek to receive an increase in its 
513.26 	property-related payment rate by reason of the new construction, replacement, remodeling, 
513.27 	or renovation. The provisions contained in section 144A.073 regarding the upgrading of 
513.28 	facilities do not apply to facilities that satisfy these requirements;
513.29 	(h) to license as a nursing home and certify as a nursing facility a facility that is licensed 
513.30 	as a boarding care facility but not certified under the medical assistance program, but only 
513.31 	if the commissioner of human services certifies to the commissioner of health that licensing 
513.32 	the facility as a nursing home and certifying the facility as a nursing facility will result in 
513.33 	a net annual savings to the state general fund of $200,000 or more;
513.34 	(i) to certify, after September 30, 1992, and prior to July 1, 1993, existing nursing home 
513.35 	beds in a facility that was licensed and in operation prior to January 1, 1992;
514.1 	(j) to license and certify new nursing home beds to replace beds in a facility acquired 
514.2 	by the Minneapolis Community Development Agency as part of redevelopment activities 
514.3 	in a city of the first class, provided the new facility is located within three miles of the site 
514.4 	of the old facility. Operating and property costs for the new facility must be determined and 
514.5 	allowed under section 256B.431 or 256B.434 or chapter 256R;
514.6 	(k) to license and certify up to 20 new nursing home beds in a community-operated 
514.7 	hospital and attached convalescent and nursing care facility with 40 beds on April 21, 1991, 
514.8 	that suspended operation of the hospital in April 1986. The commissioner of human services 
514.9 	shall provide the facility with the same per diem property-related payment rate for each 
514.10 	additional licensed and certified bed as it will receive for its existing 40 beds;
514.11 	(l) to license or certify beds in renovation, replacement, or upgrading projects as defined 
514.12 	in section 144A.073, subdivision 1, so long as the cumulative total costs of the facility's 
514.13 	remodeling projects do not exceed $1,000,000;
514.14 	(m) to license and certify beds that are moved from one location to another for the 
514.15 	purposes of converting up to five four-bed wards to single or double occupancy rooms in 
514.16 	a nursing home that, as of January 1, 1993, was county-owned and had a licensed capacity 
514.17 	of 115 beds;
514.18 	(n) to allow a facility that on April 16, 1993, was a 106-bed licensed and certified nursing 
514.19 	facility located in Minneapolis to layaway all of its licensed and certified nursing home 
514.20 	beds. These beds may be relicensed and recertified in a newly constructed teaching nursing 
514.21 	home facility affiliated with a teaching hospital upon approval by the legislature. The 
514.22 	proposal must be developed in consultation with the interagency committee on long-term 
514.23 	care planning. The beds on layaway status shall have the same status as voluntarily delicensed 
514.24 	and decertified beds, except that beds on layaway status remain subject to the surcharge in 
514.25 	section 256.9657. This layaway provision expires July 1, 1998;
514.26 	(o) to allow a project which will be completed in conjunction with an approved 
514.27 	moratorium exception project for a nursing home in southern Cass County and which is 
514.28 	directly related to that portion of the facility that must be repaired, renovated, or replaced, 
514.29 	to correct an emergency plumbing problem for which a state correction order has been 
514.30 	issued and which must be corrected by August 31, 1993;
514.31 	(p) to allow a facility that on April 16, 1993, was a 368-bed licensed and certified nursing 
514.32 	facility located in Minneapolis to layaway, upon 30 days prior written notice to the 
514.33 	commissioner, up to 30 of the facility's licensed and certified beds by converting three-bed 
514.34 	wards to single or double occupancy. Beds on layaway status shall have the same status as 
515.1 	voluntarily delicensed and decertified beds except that beds on layaway status remain subject 
515.2 	to the surcharge in section 256.9657, remain subject to the license application and renewal 
515.3 	fees under section 144A.07 and shall be subject to a $100 per bed reactivation fee. In 
515.4 	addition, at any time within three years of the effective date of the layaway, the beds on 
515.5 	layaway status may be:
515.6 	(1) relicensed and recertified upon relocation and reactivation of some or all of the beds 
515.7 	to an existing licensed and certified facility or facilities located in Pine River, Brainerd, or 
515.8 	International Falls; provided that the total project construction costs related to the relocation 
515.9 	of beds from layaway status for any facility receiving relocated beds may not exceed the 
515.10 	dollar threshold provided in subdivision 2 unless the construction project has been approved 
515.11 	through the moratorium exception process under section 144A.073;
515.12 	(2) relicensed and recertified, upon reactivation of some or all of the beds within the 
515.13 	facility which placed the beds in layaway status, if the commissioner has determined a need 
515.14 	for the reactivation of the beds on layaway status.
515.15 	The property-related payment rate of a facility placing beds on layaway status must be 
515.16 	adjusted by the incremental change in its rental per diem after recalculating the rental per 
515.17 	diem as provided in section 256B.431, subdivision 3a, paragraph (c). The property-related 
515.18 	payment rate for a facility relicensing and recertifying beds from layaway status must be 
515.19 	adjusted by the incremental change in its rental per diem after recalculating its rental per 
515.20 	diem using the number of beds after the relicensing to establish the facility's capacity day 
515.21 	divisor, which shall be effective the first day of the month following the month in which 
515.22 	the relicensing and recertification became effective. Any beds remaining on layaway status 
515.23 	more than three years after the date the layaway status became effective must be removed 
515.24 	from layaway status and immediately delicensed and decertified;
515.25 	(q) to license and certify beds in a renovation and remodeling project to convert 12 
515.26 	four-bed wards into 24 two-bed rooms, expand space, and add improvements in a nursing 
515.27 	home that, as of January 1, 1994, met the following conditions: the nursing home was located 
515.28 	in Ramsey County; had a licensed capacity of 154 beds; and had been ranked among the 
515.29 	top 15 applicants by the 1993 moratorium exceptions advisory review panel. The total 
515.30 	project construction cost estimate for this project must not exceed the cost estimate submitted 
515.31 	in connection with the 1993 moratorium exception process;
515.32 	(r) to license and certify up to 117 beds that are relocated from a licensed and certified 
515.33 	138-bed nursing facility located in St. Paul to a hospital with 130 licensed hospital beds 
515.34 	located in South St. Paul, provided that the nursing facility and hospital are owned by the 
516.1 	same or a related organization and that prior to the date the relocation is completed the 
516.2 	hospital ceases operation of its inpatient hospital services at that hospital. After relocation, 
516.3 	the nursing facility's status shall be the same as it was prior to relocation. The nursing 
516.4 	facility's property-related payment rate resulting from the project authorized in this paragraph 
516.5 	shall become effective no earlier than April 1, 1996. For purposes of calculating the 
516.6 	incremental change in the facility's rental per diem resulting from this project, the allowable 
516.7 	appraised value of the nursing facility portion of the existing health care facility physical 
516.8 	plant prior to the renovation and relocation may not exceed $2,490,000;
516.9 	(s) to license and certify two beds in a facility to replace beds that were voluntarily 
516.10 	delicensed and decertified on June 28, 1991;
516.11 	(t) to allow 16 licensed and certified beds located on July 1, 1994, in a 142-bed nursing 
516.12 	home and 21-bed boarding care home facility in Minneapolis, notwithstanding the licensure 
516.13 	and certification after July 1, 1995, of the Minneapolis facility as a 147-bed nursing home 
516.14 	facility after completion of a construction project approved in 1993 under section 144A.073, 
516.15 	to be laid away upon 30 days' prior written notice to the commissioner. Beds on layaway 
516.16 	status shall have the same status as voluntarily delicensed or decertified beds except that 
516.17 	they shall remain subject to the surcharge in section 256.9657. The 16 beds on layaway 
516.18 	status may be relicensed as nursing home beds and recertified at any time within five years 
516.19 	of the effective date of the layaway upon relocation of some or all of the beds to a licensed 
516.20 	and certified facility located in Watertown, provided that the total project construction costs 
516.21 	related to the relocation of beds from layaway status for the Watertown facility may not 
516.22 	exceed the dollar threshold provided in subdivision 2 unless the construction project has 
516.23 	been approved through the moratorium exception process under section 144A.073.
516.24 	The property-related payment rate of the facility placing beds on layaway status must 
516.25 	be adjusted by the incremental change in its rental per diem after recalculating the rental 
516.26 	per diem as provided in section 256B.431, subdivision 3a, paragraph (c). The property-related 
516.27 	payment rate for the facility relicensing and recertifying beds from layaway status must be 
516.28 	adjusted by the incremental change in its rental per diem after recalculating its rental per 
516.29 	diem using the number of beds after the relicensing to establish the facility's capacity day 
516.30 	divisor, which shall be effective the first day of the month following the month in which 
516.31 	the relicensing and recertification became effective. Any beds remaining on layaway status 
516.32 	more than five years after the date the layaway status became effective must be removed 
516.33 	from layaway status and immediately delicensed and decertified;
516.34 	(u) to license and certify beds that are moved within an existing area of a facility or to 
516.35 	a newly constructed addition which is built for the purpose of eliminating three- and four-bed 
517.1 	rooms and adding space for dining, lounge areas, bathing rooms, and ancillary service areas 
517.2 	in a nursing home that, as of January 1, 1995, was located in Fridley and had a licensed 
517.3 	capacity of 129 beds;
517.4 	(v) to relocate 36 beds in Crow Wing County and four beds from Hennepin County to 
517.5 	a 160-bed facility in Crow Wing County, provided all the affected beds are under common 
517.6 	ownership;
517.7 	(w) to license and certify a total replacement project of up to 49 beds located in Norman 
517.8 	County that are relocated from a nursing home destroyed by flood and whose residents were 
517.9 	relocated to other nursing homes. The operating cost payment rates for the new nursing 
517.10 	facility shall be determined based on the interim and settle-up payment provisions of 
517.11 	Minnesota Rules, part 9549.0057, and the reimbursement provisions of section 256B.431
517.12 	chapter 256R. Property-related reimbursement rates shall be determined under section 
517.13 	256B.431 256R.26, taking into account any federal or state flood-related loans or grants 
517.14 	provided to the facility;
517.15 	(x) to license and certify to the licensee of a nursing home in Polk County that was 
517.16 	destroyed by flood in 1997 replacement projects with a total of up to 129 beds, with at least 
517.17 	25 beds to be located in Polk County and up to 104 beds distributed among up to three other 
517.18 	counties. These beds may only be distributed to counties with fewer than the median number 
517.19 	of age intensity adjusted beds per thousand, as most recently published by the commissioner 
517.20 	of human services. If the licensee chooses to distribute beds outside of Polk County under 
517.21 	this paragraph, prior to distributing the beds, the commissioner of health must approve the 
517.22 	location in which the licensee plans to distribute the beds. The commissioner of health shall 
517.23 	consult with the commissioner of human services prior to approving the location of the 
517.24 	proposed beds. The licensee may combine these beds with beds relocated from other nursing 
517.25 	facilities as provided in section 144A.073, subdivision 3c. The operating payment rates for 
517.26 	the new nursing facilities shall be determined based on the interim and settle-up payment 
517.27 	provisions of section 256B.431 or 256B.434, chapter 256R, or Minnesota Rules, parts 
517.28 	9549.0010 to 9549.0080. Property-related reimbursement rates shall be determined under 
517.29 	section 256B.431 or 256B.434 or chapter 256R 256R.26. If the replacement beds permitted 
517.30 	under this paragraph are combined with beds from other nursing facilities, the rates shall 
517.31 	be calculated as the weighted average of rates determined as provided in this paragraph and 
517.32 	chapter 256R section 256R.50;
517.33 	(y) to license and certify beds in a renovation and remodeling project to convert 13 
517.34 	three-bed wards into 13 two-bed rooms and 13 single-bed rooms, expand space, and add 
517.35 	improvements in a nursing home that, as of January 1, 1994, met the following conditions: 
518.1 	the nursing home was located in Ramsey County, was not owned by a hospital corporation, 
518.2 	had a licensed capacity of 64 beds, and had been ranked among the top 15 applicants by 
518.3 	the 1993 moratorium exceptions advisory review panel. The total project construction cost 
518.4 	estimate for this project must not exceed the cost estimate submitted in connection with the 
518.5 	1993 moratorium exception process;
518.6 	(z) to license and certify up to 150 nursing home beds to replace an existing 285 bed 
518.7 	nursing facility located in St. Paul. The replacement project shall include both the renovation 
518.8 	of existing buildings and the construction of new facilities at the existing site. The reduction 
518.9 	in the licensed capacity of the existing facility shall occur during the construction project 
518.10 	as beds are taken out of service due to the construction process. Prior to the start of the 
518.11 	construction process, the facility shall provide written information to the commissioner of 
518.12 	health describing the process for bed reduction, plans for the relocation of residents, and 
518.13 	the estimated construction schedule. The relocation of residents shall be in accordance with 
518.14 	the provisions of law and rule;
518.15 	(aa) to allow the commissioner of human services to license an additional 36 beds to 
518.16 	provide residential services for the physically disabled under Minnesota Rules, parts 
518.17 	9570.2000 to 9570.3400, in a 198-bed nursing home located in Red Wing, provided that 
518.18 	the total number of licensed and certified beds at the facility does not increase;
518.19 	(bb) to license and certify a new facility in St. Louis County with 44 beds constructed 
518.20 	to replace an existing facility in St. Louis County with 31 beds, which has resident rooms 
518.21 	on two separate floors and an antiquated elevator that creates safety concerns for residents 
518.22 	and prevents nonambulatory residents from residing on the second floor. The project shall 
518.23 	include the elimination of three- and four-bed rooms;
518.24 	(cc) to license and certify four beds in a 16-bed certified boarding care home in 
518.25 	Minneapolis to replace beds that were voluntarily delicensed and decertified on or before 
518.26 	March 31, 1992. The licensure and certification is conditional upon the facility periodically 
518.27 	assessing and adjusting its resident mix and other factors which may contribute to a potential 
518.28 	institution for mental disease declaration. The commissioner of human services shall retain 
518.29 	the authority to audit the facility at any time and shall require the facility to comply with 
518.30 	any requirements necessary to prevent an institution for mental disease declaration, including 
518.31 	delicensure and decertification of beds, if necessary;
518.32 	(dd) to license and certify 72 beds in an existing facility in Mille Lacs County with 80 
518.33 	beds as part of a renovation project. The renovation must include construction of an addition 
518.34 	to accommodate ten residents with beginning and midstage dementia in a self-contained 
519.1 	living unit; creation of three resident households where dining, activities, and support spaces 
519.2 	are located near resident living quarters; designation of four beds for rehabilitation in a 
519.3 	self-contained area; designation of 30 private rooms; and other improvements;
519.4 	(ee) to license and certify beds in a facility that has undergone replacement or remodeling 
519.5 	as part of a planned closure under section 256R.40;
519.6 	(ff) to license and certify a total replacement project of up to 124 beds located in Wilkin 
519.7 	County that are in need of relocation from a nursing home significantly damaged by flood. 
519.8 	The operating cost payment rates for the new nursing facility shall be determined based on 
519.9 	the interim and settle-up payment provisions of Minnesota Rules, part 9549.0057, and the 
519.10 	reimbursement provisions of section 256B.431 chapter 256R. Property-related reimbursement 
519.11 	rates shall be determined under section 256B.431 256R.26, taking into account any federal 
519.12 	or state flood-related loans or grants provided to the facility;
519.13 	(gg) to allow the commissioner of human services to license an additional nine beds to 
519.14 	provide residential services for the physically disabled under Minnesota Rules, parts 
519.15 	9570.2000 to 9570.3400, in a 240-bed nursing home located in Duluth, provided that the 
519.16 	total number of licensed and certified beds at the facility does not increase;
519.17 	(hh) to license and certify up to 120 new nursing facility beds to replace beds in a facility 
519.18 	in Anoka County, which was licensed for 98 beds as of July 1, 2000, provided the new 
519.19 	facility is located within four miles of the existing facility and is in Anoka County. Operating 
519.20 	and property rates shall be determined and allowed under section 256B.431chapter 256R 
519.21 	and Minnesota Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or chapter 256R; 
519.22 	or
519.23 	(ii) to transfer up to 98 beds of a 129-licensed bed facility located in Anoka County that, 
519.24 	as of March 25, 2001, is in the active process of closing, to a 122-licensed bed nonprofit 
519.25 	nursing facility located in the city of Columbia Heights or its affiliate. The transfer is effective 
519.26 	when the receiving facility notifies the commissioner in writing of the number of beds 
519.27 	accepted. The commissioner shall place all transferred beds on layaway status held in the 
519.28 	name of the receiving facility. The layaway adjustment provisions of section 256B.431, 
519.29 	subdivision 30, do not apply to this layaway. The receiving facility may only remove the 
519.30 	beds from layaway for recertification and relicensure at the receiving facility's current site, 
519.31 	or at a newly constructed facility located in Anoka County. The receiving facility must 
519.32 	receive statutory authorization before removing these beds from layaway status, or may 
519.33 	remove these beds from layaway status if removal from layaway status is part of a 
519.34 	moratorium exception project approved by the commissioner under section 144A.073.

520.1 	Sec. 4. Minnesota Statutes 2016, section 144A.071, subdivision 4c, as amended by Laws 
520.2 	2017, chapter 40, article 1, section 24, is amended to read:
520.3 		Subd. 4c.Exceptions for replacement beds after June 30, 2003. (a) The commissioner 
520.4 	of health, in coordination with the commissioner of human services, may approve the 
520.5 	renovation, replacement, upgrading, or relocation of a nursing home or boarding care home, 
520.6 	under the following conditions:
520.7 	(1) to license and certify an 80-bed city-owned facility in Nicollet County to be 
520.8 	constructed on the site of a new city-owned hospital to replace an existing 85-bed facility 
520.9 	attached to a hospital that is also being replaced. The threshold allowed for this project 
520.10 	under section 144A.073 shall be the maximum amount available to pay the additional 
520.11 	medical assistance costs of the new facility;
520.12 	(2) to license and certify 29 beds to be added to an existing 69-bed facility in St. Louis 
520.13 	County, provided that the 29 beds must be transferred from active or layaway status at an 
520.14 	existing facility in St. Louis County that had 235 beds on April 1, 2003.
520.15 	The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment 
520.16 	rate at that facility shall not be adjusted as a result of this transfer. The operating payment 
520.17 	rate of the facility adding beds after completion of this project shall be the same as it was 
520.18 	on the day prior to the day the beds are licensed and certified. This project shall not proceed 
520.19 	unless it is approved and financed under the provisions of section 144A.073;
520.20 	(3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of the new 
520.21 	beds are transferred from a 45-bed facility in Austin under common ownership that is closed 
520.22 	and 15 of the new beds are transferred from a 182-bed facility in Albert Lea under common 
520.23 	ownership; (ii) the commissioner of human services is authorized by the 2004 legislature 
520.24 	to negotiate budget-neutral planned nursing facility closures; and (iii) money is available 
520.25 	from planned closures of facilities under common ownership to make implementation of 
520.26 	this clause budget-neutral to the state. The bed capacity of the Albert Lea facility shall be 
520.27 	reduced to 167 beds following the transfer. Of the 60 beds at the new facility, 20 beds shall 
520.28 	be used for a special care unit for persons with Alzheimer's disease or related dementias;
520.29 	(4) to license and certify up to 80 beds transferred from an existing state-owned nursing 
520.30 	facility in Cass County to a new facility located on the grounds of the Ah-Gwah-Ching 
520.31 	campus. The operating cost payment rates for the new facility shall be determined based 
520.32 	on the interim and settle-up payment provisions of Minnesota Rules, part 9549.0057, and 
520.33 	the reimbursement provisions of section 256B.431 chapter 256R. The property payment 
520.34 	rate for the first three years of operation shall be $35 per day. For subsequent years, the 
521.1 	property payment rate of $35 per day shall be adjusted for inflation as provided in section 
521.2 	256B.434, subdivision 4, paragraph (c), as long as the facility has a contract under section 
521.3 	256B.434;
521.4 	(5) to initiate a pilot program to license and certify up to 80 beds transferred from an 
521.5 	existing county-owned nursing facility in Steele County relocated to the site of a new acute 
521.6 	care facility as part of the county's Communities for a Lifetime comprehensive plan to create 
521.7 	innovative responses to the aging of its population. Upon relocation to the new site, the 
521.8 	nursing facility shall delicense 28 beds. The payment rate for external fixed costs for the 
521.9 	new facility shall be increased by an amount as calculated according to items (i) to (v):
521.10 	(i) compute the estimated decrease in medical assistance residents served by the nursing 
521.11 	facility by multiplying the decrease in licensed beds by the historical percentage of medical 
521.12 	assistance resident days;
521.13 	(ii) compute the annual savings to the medical assistance program from the delicensure 
521.14 	of 28 beds by multiplying the anticipated decrease in medical assistance residents, determined 
521.15 	in item (i), by the existing facility's weighted average payment rate multiplied by 365;
521.16 	(iii) compute the anticipated annual costs for community-based services by multiplying 
521.17 	the anticipated decrease in medical assistance residents served by the nursing facility, 
521.18 	determined in item (i), by the average monthly elderly waiver service costs for individuals 
521.19 	in Steele County multiplied by 12;
521.20 	(iv) subtract the amount in item (iii) from the amount in item (ii);
521.21 	(v) divide the amount in item (iv) by an amount equal to the relocated nursing facility's 
521.22 	occupancy factor under section 256B.431, subdivision 3f, paragraph (c), multiplied by the 
521.23 	historical percentage of medical assistance resident days; and
521.24 	(6) to consolidate and relocate nursing facility beds to a new site in Goodhue County 
521.25 	and to integrate these services with other community-based programs and services under a 
521.26 	communities for a lifetime pilot program and comprehensive plan to create innovative 
521.27 	responses to the aging of its population. Two nursing facilities, one for 84 beds and one for 
521.28 	65 beds, in the city of Red Wing licensed on July 1, 2015, shall be consolidated into a newly 
521.29 	renovated 64-bed nursing facility resulting in the delicensure of 85 beds. Notwithstanding 
521.30 	the carryforward of the approval authority in section 144A.073, subdivision 11, the funding 
521.31 	approved in April 2009 by the commissioner of health for a project in Goodhue County 
521.32 	shall not carry forward. The closure of the 85 beds shall not be eligible for a planned closure 
521.33 	rate adjustment under section 256R.40. The construction project permitted in this clause 
521.34 	shall not be eligible for a threshold project rate adjustment under section 256B.434, 
522.1 	subdivision 4f. The payment rate for external fixed costs for the new facility shall be 
522.2 	increased by an amount as calculated according to items (i) to (vi):
522.3 	(i) compute the estimated decrease in medical assistance residents served by both nursing 
522.4 	facilities by multiplying the difference between the occupied beds of the two nursing facilities 
522.5 	for the reporting year ending September 30, 2009, and the projected occupancy of the facility 
522.6 	at 95 percent occupancy by the historical percentage of medical assistance resident days;
522.7 	(ii) compute the annual savings to the medical assistance program from the delicensure 
522.8 	by multiplying the anticipated decrease in the medical assistance residents, determined in 
522.9 	item (i), by the hospital-owned nursing facility weighted average payment rate multiplied 
522.10 	by 365;
522.11 	(iii) compute the anticipated annual costs for community-based services by multiplying 
522.12 	the anticipated decrease in medical assistance residents served by the facilities, determined 
522.13 	in item (i), by the average monthly elderly waiver service costs for individuals in Goodhue 
522.14 	County multiplied by 12;
522.15 	(iv) subtract the amount in item (iii) from the amount in item (ii);
522.16 	(v) multiply the amount in item (iv) by 57.2 percent; and
522.17 	(vi) divide the difference of the amount in item (iv) and the amount in item (v) by an 
522.18 	amount equal to the relocated nursing facility's occupancy factor under section 256B.431, 
522.19 	subdivision 3f, paragraph (c), multiplied by the historical percentage of medical assistance 
522.20 	resident days.
522.21 	(b) Projects approved under this subdivision shall be treated in a manner equivalent to 
522.22 	projects approved under subdivision 4a.

522.23 	Sec. 5. Minnesota Statutes 2016, section 144A.10, subdivision 4, as amended by Laws 
522.24 	2017, chapter 40, article 1, section 27, is amended to read:
522.25 		Subd. 4.Correction orders. Whenever a duly authorized representative of the 
522.26 	commissioner of health finds upon inspection of a nursing home, that the facility or a 
522.27 	controlling person or an employee of the facility is not in compliance with sections 144.411
522.28 	to 144.417, 144.651, 144.6503, 144A.01 to 144A.155, or 626.557 or the rules promulgated 
522.29 	thereunder, a correction order shall be issued to the facility. The correction order shall state 
522.30 	the deficiency, cite the specific rule or statute violated, state the suggested method of 
522.31 	correction, and specify the time allowed for correction. If the commissioner finds that the 
522.32 	nursing home had uncorrected or repeated violations which create a risk to resident care, 
522.33 	safety, or rights, the commissioner shall notify the commissioner of human services who 
523.1 	shall require the facility to use any incentive payments received under section 256R.38, to 
523.2 	correct the violations and shall require the facility to forfeit incentive payments for failure 
523.3 	to correct the violations. The forfeiture shall not apply to correction orders issued for physical 
523.4 	plant deficiencies.

523.5 	Sec. 6. Minnesota Statutes 2016, section 144A.74, is amended to read:
523.6 	144A.74 MAXIMUM CHARGES.
523.7 	A supplemental nursing services agency must not bill or receive payments from a nursing 
523.8 	home licensed under this chapter at a rate higher than 150 percent of the sum of the weighted 
523.9 	average wage rate, plus a factor determined by the commissioner to incorporate payroll 
523.10 	taxes as defined in Minnesota Rules, part 9549.0020, subpart 33 section 256R.02, subdivision 
523.11 	37, for the applicable employee classification for the geographic group to which the nursing 
523.12 	home is assigned under Minnesota Rules, part 9549.0052. The weighted average wage rates 
523.13 	must be determined by the commissioner of human services and reported to the commissioner 
523.14 	of health on an annual basis. Wages are defined as hourly rate of pay and shift differential, 
523.15 	including weekend shift differential and overtime. Facilities shall provide information 
523.16 	necessary to determine weighted average wage rates to the commissioner of human services 
523.17 	in a format requested by the commissioner. The maximum rate must include all charges for 
523.18 	administrative fees, contract fees, or other special charges in addition to the hourly rates for 
523.19 	the temporary nursing pool personnel supplied to a nursing home.

523.20 	Sec. 7. Minnesota Statutes 2016, section 256.9657, subdivision 1, is amended to read:
523.21 		Subdivision 1.Nursing home license surcharge. (a) Effective July 1, 1993, each 
523.22 	non-state-operated nursing home licensed under chapter 144A shall pay to the commissioner 
523.23 	an annual surcharge according to the schedule in subdivision 4. The surcharge shall be 
523.24 	calculated as $620 per licensed bed. If the number of licensed beds is reduced, the surcharge 
523.25 	shall be based on the number of remaining licensed beds the second month following the 
523.26 	receipt of timely notice by the commissioner of human services that beds have been 
523.27 	delicensed. The nursing home must notify the commissioner of health in writing when beds 
523.28 	are delicensed. The commissioner of health must notify the commissioner of human services 
523.29 	within ten working days after receiving written notification. If the notification is received 
523.30 	by the commissioner of human services by the 15th of the month, the invoice for the second 
523.31 	following month must be reduced to recognize the delicensing of beds. Beds on layaway 
523.32 	status continue to be subject to the surcharge. The commissioner of human services must 
524.1 	acknowledge a medical care surcharge appeal within 30 days of receipt of the written appeal 
524.2 	from the provider.
524.3 	(b) Effective July 1, 1994, the surcharge in paragraph (a) shall be increased to $625.
524.4 	(c) Effective August 15, 2002, the surcharge under paragraph (b) shall be increased to 
524.5 	$990.
524.6 	(d) Effective July 15, 2003, the surcharge under paragraph (c) shall be increased to 
524.7 	$2,815.
524.8 	(e) The commissioner may reduce, and may subsequently restore, the surcharge under 
524.9 	paragraph (d) based on the commissioner's determination of a permissible surcharge.
524.10 	(f) Between April 1, 2002, and August 15, 2004, a facility governed by this subdivision 
524.11 	may elect to assume full participation in the medical assistance program by agreeing to 
524.12 	comply with all of the requirements of the medical assistance program, including the rate 
524.13 	equalization law in section 256B.48, subdivision 1, paragraph (a), and all other requirements 
524.14 	established in law or rule, and to begin intake of new medical assistance recipients. Rates 
524.15 	will be determined under Minnesota Rules, parts 9549.0010 to 9549.0080. Rate calculations 
524.16 	will be subject to limits as prescribed in rule and law. Other than the adjustments in sections 
524.17 	256B.431, subdivisions 30 and 32; 256B.437, subdivision 3, paragraph (b), Minnesota 
524.18 	Rules, part 9549.0057, and any other applicable legislation enacted prior to the finalization 
524.19 	of rates, facilities assuming full participation in medical assistance under this paragraph are 
524.20 	not eligible for any rate adjustments until the July 1 following their settle-up period.

524.21 	Sec. 8. Minnesota Statutes 2016, section 256B.0915, subdivision 3e, is amended to read:
524.22 		Subd. 3e.Customized living service rate. (a) Payment for customized living services 
524.23 	shall be a monthly rate authorized by the lead agency within the parameters established by 
524.24 	the commissioner. The payment agreement must delineate the amount of each component 
524.25 	service included in the recipient's customized living service plan. The lead agency, with 
524.26 	input from the provider of customized living services, shall ensure that there is a documented 
524.27 	need within the parameters established by the commissioner for all component customized 
524.28 	living services authorized.
524.29 	(b) The payment rate must be based on the amount of component services to be provided 
524.30 	utilizing component rates established by the commissioner. Counties and tribes shall use 
524.31 	tools issued by the commissioner to develop and document customized living service plans 
524.32 	and rates.
525.1 	(c) Component service rates must not exceed payment rates for comparable elderly 
525.2 	waiver or medical assistance services and must reflect economies of scale. Customized 
525.3 	living services must not include rent or raw food costs.
525.4 	(d) With the exception of individuals described in subdivision 3a, paragraph (b), the 
525.5 	individualized monthly authorized payment for the customized living service plan shall not 
525.6 	exceed 50 percent of the greater of either the statewide or any of the geographic groups' 
525.7 	weighted average monthly nursing facility rate of the case mix resident class to which the 
525.8 	elderly waiver eligible client would be assigned under Minnesota Rules, parts 9549.0051
525.9 	to 9549.0059, less the maintenance needs allowance as described in subdivision 1d, paragraph 
525.10 	(a). Effective on July 1 of the state fiscal year in which the resident assessment system as 
525.11 	described in section 256B.438 256R.17 for nursing home rate determination is implemented 
525.12 	and July 1 of each subsequent state fiscal year, the individualized monthly authorized 
525.13 	payment for the services described in this clause shall not exceed the limit which was in 
525.14 	effect on June 30 of the previous state fiscal year updated annually based on legislatively 
525.15 	adopted changes to all service rate maximums for home and community-based service 
525.16 	providers.
525.17 	(e) Effective July 1, 2011, the individualized monthly payment for the customized living 
525.18 	service plan for individuals described in subdivision 3a, paragraph (b), must be the monthly 
525.19 	authorized payment limit for customized living for individuals classified as case mix A, 
525.20 	reduced by 25 percent. This rate limit must be applied to all new participants enrolled in 
525.21 	the program on or after July 1, 2011, who meet the criteria described in subdivision 3a, 
525.22 	paragraph (b). This monthly limit also applies to all other participants who meet the criteria 
525.23 	described in subdivision 3a, paragraph (b), at reassessment.
525.24 	(f) Customized living services are delivered by a provider licensed by the Department 
525.25 	of Health as a class A or class F home care provider and provided in a building that is 
525.26 	registered as a housing with services establishment under chapter 144D. Licensed home 
525.27 	care providers are subject to section 256B.0651, subdivision 14.
525.28 	(g) A provider may not bill or otherwise charge an elderly waiver participant or their 
525.29 	family for additional units of any allowable component service beyond those available under 
525.30 	the service rate limits described in paragraph (d), nor for additional units of any allowable 
525.31 	component service beyond those approved in the service plan by the lead agency.
525.32 	(h) Effective July 1, 2016, and each July 1 thereafter, individualized service rate limits 
525.33 	for customized living services under this subdivision shall be increased by the difference 
525.34 	between any legislatively adopted home and community-based provider rate increases 
526.1 	effective on July 1 or since the previous July 1 and the average statewide percentage increase 
526.2 	in nursing facility operating payment rates under sections 256B.431, 256B.434, and 256B.441
526.3 	chapter 256R, effective the previous January 1. This paragraph shall only apply if the average 
526.4 	statewide percentage increase in nursing facility operating payment rates is greater than any 
526.5 	legislatively adopted home and community-based provider rate increases effective on July 
526.6 	1, or occurring since the previous July 1.

526.7 	Sec. 9. Minnesota Statutes 2016, section 256B.35, subdivision 4, as amended by Laws 
526.8 	2017, chapter 40, article 1, section 72, is amended to read:
526.9 		Subd. 4.Field audits required. The commissioner of human services shall conduct 
526.10 	field audits at the same time as cost report audits required under section 256R.13, subdivision 
526.11 	1, and at any other time but at least once every four years, without notice, to determine 
526.12 	whether this section was complied with and that the funds provided residents for their 
526.13 	personal needs were actually expended for that purpose.

526.14 	Sec. 10. Minnesota Statutes 2016, section 256B.431, subdivision 30, is amended to read:
526.15 		Subd. 30.Bed layaway and delicensure. (a) For rate years beginning on or after July 
526.16 	1, 2000, a nursing facility reimbursed under this section which has placed beds on layaway 
526.17 	shall, for purposes of application of the downsizing incentive in subdivision 3a, paragraph 
526.18 	(c), and calculation of the rental per diem, have those beds given the same effect as if the 
526.19 	beds had been delicensed so long as the beds remain on layaway. At the time of a layaway, 
526.20 	a facility may change its single bed election for use in calculating capacity days under 
526.21 	Minnesota Rules, part 9549.0060, subpart 11. The property payment rate increase shall be 
526.22 	effective the first day of the month following the month in which the layaway of the beds 
526.23 	becomes effective under section 144A.071, subdivision 4b.
526.24 	(b) For rate years beginning on or after July 1, 2000, notwithstanding any provision to 
526.25 	the contrary under section 256B.434 or chapter 256R, a nursing facility reimbursed under 
526.26 	that section or chapter which has placed beds on layaway shall, for so long as the beds 
526.27 	remain on layaway, be allowed to:
526.28 	(1) aggregate the applicable investment per bed limits based on the number of beds 
526.29 	licensed immediately prior to entering the alternative payment system;
526.30 	(2) retain or change the facility's single bed election for use in calculating capacity days 
526.31 	under Minnesota Rules, part 9549.0060, subpart 11; and
527.1 	(3) establish capacity days based on the number of beds immediately prior to the layaway 
527.2 	and the number of beds after the layaway.
527.3 	The commissioner shall increase the facility's property payment rate by the incremental 
527.4 	increase in the rental per diem resulting from the recalculation of the facility's rental per 
527.5 	diem applying only the changes resulting from the layaway of beds and clauses (1), (2), and 
527.6 	(3). If a facility reimbursed under section 256B.434 or chapter 256R completes a moratorium 
527.7 	exception project after its base year, the base year property rate shall be the moratorium 
527.8 	project property rate. The base year rate shall be inflated by the factors in section 256B.434, 
527.9 	subdivision 4, paragraph (c). The property payment rate increase shall be effective the first 
527.10 	day of the month following the month in which the layaway of the beds becomes effective.
527.11 	(c) If a nursing facility removes a bed from layaway status in accordance with section 
527.12 	144A.071, subdivision 4b, the commissioner shall establish capacity days based on the 
527.13 	number of licensed and certified beds in the facility not on layaway and shall reduce the 
527.14 	nursing facility's property payment rate in accordance with paragraph (b).
527.15 	(d) For the rate years beginning on or after July 1, 2000, notwithstanding any provision 
527.16 	to the contrary under section 256B.434 or chapter 256R, a nursing facility reimbursed under 
527.17 	that section or chapter, which has delicensed beds after July 1, 2000, by giving notice of 
527.18 	the delicensure to the commissioner of health according to the notice requirements in section 
527.19 	144A.071, subdivision 4b, shall be allowed to:
527.20 	(1) aggregate the applicable investment per bed limits based on the number of beds 
527.21 	licensed immediately prior to entering the alternative payment system;
527.22 	(2) retain or change the facility's single bed election for use in calculating capacity days 
527.23 	under Minnesota Rules, part 9549.0060, subpart 11; and
527.24 	(3) establish capacity days based on the number of beds immediately prior to the 
527.25 	delicensure and the number of beds after the delicensure.
527.26 	The commissioner shall increase the facility's property payment rate by the incremental 
527.27 	increase in the rental per diem resulting from the recalculation of the facility's rental per 
527.28 	diem applying only the changes resulting from the delicensure of beds and clauses (1), (2), 
527.29 	and (3). If a facility reimbursed under section 256B.434 completes a moratorium exception 
527.30 	project after its base year, the base year property rate shall be the moratorium project property 
527.31 	rate. The base year rate shall be inflated by the factors in section 256B.434, subdivision 4, 
527.32 	paragraph (c). The property payment rate increase shall be effective the first day of the 
527.33 	month following the month in which the delicensure of the beds becomes effective.
528.1 	(e) For nursing facilities reimbursed under this section or, section 256B.434, or chapter 
528.2 	256R, any beds placed on layaway shall not be included in calculating facility occupancy 
528.3 	as it pertains to leave days defined in Minnesota Rules, part 9505.0415.
528.4 	(f) For nursing facilities reimbursed under this section or, section 256B.434, or chapter 
528.5 	256R, the rental rate calculated after placing beds on layaway may not be less than the rental 
528.6 	rate prior to placing beds on layaway.
528.7 	(g) A nursing facility receiving a rate adjustment as a result of this section shall comply 
528.8 	with section 256B.47, subdivision 2 256R.06, subdivision 5.
528.9 	(h) A facility that does not utilize the space made available as a result of bed layaway 
528.10 	or delicensure under this subdivision to reduce the number of beds per room or provide 
528.11 	more common space for nursing facility uses or perform other activities related to the 
528.12 	operation of the nursing facility shall have its property rate increase calculated under this 
528.13 	subdivision reduced by the ratio of the square footage made available that is not used for 
528.14 	these purposes to the total square footage made available as a result of bed layaway or 
528.15 	delicensure.

528.16 	Sec. 11. EFFECTIVE DATE.
 528.17 	Sections 1 to 10 are effective the day following final enactment.

528.18 	ARTICLE 15
528.19 	MANAGED CARE ORGANIZATIONS

528.20 	Section 1. Minnesota Statutes 2016, section 256.045, subdivision 3a, is amended to read:
528.21 		Subd. 3a.Prepaid health plan appeals. (a) All prepaid health plans under contract to 
528.22 	the commissioner under chapter 256B must provide for a complaint system according to 
528.23 	section 62D.11. When a prepaid health plan denies, reduces, or terminates a health service 
528.24 	or denies a request to authorize a previously authorized health service, the prepaid health 
528.25 	plan must notify the recipient of the right to file a complaint or an appeal. The notice must 
528.26 	include the name and telephone number of the ombudsman and notice of the recipient's 
528.27 	right to request a hearing under paragraph (b). Recipients may request the assistance of the 
528.28 	ombudsman in the complaint system process. The prepaid health plan must issue a written 
528.29 	resolution of the complaint to the recipient within 30 days after the complaint is filed with 
528.30 	the prepaid health plan. A recipient is not required to exhaust the complaint system 
528.31 	procedures in order to request a hearing under paragraph (b).
529.1 	(b) Recipients enrolled in a prepaid health plan under chapter 256B may contest a prepaid 
529.2 	health plan's denial, reduction, or termination of health services, a prepaid health plan's 
529.3 	denial of a request to authorize a previously authorized health service, or the prepaid health 
529.4 	plan's written resolution of a complaint by submitting a written request for a hearing 
529.5 	according to subdivision 3. A state human services judge shall conduct a hearing on the 
529.6 	matter and shall recommend an order to the commissioner of human services. The 
529.7 	commissioner need not grant a hearing if the sole issue raised by a recipient is the 
529.8 	commissioner's authority to require mandatory enrollment in a prepaid health plan in a 
529.9 	county where prepaid health plans are under contract with the commissioner. The state 
529.10 	human services judge may order a second medical opinion from the prepaid health plan or 
529.11 	may order a second medical opinion from a nonprepaid health plan provider at the expense 
529.12 	of the prepaid health plan Department of Human Services. Recipients may request the 
529.13 	assistance of the ombudsman in the appeal process.
529.14 	(c) In the written request for a hearing to appeal from a prepaid health plan's denial, 
529.15 	reduction, or termination of a health service, a prepaid health plan's denial of a request to 
529.16 	authorize a previously authorized service, or the prepaid health plan's written resolution to 
529.17 	a complaint, a recipient may request an expedited hearing. If an expedited appeal is 
529.18 	warranted, the state human services judge shall hear the appeal and render a decision within 
529.19 	a time commensurate with the level of urgency involved, based on the individual 
529.20 	circumstances of the case.
529.21 	(d) Beginning January 1, 2018, the requirements of Code of Federal Regulations, part 
529.22 	42, sections 438.400 to 438.424, take precedent over any conflicting provisions in this 
529.23 	subdivision. All other provisions of this section remain in effect.

529.24 	Sec. 2. Minnesota Statutes 2016, section 256B.69, is amended by adding a subdivision to 
529.25 	read:
529.26 		Subd. 36.Enrollee support system. (a) The commissioner shall establish an enrollee 
529.27 	support system that provides support to an enrollee before and during enrollment in a 
529.28 	managed care plan.
529.29 	(b) The enrollee support system must:
529.30 	(1) provide access to counseling for each potential enrollee on choosing a managed care 
529.31 	plan;
529.32 	(2) assist an enrollee in understanding enrollment in a managed care plan;
530.1 	(3) provide an access point for complaints regarding enrollment, covered services, and 
530.2 	other related matters;
530.3 	(4) provide information on an enrollee's grievance and appeal rights within the managed 
530.4 	care organization and the state's fair hearing process, including an enrollee's rights and 
530.5 	responsibilities; and
530.6 	(5) provide assistance to an enrollee, upon request, in navigating the grievance and 
530.7 	appeals process within the managed care organization and in appealing adverse benefit 
530.8 	determinations made by the managed care organization to the state's fair hearing process 
530.9 	after the managed care organization's internal appeals process has been exhausted. Assistance 
530.10 	does not include providing representation to an enrollee at the state's fair hearing, but may 
530.11 	include a referral to appropriate legal representation sources.
530.12 	(c) Outreach to enrollees through the support system must be accessible to an enrollee 
530.13 	through multiple formats, including telephone, Internet, in-person, and, if requested, through 
530.14 	auxiliary aids and services.
530.15 	(d) The commissioner may designate enrollment brokers to assist enrollees on selecting 
530.16 	a managed care organization and providing necessary enrollment information. For purposes 
530.17 	of this subdivision, "enrollment broker" means an individual or entity that performs choice 
530.18 	counseling or enrollment activities in accordance with Code of Federal Regulations, part 
530.19 	42, section 438.810, or both.

530.20 	Sec. 3. Minnesota Statutes 2016, section 256B.69, is amended by adding a subdivision to 
530.21 	read:
530.22 		Subd. 37.Networks. (a) The commissioner shall ensure that a managed care 
530.23 	organization's network providers are enrolled with the commissioner as medical assistance 
530.24 	providers, and that the providers comply with the provider disclosure, screening, and 
530.25 	enrollment requirements in Code of Federal Regulations, part 42, section 455. A provider 
530.26 	that has a network provider contract with the managed care organization is not required to 
530.27 	provide services to a medical assistance or MinnesotaCare recipient who is receiving services 
530.28 	through the fee-for-service system.
530.29 	(b) A managed care organization may enter into a network provider contract with a 
530.30 	provider that is not a medical assistance provider for a period of up to 120 days pending the 
530.31 	outcome of the medical assistance provider enrollment process. A managed care organization 
530.32 	must terminate the contract upon notification that the provider cannot be enrolled as a 
530.33 	medical assistance provider or upon expiration of the 120-day period if notification has not 
531.1 	been received within that period. The managed care organization must notify each affected 
531.2 	enrollee of the provider contract termination.
531.3 	(c) For purposes of this subdivision, "network provider" means any provider, group of 
531.4 	providers, entity with a network provider agreement with the managed care organization, 
531.5 	or subcontractor that receives payments from the managed care organization either directly 
531.6 	or indirectly to provide services under a managed care contract between the commissioner 
531.7 	and the managed care organization.

531.8 	Sec. 4. [256B.6925] ENROLLEE INFORMATION.
531.9 		Subdivision 1.Information provided by the commissioner. The commissioner shall 
531.10 	provide to each potential enrollee the following information:
531.11 	(1) basic features of receiving services through managed care;
531.12 	(2) which individuals are excluded from managed care enrollment, subject to mandatory 
531.13 	managed care enrollment, or who may choose to enroll voluntarily;
531.14 	(3) for mandatory and voluntary enrollment, the length of the enrollment period and 
531.15 	information about an enrollee's right to disenroll in accordance with Code of Federal 
531.16 	Regulations, part 42, section 438.56;
531.17 	(4) the service area covered by each managed care organization;
531.18 	(5) covered services, including services provided by the managed care organization and 
531.19 	services provided by the commissioner;
531.20 	(6) the provider directory and drug formulary for each managed care organization;
531.21 	(7) cost-sharing requirements;
531.22 	(8) requirements for adequate access to services, including provider network adequacy 
531.23 	standards;
531.24 	(9) a managed care organization's responsibility for coordination of enrollee care; and
531.25 	(10) quality and performance indicators, including enrollee satisfaction for each managed 
531.26 	care organization, if available.
531.27 		Subd. 2.Information provided by the managed care organization. The commissioner 
531.28 	shall ensure that managed care organizations provide to each enrollee the following 
531.29 	information:
531.30 	(1) an enrollee handbook within a reasonable time after receiving notice of the enrollee's 
531.31 	enrollment. The handbook must, at a minimum, include information on benefits provided, 
532.1 	how and where to access benefits, cost-sharing requirements, how transportation is provided, 
532.2 	and other information as required by Code of Federal Regulations, part 42, section 438.10, 
532.3 	paragraph (g);
532.4 	(2) a provider directory for the following provider types: physicians, specialists, hospitals, 
532.5 	pharmacies, behavioral health providers, and long-term supports and services providers, as 
532.6 	appropriate. The directory must include the provider's name, group affiliation, street address, 
532.7 	telephone number, Web site, specialty if applicable, whether the provider accepts new 
532.8 	enrollees, the provider's cultural and linguistic capabilities as identified in Code of Federal 
532.9 	Regulations, part 42, section 438.10, paragraph (h), and whether the provider's office 
532.10 	accommodates people with disabilities;
532.11 	(3) a drug formulary that includes both generic and name brand medications that are 
532.12 	covered and each medication tier, if applicable;
532.13 	(4) written notice of termination of a contracted provider. Within 15 calendar days after 
532.14 	receipt or issuance of the termination notice, the managed care organization must make a 
532.15 	good faith effort to provide notice to each enrollee who received primary care from, or was 
532.16 	seen on a regular basis by, the terminated provider; and
532.17 	(5) upon enrollee request, the managed care organization's physician incentive plan.
532.18 		Subd. 3.Provision of information. (a) All information required to be provided to 
532.19 	enrollees and potential enrollees of a managed care organization, including the provider 
532.20 	directory, enrollee handbook, and drug formulary, must be provided in a manner and format 
532.21 	that is easily understood and readily accessible. The information must be available through 
532.22 	the enrollee support system established under section 256B.69, subdivision 36, the 
532.23 	department's Web site and each managed care organization's Web site. The commissioner 
532.24 	and managed care organization shall inform each enrollee that the information is available 
532.25 	on the department's and the managed care organization's Web sites and shall provide the 
532.26 	potential enrollee or enrollee with the applicable URL to access the information. An enrollee 
532.27 	with a disability who cannot access the information online must be provided, upon request, 
532.28 	with auxiliary aids and services necessary to access the information at no cost to the enrollee.
532.29 	(b) The commissioner and managed care organization shall provide all required 
532.30 	information electronically to potential enrollees and enrollees unless the enrollee requests 
532.31 	the information in paper form. The commissioner and managed care organization shall 
532.32 	inform an enrollee that, upon request, the information is available in paper form without 
532.33 	charge to the enrollee, and shall mail the information to the potential enrollee's or the 
532.34 	enrollee's mailing address within five business days of the request. If the information is 
533.1 	provided to the enrollee through e-mail, the managed care organization must receive the 
533.2 	enrollee's agreement before providing the information by e-mail.
533.3 	(c) The information required to be provided electronically to a potential enrollee or 
533.4 	enrollee must:
533.5 	(1) be readily accessible;
533.6 	(2) be published in a prominent location on the commissioner's and managed care 
533.7 	organization's Web sites in a format that has the capability of being retained and printed; 
533.8 	and
533.9 	(3) satisfy the requirements for content and language requirements in accordance with 
533.10 	Code of Federal Regulations, part 42, section 438.10, paragraph (d).
533.11 		Subd. 4.Language and accessibility standards. (a) Managed care contracts entered 
533.12 	into under section 256B.69, 256B.692, or 256L.12, must require a managed care organization 
533.13 	to provide language assistance, and auxiliary aids and services, if requested, to ensure access 
533.14 	to a managed care organization's programs and services, as required under United States 
533.15 	Code, title 42, sections 18116 and 2000d, and any other federal regulations or guidance 
533.16 	from the United States Department of Health and Human Services.
533.17 	(b) The commissioner shall establish a methodology to identify the prevalent non-English 
533.18 	languages spoken by enrollees and potential enrollees throughout Minnesota and in each 
533.19 	managed care organization's service area.
533.20 	(c) The commissioner shall ensure that oral interpretation is provided in all languages 
533.21 	and written interpretation is provided in each prevalent non-English language, and that both 
533.22 	are available to enrollees and potential enrollees free of charge. Oral interpretation services 
533.23 	shall include the use of auxiliary aids, TTY/TDY, and American sign language.
533.24 	(d) All written materials that target potential enrollees and are provided to enrollees, 
533.25 	including the provider directory, enrollee handbook, appeals and grievance notices, and 
533.26 	denial and termination notices, must:
533.27 	(1) use at least 12-point font;
533.28 	(2) be written at a 7th grade reading level;
533.29 	(3) be available in alternative formats and through auxiliary aids and services that consider 
533.30 	the special needs of the enrollee, including an enrollee with a disability or limited English 
533.31 	proficiency;
534.1 	(4) use taglines that consist of short statements in each of the prevalent non-English 
534.2 	languages, in an 18-point font, that explain the availability of language interpreter services 
534.3 	free of charge; and
534.4 	(5) explain how to request auxiliary aids and services, including the provision of the 
534.5 	materials in alternative formats and the TTY/TDY telephone number of the managed care 
534.6 	organization's customer service unit and the department's enrollee support system.
534.7 	(e) For purposes of this subdivision, "prevalent non-English language" means a 
534.8 	non-English language that is determined by the commissioner to be spoken by a significant 
534.9 	number or percentage of potential enrollees and enrollees with limited proficiency in English.
534.10 		Subd. 5.Enrollee communication. (a) The commissioner shall ensure that the managed 
534.11 	care organization:
534.12 	(1) submits all marketing materials to the commissioner for approval before distribution 
534.13 	and that marketing materials are accurate and do not mislead, confuse, or defraud;
534.14 	(2) distributes marketing materials to a managed care organization's entire service area 
534.15 	and as otherwise permitted by contract;
534.16 	(3) complies with the information requirements in Code of Federal Regulations, part 42, 
534.17 	section 438.10;
534.18 	(4) does not seek to influence enrollment with the sale or offering of any private 
534.19 	insurance, with the exception of communications between an enrollee and a managed care 
534.20 	organization that is related to the offering of a qualified health plan as defined under section 
534.21 	62K.03; and
534.22 	(5) does not directly, or indirectly, engage in door-to-door, telephone, e-mail, texting, 
534.23 	or other cold-call marketing activities.
534.24 	(b) For the purposes of this subdivision, "cold-call marketing activities" means any 
534.25 	unsolicited personal contact or communication by a managed care organization with an 
534.26 	individual who is not enrolled in that managed care organization that can be reasonably 
534.27 	interpreted as intended to influence the individual to enroll in a specific managed care 
534.28 	organization or to not enroll in or disenroll from another managed care organization.

534.29 	Sec. 5. [256B.6926] STATE MONITORING.
534.30 		Subdivision 1.Generally. (a) The commissioner shall establish a monitoring system 
534.31 	that addresses all aspects of the managed care program, including the performance of each 
535.1 	managed care organization in the areas identified under Code of Federal Regulations, part 
535.2 	42, section 438.66, paragraph (b).
535.3 	(b) The commissioner shall use data collected from the monitoring activities, including, 
535.4 	at a minimum, the data identified in Code of Federal Regulations, part 42, section 438.66, 
535.5 	paragraph (c), to improve the performance of the managed care program.
535.6 		Subd. 2.Readiness review. The commissioner shall conduct a readiness review of each 
535.7 	managed care organization that contracts with the commissioner to assess the managed care 
535.8 	organization's ability and capacity to perform satisfactorily in the areas described in Code 
535.9 	of Federal Regulations, part 42, section 438.66, paragraph (d), clauses (1) to (4). The review 
535.10 	must be conducted and approval must be received from the Centers for Medicare and 
535.11 	Medicaid Services prior to the commissioner entering into a contract with the managed care 
535.12 	organization.
535.13 		Subd. 3.Report. (a) The commissioner shall submit to the Centers for Medicare and 
535.14 	Medicaid Services, no later than 180 days after each contract year, a report on the managed 
535.15 	care program administered by the commissioner, regardless of the authority under which 
535.16 	the program operates, with the initial report being submitted 180 days after the contract 
535.17 	year following the release of the Centers for Medicare and Medicaid Services guidance. 
535.18 	Each report must, at a minimum, assess the managed care program's operation in the areas 
535.19 	identified in Code of Federal Regulations, part 42, section 438.66, paragraph (e), clause 
535.20 	(2), and must be:
535.21 	(1) provided to the Medicaid Citizens' Advisory Committee as required under Code of 
535.22 	Federal Regulations, part 42, section 431.12;
535.23 	(2) provided to the stakeholder consultation group as required under Code of Federal 
535.24 	Regulations, part 42, section 438.70, to the extent the managed care program includes 
535.25 	long-term services and supports; and
535.26 	(3) published on the department's Web site.
535.27 	(b) The report described under this subdivision may be used to meet the commissioner's 
535.28 	reporting obligation under the managed care waiver authority for the managed care program.
535.29 		Subd. 4.Conflicts of interest. The commissioner shall implement safeguards against 
535.30 	conflicts of interest on behalf of state and local officers and employees and agents of the 
535.31 	state who have responsibilities relating to managed care contracts. The safeguards must be 
535.32 	at least as effective as the safeguards specified in United States Code, title 41, sections 2101 
535.33 	to 2107. The commissioner shall comply with Code of Federal Regulations, part 42, section 
536.1 	438.58, and United States Code, title 42, section 1396a, paragraph (a), clause (4), item (c), 
536.2 	applicable to contracting officers, employees, or independent contractors.

536.3 	Sec. 6. [256B.6927] QUALITY ASSESSMENT AND PERFORMANCE.
536.4 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
536.5 	the meanings given them.
536.6 	(b) "Access" means the availability and timely use of services to achieve optimal 
536.7 	outcomes as required under Code of Federal Regulations, part 42, sections 438.68 and 
536.8 	438.206.
536.9 	(c) "External quality review" means the analysis and evaluation by an external quality 
536.10 	review organization of the aggregated information on quality, timeliness, and access to the 
536.11 	health care services that a managed care organization or the managed care organization's 
536.12 	contractor provides to enrollees.
536.13 	(d) "External quality review organization" means an organization that meets the 
536.14 	competence and independence requirements under Code of Federal Regulations, part 42, 
536.15 	section 438.354, and performs external quality review and may perform other external 
536.16 	quality review-related activities as required under Code of Federal Regulations, part 42, 
536.17 	section 438.358.
536.18 	(e) "Quality" means the degree that a managed care organization increases the likelihood 
536.19 	of desired outcomes of a managed care organization's enrollees through:
536.20 	(1) a managed care organization's structural and operational characteristics;
536.21 	(2) the provision of services that are consistent with current professional, evidence-based 
536.22 	knowledge; and
536.23 	(3) interventions for performance improvement.
536.24 	(f) "Validation" means the review of information, data, and procedures to determine the 
536.25 	extent that information, data, and procedures are accurate, reliable, free from bias, and 
536.26 	according to standards for data collection and analysis.
536.27 		Subd. 2.Quality strategy. (a) The commissioner shall implement a written quality 
536.28 	strategy for assessing and improving the quality of health care and other services provided 
536.29 	by managed care organizations. At a minimum, the quality strategy must include:
536.30 	(1) defined network adequacy requirements and availability of services standards for 
536.31 	managed care organizations, including examples of evidence-based clinical practice 
536.32 	guidelines;
537.1 	(2) measurable goals and objectives for continuous quality improvement that consider 
537.2 	the health status of all populations served by the managed care organization;
537.3 	(3) a description of:
537.4 	(i) the quality metrics and performance targets used in measuring the performance and 
537.5 	improvement of each managed care organization; and
537.6 	(ii) performance improvement projects, including a description of any intervention 
537.7 	proposed by the commissioner to improve access, quality, or timeliness of care for enrollees;
537.8 	(4) annual, external independent reviews of quality outcomes, and the timeliness of and 
537.9 	access to services covered by the managed care organization;
537.10 	(5) a description of the managed care organization's transition of care policy;
537.11 	(6) a plan to identify, evaluate, and reduce health disparities based on an enrollee's age, 
537.12 	race, ethnicity, sex, primary language, or disability status, and provide this demographic 
537.13 	information to the managed care organization at the time of enrollment;
537.14 	(7) appropriate use of intermediate sanctions to be imposed on a managed care 
537.15 	organization;
537.16 	(8) the mechanisms implemented to identify enrollees who need long-term services and 
537.17 	supports or enrollees with special health care needs; and
537.18 	(9) information related to nonduplication of the external quality review activities in 
537.19 	accordance with Code of Federal Regulations, part 42, section 438.360, paragraph (c).
537.20 	(b) In developing the initial quality strategy, the commissioner shall:
537.21 	(1) obtain input from the Medicaid Citizens' Advisory Committee, enrollees, and other 
537.22 	interested stakeholders;
537.23 	(2) consult with the tribes according to the tribal consultation policy;
537.24 	(3) consider recommendations from the external quality review organization identified 
537.25 	under subdivision 3, for improving the quality of health care services furnished by the 
537.26 	managed care organization; and
537.27 	(4) make the strategy available for public comment.
537.28 	(c) The commissioner shall submit a copy of the initial quality strategy to the Centers 
537.29 	for Medicare and Medicaid Services for comments and feedback. If significant changes are 
537.30 	made based on the comments and feedback received, the commissioner shall publish the 
538.1 	revised quality strategy on the department's Web site. The commissioner shall make the 
538.2 	final quality strategy available on the department's Web site.
538.3 	(d) The commissioner shall review and update the quality strategy at least every three 
538.4 	years or more frequently, if needed. The review shall include an evaluation of the 
538.5 	effectiveness of the quality strategy conducted within the previous three years. The results 
538.6 	of the review and any updates shall be published on the department's Web site.
538.7 		Subd. 3.External quality reviews. (a) The commissioner shall contract with an external 
538.8 	quality review organization in accordance with Code of Federal Regulations, part 42, section 
538.9 	438.354, to conduct an annual external quality review of each managed care organization. 
538.10 	The commissioner shall ensure that all necessary information is provided to the external 
538.11 	quality review organization for analysis and inclusion in the external quality review technical 
538.12 	report required under paragraph (g). The information provided must be obtained in 
538.13 	accordance with Code of Federal Regulations, part 42, section 438.352.
538.14 	(b) The commissioner shall follow an open, competitive procurement process according 
538.15 	to state and federal law for any contract with an external quality review organization. The 
538.16 	external quality review organization may use a subcontractor if the subcontractor meets the 
538.17 	requirements for independence. The external quality review organization is accountable for 
538.18 	and must oversee all functions performed by the subcontractor.
538.19 	(c) The following mandatory external quality review related activities must be performed 
538.20 	for each managed care organization:
538.21 	(1) validation of performance improvement projects, performance measures, and meeting 
538.22 	network adequacy requirements for the 12 months preceding the most recently completed 
538.23 	contract period; and
538.24 	(2) review of the managed care organization's compliance with Code of Federal 
538.25 	Regulations, part 42, subpart D, and section 438.330 for the preceding three years.
538.26 	(d) The commissioner may elect to incorporate any of the optional activities listed in 
538.27 	Code of Federal Regulations, part 42, section 438.358, paragraph (c), as part of the external 
538.28 	quality review.
538.29 	(e) To avoid duplication, the commissioner may use information from a Medicare or 
538.30 	private accreditation review to provide information for a managed care organization's annual 
538.31 	external quality review instead of conducting one or more of the mandatory external quality 
538.32 	review activities. The information used must satisfy Code of Federal Regulations, part 42, 
538.33 	section 438.360, paragraph (a).
539.1 	(f) If the conditions in Code of Federal Regulations, part 42, section 438.362, are satisfied, 
539.2 	the commissioner may accept the data, correspondence, information, and findings regarding  
539.3 	the managed care organization's compliance with a Medicare quality review in lieu of 
539.4 	performing an external quality review. For each managed care organization exempt from 
539.5 	an external quality review, the commissioner shall obtain the most recent Medicare review 
539.6 	findings or Medicare information from a private national accrediting organization that the 
539.7 	Centers for Medicare and Medicaid Services approves and recognizes for Medicare 
539.8 	Advantage Organization deeming.
539.9 	(g) The qualified external quality review organization must produce an annual external 
539.10 	quality review technical report in accordance with Code of Federal Regulations, part 42, 
539.11 	section 438.364. The technical report must summarize findings on access and quality of 
539.12 	care. The commissioner may revise the final external quality review technical report if there 
539.13 	is evidence of error or omission. The final external quality review technical report must be 
539.14 	published on the department's Web site by April 30 of each year and copies of the report 
539.15 	must be made available upon request and in alternative formats. Information in the technical 
539.16 	report must not disclose the identity or other protected patient identifying health information.

539.17 	Sec. 7. [256B.6928] MANAGED CARE RATES AND PAYMENTS.
539.18 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
539.19 	the meanings given them.
539.20 	(b) "Base amount" has the meaning given in Code of Federal Regulations, part 42, section 
539.21 	438.6, paragraph (a).
539.22 	(c) "Budget neutral" has the meaning given in Code of Federal Regulations, part 42, 
539.23 	section 438.5, paragraph (a).
539.24 	(d) "Credibility adjustment" has the meaning given in Code of Federal Regulations, part 
539.25 	42, section 438.8, paragraph (b).
539.26 	(e) "Full credibility" has the meaning given in Code of Federal Regulations, part 42, 
539.27 	section 438.8, paragraph (b).
539.28 	(f) "Incentive arrangement" has the meaning given in Code of Federal Regulations, part 
539.29 	42, section 438.6.
539.30 	(g) "Medical loss ratio" has the meaning given in Code of Federal Regulations, part 42, 
539.31 	section 438.8, paragraph (b).
540.1 	(h) "Medical loss ratio reporting year" has the meaning given in Code of Federal 
540.2 	Regulations, part 42, section 438.8, paragraph (b).
540.3 	(i) "Member months" has the meaning given in Code of Federal Regulations, part 42, 
540.4 	section 438.8, paragraph (b).
540.5 	(j) "No credibility" has the meaning given in Code of Federal Regulations, part 42, 
540.6 	section 438.8, paragraph (b).
540.7 	(k) "Partial credibility" has the meaning given in Code of Federal Regulations, part 42, 
540.8 	section 438.8, paragraph (b).
540.9 	(l) "Pass-through payment" has the meaning given in Code of Federal Regulations, part 
540.10 	42, section 438.6, paragraph (a).
540.11 	(m) "Rate cell" has the meaning given in Code of Federal Regulations, part 42, section 
540.12 	438.2.
540.13 	(n) "Risk adjustment" has the meaning given in Code of Federal Regulations, part 42, 
540.14 	section 438.5, paragraph (a).
540.15 		Subd. 2.Actuarial soundness. (a) Capitation rates for managed care organizations must 
540.16 	be reviewed and approved by the Centers for Medicare and Medicaid Services as actuarially 
540.17 	sound. The capitation rates must be provided in the format and time frame required by Code 
540.18 	of Federal Regulations, part 42, section 438.7. Capitation rates must:
540.19 	(1) be developed in accordance with the rates standards in Code of Federal Regulations, 
540.20 	part 42, section 438.5, and generally accepted actuarial principles and practices. Any proposed 
540.21 	differences in capitation rates between covered populations must be based on valid rate 
540.22 	development standards and not on the rate of federal financial participation associated with 
540.23 	the covered populations;
540.24 	(2) be appropriate for the populations covered and the services furnished under the 
540.25 	contract;
540.26 	(3) meet the requirements for availability of services, adequate capacity, and coordination 
540.27 	and continuity of care in accordance with Code of Federal Regulations, part 42, sections 
540.28 	438.206, 438.207, and 438.208;
540.29 	(4) be specific to each rate cell under the contract, and must not cross-subsidize or be 
540.30 	cross-subsidized by payments from any other rate cell;
540.31 	(5) meet any special contract provisions in accordance with Code of Federal Regulations, 
540.32 	part 42, section 438.6; and
541.1 	(6) be developed to reasonably achieve a medical loss ratio standard of at least 85 percent 
541.2 	for the rate year, or a higher minimum medical loss ratio if mandated by the commissioner, 
541.3 	as long as the capitation rates are adequate for reasonable, appropriate, and attainable 
541.4 	nonbenefit costs.
541.5 	(b) An independent actuary must certify that the rates were developed in accordance 
541.6 	with Code of Federal Regulations, part 42, section 438.3, paragraph (c), clause (1), item 
541.7 	(ii), paragraph (e).
541.8 		Subd. 3.Rate development standards. (a) In developing capitation rates, the 
541.9 	commissioner shall:
541.10 	(1) identify and develop base utilization and price data, including validated encounter 
541.11 	data and audited financial reports received from the managed care organizations that 
541.12 	demonstrate experience for the populations served by the managed care organizations, for 
541.13 	the three most recent and complete years before the rating period;
541.14 	(2) develop and apply reasonable trend factors, including cost and utilization, to base 
541.15 	data that are developed from actual experience of the medical assistance population or a 
541.16 	similar population according to generally accepted actuarial practices and principles;
541.17 	(3) develop the nonbenefit component of the rate to account for reasonable expenses 
541.18 	related to the managed care organization's administration; taxes; licensing and regulatory 
541.19 	fees; contribution to reserves; risk margin; cost of capital and other operational costs 
541.20 	associated with the managed care organization's provision of covered services to enrollees;
541.21 	(4) consider the value of cost-sharing for rate development purposes, regardless of 
541.22 	whether the managed care organization imposes the cost-sharing on the enrollee or the 
541.23 	cost-sharing is collected by the provider;
541.24 	(5) make appropriate and reasonable adjustments to account for changes to the base data, 
541.25 	programmatic changes, changes to nonbenefit components, and any other adjustment 
541.26 	necessary to establish actuarially sound rates. Each adjustment must reasonably support the 
541.27 	development of an accurate base data set for purposes of rate setting, reflect the health status 
541.28 	of the enrolled population, and be developed in accordance with generally accepted actuarial 
541.29 	principles and practices;
541.30 	(6) consider the managed care organization's past medical loss ratio in the development 
541.31 	of the capitation rates and consider the projected medical loss ratio; and
542.1 	(7) select a prospective or retrospective risk adjustment methodology that must be 
542.2 	developed in a budget-neutral manner consistent with generally accepted actuarial principles 
542.3 	and practices.
542.4 	(b) The base data must be derived from the medical assistance population or, if data on 
542.5 	the medical assistance population is not available, derived from a similar population and 
542.6 	adjusted to make the utilization and price data comparable to the medical assistance 
542.7 	population. Data must be in accordance with actuarial standards for data quality and an 
542.8 	explanation of why that specific data is used must be provided in the rate certification. If 
542.9 	the commissioner is unable to base the rates on data that are within the three most recent 
542.10 	and complete years before the rating period, the commissioner may request an approval 
542.11 	from the Centers for Medicare and Medicaid Services for an exception. The request must 
542.12 	describe why an exception is necessary and describe the actions that the commissioner 
542.13 	intends to take to comply with the request.
542.14 		Subd. 4.Special contract requirements related to payment. (a) If the commissioner 
542.15 	uses risk-sharing mechanisms, including reinsurance, risk corridors, or stop-loss limits, the 
542.16 	risk-sharing mechanism must be described in the contract, and must be developed according 
542.17 	to the rate development standards and generally accepted actuarial principles and practices.
542.18 	(b) The commissioner may utilize incentive payment arrangements in managed care 
542.19 	organization contracts. Any incentive arrangement utilized by the commissioner must be 
542.20 	made available to all managed care organizations under contract with the commissioner 
542.21 	under the same terms of performance. The payment must not exceed 105 percent of the 
542.22 	approved capitation payments attributable to the enrollees or services covered by the incentive 
542.23 	arrangement and must be actuarially sound. For all incentive arrangements the contract 
542.24 	must state that the arrangement is:
542.25 	(1) for a fixed period of time and performance is measured during the rating period in 
542.26 	which the incentive arrangement is applied;
542.27 	(2) not renewed automatically; and
542.28 	(3) associated with specified activities, targets, performance measures, or quality-based 
542.29 	outcomes in the quality strategy described under section 256B.6927.
542.30 	The incentive payment arrangement must not condition a managed care organization's 
542.31 	participation in the incentive arrangement upon entering into or adhering to an 
542.32 	intergovernmental transfer agreement.
543.1 	(c) The commissioner may utilize withhold arrangements in managed care organization 
543.2 	contracts. Any withhold arrangement utilized by the commissioner must be applied to all 
543.3 	managed care organizations under contract with the commissioner under the same terms of 
543.4 	performance. Any withhold arrangement must ensure that the capitation payment minus 
543.5 	any portion of the withheld funds that is not reasonably achievable is actuarially sound. The 
543.6 	total amount of the withheld funds, achievable or not, must be reasonable and must take 
543.7 	into consideration each managed care organization's financial operating needs, accounting 
543.8 	for the size and characteristics of the populations covered under the contract, as well as the 
543.9 	managed care organization's capital reserves, as measured by the risk based capital level, 
543.10 	months of claims reserve, or other appropriate measure of reserves. The data, assumptions, 
543.11 	and methodologies used to determine the portion of the withhold that is reasonably achievable 
543.12 	must be submitted as part of the documentation required by Code of Federal Regulations, 
543.13 	part 42, section 438.7, paragraph (b), clause (6). For all withhold arrangements, the contract 
543.14 	must state that the arrangement is:
543.15 	(1) for a fixed period of time and performance is measured during the rating period in 
543.16 	which the withhold arrangement is applied;
543.17 	(2) not renewed automatically; and
543.18 	(3) associated with specified activities, targets, performance measures, or quality-based 
543.19 	outcomes in the state's quality strategy.
543.20 	The withhold payment arrangement must not condition a managed care organization's 
543.21 	participation in the withhold arrangement upon entering into or adhering to an 
543.22 	intergovernmental transfer agreement.
543.23 		Subd. 5.Direction of managed care organization expenditures. (a) The commissioner 
543.24 	shall not direct managed care organizations expenditures under the managed care contract, 
543.25 	except in the following situations:
543.26 	(1) implementation of a value-based purchasing model for provider reimbursement, 
543.27 	including pay-for-performance arrangements, bundled payments, or other service payments 
543.28 	intended to recognize value or outcomes over volume of services;
543.29 	(2) participation in a multipayer or medical assistance-specific delivery system reform 
543.30 	or performance improvement initiative; or
543.31 	(3) implementation of a minimum or maximum fee schedule, or a uniform dollar or 
543.32 	percentage increase for network providers that provide a particular service. The maximum 
544.1 	fee schedule must allow the managed care organization the ability to reasonably manage 
544.2 	risk and provide discretion in accomplishing the goals of the contract.
544.3 	(b) Any managed care contract that directs managed care organization expenditures as 
544.4 	permitted under paragraph (a), clauses (1) to (3), must be developed in accordance with 
544.5 	Code of Federal Regulations, part 42, sections 438.4 and 438.5; comply with actuarial 
544.6 	soundness and generally accepted actuarial principles and practices; and have written 
544.7 	approval from the Centers for Medicare and Medicaid Services before implementation. To 
544.8 	obtain approval, the commissioner shall demonstrate in writing that the contract arrangement:
544.9 	(1) is based on the utilization and delivery of services;
544.10 	(2) directs expenditures equally, using the same terms of performance for a class of 
544.11 	providers providing service under the contract;
544.12 	(3) is intended to advance at least one of the goals and objectives in the commissioner's 
544.13 	quality strategy;
544.14 	(4) has an evaluation plan that measures the degree to which the arrangement advances 
544.15 	at least one of the goals in the commissioner's quality strategy;
544.16 	(5) does not condition network provider participation on the network provider entering 
544.17 	into or adhering to an intergovernmental transfer agreement; and
544.18 	(6) is not renewed automatically.
544.19 	(c) For contract arrangements identified in paragraph (a), clauses (1) and (2), the 
544.20 	commissioner shall:
544.21 	(1) make participation in the value-based purchasing model, special delivery system 
544.22 	reform, or performance improvement initiative available, using the same terms of 
544.23 	performance, to a class of providers providing services under the contract related to the 
544.24 	model, reform, or initiative; and
544.25 	(2) use a common set of performance measures across all payers and providers.
544.26 	(d) The commissioner shall not set the amount or frequency of the expenditures or recoup 
544.27 	from the managed care organization any unspent funds allocated for these arrangements.
544.28 		Subd. 6.Monthly capitation payments for placements in institutions of mental 
544.29 	disease. The commissioner may make a monthly capitation payment to a managed care 
544.30 	organization for an enrollee under the age of 65 receiving treatment for psychiatric or 
544.31 	substance use disorder in an institution for mental diseases in accordance with Code of 
544.32 	Federal Regulations, part 42, section 438.6, paragraph (e).
545.1 		Subd. 7.Rate certification submission. (a) The commissioner shall submit the rate 
545.2 	certifications to the Centers for Medicare and Medicaid Services for review and approval 
545.3 	at the same time as the managed care contracts. The rate certification must satisfy Code of 
545.4 	Federal Regulations, part 42, section 438.7, paragraph (b), and must include:
545.5 	(1) base data used in the rate setting process;
545.6 	(2) trend, including changes in the utilization and the price of services;
545.7 	(3) the nonbenefit component of the rate;
545.8 	(4) any adjustments;
545.9 	(5) the prospective and retrospective risk adjustment methodology; and
545.10 	(6) any special contract provisions related to payment.
545.11 	(b) The commissioner, through the state's actuary, must certify the final capitation rates 
545.12 	paid per rate cell under each contract and document the underlying data, assumptions and 
545.13 	methodologies.
545.14 	(c) The commissioner may pay a managed care organization a capitation rate under a 
545.15 	managed care contract that is different than the capitation rate paid to another managed care 
545.16 	organization, if each capitation rate per rate cell that is paid is independently developed and 
545.17 	set in accordance with Code of Federal Regulations, part 42, sections 438.4, 438.5, 438.6, 
545.18 	and 438.8. The commissioner may increase or decrease the capitation rate per rate cell in 
545.19 	accordance with Code of Federal Regulations, part 42, sections 438.4, paragraph (b), clause 
545.20 	(4), and 438.7, paragraph (c), up to 1.5 percent without submitting a revised rate certification.
545.21 	(d) If the commissioner determines that a retroactive adjustment to the capitation rate 
545.22 	is necessary, the retroactive adjustment must be supported by a rationale for the adjustment 
545.23 	and the data. Assumptions and methodologies used to develop the adjustment must be 
545.24 	described with enough detail to allow the Centers for Medicare and Medicaid Services or 
545.25 	an actuary to determine the reasonableness of the adjustment. Any retroactive adjustments 
545.26 	must be certified by an actuary in a revised rate certification and submitted to the Centers 
545.27 	for Medicare and Medicaid Services for approval as a contract amendment. All adjustments 
545.28 	are subject to timely federal claim filing requirements.
545.29 	(e) The commissioner shall, upon request from the Centers for Medicare and Medicaid 
545.30 	Services, provide additional information if the Centers for Medicare and Medicaid Services 
545.31 	determines the information is pertinent to certification approval. The commissioner shall 
545.32 	identify whether the additional information shall be provided by the commissioner, the 
545.33 	actuary, or another party.
546.1 		Subd. 8.Medical loss ratio. (a) The commissioner shall require that each managed care 
546.2 	organization calculate and submit to the commissioner a medical loss ratio report for each 
546.3 	contract year. The calculation of the medical loss ratio in the medical loss ratio reporting 
546.4 	year must be the ratio of the numerator to the denominator. The numerator must be the sum 
546.5 	of the managed care organization's incurred claims, the managed care organization's 
546.6 	expenditures for activities that improve health care quality, and fraud prevention activities. 
546.7 	The denominator must be calculated as the managed care organization's adjusted premium 
546.8 	revenue minus the managed care organization's federal, state, and local taxes and licensing 
546.9 	and regulatory fees identified in Code of Federal Regulations, part 42, section 438.8, 
546.10 	paragraph (f), clause (3). The total amount of the denominator for a managed care 
546.11 	organization that is assumed by another managed care organization must be reported by the 
546.12 	assuming managed care organization for the entire medical loss ratio reporting year. The 
546.13 	managed care organization must aggregate the data for all eligibility groups covered under 
546.14 	the contract, unless the commissioner requires separate reporting and a separate medical 
546.15 	loss ratio calculation for specific populations.
546.16 	(b) Incurred claims must be identified by the expenditures, liabilities, reserves, deductions, 
546.17 	and exclusions in accordance with Code of Federal Regulations, part 42, section 438.8, 
546.18 	paragraph (e), clause (2).
546.19 	(c) Activities that improve health care quality must be in one category in accordance 
546.20 	with Code of Federal Regulations, part 42, section 438.8, paragraph (e), clause (3).
546.21 	(d) Fraud prevention activities, including managed care organization expenditures on 
546.22 	activities related to fraud prevention must be identified in accordance with Code of Federal 
546.23 	Regulations, part 45, section 158.
546.24 	(e) Premium revenue must include capitation payments; onetime payments for specific 
546.25 	life events of enrollees; other payments to the managed care organization in accordance 
546.26 	with Code of Federal Regulations, part 42, section 438.6, paragraph (b), clause (3); unpaid 
546.27 	cost-sharing amounts; and changes to unearned premium reserves, net payments, and receipts 
546.28 	related to risk-sharing mechanisms.
546.29 	(f) When calculating the medical loss ratio, each expense must be included under only 
546.30 	one type of expense, unless a portion of the expense fits under the definition of, or criteria 
546.31 	for, one type of expense and the remainder fits into a different type of expense, in which 
546.32 	case the expense must be prorated between types of expenses. Expenditures that benefit 
546.33 	multiple contracts or populations, or contracts other than those being reported, must be 
547.1 	reported on a pro rata basis. Expenses must be allocated using the methods described in 
547.2 	Code of Federal Regulations, part 42, section 438.8, paragraph (g), clause (2).
547.3 	(g) The commissioner may require the managed care organization to provide a remittance 
547.4 	if the medical loss ratio for the medical loss ratio reporting year does not meet the minimum 
547.5 	medical loss ratio standard of 85 percent, or if applicable, a higher ratio mandated by the 
547.6 	commissioner.
547.7 		Subd. 9.Reports. (a) The commissioner shall require each managed care organization 
547.8 	to submit a report to the commissioner for each medical loss ratio reporting year that includes 
547.9 	the information identified in Code of Federal Regulations, part 42, section 438.8, paragraph 
547.10 	(k). The report must be submitted within 12 months of the end of each medical loss ratio 
547.11 	reporting year. The managed care organization must require any third-party vendor providing 
547.12 	claims adjudication to provide all underlying data associated with medical loss ratio reporting 
547.13 	to the managed care organization within 180 days of the end of the medical loss ratio 
547.14 	reporting year or within 30 days of being requested by the managed care organization to 
547.15 	calculate and validate the accuracy of medical loss ratio reporting. The managed care 
547.16 	organization must include with the medical loss ratio report an attestation as to the accuracy 
547.17 	of the calculation of the medical loss ratio.
547.18 	(b) The commissioner shall annually submit to the Centers for Medicare and Medicaid 
547.19 	Services a summary description of the reports received from the managed care organizations 
547.20 	in accordance with Code of Federal Regulations, part 42, section 438.8, paragraph (k), along 
547.21 	with the rate certification required under subdivision 7. At a minimum, the summary 
547.22 	description must include for the medical loss ratio report reporting year, the amount of the 
547.23 	numerator, the amount of the denominator, the medical loss ratio percentage achieved, the 
547.24 	number of member months, and any remittances owed. If through the contract the 
547.25 	commissioner requires the managed care organization to pay remittances for not meeting 
547.26 	the minimum medical loss ratio, the commissioner must reimburse the Centers for Medicare 
547.27 	and Medicaid Services the federal share that reflects any differences in the federal matching 
547.28 	rate. If a remittance is owed, the commissioner shall submit with the required report a 
547.29 	separate report describing the methodology used to determine the state and federal shares 
547.30 	of the remittance.
547.31 	(c) If the commissioner makes a retroactive change to the capitation payments for a 
547.32 	medical loss ratio reporting year for which the report was already submitted to the 
547.33 	commissioner, the managed care organization shall recalculate the medical loss ratio for 
547.34 	that year and submit a new report meeting the reporting requirements under paragraph (a).
548.1 	(d) The commissioner may exempt a newly contracted managed care organization from 
548.2 	calculating and reporting the medical loss ratio for the first year of the managed care 
548.3 	organization's operation as required under this subdivision. If a managed care organization 
548.4 	is excluded, the managed care organization must comply with the requirements of this 
548.5 	section during the next medical loss ratio reporting year.

548.6 	ARTICLE 16
548.7 	CHILD CARE DEVELOPMENT BLOCK GRANT COMPLIANCE

548.8 	Section 1. Minnesota Statutes 2016, section 245A.04, subdivision 4, is amended to read:
548.9 		Subd. 4.Inspections; waiver. (a) Before issuing an initial license, the commissioner 
548.10 	shall conduct an inspection of the program. The inspection must include but is not limited 
548.11 	to:
548.12 	(1) an inspection of the physical plant;
548.13 	(2) an inspection of records and documents;
548.14 	(3) an evaluation of the program by consumers of the program; and
548.15 	(4) observation of the program in operation.; and
548.16 	(5) an inspection for the health, safety, and fire standards in licensing requirements for 
548.17 	a child care license holder.
548.18 	For the purposes of this subdivision, "consumer" means a person who receives the 
548.19 	services of a licensed program, the person's legal guardian, or the parent or individual having 
548.20 	legal custody of a child who receives the services of a licensed program.
548.21 	(b) The evaluation required in paragraph (a), clause (3) or the observation in paragraph 
548.22 	(a), clause (4) is not required prior to issuing an initial license under subdivision 7. If the 
548.23 	commissioner issues an initial license under subdivision 7, these requirements must be 
548.24 	completed within one year after the issuance of an initial license.
548.25 	(c) The commissioner or the county shall inspect at least annually a child care provider 
548.26 	licensed under this chapter and Minnesota Rules, chapter 9502 or 9503, for compliance 
548.27 	with applicable licensing standards.
548.28 	(d) No later than November 19, 2017, the commissioner shall make publicly available 
548.29 	on the department's Web site the results of inspection reports of all child care providers 
548.30 	licensed under this chapter and under Minnesota Rules, chapter 9502 or 9503, and the 
549.1 	number of deaths, serious injuries, and instances of substantiated child maltreatment that 
549.2 	occurred in licensed child care settings each year.

549.3 	EFFECTIVE DATE. This section is effective August 1, 2017.

549.4 	Sec. 2. Minnesota Statutes 2016, section 245A.09, subdivision 7, is amended to read:
549.5 		Subd. 7.Regulatory methods. (a) Where appropriate and feasible the commissioner 
549.6 	shall identify and implement alternative methods of regulation and enforcement to the extent 
549.7 	authorized in this subdivision. These methods shall include:
549.8 	(1) expansion of the types and categories of licenses that may be granted;
549.9 	(2) when the standards of another state or federal governmental agency or an independent 
549.10 	accreditation body have been shown to require the same standards, methods, or alternative 
549.11 	methods to achieve substantially the same intended outcomes as the licensing standards, 
549.12 	the commissioner shall consider compliance with the governmental or accreditation standards 
549.13 	to be equivalent to partial compliance with the licensing standards; and
549.14 	(3) use of an abbreviated inspection that employs key standards that have been shown 
549.15 	to predict full compliance with the rules.
549.16 	(b) If the commissioner accepts accreditation as documentation of compliance with a 
549.17 	licensing standard under paragraph (a), the commissioner shall continue to investigate 
549.18 	complaints related to noncompliance with all licensing standards. The commissioner may 
549.19 	take a licensing action for noncompliance under this chapter and shall recognize all existing 
549.20 	appeal rights regarding any licensing actions taken under this chapter.
549.21 	(c) The commissioner shall work with the commissioners of health, public safety, 
549.22 	administration, and education in consolidating duplicative licensing and certification rules 
549.23 	and standards if the commissioner determines that consolidation is administratively feasible, 
549.24 	would significantly reduce the cost of licensing, and would not reduce the protection given 
549.25 	to persons receiving services in licensed programs. Where administratively feasible and 
549.26 	appropriate, the commissioner shall work with the commissioners of health, public safety, 
549.27 	administration, and education in conducting joint agency inspections of programs.
549.28 	(d) The commissioner shall work with the commissioners of health, public safety, 
549.29 	administration, and education in establishing a single point of application for applicants 
549.30 	who are required to obtain concurrent licensure from more than one of the commissioners 
549.31 	listed in this clause.
550.1 	(e) Unless otherwise specified in statute, the commissioner may conduct routine 
550.2 	inspections biennially.
550.3 	(f) For a licensed child care center, the commissioner shall conduct one unannounced 
550.4 	licensing inspection at least annually.

550.5 	EFFECTIVE DATE. This section is effective August 1, 2017.

550.6 	Sec. 3. Minnesota Statutes 2016, section 245A.10, subdivision 2, is amended to read:
550.7 		Subd. 2.County fees for background studies and licensing inspections. (a) Before 
550.8 	the implementation of NETStudy 2.0, for purposes of family and group family child care 
550.9 	licensing under this chapter, a county agency may charge a fee to an applicant or license 
550.10 	holder to recover the actual cost of background studies, but in any case not to exceed $100 
550.11 	annually. A county agency may also charge a license fee to an applicant or license holder 
550.12 	not to exceed $50 for a one-year license or $100 for a two-year license.
550.13 	(b) Before the implementation of NETStudy 2.0, a county agency may charge a fee to 
550.14 	a legal nonlicensed child care provider or applicant for authorization to recover the actual 
550.15 	cost of background studies completed under section 119B.125, but in any case not to exceed 
550.16 	$100 annually.
550.17 	(c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):
550.18 	(1) in cases of financial hardship;
550.19 	(2) if the county has a shortage of providers in the county's area;
550.20 	(3) for new providers; or
550.21 	(4) for providers who have attained at least 16 hours of training before seeking initial 
550.22 	licensure.
550.23 	(d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on an 
550.24 	installment basis for up to one year. If the provider is receiving child care assistance payments 
550.25 	from the state, the provider may have the fees under paragraph (a) or (b) deducted from the 
550.26 	child care assistance payments for up to one year and the state shall reimburse the county 
550.27 	for the county fees collected in this manner.
550.28 	(e) For purposes of adult foster care and child foster care licensing, and licensing the 
550.29 	physical plant of a community residential setting, under this chapter, a county agency may 
550.30 	charge a fee to a corporate applicant or corporate license holder to recover the actual cost 
550.31 	of licensing inspections, not to exceed $500 annually.
551.1 	(f) Counties may elect to reduce or waive the fees in paragraph (e) under the following 
551.2 	circumstances:
551.3 	(1) in cases of financial hardship;
551.4 	(2) if the county has a shortage of providers in the county's area; or
551.5 	(3) for new providers.

551.6 	EFFECTIVE DATE. This section is effective August 1, 2017.

551.7 	Sec. 4. Minnesota Statutes 2016, section 245A.14, is amended by adding a subdivision to 
551.8 	read:
551.9 		Subd. 15.Parental access in child care programs. An enrolled child's parent or legal 
551.10 	guardian must be allowed access to the parent's or legal guardian's child any time while the 
551.11 	child is in care.

551.12 	EFFECTIVE DATE. This section is effective August 1, 2017.

551.13 	Sec. 5. Minnesota Statutes 2016, section 245A.16, subdivision 1, is amended to read:
551.14 		Subdivision 1.Delegation of authority to agencies. (a) County agencies and private 
551.15 	agencies that have been designated or licensed by the commissioner to perform licensing 
551.16 	functions and activities under section 245A.04 and background studies for family child care 
551.17 	under chapter 245C; to recommend denial of applicants under section 245A.05; to issue 
551.18 	correction orders, to issue variances, and recommend a conditional license under section 
551.19 	245A.06; or to recommend suspending or revoking a license or issuing a fine under section 
551.20 	245A.07, shall comply with rules and directives of the commissioner governing those 
551.21 	functions and with this section. The following variances are excluded from the delegation 
551.22 	of variance authority and may be issued only by the commissioner:
551.23 	(1) dual licensure of family child care and child foster care, dual licensure of child and 
551.24 	adult foster care, and adult foster care and family child care;
551.25 	(2) adult foster care maximum capacity;
551.26 	(3) adult foster care minimum age requirement;
551.27 	(4) child foster care maximum age requirement;
551.28 	(5) variances regarding disqualified individuals except that, before the implementation 
551.29 	of NETStudy 2.0, county agencies may issue variances under section 245C.30 regarding 
551.30 	disqualified individuals when the county is responsible for conducting a consolidated 
552.1 	reconsideration according to sections 245C.25 and 245C.27, subdivision 2, clauses (a) and 
552.2 	(b), of a county maltreatment determination and a disqualification based on serious or 
552.3 	recurring maltreatment;
552.4 	(6) the required presence of a caregiver in the adult foster care residence during normal 
552.5 	sleeping hours; and
552.6 	(7) variances to requirements relating to chemical use problems of a license holder or a 
552.7 	household member of a license holder.
552.8 	Except as provided in section 245A.14, subdivision 4, paragraph (e), a county agency must 
552.9 	not grant a license holder a variance to exceed the maximum allowable family child care 
552.10 	license capacity of 14 children.
552.11 	(b) Before the implementation of NETStudy 2.0, county agencies must report information 
552.12 	about disqualification reconsiderations under sections 245C.25 and 245C.27, subdivision 
552.13 	2, paragraphs (a) and (b), and variances granted under paragraph (a), clause (5), to the 
552.14 	commissioner at least monthly in a format prescribed by the commissioner.
552.15 	(c) For family day child care programs, the commissioner may authorize shall require 
552.16 	a county agency to conduct one unannounced licensing reviews every two years after a 
552.17 	licensee has had at least one annual review at least annually.
552.18 	(d) For family adult day services programs, the commissioner may authorize licensing 
552.19 	reviews every two years after a licensee has had at least one annual review.
552.20 	(e) A license issued under this section may be issued for up to two years.
552.21 	(f) During implementation of chapter 245D, the commissioner shall consider:
552.22 	(1) the role of counties in quality assurance;
552.23 	(2) the duties of county licensing staff; and
552.24 	(3) the possible use of joint powers agreements, according to section 471.59, with counties 
552.25 	through which some licensing duties under chapter 245D may be delegated by the 
552.26 	commissioner to the counties.
552.27 	Any consideration related to this paragraph must meet all of the requirements of the corrective 
552.28 	action plan ordered by the federal Centers for Medicare and Medicaid Services.
552.29 	(g) Licensing authority specific to section 245D.06, subdivisions 5, 6, 7, and 8, or 
552.30 	successor provisions; and section 245D.061 or successor provisions, for family child foster 
552.31 	care programs providing out-of-home respite, as identified in section 245D.03, subdivision 
553.1 	1, paragraph (b), clause (1), is excluded from the delegation of authority to county and 
553.2 	private agencies.
553.3 	(h) A county agency shall report to the commissioner, in a manner prescribed by the 
553.4 	commissioner, the following information for a licensed family child care program:
553.5 	(1) the results of each licensing review completed, including the date of the review, any 
553.6 	licensing correction order issued; and
553.7 	(2) any death, serious injury, or determination of substantiated maltreatment.

553.8 	EFFECTIVE DATE. This section is effective August 1, 2017.

553.9 	Sec. 6. Minnesota Statutes 2016, section 245A.16, is amended by adding a subdivision to 
553.10 	read:
553.11 		Subd. 7.Family child care licensing oversight. Only county staff trained by the 
553.12 	commissioner on the family child care licensing standards in this chapter and Minnesota 
553.13 	Rules, chapter 9502, shall perform family child care licensing functions under subdivision 
553.14 	1. Training must occur within 90 days of a staff person's employment.

553.15 	EFFECTIVE DATE. This section is effective August 1, 2017.

553.16 	Sec. 7. Minnesota Statutes 2016, section 245A.40, subdivision 1, is amended to read:
553.17 		Subdivision 1.Orientation. The child care center license holder must ensure that every 
553.18 	staff person and volunteer is given orientation training and successfully completes the 
553.19 	training before starting assigned duties. The orientation training in this subdivision applies 
553.20 	to volunteers who will have direct contact with or access to children and who are not under 
553.21 	the direct supervision of a staff person. Completion of the orientation must be documented 
553.22 	in the individual's personnel record. The orientation training must include information about:
553.23 	(1) the center's philosophy, child care program, and procedures for maintaining health 
553.24 	and safety according to section 245A.41 and Minnesota Rules, part 9503.0140, and handling 
553.25 	emergencies and accidents according to Minnesota Rules, part 9503.0110;
553.26 	(2) specific job responsibilities;
553.27 	(3) the behavior guidance standards in Minnesota Rules, part 9503.0055; and
553.28 	(4) the reporting responsibilities in section 626.556, and Minnesota Rules, part 9503.0130.

553.29 	EFFECTIVE DATE. This section is effective August 1, 2017.

554.1 	Sec. 8. Minnesota Statutes 2016, section 245A.40, subdivision 2, is amended to read:
554.2 		Subd. 2.Child growth and development and learning training. (a) For purposes of 
554.3 	child care centers, the director and all staff hired after July 1, 2006, shall complete and 
554.4 	document at least two hours of child growth and development and learning training within 
554.5 	the first year 90 days of employment. For purposes of this subdivision, "child growth and
554.6 	development and learning training" means training in understanding how children acquire 
554.7 	language and develop physically, cognitively, emotionally, and socially and learn as part 
554.8 	of the children's family, culture, and community. Training completed under this subdivision 
554.9 	may be used to meet the orientation training requirements under subdivision 1 and the 
554.10 	in-service training requirements under subdivision 7.
554.11 	(b) Notwithstanding paragraph (a), individuals are exempt from this requirement if they:
554.12 	(1) have taken a three-credit college course on early childhood development within the 
554.13 	past five years;
554.14 	(2) have received a baccalaureate or master's degree in early childhood education or 
554.15 	school-age child care within the past five years;
554.16 	(3) are licensed in Minnesota as a prekindergarten teacher, an early childhood educator, 
554.17 	a kindergarten to sixth grade teacher with a prekindergarten specialty, an early childhood 
554.18 	special education teacher, or an elementary teacher with a kindergarten endorsement; or
554.19 	(4) have received a baccalaureate degree with a Montessori certificate within the past 
554.20 	five years.

554.21 	EFFECTIVE DATE. This section is effective August 1, 2017.

554.22 	Sec. 9. Minnesota Statutes 2016, section 245A.40, subdivision 3, is amended to read:
554.23 		Subd. 3.First aid. (a) All teachers and assistant teachers in a child care center governed 
554.24 	by Minnesota Rules, parts 9503.0005 to 9503.0170, and at least one staff person during 
554.25 	field trips and when transporting children in care, must satisfactorily complete pediatric 
554.26 	first aid training within 90 days of the start of work, unless the training has been completed 
554.27 	within the previous three two years.
554.28 	(b) Notwithstanding paragraph (a), which allows 90 days to complete training, at least 
554.29 	one staff person who has satisfactorily completed pediatric first aid training must be present 
554.30 	at all times in the center, during field trips, and when transporting children in care.
554.31 	(c) The pediatric first aid training must be repeated at least every three two years, 
554.32 	documented in the person's personnel record and indicated on the center's staffing chart, 
555.1 	and provided by an individual approved as a first aid instructor. This training may be less 
555.2 	than eight hours.

555.3 	EFFECTIVE DATE. This section is effective August 1, 2017.

555.4 	Sec. 10. Minnesota Statutes 2016, section 245A.40, subdivision 4, is amended to read:
555.5 		Subd. 4.Cardiopulmonary resuscitation. (a) All teachers and assistant teachers in a 
555.6 	child care center governed by Minnesota Rules, parts 9503.0005 to 9503.0170, and at least 
555.7 	one staff person during field trips and when transporting children in care, must satisfactorily 
555.8 	complete training in cardiopulmonary resuscitation (CPR) that includes CPR techniques 
555.9 	for infants and children and in the treatment of obstructed airways. The CPR training must 
555.10 	be completed within 90 days of the start of work, unless the training has been completed 
555.11 	within the previous three two years. The CPR training must have been provided by an 
555.12 	individual approved to provide CPR instruction, must be repeated at least once every three
555.13 	two years, and must be documented in the staff person's records.
555.14 	(b) Notwithstanding paragraph (a), which allows 90 days to complete training, at least 
555.15 	one staff person who has satisfactorily completed cardiopulmonary resuscitation training 
555.16 	must be present at all times in the center, during field trips, and when transporting children 
555.17 	in care.
555.18 	(c) CPR training may be provided for less than four hours.
555.19 	(d) Persons providing CPR training must use CPR training that has been developed:
555.20 	(1) by the American Heart Association or the American Red Cross and incorporates 
555.21 	psychomotor skills to support the instruction; or
555.22 	(2) using nationally recognized, evidence-based guidelines for CPR and incorporates 
555.23 	psychomotor skills to support the instruction.

555.24 	EFFECTIVE DATE. This section is effective August 1, 2017.

555.25 	Sec. 11. Minnesota Statutes 2016, section 245A.40, subdivision 7, is amended to read:
555.26 		Subd. 7.In-service. (a) A license holder must ensure that an annual in-service training 
555.27 	plan is developed and carried out and that it meets the requirements in clauses (1) to (7). 
555.28 	The in-service training plan must: the center director and all staff who have direct contact 
555.29 	with a child complete annual in-service training. In-service training requirements must be 
555.30 	met by a staff person's participation in the following training areas:
555.31 	(1) be consistent with the center's child care program plan;
556.1 	(2) meet the training needs of individual staff persons as specified in each staff person's 
556.2 	annual evaluation report;
556.3 	(3) provide training, at least one-fourth of which is by a resource not affiliated with the 
556.4 	license holder;
556.5 	(4) include Minnesota Rules, parts 9503.0005 to 9503.0170, relevant to the staff person's 
556.6 	position and must occur within two weeks of initial employment;
556.7 	(5) provide that at least one-half of the annual in-service training completed by a staff 
556.8 	person each year pertains to the age of children for which the person is providing care;
556.9 	(6) provide that no more than four hours of each annual in-service training requirement 
556.10 	relate to administration, finances, and records training for a teacher, assistant teacher, or 
556.11 	aide; and
556.12 	(7) provide that the remainder of the in-service training requirement be met by 
556.13 	participation in training in child growth and development; learning environment and 
556.14 	curriculum; assessment and planning for individual needs; interactions with children; families 
556.15 	and communities; health, safety, and nutrition; and program planning and evaluation.
556.16 	(1) child development and learning;
556.17 	(2) developmentally appropriate learning experiences;
556.18 	(3) relationships with families;
556.19 	(4) assessment, evaluation, and individualization;
556.20 	(5) historical and contemporary development of early childhood education;
556.21 	(6) professionalism; and
556.22 	(7) health, safety, and nutrition.
556.23 	(b) For purposes of this subdivision, the following terms have the meanings given them.
556.24 	(1) "Child growth and development and learning training" has the meaning given it in 
556.25 	subdivision 2, paragraph (a).
556.26 	(2) "Learning environment and curriculum" means training in establishing an environment 
556.27 	that provides learning experiences to meet each child's needs, capabilities, and interests, 
556.28 	including early childhood education methods or theory, recreation, sports, promoting 
556.29 	creativity in the arts, arts and crafts methods or theory, and early childhood special education 
556.30 	methods or theory.
557.1 	(3) "Assessment and planning for individual needs" means training in observing and 
557.2 	assessing what children know and can do in order to provide curriculum and instruction 
557.3 	that addresses their developmental and learning needs, including children with special needs.
557.4 	(4) "Interactions with children" means training in establishing supportive relationships 
557.5 	with children and guiding them as individuals and as part of a group, including child study 
557.6 	techniques and behavior guidance.
557.7 	(5) "Families and communities" means training in working collaboratively with families, 
557.8 	agencies, and organizations to meet children's needs and to encourage the community's 
557.9 	involvement, including family studies and parent involvement.
557.10 	(6) "Health, safety, and nutrition" means training in establishing and maintaining an 
557.11 	environment that ensures children's health, safety, and nourishment, including first aid, 
557.12 	cardiopulmonary resuscitation, child nutrition, and child abuse and neglect prevention.
557.13 	(7) "Program planning and evaluation" means training in establishing, implementing, 
557.14 	evaluating, and enhancing program operations.
557.15 	(2) "Developmentally appropriate learning experiences" means creating positive learning 
557.16 	experiences, promoting cognitive development, promoting social and emotional development, 
557.17 	promoting physical development, and promoting creative development.
557.18 	(3) "Relationships with families" means training on building a positive, respectful 
557.19 	relationship with the child's family.
557.20 	(4) "Assessment, evaluation, and individualization" means training in observing, 
557.21 	recording, and assessing development; assessing and using information to plan; and assessing 
557.22 	and using information to enhance and maintain program quality.
557.23 	(5) "Historical and contemporary development of early childhood education" means 
557.24 	training in past and current practices in early childhood education and how current events 
557.25 	and issues affect children, families, and programs.
557.26 	(6) "Professionalism" means training in knowledge, skills, and abilities that promote 
557.27 	ongoing professional development.
557.28 	(7) "Health, safety, and nutrition" means training in establishing health practices, ensuring 
557.29 	safety, and providing healthy nutrition.
557.30 	(c) The director and all program staff persons must annually complete a number of hours 
557.31 	of in-service training equal to at least two percent of the hours for which the director or 
557.32 	program staff person is annually paid, unless one of the following is applicable.
558.1 	(1) A teacher at a child care center must complete one percent of working hours of 
558.2 	in-service training annually if the teacher:
558.3 	(i) possesses a baccalaureate or master's degree in early childhood education or school-age 
558.4 	care;
558.5 	(ii) is licensed in Minnesota as a prekindergarten teacher, an early childhood educator, 
558.6 	a kindergarten to sixth grade teacher with a prekindergarten specialty, an early childhood 
558.7 	special education teacher, or an elementary teacher with a kindergarten endorsement; or
558.8 	(iii) possesses a baccalaureate degree with a Montessori certificate.
558.9 	(2) A teacher or assistant teacher at a child care center must complete one and one-half 
558.10 	percent of working hours of in-service training annually if the individual is:
558.11 	(i) a registered nurse or licensed practical nurse with experience working with infants;
558.12 	(ii) possesses a Montessori certificate, a technical college certificate in early childhood 
558.13 	development, or a child development associate certificate; or
558.14 	(iii) possesses an associate of arts degree in early childhood education, a baccalaureate 
558.15 	degree in child development, or a technical college diploma in early childhood development.
558.16 	(d) The number of required training hours may be prorated for individuals not employed 
558.17 	full time or for an entire year.
558.18 	(e) The annual in-service training must be completed within the calendar year for which 
558.19 	it was required. In-service training completed by staff persons is transferable upon a staff 
558.20 	person's change in employment to another child care program.
558.21 	(f) The license holder must ensure that, when a staff person completes in-service training, 
558.22 	the training is documented in the staff person's personnel record. The documentation must 
558.23 	include the date training was completed, the goal of the training and topics covered, trainer's 
558.24 	name and organizational affiliation, trainer's signed statement that training was successfully 
558.25 	completed, and the director's approval of the training.

558.26 	EFFECTIVE DATE. This section is effective August 1, 2017.

558.27 	Sec. 12. Minnesota Statutes 2016, section 245A.40, is amended by adding a subdivision 
558.28 	to read:
558.29 		Subd. 9.Ongoing health and safety training. A staff person's orientation training on 
558.30 	maintaining health and safety and handling emergencies and accidents, as required in 
559.1 	subdivision 1, must be repeated at least once each calendar year by each staff person. The 
559.2 	completion of the annual training must be documented in the staff person's personnel record.

559.3 	EFFECTIVE DATE. This section is effective August 1, 2017.

559.4 	Sec. 13. [245A.41] CHILD CARE CENTER HEALTH AND SAFETY 
559.5 	REQUIREMENTS.
559.6 		Subdivision 1.Allergy prevention and response. (a) Before admitting a child for care, 
559.7 	the license holder must obtain documentation of any known allergy from the child's parent 
559.8 	or legal guardian or the child's source of medical care. If a child has a known allergy, the 
559.9 	license holder must maintain current information about the allergy in the child's record and 
559.10 	develop an individual child care program plan as specified in Minnesota Rules, part 
559.11 	9503.0065, subpart 3. The individual child care program plan must include but not be limited 
559.12 	to a description of the allergy, specific triggers, avoidance techniques, symptoms of an 
559.13 	allergic reaction, and procedures for responding to an allergic reaction, including medication, 
559.14 	dosages, and a doctor's contact information.
559.15 	(b) The license holder must ensure that each staff person who is responsible for carrying 
559.16 	out the individual child care program plan review and follow the plan. Documentation of a 
559.17 	staff person's review must be kept on site.
559.18 	(c) At least annually or following any changes made to allergy-related information in 
559.19 	the child's record, the license holder must update the child's individual child care program 
559.20 	plan and inform each staff person who is responsible for carrying out the individual child 
559.21 	care program plan of the change. The license holder must keep on site documentation that 
559.22 	a staff person was informed of a change.
559.23 	(d) A child's allergy information must be available at all times including on site, when 
559.24 	on field trips, or during transportation. A child's food allergy information must be readily 
559.25 	available to a staff person in the area where food is prepared and served to the child.
559.26 	(e) The license holder must contact the child's parent or legal guardian as soon as possible 
559.27 	in any instance of exposure or allergic reaction that requires medication or medical 
559.28 	intervention. The license holder must call emergency medical services when epinephrine 
559.29 	is administered to a child in the license holder's care.
559.30 		Subd. 2.Handling and disposal of bodily fluids. The licensed child care center must 
559.31 	comply with the following procedures for safely handling and disposing of bodily fluids:
560.1 	(1) surfaces that come in contact with potentially infectious bodily fluids, including 
560.2 	blood and vomit, must be cleaned and disinfected according to Minnesota Rules, part 
560.3 	9503.0005, subpart 11;
560.4 	(2) blood-contaminated material must be disposed of in a plastic bag with a secure tie;
560.5 	(3) sharp items used for a child with special care needs must be disposed of in a "sharps 
560.6 	container." The sharps container must be stored out of reach of a child;
560.7 	(4) the license holder must have the following bodily fluid disposal supplies in the center: 
560.8 	disposable gloves, disposal bags, and eye protection; and
560.9 	(5) the license holder must ensure that each staff person is trained on universal precautions 
560.10 	to reduce the risk of spreading infectious disease. A staff person's completion of the training 
560.11 	must be documented in the staff person's personnel record.
560.12 		Subd. 3.Emergency preparedness. (a) No later than September 30, 2017, a licensed 
560.13 	child care center must have a written emergency plan for emergencies that require evacuation, 
560.14 	sheltering, or other protection of a child, such as fire, natural disaster, intruder, or other 
560.15 	threatening situation that may pose a health or safety hazard to a child. The plan must be 
560.16 	written on a form developed by the commissioner and must include:
560.17 	(1) procedures for an evacuation, relocation, shelter-in-place, or lockdown;
560.18 	(2) a designated relocation site and evacuation route;
560.19 	(3) procedures for notifying a child's parent or legal guardian of the evacuation, relocation,  
560.20 	shelter-in-place, or lockdown, including procedures for reunification with families;
560.21 	(4) accommodations for a child with a disability or a chronic medical condition;
560.22 	(5) procedures for storing a child's medically necessary medicine that facilitates easy 
560.23 	removal during an evacuation or relocation;
560.24 	(6) procedures for continuing operations in the period during and after a crisis; and
560.25 	(7) procedures for communicating with local emergency management officials, law 
560.26 	enforcement officials, or other appropriate state or local authorities.
560.27 	(b) The license holder must train staff persons on the emergency plan at orientation, 
560.28 	when changes are made to the plan, and at least once each calendar year. Training must be 
560.29 	documented in each staff person's personnel file.
560.30 	(c) The license holder must conduct drills according to the requirements in Minnesota 
560.31 	Rules, part 9503.0110, subpart 3. The date and time of the drills must be documented.
561.1 	(d) The license holder must review and update the emergency plan annually. 
561.2 	Documentation of the annual emergency plan review shall be maintained in the program's 
561.3 	administrative records.
561.4 	(e) The license holder must include the emergency plan in the program's policies and 
561.5 	procedures as specified under section 245A.04, subdivision 14. The license holder must 
561.6 	provide a physical or electronic copy of the emergency plan to the child's parent or legal 
561.7 	guardian upon enrollment.
561.8 	(f) The relocation site and evacuation route must be posted in a visible place as part of 
561.9 	the written procedures for emergencies and accidents in Minnesota Rules, part 9503.0140, 
561.10 	subpart 21.

561.11 	EFFECTIVE DATE. This section is effective August 1, 2017.

561.12 	Sec. 14. Minnesota Statutes 2016, section 245A.50, subdivision 2, is amended to read:
561.13 		Subd. 2.Child growth and development and learning and behavior guidance 
561.14 	training. (a) For purposes of family and group family child care, the license holder and 
561.15 	each adult caregiver who provides care in the licensed setting for more than 30 days in any 
561.16 	12-month period shall complete and document at least four hours of child growth and 
561.17 	development learning and behavior guidance training prior to initial licensure, and before 
561.18 	caring for children. For purposes of this subdivision, "child growth and development and 
561.19 	learning training" means training in understanding how children acquire language and
561.20 	develop physically, cognitively, emotionally, and socially and learn as part of the children's 
561.21 	family, culture, and community. "Behavior guidance training" means training in the 
561.22 	understanding of the functions of child behavior and strategies for managing challenging 
561.23 	situations. At least two hours of child growth and development and learning or behavior 
561.24 	guidance training must be repeated annually. Training curriculum shall be developed or 
561.25 	approved by the commissioner of human services by January 1, 2014.
561.26 	(b) Notwithstanding paragraph (a), individuals are exempt from this requirement if they:
561.27 	(1) have taken a three-credit course on early childhood development within the past five 
561.28 	years;
561.29 	(2) have received a baccalaureate or master's degree in early childhood education or 
561.30 	school-age child care within the past five years;
561.31 	(3) are licensed in Minnesota as a prekindergarten teacher, an early childhood educator, 
561.32 	a kindergarten to grade 6 teacher with a prekindergarten specialty, an early childhood special 
561.33 	education teacher, or an elementary teacher with a kindergarten endorsement; or
562.1 	(4) have received a baccalaureate degree with a Montessori certificate within the past 
562.2 	five years.

562.3 	EFFECTIVE DATE. This section is effective August 1, 2017.

562.4 	Sec. 15. Minnesota Statutes 2016, section 245A.50, subdivision 7, is amended to read:
562.5 		Subd. 7.Training requirements for family and group family child care. For purposes 
562.6 	of family and group family child care, the license holder and each primary caregiver must 
562.7 	complete 16 hours of ongoing training each year. For purposes of this subdivision, a primary 
562.8 	caregiver is an adult caregiver who provides services in the licensed setting for more than 
562.9 	30 days in any 12-month period. Repeat of topical training requirements in subdivisions 2 
562.10 	to 8 shall count toward the annual 16-hour training requirement. Additional ongoing training 
562.11 	subjects to meet the annual 16-hour training requirement must be selected from the following 
562.12 	areas:
562.13 	(1) child growth and development and learning training under subdivision 2, paragraph 
562.14 	(a);
562.15 	(2) learning environment and curriculum, including training in establishing an 
562.16 	environment and providing activities that provide learning experiences to meet each child's 
562.17 	needs, capabilities, and interests;
562.18 	(3) assessment and planning for individual needs, including training in observing and 
562.19 	assessing what children know and can do in order to provide curriculum and instruction 
562.20 	that addresses their developmental and learning needs, including children with special needs 
562.21 	and bilingual children or children for whom English is not their primary language;
562.22 	(4) interactions with children, including training in establishing supportive relationships 
562.23 	with children, guiding them as individuals and as part of a group;
562.24 	(5) families and communities, including training in working collaboratively with families 
562.25 	and agencies or organizations to meet children's needs and to encourage the community's 
562.26 	involvement;
562.27 	(6) health, safety, and nutrition, including training in establishing and maintaining an 
562.28 	environment that ensures children's health, safety, and nourishment, including child abuse, 
562.29 	maltreatment, prevention, and reporting; home and fire safety; child injury prevention; 
562.30 	communicable disease prevention and control; first aid; and CPR;
562.31 	(7) program planning and evaluation, including training in establishing, implementing, 
562.32 	evaluating, and enhancing program operations; and
563.1 	(8) behavior guidance, including training in the understanding of the functions of child 
563.2 	behavior and strategies for managing behavior.
563.3 	(2) developmentally appropriate learning experiences, including training in creating 
563.4 	positive learning experiences, promoting cognitive development, promoting social and 
563.5 	emotional development, promoting physical development, promoting creative development; 
563.6 	and behavior guidance;
563.7 	(3) relationships with families, including training in building a positive, respectful 
563.8 	relationship with the child's family;
563.9 	(4) assessment, evaluation, and individualization, including training in observing, 
563.10 	recording, and assessing development; assessing and using information to plan; and assessing 
563.11 	and using information to enhance and maintain program quality;
563.12 	(5) historical and contemporary development of early childhood education, including 
563.13 	training in past and current practices in early childhood education and how current events 
563.14 	and issues affect children, families, and programs;
563.15 	(6) professionalism, including training in knowledge, skills, and abilities that promote 
563.16 	ongoing professional development; and
563.17 	(7) health, safety, and nutrition, including training in establishing healthy practices; 
563.18 	ensuring safety; and providing healthy nutrition.

563.19 	EFFECTIVE DATE. This section is effective August 1, 2017.

563.20 	Sec. 16. Minnesota Statutes 2016, section 245A.50, subdivision 9, is amended to read:
563.21 		Subd. 9.Supervising for safety; training requirement. Effective July 1, 2014 (a) 
563.22 	Before initial licensure and before caring for a child, all family child care license holders 
563.23 	and each adult caregiver who provides care in the licensed family child care home for more 
563.24 	than 30 days in any 12-month period shall complete and document at least six hours of 
563.25 	approved training on supervising for safety prior to initial licensure, and before caring for 
563.26 	children. At least two hours of training on supervising for safety must be repeated annually. 
563.27 	For purposes of this subdivision, "supervising for safety" includes supervision basics, 
563.28 	supervision outdoors, equipment and materials, illness, injuries, and disaster preparedness. 
563.29 	The commissioner shall develop the supervising for safety curriculum by January 1, 2014.
563.30 	the completion of the six-hour Supervising for Safety for Family Child Care course developed 
563.31 	by the commissioner.
564.1 	(b) The family child care license holder and each adult caregiver who provides care in 
564.2 	the licensed family child care home for more than 30 days in any 12-month period shall 
564.3 	complete and document:
564.4 	(1) the annual completion of a two-hour active supervision course developed by the 
564.5 	commissioner; and
564.6 	(2) the completion at least once every five years of the two-hour courses Health and 
564.7 	Safety I and Health and Safety II. A license holder's or adult caregiver's completion of either 
564.8 	training in a given year meets the annual active supervision training requirement in clause 
564.9 	(1).

564.10 	Sec. 17. [245A.51] FAMILY CHILD CARE HEALTH AND SAFETY 
564.11 	REQUIREMENTS.
564.12 		Subdivision 1.Allergy prevention and response. (a) Before admitting a child for care, 
564.13 	the license holder must obtain information about any known allergy from the child's parent 
564.14 	or legal guardian. The license holder must maintain current allergy information in each 
564.15 	child's record. The allergy information must include a description of the allergy, specific 
564.16 	triggers, avoidance techniques, symptoms of an allergic reaction, and procedures for 
564.17 	responding to an allergic reaction, including medication, dosages, and a doctor's contact 
564.18 	information.
564.19 	(b) The child's allergy information must be documented on a form approved by the 
564.20 	commissioner, readily available to all caregivers, and reviewed annually by the license 
564.21 	holder and each caregiver.
564.22 		Subd. 2.Handling and disposal of bodily fluids. The licensed family child care provider 
564.23 	must comply with the following procedures for safely handling and disposing of bodily 
564.24 	fluids:
564.25 	(1) surfaces that come in contact with potentially infectious bodily fluids, including 
564.26 	blood and vomit, must be cleaned and disinfected as described in section 245A.148;
564.27 	(2) blood-contaminated material must be disposed of in a plastic bag with a secure tie;
564.28 	(3) sharp items used for a child with special care needs must be disposed of in a "sharps 
564.29 	container." The sharps container must be stored out of reach of a child; and
564.30 	(4) the license holder must have the following bodily fluid disposal supplies available: 
564.31 	disposable gloves, disposal bags, and eye protection.
565.1 		Subd. 3.Emergency preparedness plan. (a) No later than September 30, 2017, a 
565.2 	licensed family child care provider must have a written emergency preparedness plan for 
565.3 	emergencies that require evacuation, sheltering, or other protection of children, such as fire, 
565.4 	natural disaster, intruder, or other threatening situation that may pose a health or safety 
565.5 	hazard to children. The plan must be written on a form developed by the commissioner and 
565.6 	updated at least annually. The plan must include:
565.7 	(1) procedures for an evacuation, relocation, shelter-in-place, or lockdown;
565.8 	(2) a designated relocation site and evacuation route;
565.9 	(3) procedures for notifying a child's parent or legal guardian of the evacuation, 
565.10 	shelter-in-place, or lockdown, including procedures for reunification with families;
565.11 	(4) accommodations for a child with a disability or a chronic medical condition;
565.12 	(5) procedures for storing a child's medically necessary medicine that facilitate easy 
565.13 	removal during an evacuation or relocation;
565.14 	(6) procedures for continuing operations in the period during and after a crisis; and
565.15 	(7) procedures for communicating with local emergency management officials, law 
565.16 	enforcement officials, or other appropriate state or local authorities.
565.17 	(b) The license holder must train caregivers before the caregiver provides care and at 
565.18 	least annually on the emergency preparedness plan and document completion of this training.
565.19 	(c) The license holder must conduct drills according to the requirements in Minnesota 
565.20 	Rules, part 9502.0435, subpart 8. The date and time of the drills must be documented.
565.21 	(d) The license holder must have the emergency preparedness plan available for review 
565.22 	and posted in a prominent location. The license holder must provide a physical or electronic 
565.23 	copy of the plan to the child's parent or legal guardian upon enrollment.

565.24 	EFFECTIVE DATE. This section is effective August 1, 2017.

565.25 	Sec. 18. Minnesota Statutes 2016, section 245C.02, is amended by adding a subdivision 
565.26 	to read:
565.27 		Subd. 6a.Child care staff person. "Child care staff person" means an individual other 
565.28 	than an individual who is related to all children for whom child care services are provided 
565.29 	and:
565.30 	(1) who is employed by a child care provider for compensation;
566.1 	(2) whose activities involve the care or supervision of a child for a child care provider 
566.2 	or unsupervised access to a child who is cared for or supervised by a child care provider; 
566.3 	or
566.4 	(3) an individual 13 years of age or older residing in a licensed family child care home 
566.5 	or legal nonlicensed child care program.

566.6 	EFFECTIVE DATE. This section is effective October 1, 2017.

566.7 	Sec. 19. Minnesota Statutes 2016, section 245C.03, subdivision 1, is amended to read:
566.8 		Subdivision 1.Licensed programs. (a) The commissioner shall conduct a background 
566.9 	study on:
566.10 	(1) the person or persons applying for a license;
566.11 	(2) an individual age 13 and over living in the household where the licensed program 
566.12 	will be provided who is not receiving licensed services from the program;
566.13 	(3) current or prospective employees or contractors of the applicant who will have direct 
566.14 	contact with persons served by the facility, agency, or program;
566.15 	(4) volunteers or student volunteers who will have direct contact with persons served 
566.16 	by the program to provide program services if the contact is not under the continuous, direct 
566.17 	supervision by an individual listed in clause (1) or (3);
566.18 	(5) an individual age ten to 12 living in the household where the licensed services will 
566.19 	be provided when the commissioner has reasonable cause;
566.20 	(6) an individual who, without providing direct contact services at a licensed program, 
566.21 	may have unsupervised access to children or vulnerable adults receiving services from a 
566.22 	program, when the commissioner has reasonable cause; and
566.23 	(7) all managerial officials controlling individuals as defined under in section 245A.02, 
566.24 	subdivision 5a.; and
566.25 	(8) child care staff persons as defined in section 245C.02, subdivision 6a.
566.26 	(b) Paragraph (a), clauses (5) and (6), apply to legal nonlicensed child care and certified 
566.27 	license-exempt child care programs.
566.28 	(b) (c) For family child foster care settings, a short-term substitute caregiver providing 
566.29 	direct contact services for a child for less than 72 hours of continuous care is not required 
566.30 	to receive a background study under this chapter.

567.1 	EFFECTIVE DATE. This section is effective when the Department of Human Services 
567.2 	implements NETStudy 2.0 or October 1, 2017, whichever is later. The commissioner of 
567.3 	human services shall notify the revisor of statutes when the department implements 
567.4 	NETStudy 2.0.

567.5 	Sec. 20. Minnesota Statutes 2016, section 245C.03, is amended by adding a subdivision 
567.6 	to read:
567.7 		Subd. 6a.Legal nonlicensed and certified child care programs. The commissioner 
567.8 	shall conduct background studies on an individual required under sections 119B.125 and 
567.9 	245G.10 to complete a background study under this chapter.

567.10 	EFFECTIVE DATE. This section is effective October 1, 2017.

567.11 	Sec. 21. Minnesota Statutes 2016, section 245C.04, subdivision 1, is amended to read:
567.12 		Subdivision 1.Licensed programs; other child care programs. (a) The commissioner 
567.13 	shall conduct a background study of an individual required to be studied under section 
567.14 	245C.03, subdivision 1, at least upon application for initial license for all license types.
567.15 	(b) The commissioner shall conduct a background study of an individual required to be 
567.16 	studied under section 245C.03, subdivision 1, including a child care staff person as defined 
567.17 	in section 245C.02, subdivision 6a, in a family child care program, licensed child care center, 
567.18 	certified license-exempt child care center, or legal nonlicensed child care provider, on a 
567.19 	schedule determined by the commissioner. The background study must include submission 
567.20 	of fingerprints for a national criminal history record check and a review of the information 
567.21 	under section 245C.08. A background study for a child care program must be repeated 
567.22 	within five years from the most recent study conducted under this paragraph.
567.23 	(c) At reapplication for a license for a family child care. license:
567.24 	(1) for a background study affiliated with a licensed family child care center or legal 
567.25 	nonlicensed child care provider, the individual shall provide information required under 
567.26 	section 245C.05, subdivision 1, paragraphs (a), (b), and (d), to the county agency, and be 
567.27 	fingerprinted and photographed under section 245C.05, subdivision 5;
567.28 	(2) the county agency shall verify the information received under clause (1) and forward 
567.29 	the information to the commissioner to complete the background study; and
567.30 	(3) the background study conducted by the commissioner under this paragraph must 
567.31 	include a review of the information required under section 245C.08.
568.1 	(c) (d) The commissioner is not required to conduct a study of an individual at the time 
568.2 	of reapplication for a license if the individual's background study was completed by the 
568.3 	commissioner of human services and the following conditions are met:
568.4 	(1) a study of the individual was conducted either at the time of initial licensure or when 
568.5 	the individual became affiliated with the license holder;
568.6 	(2) the individual has been continuously affiliated with the license holder since the last 
568.7 	study was conducted; and
568.8 	(3) the last study of the individual was conducted on or after October 1, 1995.
568.9 	(d) (e) The commissioner of human services shall conduct a background study of an 
568.10 	individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), 
568.11 	who is newly affiliated with a child foster care license holder. The county or private agency 
568.12 	shall collect and forward to the commissioner the information required under section 245C.05, 
568.13 	subdivisions 1 and 5. The background study conducted by the commissioner of human 
568.14 	services under this paragraph must include a review of the information required under 
568.15 	section 245C.08, subdivisions 1, 3, and 4.
568.16 	(e) (f) The commissioner shall conduct a background study of an individual specified 
568.17 	under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly affiliated 
568.18 	with an adult foster care or family adult day services and with a family child care license 
568.19 	holder or a legal nonlicensed child care provider authorized under chapter 119B: (1) the 
568.20 	county shall collect and forward to the commissioner the information required under section 
568.21 	245C.05, subdivision 1, paragraphs (a) and (b), and subdivision 5, paragraphs (a) and, (b),
568.22 	and (d), for background studies conducted by the commissioner for all family adult day 
568.23 	services and, for adult foster care when the adult foster care license holder resides in the 
568.24 	adult foster care residence, and for family child care and legal nonlicensed child care 
568.25 	authorized under chapter 119B; (2) the license holder shall collect and forward to the 
568.26 	commissioner the information required under section 245C.05, subdivisions 1, paragraphs 
568.27 	(a) and (b); and 5, paragraphs (a) and (b), for background studies conducted by the 
568.28 	commissioner for adult foster care when the license holder does not reside in the adult foster 
568.29 	care residence; and (3) the background study conducted by the commissioner under this 
568.30 	paragraph must include a review of the information required under section 245C.08, 
568.31 	subdivision 1, paragraph (a), and subdivisions 3 and 4.
568.32 	(f) (g) Applicants for licensure, license holders, and other entities as provided in this 
568.33 	chapter must submit completed background study requests to the commissioner using the 
569.1 	electronic system known as NETStudy before individuals specified in section 245C.03, 
569.2 	subdivision 1, begin positions allowing direct contact in any licensed program.
569.3 	(g) (h) For an individual who is not on the entity's active roster, the entity must initiate 
569.4 	a new background study through NETStudy when:
569.5 	(1) an individual returns to a position requiring a background study following an absence 
569.6 	of 120 or more consecutive days; or
569.7 	(2) a program that discontinued providing licensed direct contact services for 120 or 
569.8 	more consecutive days begins to provide direct contact licensed services again.
569.9 	The license holder shall maintain a copy of the notification provided to the commissioner 
569.10 	under this paragraph in the program's files. If the individual's disqualification was previously 
569.11 	set aside for the license holder's program and the new background study results in no new 
569.12 	information that indicates the individual may pose a risk of harm to persons receiving 
569.13 	services from the license holder, the previous set-aside shall remain in effect.
569.14 	(h) (i) For purposes of this section, a physician licensed under chapter 147 is considered 
569.15 	to be continuously affiliated upon the license holder's receipt from the commissioner of 
569.16 	health or human services of the physician's background study results.
569.17 	(i) (j) For purposes of family child care, a substitute caregiver must receive repeat 
569.18 	background studies at the time of each license renewal.
569.19 	(k) A repeat background study at the time of license renewal is not required if the family 
569.20 	child care substitute caregiver's background study was completed by the commissioner on 
569.21 	or after October 1, 2017, and the substitute caregiver is on the license holder's active roster 
569.22 	in NETStudy 2.0.
569.23 	(l) Before and after school programs authorized under chapter 119B, are exempt from 
569.24 	the background study requirements under section123B.03, or an employee for whom a 
569.25 	background study under this chapter has been completed.

569.26 	EFFECTIVE DATE. This section is effective October 1, 2017.

569.27 	Sec. 22. Minnesota Statutes 2016, section 245C.04, subdivision 8, is amended to read:
569.28 		Subd. 8.Current or prospective contractors serving multiple family child care 
569.29 	license holders. (a) Before the implementation of NETStudy 2.0, current or prospective 
569.30 	contractors who are required to have a background study under section 245C.03, subdivision 
569.31 	1, who provide services for multiple family child care license holders in a single county, 
569.32 	and will have direct contact with children served in the family child care setting are required 
570.1 	to have only one background study which is transferable to all family child care programs 
570.2 	in that county if:
570.3 	(1) the county agency maintains a record of the contractor's background study results 
570.4 	which verify the contractor is approved to have direct contact with children receiving 
570.5 	services;
570.6 	(2) the license holder contacts the county agency and obtains notice that the current or 
570.7 	prospective contractor is in compliance with background study requirements and approved 
570.8 	to have direct contact; and
570.9 	(3) the contractor's background study is repeated every two years.
570.10 	(b) For a family child care license holder operating under NETStudy 2.0, the license 
570.11 	holder's active roster shall be the system used to document when a background study subject 
570.12 	is affiliated with the license holder.

570.13 	EFFECTIVE DATE. This section is effective August 1, 2017.

570.14 	Sec. 23. Minnesota Statutes 2016, section 245C.05, subdivision 2b, is amended to read:
570.15 		Subd. 2b.County agency to collect and forward information to commissioner. (a) 
570.16 	For background studies related to all family adult day services and to adult foster care when 
570.17 	the adult foster care license holder resides in the adult foster care residence, the county 
570.18 	agency must collect the information required under subdivision 1 and forward it to the 
570.19 	commissioner.
570.20 	(b) Upon implementation of NETStudy 2.0, for background studies related to family 
570.21 	child care and legal nonlicensed child care authorized under chapter 119B, the county agency 
570.22 	must collect the information required under subdivision 1 and provide the information to 
570.23 	the commissioner.

570.24 	EFFECTIVE DATE. This section is effective the day following final enactment.

570.25 	Sec. 24. Minnesota Statutes 2016, section 245C.05, subdivision 4, is amended to read:
570.26 		Subd. 4.Electronic transmission. (a) For background studies conducted by the 
570.27 	Department of Human Services, the commissioner shall implement a secure system for the 
570.28 	electronic transmission of:
570.29 	(1) background study information to the commissioner;
570.30 	(2) background study results to the license holder;
571.1 	(3) background study results to county and private agencies for background studies 
571.2 	conducted by the commissioner for child foster care; and
571.3 	(4) background study results to county agencies for background studies conducted by 
571.4 	the commissioner for adult foster care and family adult day services and, upon 
571.5 	implementation of NETStudy 2.0, family child care and legal nonlicensed child care 
571.6 	authorized under chapter 119B.
571.7 	(b) Unless the commissioner has granted a hardship variance under paragraph (c), a 
571.8 	license holder or an applicant must use the electronic transmission system known as 
571.9 	NETStudy or NETStudy 2.0 to submit all requests for background studies to the 
571.10 	commissioner as required by this chapter.
571.11 	(c) A license holder or applicant whose program is located in an area in which high-speed 
571.12 	Internet is inaccessible may request the commissioner to grant a variance to the electronic 
571.13 	transmission requirement.

571.14 	EFFECTIVE DATE. This section is effective the day following final enactment.

571.15 	Sec. 25. Minnesota Statutes 2016, section 245C.05, subdivision 5, is amended to read:
571.16 		Subd. 5.Fingerprints and photograph. (a) Before the implementation of NETStudy 
571.17 	2.0, except as provided in paragraph (c), for any background study completed under this 
571.18 	chapter, when the commissioner has reasonable cause to believe that further pertinent 
571.19 	information may exist on the subject of the background study, the subject shall provide the 
571.20 	commissioner with a set of classifiable fingerprints obtained from an authorized agency.
571.21 	(b) Before the implementation of NETStudy 2.0, for purposes of requiring fingerprints, 
571.22 	the commissioner has reasonable cause when, but not limited to, the:
571.23 	(1) information from the Bureau of Criminal Apprehension indicates that the subject is 
571.24 	a multistate offender;
571.25 	(2) information from the Bureau of Criminal Apprehension indicates that multistate 
571.26 	offender status is undetermined; or
571.27 	(3) commissioner has received a report from the subject or a third party indicating that 
571.28 	the subject has a criminal history in a jurisdiction other than Minnesota.
571.29 	(c) Notwithstanding paragraph (d), for background studies conducted by the commissioner 
571.30 	for child foster care, adoptions, or a transfer of permanent legal and physical custody of a 
571.31 	child, the subject of the background study, who is 18 years of age or older, shall provide 
572.1 	the commissioner with a set of classifiable fingerprints obtained from an authorized agency
572.2 	for a national criminal history record check.
572.3 	(d) For background studies initiated on or after the implementation of NETStudy 2.0, 
572.4 	every subject of a background study must provide the commissioner with a set of the 
572.5 	background study subject's classifiable fingerprints and photograph. The photograph and 
572.6 	fingerprints must be recorded at the same time by the commissioner's authorized fingerprint 
572.7 	collection vendor and sent to the commissioner through the commissioner's secure data 
572.8 	system described in section 245C.32, subdivision 1a, paragraph (b). The fingerprints shall 
572.9 	not be retained by the Department of Public Safety, Bureau of Criminal Apprehension, or 
572.10 	the commissioner, but will be retained by the Federal Bureau of Investigation. The 
572.11 	commissioner's authorized fingerprint collection vendor shall, for purposes of verifying the 
572.12 	identity of the background study subject, be able to view the identifying information entered 
572.13 	into NETStudy 2.0 by the entity that initiated the background study, but shall not retain the 
572.14 	subject's fingerprints, photograph, or information from NETStudy 2.0. The authorized 
572.15 	fingerprint collection vendor shall retain no more than the name and date and time the 
572.16 	subject's fingerprints were recorded and sent, only as necessary for auditing and billing 
572.17 	activities.
572.18 	(e) When specifically required by law, fingerprints collected under this section must be 
572.19 	submitted for a national criminal history record check.

572.20 	EFFECTIVE DATE. This section is effective the day following final enactment.

572.21 	Sec. 26. Minnesota Statutes 2016, section 245C.05, subdivision 7, is amended to read:
572.22 		Subd. 7.Probation officer and corrections agent. (a) A probation officer or corrections 
572.23 	agent shall notify the commissioner of an individual's conviction if the individual:
572.24 	(1) has been affiliated with a program or facility regulated by the Department of Human 
572.25 	Services or Department of Health, a facility serving children or youth licensed by the 
572.26 	Department of Corrections, or any type of home care agency or provider of personal care 
572.27 	assistance services within the preceding year; and
572.28 	(2) has been convicted of a crime constituting a disqualification under section 245C.14.
572.29 	(b) For the purpose of this subdivision, "conviction" has the meaning given it in section 
572.30 	609.02, subdivision 5.
572.31 	(c) The commissioner, in consultation with the commissioner of corrections, shall develop 
572.32 	forms and information necessary to implement this subdivision and shall provide the forms 
573.1 	and information to the commissioner of corrections for distribution to local probation officers 
573.2 	and corrections agents.
573.3 	(d) The commissioner shall inform individuals subject to a background study that criminal 
573.4 	convictions for disqualifying crimes will shall be reported to the commissioner by the 
573.5 	corrections system.
573.6 	(e) A probation officer, corrections agent, or corrections agency is not civilly or criminally 
573.7 	liable for disclosing or failing to disclose the information required by this subdivision.
573.8 	(f) Upon receipt of disqualifying information, the commissioner shall provide the notice 
573.9 	required under section 245C.17, as appropriate, to agencies on record as having initiated a 
573.10 	background study or making a request for documentation of the background study status 
573.11 	of the individual.
573.12 	(g) This subdivision does not apply to family child care programs or legal nonlicensed 
573.13 	child care programs for individuals whose background study was completed in NETStudy 
573.14 	2.0.

573.15 	EFFECTIVE DATE. This section is effective the day following final enactment.

573.16 	Sec. 27. Minnesota Statutes 2016, section 245C.08, subdivision 1, is amended to read:
573.17 		Subdivision 1.Background studies conducted by Department of Human Services.
 573.18 	(a) For a background study conducted by the Department of Human Services, the 
573.19 	commissioner shall review:
573.20 	(1) information related to names of substantiated perpetrators of maltreatment of 
573.21 	vulnerable adults that has been received by the commissioner as required under section 
573.22 	626.557, subdivision 9c, paragraph (j);
573.23 	(2) the commissioner's records relating to the maltreatment of minors in licensed 
573.24 	programs, and from findings of maltreatment of minors as indicated through the social 
573.25 	service information system;
573.26 	(3) information from juvenile courts as required in subdivision 4 for individuals listed 
573.27 	in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;
573.28 	(4) information from the Bureau of Criminal Apprehension, including information 
573.29 	regarding a background study subject's registration in Minnesota as a predatory offender 
573.30 	under section 243.166;
573.31 	(5) except as provided in clause (6), information from the national crime information 
573.32 	system received as a result of submission of fingerprints for a national criminal history 
574.1 	record check, when the commissioner has reasonable cause as defined under section 245C.05, 
574.2 	subdivision 5, or as required under section 144.057, subdivision 1, clause (2); and
574.3 	(6) for a background study related to a child foster care application for licensure, a 
574.4 	transfer of permanent legal and physical custody of a child under sections 260C.503 to 
574.5 	260C.515, or adoptions, and for a background study required for family child care, certified 
574.6 	license-exempt child care, child care centers, and legal nonlicensed child care authorized 
574.7 	under chapter 119B, the commissioner shall also review:
574.8 	(i) information from the child abuse and neglect registry for any state in which the 
574.9 	background study subject has resided for the past five years; and
574.10 	(ii) information from national crime information databases, when the background study 
574.11 	subject is 18 years of age or older., information received following submission of fingerprints 
574.12 	for a national criminal history record check; and
574.13 	(7) for a background study required for family child care, certified license-exempt child 
574.14 	care centers, licensed child care centers, and legal nonlicensed child care authorized under 
574.15 	chapter 119B, the background study shall also include a name and date-of-birth search of 
574.16 	the National Sex Offender Public Web site.
574.17 	(b) Notwithstanding expungement by a court, the commissioner may consider information 
574.18 	obtained under paragraph (a), clauses (3) and (4), unless the commissioner received notice 
574.19 	of the petition for expungement and the court order for expungement is directed specifically 
574.20 	to the commissioner.
574.21 	(c) The commissioner shall also review criminal case information received according 
574.22 	to section 245C.04, subdivision 4a, from the Minnesota court information system that relates 
574.23 	to individuals who have already been studied under this chapter and who remain affiliated 
574.24 	with the agency that initiated the background study.
574.25 	(d) When the commissioner has reasonable cause to believe that the identity of a 
574.26 	background study subject is uncertain, the commissioner may require the subject to provide 
574.27 	a set of classifiable fingerprints for purposes of completing a fingerprint-based record check 
574.28 	with the Bureau of Criminal Apprehension. Fingerprints collected under this paragraph 
574.29 	shall not be saved by the commissioner after they have been used to verify the identity of 
574.30 	the background study subject against the particular criminal record in question.
574.31 	(e) The commissioner may inform the entity that initiated a background study under 
574.32 	NETStudy 2.0 of the status of processing of the subject's fingerprints.

574.33 	EFFECTIVE DATE. This section is effective October 1, 2017.

575.1 	Sec. 28. Minnesota Statutes 2016, section 245C.08, subdivision 2, is amended to read:
575.2 		Subd. 2.Background studies conducted by a county agency for family child care.
 575.3 	(a) Before the implementation of NETStudy 2.0, for a background study conducted by a 
575.4 	county agency for family child care services, the commissioner shall review:
575.5 	(1) information from the county agency's record of substantiated maltreatment of adults 
575.6 	and the maltreatment of minors;
575.7 	(2) information from juvenile courts as required in subdivision 4 for:
575.8 	(i) individuals listed in section 245C.03, subdivision 1, paragraph (a), who are ages 13 
575.9 	through 23 living in the household where the licensed services will be provided; and
575.10 	(ii) any other individual listed under section 245C.03, subdivision 1, when there is 
575.11 	reasonable cause; and
575.12 	(3) information from the Bureau of Criminal Apprehension.
575.13 	(b) If the individual has resided in the county for less than five years, the study shall 
575.14 	include the records specified under paragraph (a) for the previous county or counties of 
575.15 	residence for the past five years.
575.16 	(c) Notwithstanding expungement by a court, the county agency may consider information 
575.17 	obtained under paragraph (a), clause (3), unless the commissioner received notice of the 
575.18 	petition for expungement and the court order for expungement is directed specifically to 
575.19 	the commissioner.

575.20 	EFFECTIVE DATE. This section is effective the day following final enactment.

575.21 	Sec. 29. Minnesota Statutes 2016, section 245C.08, subdivision 4, is amended to read:
575.22 		Subd. 4.Juvenile court records. (a) For a background study conducted by the 
575.23 	Department of Human Services, the commissioner shall review records from the juvenile 
575.24 	courts for an individual studied under section 245C.03, subdivision 1, paragraph (a), when 
575.25 	the commissioner has reasonable cause.
575.26 	(b) For a background study conducted by a county agency for family child care before 
575.27 	the implementation of NETStudy 2.0, the commissioner shall review records from the 
575.28 	juvenile courts for individuals listed in section 245C.03, subdivision 1, who are ages 13 
575.29 	through 23 living in the household where the licensed services will be provided. The 
575.30 	commissioner shall also review records from juvenile courts for any other individual listed 
575.31 	under section 245C.03, subdivision 1, when the commissioner has reasonable cause.
576.1 	(c) The juvenile courts shall help with the study by giving the commissioner existing 
576.2 	juvenile court records relating to delinquency proceedings held on individuals described in 
576.3 	section 245C.03, subdivision 1, paragraph (a), when requested pursuant to this subdivision.
576.4 	(d) For purposes of this chapter, a finding that a delinquency petition is proven in juvenile 
576.5 	court shall be considered a conviction in state district court.
576.6 	(e) Juvenile courts shall provide orders of involuntary and voluntary termination of 
576.7 	parental rights under section 260C.301 to the commissioner upon request for purposes of 
576.8 	conducting a background study under this chapter.

576.9 	EFFECTIVE DATE. This section is effective the day following final enactment.

576.10 	Sec. 30. Minnesota Statutes 2016, section 245C.09, is amended by adding a subdivision 
576.11 	to read:
576.12 		Subd. 3.False statement in connection with a background study. A child care staff 
576.13 	person shall be disqualified for knowingly making a materially false statement in connection 
576.14 	with a background study.

576.15 	EFFECTIVE DATE. This section is effective the day following final enactment.

576.16 	Sec. 31. Minnesota Statutes 2016, section 245C.10, subdivision 9, is amended to read:
576.17 		Subd. 9.Human services licensed programs. The commissioner shall recover the cost 
576.18 	of background studies required under section 245C.03, subdivision 1, for all programs that 
576.19 	are licensed by the commissioner, except child foster care and, family child care, child care 
576.20 	centers, certified license-exempt child care centers, and legal nonlicensed child care 
576.21 	authorized under chapter 119B, through a fee of no more than $20 per study charged to the 
576.22 	license holder. The fees collected under this subdivision are appropriated to the commissioner 
576.23 	for the purpose of conducting background studies.

576.24 	EFFECTIVE DATE. This section is effective the day following final enactment.

576.25 	Sec. 32. Minnesota Statutes 2016, section 245C.10, is amended by adding a subdivision 
576.26 	to read:
576.27 		Subd. 9a.Child care programs. The commissioner shall recover the cost of a background 
576.28 	study required for family child care, certified license-exempt child care centers, licensed 
576.29 	child care centers, and legal nonlicensed child care providers authorized under chapter 119B 
576.30 	through a fee of no more than $40 per study charged to the license holder. The fees collected 
576.31 	under this subdivision are appropriated to the commissioner to conduct background studies.

577.1 	Sec. 33. Minnesota Statutes 2016, section 245C.11, subdivision 3, is amended to read:
577.2 		Subd. 3.Criminal history data. County agencies shall have access to the criminal 
577.3 	history data in the same manner as county licensing agencies under this chapter for purposes 
577.4 	of background studies completed before the implementation of NETStudy 2.0 by county 
577.5 	agencies on legal nonlicensed child care providers to determine eligibility for child care 
577.6 	funds under chapter 119B.

577.7 	EFFECTIVE DATE. This section is effective the day following final enactment.

577.8 	Sec. 34. Minnesota Statutes 2016, section 245C.15, subdivision 1, is amended to read:
577.9 		Subdivision 1.Permanent disqualification. (a) An individual is disqualified under 
577.10 	section 245C.14 if: (1) regardless of how much time has passed since the discharge of the 
577.11 	sentence imposed, if any, for the offense; and (2) unless otherwise specified, regardless of 
577.12 	the level of the offense, the individual has committed any of the following offenses: sections 
577.13 	243.166 (violation of predatory offender registration law); 609.185 (murder in the first 
577.14 	degree); 609.19 (murder in the second degree); 609.195 (murder in the third degree); 609.20
577.15 	(manslaughter in the first degree); 609.205 (manslaughter in the second degree); a felony 
577.16 	offense under 609.221 or 609.222 (assault in the first or second degree); a felony offense 
577.17 	under sections 609.2242 and 609.2243 (domestic assault), spousal abuse, child abuse or 
577.18 	neglect, or a crime against children; 609.2247 (domestic assault by strangulation); 609.228
577.19 	(great bodily harm caused by distribution of drugs); 609.245 (aggravated robbery); 609.25
577.20 	(kidnapping); 609.2661 (murder of an unborn child in the first degree); 609.2662 (murder 
577.21 	of an unborn child in the second degree); 609.2663 (murder of an unborn child in the third 
577.22 	degree); 609.322 (solicitation, inducement, and promotion of prostitution); 609.324, 
577.23 	subdivision 1 (other prohibited acts); 609.342 (criminal sexual conduct in the first degree); 
577.24 	609.343 (criminal sexual conduct in the second degree); 609.344 (criminal sexual conduct 
577.25 	in the third degree); 609.345 (criminal sexual conduct in the fourth degree); 609.3451
577.26 	(criminal sexual conduct in the fifth degree); 609.3453 (criminal sexual predatory conduct); 
577.27 	609.352 (solicitation of children to engage in sexual conduct); 609.365 (incest); a felony 
577.28 	offense under 609.377 (malicious punishment of a child); a felony offense under 609.378
577.29 	(neglect or endangerment of a child); 609.561 (arson in the first degree); 609.66, subdivision 
577.30 	1e (drive-by shooting); 609.749, subdivision 3, 4, or 5 (felony-level stalking); 609.855, 
577.31 	subdivision 5 (shooting at or in a public transit vehicle or facility); 617.23, subdivision 2, 
577.32 	clause (1), or subdivision 3, clause (1) (indecent exposure involving a minor); 617.246 (use 
577.33 	of minors in sexual performance prohibited); or617.247 (possession of pictorial 
577.34 	representations of minors); or, for a child care staff person, conviction of a crime that would 
578.1 	make the individual ineligible for employment under United States Code, title 42, section 
578.2 	9858F, regardless of whether a period of disqualification under subdivisions 2 to 4, would 
578.3 	apply if the individual were not a child care staff person.
578.4 	(b) An individual's aiding and abetting, attempt, or conspiracy to commit any of the 
578.5 	offenses listed in paragraph (a), as each of these offenses is defined in Minnesota Statutes, 
578.6 	permanently disqualifies the individual under section 245C.14.
578.7 	(c) An individual's offense in any other state or country, where the elements of the offense 
578.8 	are substantially similar to any of the offenses listed in paragraph (a), permanently disqualifies 
578.9 	the individual under section 245C.14.
578.10 	(d) When a disqualification is based on a judicial determination other than a conviction, 
578.11 	the disqualification period begins from the date of the court order. When a disqualification 
578.12 	is based on an admission, the disqualification period begins from the date of an admission 
578.13 	in court. When a disqualification is based on an Alford Plea, the disqualification period 
578.14 	begins from the date the Alford Plea is entered in court. When a disqualification is based 
578.15 	on a preponderance of evidence of a disqualifying act, the disqualification date begins from 
578.16 	the date of the dismissal, the date of discharge of the sentence imposed for a conviction for 
578.17 	a disqualifying crime of similar elements, or the date of the incident, whichever occurs last.
578.18 	(e) If the individual studied commits one of the offenses listed in paragraph (a) that is 
578.19 	specified as a felony-level only offense, but the sentence or level of offense is a gross 
578.20 	misdemeanor or misdemeanor, the individual is disqualified, but the disqualification 
578.21 	look-back period for the offense is the period applicable to gross misdemeanor or 
578.22 	misdemeanor offenses.
578.23 	(f) A child care staff person shall be disqualified as long as the individual is registered, 
578.24 	or required to be registered, on a state sex offender registry or repository or the National 
578.25 	Sex Offender Registry.

578.26 	EFFECTIVE DATE. This section is effective October 1, 2017.

578.27 	Sec. 35. Minnesota Statutes 2016, section 245C.16, subdivision 1, is amended to read:
578.28 		Subdivision 1.Determining immediate risk of harm. (a) If the commissioner determines 
578.29 	that the individual studied has a disqualifying characteristic, the commissioner shall review 
578.30 	the information immediately available and make a determination as to the subject's immediate 
578.31 	risk of harm to persons served by the program where the individual studied will have direct 
578.32 	contact with, or access to, people receiving services.
579.1 	(b) The commissioner shall consider all relevant information available, including the 
579.2 	following factors in determining the immediate risk of harm:
579.3 	(1) the recency of the disqualifying characteristic;
579.4 	(2) the recency of discharge from probation for the crimes;
579.5 	(3) the number of disqualifying characteristics;
579.6 	(4) the intrusiveness or violence of the disqualifying characteristic;
579.7 	(5) the vulnerability of the victim involved in the disqualifying characteristic;
579.8 	(6) the similarity of the victim to the persons served by the program where the individual 
579.9 	studied will have direct contact;
579.10 	(7) whether the individual has a disqualification from a previous background study that 
579.11 	has not been set aside; and
579.12 	(8) if the individual has a disqualification which may not be set aside because it is a 
579.13 	permanent bar under section 245C.24, subdivision 1, or the individual is a child care staff 
579.14 	person who has a felony-level conviction for a drug-related offense in the last five years,
579.15 	the commissioner may order the immediate removal of the individual from any position 
579.16 	allowing direct contact with, or access to, persons receiving services from the program.
579.17 	(c) This section does not apply when the subject of a background study is regulated by 
579.18 	a health-related licensing board as defined in chapter 214, and the subject is determined to 
579.19 	be responsible for substantiated maltreatment under section 626.556 or 626.557.
579.20 	(d) This section does not apply to a background study related to an initial application 
579.21 	for a child foster care license.
579.22 	(e) Except for paragraph (f), this section does not apply to a background study that is 
579.23 	also subject to the requirements under section 256B.0659, subdivisions 11 and 13, for a 
579.24 	personal care assistant or a qualified professional as defined in section 256B.0659, 
579.25 	subdivision 1.
579.26 	(f) If the commissioner has reason to believe, based on arrest information or an active 
579.27 	maltreatment investigation, that an individual poses an imminent risk of harm to persons 
579.28 	receiving services, the commissioner may order that the person be continuously supervised 
579.29 	or immediately removed pending the conclusion of the maltreatment investigation or criminal 
579.30 	proceedings.

579.31 	EFFECTIVE DATE. This section is effective October 1, 2017.

580.1 	Sec. 36. Minnesota Statutes 2016, section 245C.17, subdivision 6, is amended to read:
580.2 		Subd. 6.Notice to county agency. For studies on individuals related to a license to 
580.3 	provide adult foster care and family adult day services and, effective upon implementation 
580.4 	of NETStudy 2.0, family child care and legal nonlicensed child care authorized under chapter 
580.5 	119B, the commissioner shall also provide a notice of the background study results to the 
580.6 	county agency that initiated the background study.

580.7 	EFFECTIVE DATE. This section is effective the day following final enactment.

580.8 	Sec. 37. Minnesota Statutes 2016, section 245C.21, subdivision 1, is amended to read:
580.9 		Subdivision 1.Who may request reconsideration. An individual who is the subject of 
580.10 	a disqualification may request a reconsideration of the disqualification pursuant to this 
580.11 	section. The individual must submit the request for reconsideration to the commissioner in 
580.12 	writing.

580.13 	EFFECTIVE DATE. This section is effective the day following final enactment.

580.14 	Sec. 38. Minnesota Statutes 2016, section 245C.22, subdivision 5, is amended to read:
580.15 		Subd. 5.Scope of set-aside. (a) If the commissioner sets aside a disqualification under 
580.16 	this section, the disqualified individual remains disqualified, but may hold a license and 
580.17 	have direct contact with or access to persons receiving services. Except as provided in 
580.18 	paragraph (b), the commissioner's set-aside of a disqualification is limited solely to the 
580.19 	licensed program, applicant, or agency specified in the set aside notice under section 245C.23. 
580.20 	For personal care provider organizations, the commissioner's set-aside may further be limited 
580.21 	to a specific individual who is receiving services. For new background studies required 
580.22 	under section 245C.04, subdivision 1, paragraph (g) (h), if an individual's disqualification 
580.23 	was previously set aside for the license holder's program and the new background study 
580.24 	results in no new information that indicates the individual may pose a risk of harm to persons 
580.25 	receiving services from the license holder, the previous set-aside shall remain in effect.
580.26 	(b) If the commissioner has previously set aside an individual's disqualification for one 
580.27 	or more programs or agencies, and the individual is the subject of a subsequent background 
580.28 	study for a different program or agency, the commissioner shall determine whether the 
580.29 	disqualification is set aside for the program or agency that initiated the subsequent 
580.30 	background study. A notice of a set-aside under paragraph (c) shall be issued within 15 
580.31 	working days if all of the following criteria are met:
581.1 	(1) the subsequent background study was initiated in connection with a program licensed 
581.2 	or regulated under the same provisions of law and rule for at least one program for which 
581.3 	the individual's disqualification was previously set aside by the commissioner;
581.4 	(2) the individual is not disqualified for an offense specified in section 245C.15, 
581.5 	subdivision 1 or 2;
581.6 	(3) the commissioner has received no new information to indicate that the individual 
581.7 	may pose a risk of harm to any person served by the program; and
581.8 	(4) the previous set-aside was not limited to a specific person receiving services.
581.9 	(c) When a disqualification is set aside under paragraph (b), the notice of background 
581.10 	study results issued under section 245C.17, in addition to the requirements under section 
581.11 	245C.17, shall state that the disqualification is set aside for the program or agency that 
581.12 	initiated the subsequent background study. The notice must inform the individual that the 
581.13 	individual may request reconsideration of the disqualification under section 245C.21 on the 
581.14 	basis that the information used to disqualify the individual is incorrect.

581.15 	EFFECTIVE DATE. This section is effective October 1, 2017.

581.16 	Sec. 39. Minnesota Statutes 2016, section 245C.22, subdivision 7, is amended to read:
581.17 		Subd. 7.Classification of certain data. (a) Notwithstanding section 13.46, except as 
581.18 	provided in paragraph (f), upon setting aside a disqualification under this section, the identity 
581.19 	of the disqualified individual who received the set-aside and the individual's disqualifying 
581.20 	characteristics are public data if the set-aside was:
581.21 	(1) for any disqualifying characteristic under section 245C.15, except a felony-level 
581.22 	conviction for a drug-related offense within the past five years, when the set-aside relates 
581.23 	to a child care center or a family child care provider licensed under chapter 245A, certified 
581.24 	license-exempt child care center, or legal nonlicensed family child care; or
581.25 	(2) for a disqualifying characteristic under section 245C.15, subdivision 2.
581.26 	(b) Notwithstanding section 13.46, upon granting a variance to a license holder under 
581.27 	section 245C.30, the identity of the disqualified individual who is the subject of the variance, 
581.28 	the individual's disqualifying characteristics under section 245C.15, and the terms of the 
581.29 	variance are public data, except as provided in paragraph (c), clause (6), when the variance:
581.30 	(1) is issued to a child care center or a family child care provider licensed under chapter 
581.31 	245A; or
582.1 	(2) relates to an individual with a disqualifying characteristic under section 245C.15, 
582.2 	subdivision 2.
582.3 	(c) The identity of a disqualified individual and the reason for disqualification remain 
582.4 	private data when:
582.5 	(1) a disqualification is not set aside and no variance is granted, except as provided under 
582.6 	section 13.46, subdivision 4;
582.7 	(2) the data are not public under paragraph (a) or (b);
582.8 	(3) the disqualification is rescinded because the information relied upon to disqualify 
582.9 	the individual is incorrect;
582.10 	(4) the disqualification relates to a license to provide relative child foster care. As used 
582.11 	in this clause, "relative" has the meaning given it under section 260C.007, subdivision 26b 
582.12 	or 27; or
582.13 	(5) the disqualified individual is a household member of a licensed foster care provider 
582.14 	and:
582.15 	(i) the disqualified individual previously received foster care services from this licensed 
582.16 	foster care provider;
582.17 	(ii) the disqualified individual was subsequently adopted by this licensed foster care 
582.18 	provider; and
582.19 	(iii) the disqualifying act occurred before the adoption; or
582.20 	(6) a variance is granted to a child care center or family child care license holder for an 
582.21 	individual's disqualification that is based on a felony-level conviction for a drug-related 
582.22 	offense that occurred within the past five years.
582.23 	(d) Licensed family child care providers and child care centers must provide notices as 
582.24 	required under section 245C.301.
582.25 	(e) Notwithstanding paragraphs (a) and (b), the identity of household members who are 
582.26 	the subject of a disqualification related set-aside or variance is not public data if:
582.27 	(1) the household member resides in the residence where the family child care is provided;
582.28 	(2) the subject of the set-aside or variance is under the age of 18 years; and
582.29 	(3) the set-aside or variance only relates to a disqualification under section 245C.15, 
582.30 	subdivision 4, for a misdemeanor-level theft crime as defined in section 609.52.
583.1 	(f) When the commissioner has reason to know that a disqualified individual has received 
583.2 	an order for expungement for the disqualifying record that does not limit the commissioner's 
583.3 	access to the record, and the record was opened or exchanged with the commissioner for 
583.4 	purposes of a background study under this chapter, the data that would otherwise become 
583.5 	public under paragraph (a) or (b) remain private data.

583.6 	EFFECTIVE DATE. This section is effective October 1, 2017.

583.7 	Sec. 40. Minnesota Statutes 2016, section 245C.23, is amended to read:
583.8 	245C.23 COMMISSIONER'S RECONSIDERATION NOTICE.
583.9 		Subdivision 1.Disqualification that is rescinded or set aside. (a) If the commissioner 
583.10 	rescinds or sets aside a disqualification, the commissioner shall notify the applicant, license 
583.11 	holder, or other entity in writing or by electronic transmission of the decision.
583.12 	(b) In the notice from the commissioner that a disqualification has been rescinded, the 
583.13 	commissioner must inform the applicant, license holder, or other entity that the information 
583.14 	relied upon to disqualify the individual was incorrect.
583.15 	(c) Except as provided in paragraph paragraphs (d) and (e), in the notice from the 
583.16 	commissioner that a disqualification has been set aside, the commissioner must inform the 
583.17 	applicant, license holder, or other entity of the reason for the individual's disqualification 
583.18 	and that information about which factors under section 245C.22, subdivision 4, were the 
583.19 	basis of the decision to set aside the disqualification are available to the license holder upon 
583.20 	request without the consent of the background study subject.
583.21 	(d) When the commissioner has reason to know that a disqualified individual has received 
583.22 	an order for expungement for the disqualifying record that does not limit the commissioner's 
583.23 	access to the record, and the record was opened or exchanged with the commissioner for 
583.24 	purposes of a background study under this chapter, the information provided under paragraph 
583.25 	(c) must only inform the applicant, license holder, or other entity that the disqualifying 
583.26 	criminal record is sealed under a court order.
583.27 	(e) The notification requirements in paragraph (c) do not apply when the set aside is 
583.28 	granted to an individual related to a background study for a licensed child care center, 
583.29 	certified license-exempt child care center, or family child care license holder, or for a legal 
583.30 	nonlicensed child care provider authorized under chapter 119B, and the individual is 
583.31 	disqualified for a felony-level conviction for a drug-related offense that occurred within the 
583.32 	past five years. The notice that the individual's disqualification is set aside must inform the 
584.1 	applicant, license holder, or legal nonlicensed child care provider that the disqualifying 
584.2 	criminal record is not public.
584.3 		Subd. 2.Commissioner's notice of disqualification that is not set aside. (a) The 
584.4 	commissioner shall notify the license holder of the disqualification and order the license 
584.5 	holder to immediately remove the individual from any position allowing direct contact with 
584.6 	persons receiving services from the license holder if:
584.7 	(1) the individual studied does not submit a timely request for reconsideration under 
584.8 	section 245C.21;
584.9 	(2) the individual submits a timely request for reconsideration, but the commissioner 
584.10 	does not set aside the disqualification for that license holder under section 245C.22, unless 
584.11 	the individual has a right to request a hearing under section 245C.27, 245C.28, or 256.045;
584.12 	(3) an individual who has a right to request a hearing under sections 245C.27 and 256.045, 
584.13 	or 245C.28 and chapter 14 for a disqualification that has not been set aside, does not request 
584.14 	a hearing within the specified time; or
584.15 	(4) an individual submitted a timely request for a hearing under sections 245C.27 and 
584.16 	256.045, or 245C.28 and chapter 14, but the commissioner does not set aside the 
584.17 	disqualification under section 245A.08, subdivision 5, or 256.045.
584.18 	(b) If the commissioner does not set aside the disqualification under section 245C.22, 
584.19 	and the license holder was previously ordered under section 245C.17 to immediately remove 
584.20 	the disqualified individual from direct contact with persons receiving services or to ensure 
584.21 	that the individual is under continuous, direct supervision when providing direct contact 
584.22 	services, the order remains in effect pending the outcome of a hearing under sections 245C.27
584.23 	and 256.045, or 245C.28 and chapter 14.
584.24 	(c) If the commissioner does not set aside the disqualification under section 245C.22, 
584.25 	and the license holder was not previously ordered under section 245C.17 to immediately 
584.26 	remove the disqualified individual from direct contact with persons receiving services or 
584.27 	to ensure that the individual is under continuous direct supervision when providing direct 
584.28 	contact services, the commissioner shall order the individual to remain under continuous 
584.29 	direct supervision pending the outcome of a hearing under sections 245C.27 and 256.045, 
584.30 	or 245C.28 and chapter 14.
584.31 	(d) For background studies related to child foster care, the commissioner shall also notify 
584.32 	the county or private agency that initiated the study of the results of the reconsideration.
585.1 	(e) For background studies related to family child care, legal nonlicensed child care, 
585.2 	adult foster care, and family adult day services, the commissioner shall also notify the county 
585.3 	that initiated the study of the results of the reconsideration.

585.4 	EFFECTIVE DATE. This section is effective October 1, 2017.

585.5 	Sec. 41. Minnesota Statutes 2016, section 245C.25, is amended to read:
585.6 	245C.25 CONSOLIDATED RECONSIDERATION OF MALTREATMENT 
585.7 	DETERMINATION AND DISQUALIFICATION.
585.8 	(a) If an individual is disqualified on the basis of a determination of maltreatment under 
585.9 	section 626.556 or 626.557, which was serious or recurring, and the individual requests 
585.10 	reconsideration of the maltreatment determination under section 626.556, subdivision 10i, 
585.11 	or 626.557, subdivision 9d, and also requests reconsideration of the disqualification under 
585.12 	section 245C.21, the commissioner shall consolidate the reconsideration of the maltreatment 
585.13 	determination and the disqualification into a single reconsideration.
585.14 	(b) For maltreatment and disqualification determinations made by county agencies, the 
585.15 	county agency shall conduct the consolidated reconsideration. If the county agency has 
585.16 	disqualified an individual on multiple bases, one of which is a county maltreatment 
585.17 	determination for which the individual has a right to request reconsideration, the county 
585.18 	shall conduct the reconsideration of all disqualifications.
585.19 	(c) If the county has previously conducted a consolidated reconsideration under paragraph 
585.20 	(b) of a maltreatment determination and a disqualification based on serious or recurring 
585.21 	maltreatment, and the county subsequently disqualifies the individual based on that 
585.22 	determination, the county shall conduct the reconsideration of the subsequent disqualification. 
585.23 	The scope of the subsequent disqualification shall be limited to whether the individual poses 
585.24 	a risk of harm in accordance with section 245C.22, subdivision 4. If the commissioner 
585.25 	subsequently disqualifies the individual in connection with a child foster care license based 
585.26 	on the county's previous maltreatment determination, the commissioner shall conduct the 
585.27 	reconsideration of the subsequent disqualification.

585.28 	EFFECTIVE DATE. This section is effective October 1, 2017.

585.29 	Sec. 42. Minnesota Statutes 2016, section 245C.30, subdivision 2, is amended to read:
585.30 		Subd. 2.Disclosure of reason for disqualification. (a) The commissioner may not grant 
585.31 	a variance for a disqualified individual unless the applicant or license holder requests the 
586.1 	variance and the disqualified individual provides written consent for the commissioner to 
586.2 	disclose to the applicant or license holder the reason for the disqualification.
586.3 	(b) This subdivision does not apply to programs licensed to provide family child care 
586.4 	for children, foster care for children in the provider's own home, or foster care or day care 
586.5 	services for adults in the provider's own home. When the commissioner grants a variance 
586.6 	for a disqualified individual in connection with a license to provide the services specified 
586.7 	in this paragraph, the disqualified individual's consent is not required to disclose the reason 
586.8 	for the disqualification to the license holder in the variance issued under subdivision 1, 
586.9 	provided that the commissioner may not disclose the reason for the disqualification if the 
586.10 	disqualification is based on a felony-level conviction for a drug-related offense within the 
586.11 	past five years.

586.12 	EFFECTIVE DATE. This section is effective October 1, 2017.

586.13 	Sec. 43. [245G.01] DEFINITIONS.
586.14 		Subdivision 1.Scope. The terms used in this chapter have the meanings given in this 
586.15 	section.
586.16 		Subd. 2.Applicant. "Applicant" means an individual or organization that is subject to 
586.17 	certification under this chapter and that applied for but is not yet granted certification under 
586.18 	this chapter.
586.19 		Subd. 3.Center operator or program operator. "Center operator" or "program operator" 
586.20 	means the person exercising supervision or control over the center's or program's operations, 
586.21 	planning, and functioning. There may be more than one designated center operator or 
586.22 	program operator.
586.23 		Subd. 4.Certification holder. "Certification holder" means the individual or organization 
586.24 	that is legally responsible for the operation of the center, and granted certification by the 
586.25 	commissioner under this chapter.
586.26 		Subd. 5.Certified license-exempt child care center. "Certified license-exempt child 
586.27 	care center" means the commissioner's written authorization for a child care center excluded 
586.28 	from licensure under section 245A.03, subdivision 2, paragraph (a), clause (5), (11) to (13), 
586.29 	(15), (18), or (26), to register to receive child care assistance payments under chapter 119B.
586.30 		Subd. 6.Disinfecting. "Disinfecting" means the use of a product capable of destroying 
586.31 	or inactivating harmful germs, except bacterial spores, consistent with label directions on 
587.1 	environmental surfaces including bathroom toilets and floors, diaper-changing surfaces, 
587.2 	and surfaces exposed to blood or other bodily fluids.

587.3 	EFFECTIVE DATE. This section is effective August 1, 2017.

587.4 	Sec. 44. [245G.02] WHO MUST BE CERTIFIED.
587.5 	A program that is exempt from licensure under section 245A.03, subdivision 2, paragraph 
587.6 	(a), clause (5), (11) to (13), (15), (18), or (26), and is authorized to receive child care 
587.7 	assistance payments under chapter 119B, must be a certified license-exempt child care 
587.8 	center according to this section.

587.9 	EFFECTIVE DATE. This section is effective August 1, 2017.

587.10 	Sec. 45. [245G.03] APPLICATION PROCEDURES.
587.11 		Subdivision 1.Schedule. The certification of license-exempt child care centers shall be 
587.12 	implemented by September 30, 2017. Certification applications shall be received and 
587.13 	processed on a phased-in schedule as determined by the commissioner.
587.14 		Subd. 2.Application submission. The commissioner shall provide application 
587.15 	instructions and information about the rules and requirements of other state agencies that 
587.16 	affect the applicant. The certification application must be submitted in a manner prescribed 
587.17 	by the commissioner. The commissioner shall act on the application within 90 working days 
587.18 	of receiving a completed application.
587.19 		Subd. 3.Incomplete applications. When the commissioner receives an application for 
587.20 	initial certification that is incomplete because the applicant failed to submit required 
587.21 	documents or is deficient because the documents submitted do not meet certification 
587.22 	requirements, the commissioner shall provide the applicant written notice that the application 
587.23 	is incomplete or deficient. In the notice, the commissioner shall identify documents that are 
587.24 	missing or deficient and give the applicant 45 days to resubmit a second application that is 
587.25 	complete. An applicant's failure to submit a complete application after receiving notice from 
587.26 	the commissioner is basis for certification denial.

587.27 	EFFECTIVE DATE. This section is effective August 1, 2017.

587.28 	Sec. 46. [245G.04] COMMISSIONER'S RIGHT OF ACCESS.
587.29 	(a) When the commissioner is exercising the powers conferred by this chapter, whenever 
587.30 	the center is in operation and the information is relevant to the commissioner's inspection 
587.31 	or investigation, the commissioner must be given access to:
588.1 	(1) the physical facility and grounds where the program is provided;
588.2 	(2) documentation and records, including electronically maintained records;
588.3 	(3) children served by the center; and
588.4 	(4) staff and personnel records of current and former staff.
588.5 	(b) The commissioner must be given access without prior notice and as often as the 
588.6 	commissioner considers necessary if the commissioner is investigating alleged maltreatment 
588.7 	or a violation of a law or rule, or conducting an inspection. When conducting an inspection, 
588.8 	the commissioner may request and shall receive assistance from other state, county, and 
588.9 	municipal governmental agencies and departments. The applicant or certification holder 
588.10 	shall allow the commissioner, at the commissioner's expense, to photocopy, photograph, 
588.11 	and make audio and video recordings during an inspection at the commissioner's expense.

588.12 	EFFECTIVE DATE. This section is effective August 1, 2017.

588.13 	Sec. 47. [245G.05] MONITORING AND INSPECTIONS.
588.14 	(a) The commissioner must conduct an on-site inspection of a certified license-exempt 
588.15 	child care center at least annually to determine compliance with the health, safety, and fire 
588.16 	standards specific to a certified license-exempt child care center.
588.17 	(b) No later than November 19, 2017, the commissioner shall make publicly available 
588.18 	on the department's Web site the results of inspection reports for all certified centers including 
588.19 	the number of deaths, serious injuries, and instances of substantiated child maltreatment 
588.20 	that occurred in certified centers each year.

588.21 	EFFECTIVE DATE. This section is effective August 1, 2017.

588.22 	Sec. 48. [245G.06] CORRECTION ORDER.
588.23 		Subdivision 1.Correction order requirements. If the applicant or certification holder 
588.24 	failed to comply with a law or rule, the commissioner may issue a correction order. The 
588.25 	correction order must state:
588.26 	(1) the condition that constitutes a violation of the law or rule;
588.27 	(2) the specific law or rule violated; and
588.28 	(3) the time allowed to correct each violation.
588.29 		Subd. 2.Reconsideration request. (a) If the applicant or certification holder believes 
588.30 	that the commissioner's correction order is erroneous, the applicant or certification holder 
589.1 	may ask the commissioner to reconsider the part of the correction order that is allegedly 
589.2 	erroneous. A request for reconsideration must be made in writing, postmarked, and sent to 
589.3 	the commissioner within 20 calendar days after the applicant or certification holder received 
589.4 	the correction order, and must:
589.5 	(1) specify the part of the correction order that is allegedly erroneous;
589.6 	(2) explain why the specified part is erroneous; and
589.7 	(3) include documentation to support the allegation of error.
589.8 	(b) A request for reconsideration does not stay any provision or requirement of the 
589.9 	correction order. The commissioner's disposition of a request for reconsideration is final 
589.10 	and not subject to appeal.
589.11 		Subd. 3.Decertification following a correction order. (a) If the commissioner finds 
589.12 	that the applicant or certification holder failed to correct the violation specified in the 
589.13 	correction order, the commissioner may decertify the license-exempt center pursuant to 
589.14 	section 245G.07.
589.15 	(b) Nothing in this section prohibits the commissioner from decertifying a center 
589.16 	according to section 245G.07.

589.17 	EFFECTIVE DATE. This section is effective August 1, 2017.

589.18 	Sec. 49. [245G.07] DECERTIFICATION.
589.19 	(a) The commissioner may decertify a center if a certification holder:
589.20 	(1) failed to comply with an applicable law or rule; or
589.21 	(2) knowingly withheld relevant information from or gave false or misleading information 
589.22 	to the commissioner in connection with an application for certification, in connection with 
589.23 	the background study status of an individual, during an investigation, or regarding compliance 
589.24 	with applicable laws or rules.
589.25 	(b) When considering decertification, the commissioner shall consider the nature, 
589.26 	chronicity, or severity of the violation of law or rule.
589.27 	(c) When a center is decertified, the center is ineligible to receive a child care assistance 
589.28 	payment.

589.29 	EFFECTIVE DATE. This section is effective August 1, 2017.

590.1 	Sec. 50. [245G.08] STAFFING REQUIREMENTS.
590.2 		Subdivision 1.Staffing requirements. During hours of operation, a certified center 
590.3 	must have a director or designee on site who is responsible for overseeing implementation 
590.4 	of written policies relating to the management and control of the daily activities of the 
590.5 	program, ensuring the health and safety of program participants, and supervising staff and 
590.6 	volunteers.
590.7 		Subd. 2.Director qualifications. The director must be 18 years of age or older and have 
590.8 	completed at least 16 hours of training in any of the following topic areas: child development 
590.9 	and learning; developmentally appropriate learning experiences; relationships with families; 
590.10 	assessment, evaluation, and individualization; historical and contemporary development of 
590.11 	early childhood education; professionalism; and health, safety, and nutrition.
590.12 		Subd. 3.Staff qualifications. A staff person must be 16 years of age or older before 
590.13 	providing direct, unsupervised care to a child.
590.14 		Subd. 4.Maximum group size. (a) For a child six weeks old through 16 months old, 
590.15 	the maximum group size shall be no more than eight children.
590.16 	(b) For a child 16 months old through 33 months old, the maximum group size shall be 
590.17 	no more than 14 children.
590.18 	(c) For a child 33 months old through prekindergarten, a maximum group size shall be 
590.19 	no more than 20 children.
590.20 	(d) For a child in kindergarten through 13 years old, a maximum group size shall be no 
590.21 	more than 30 children.
590.22 	(e) The maximum group size applies at all times except during group activity coordination 
590.23 	time not exceeding 15 minutes, during a meal, outdoor activity, field trip, nap and rest, and 
590.24 	special activity including a film, guest speaker, indoor large muscle activity, or holiday 
590.25 	program.
590.26 		Subd. 5.Ratios. (a) The minimally acceptable staff-to-child ratios are:

590.27	six weeks old through 16 months old
	1:4
	
590.28	16 months old through 33 months old
	1:7
	
590.29	33 months old through prekindergarten
	1:10
	
590.30	kindergarten through 13 years old
	1:15
	
590.31 	(b) Kindergarten includes a child of sufficient age to have attended the first day of 
590.32 	kindergarten or who is eligible to enter kindergarten within the next four months.
591.1 	(c) For mixed groups, the ratio for the age group of the youngest child applies.

591.2 	EFFECTIVE DATE. This section is effective August 1, 2017.

591.3 	Sec. 51. [245G.10] BACKGROUND STUDIES.
591.4 		Subdivision 1.Documentation. (a) The applicant or certification holder must submit 
591.5 	and maintain documentation of a completed background study for:
591.6 	(1) each person applying for the certification;
591.7 	(2) each person identified as a center operator or program operator as defined in section 
591.8 	245G.01, subdivision 5;
591.9 	(3) each current or prospective staff person or contractor of the certified center who will 
591.10 	have direct contact with a child served by the center;
591.11 	(4) each volunteer who has direct contact with a child served by the center if the contact 
591.12 	is not under the continuous, direct supervision by an individual listed in clause (1), (2), or 
591.13 	(3); and
591.14 	(5) each managerial staff of the certification holder with oversight and supervision of 
591.15 	the certified center.
591.16 	(b) To be accepted for certification, a background study on every individual in subdivision 
591.17 	1, clause (1), must be completed under chapter 245C and result in a not disqualified 
591.18 	determination under section 245C.14 or a disqualification that was set aside under section 
591.19 	245C.22.
591.20 		Subd. 2.Direct contact. (a) The subject of the background study may not provide direct 
591.21 	contact services to a child served by a certified center unless the subject is under continuous 
591.22 	direct supervision pending completion of the background study.
591.23 	(b) The certified center must document in the staff person's personnel file the date the 
591.24 	program initiates a background study and the date the subject of the study first had direct 
591.25 	contact with a child served by the center.

591.26 	EFFECTIVE DATE. This section is effective August 1, 2017.

591.27 	Sec. 52. [245G.11] REPORTING.
591.28 	(a) The certification holder must comply with the reporting requirements for abuse and 
591.29 	neglect specified in section 626.556. A person mandated to report physical or sexual child 
592.1 	abuse or neglect occurring within a certified center shall report the information to the 
592.2 	commissioner.
592.3 	(b) The certification holder must inform the commissioner within 24 hours of:
592.4 	(1) the death of a child in the program; and
592.5 	(2) any injury to a child in the program that required treatment by a physician.

592.6 	EFFECTIVE DATE. This section is effective August 1, 2017.

592.7 	Sec. 53. [245G.12] FEES.
592.8 	The commissioner shall consult with stakeholders to develop an administrative fee to 
592.9 	implement this chapter. By February 15, 2019, the commissioner shall provide 
592.10 	recommendations on the amount of an administrative fee to the legislative committees with 
592.11 	jurisdiction over health and human services policy and finance.

592.12 	EFFECTIVE DATE. This section is effective August 1, 2017.

592.13 	Sec. 54. [245G.13] HEALTH AND SAFETY REQUIREMENTS.
592.14 		Subdivision 1.Exclusion of sick children and infectious disease outbreak control.
 592.15 	(a) A certified center must supervise and isolate a child from other children in the program 
592.16 	when a child becomes sick and immediately notify the sick child's parent or legal guardian.
592.17 	(b) A certified center must post or give notice to the parent or legal guardian of an 
592.18 	exposed child the same day the program is notified of a child's contagious reportable disease 
592.19 	specified in Minnesota Rules, part 4605.7040, or scabies, impetigo, ringworm, or chicken 
592.20 	pox.
592.21 		Subd. 2.Immunizations. By a child's date of attendance, the certified center must 
592.22 	maintain or have access to a record detailing the child's current immunizations or applicable 
592.23 	exemption.
592.24 		Subd. 3.Administration of medication. (a) A certified center that chooses to administer 
592.25 	medicine must meet the requirements in this subdivision.
592.26 	(b) The certified center must obtain written permission from the child's parent or legal 
592.27 	guardian before administering prescription medicine, diapering product, sunscreen lotion, 
592.28 	and insect repellent.
593.1 	(c) The certified center must administer nonprescription medicine, diapering product, 
593.2 	sunscreen lotion, and insect repellent according to the manufacturer's instructions unless 
593.3 	provided written instructions by a licensed health professional to use a product differently.
593.4 	(d) The certified center must obtain and follow written instructions from the prescribing 
593.5 	health professional before administering prescription medicine. Medicine with the child's 
593.6 	first and last name and current prescription information on the label is considered written 
593.7 	instructions.
593.8 	(e) The certified center must ensure all medicine is:
593.9 	(1) kept in the medicine's original container with a legible label stating the child's first 
593.10 	and last name;
593.11 	(2) given only to the child whose name is on the label;
593.12 	(3) not given after an expiration date on the label; and
593.13 	(4) returned to the child's parent or legal guardian or destroyed, if unused.
593.14 	(f) The certified center must document in the child's record the administration of 
593.15 	medication, including the child's first and last name; the name of the medication or 
593.16 	prescription number; the date, time, and dosage; and the name and signature of the person 
593.17 	who administered the medicine. This documentation must be available to the child's parent 
593.18 	or legal guardian.
593.19 	(g) The certified center must store medicines, insect repellents, and diapering products 
593.20 	according to directions on the original container.
593.21 		Subd. 4.Preventing and responding to allergies. (a) Before admitting a child for care, 
593.22 	the certified center must obtain documentation of any known allergies from the child's parent 
593.23 	or legal guardian. The certified center must maintain current allergy information in each 
593.24 	child's record. The allergy information must include:
593.25 	(1) a description of the allergy, specific triggers, avoidance techniques, and symptoms 
593.26 	of an allergic reaction; and
593.27 	(2) procedures for responding to an allergic reaction, including medication, dosages, 
593.28 	and a doctor's contact information.
593.29 	(b) The certified center must inform staff of each child's current allergy information. At 
593.30 	least annually and when a change is made to allergy-related information in a child's record, 
593.31 	the certified center must inform staff of any change. Documentation that staff were informed 
593.32 	of the child's current allergy information must be kept on site.
594.1 	(c) A child's allergy information must be available at all times including on site, when 
594.2 	on field trips, or during transportation. Food allergy information must be readily available 
594.3 	to staff in the area where food is prepared and served to the child.
594.4 		Subd. 5.Building and physical premises; free of hazards. (a) The certified center 
594.5 	must document compliance with the State Fire Code by providing documentation of a fire 
594.6 	marshal inspection completed within the previous three years by a state fire marshal or a 
594.7 	local fire code inspector trained by the state fire marshal.
594.8 	(b) The certified center must designate a primary indoor and outdoor space used for 
594.9 	child care on a facility site floor plan.
594.10 	(c) The certified center must ensure the areas used by a child are clean and in good repair, 
594.11 	with structurally sound and functional furniture and equipment that is appropriate to the 
594.12 	age and size of a child who uses the area.
594.13 	(d) The certified center must ensure hazardous items including but not limited to sharp 
594.14 	objects, medicines, cleaning supplies, poisonous plants, and chemicals are out of reach of 
594.15 	a child.
594.16 	(e) The certified center must safely handle and dispose of bodily fluids and other 
594.17 	potentially infectious fluids by using gloves, disinfecting surfaces that come in contact with 
594.18 	potentially infectious bodily fluids, and disposing of bodily fluid in a securely sealed plastic 
594.19 	bag.
594.20 		Subd. 6.Transporting children. (a) If a certified center chooses to transport a child, 
594.21 	the certified center must ensure that the driver of the vehicle holds a valid driver's license, 
594.22 	appropriate to the vehicle driven.
594.23 	(b) If a certified center chooses to transport a child, the center must comply with all seat 
594.24 	belt and child passenger restraint system requirements under sections 169.685 and 169.686.

594.25 	EFFECTIVE DATE. This section is effective August 1, 2017.

594.26 	Sec. 55. [245G.14] TRAINING REQUIREMENTS.
594.27 		Subdivision 1.First aid and cardiopulmonary resuscitation. At least one designated 
594.28 	staff person who completed pediatric first aid training and pediatric cardiopulmonary 
594.29 	resuscitation (CPR) training must be present at all times at the program, during field trips, 
594.30 	and when transporting a child. The designated staff person must repeat pediatric first aid 
594.31 	training and pediatric CPR training at least once every two years.
595.1 		Subd. 2.Sudden unexpected infant death. A certified center that cares for an infant 
595.2 	who is younger than one year of age must ensure that staff persons and volunteers receive 
595.3 	training according to section 245A.1435 on reducing the risk of sudden unexpected infant 
595.4 	death before assisting in the care of an infant.
595.5 		Subd. 3.Abusive head trauma. A certified center that cares for a child through four 
595.6 	years of age must ensure that staff persons and volunteers receive training on abusive head 
595.7 	trauma from shaking infants and young children before assisting in the care of a child through 
595.8 	four years of age.
595.9 		Subd. 4.Child development. The certified center must ensure each staff person completes 
595.10 	at least two hours of child development and learning training within 14 days of employment 
595.11 	and annually thereafter. For purposes of this subdivision, "child development and learning 
595.12 	training" means how a child develops physically, cognitively, emotionally, and socially and 
595.13 	learns as part of the child's family, culture, and community.
595.14 		Subd. 5.Orientation. The certified center must ensure each staff person is trained at 
595.15 	orientation on health and safety requirements in sections 245G.11, 245G.13, 245G.14, and 
595.16 	245G.15. The certified center must provide staff with an orientation within 14 days of 
595.17 	employment. Before the completion of orientation, a staff person must be supervised while 
595.18 	providing direct care to a child.
595.19 		Subd. 6.In service. (a) The certified center must ensure each staff person is trained at 
595.20 	least annually on health and safety requirements in sections 245G.11, 245G.13, 245G.14, 
595.21 	and 245G.15.
595.22 	(b) Each staff person must annually complete at least six hours of training. Training 
595.23 	required under paragraph (a) may be used toward the hourly training requirements of this 
595.24 	subdivision.
595.25 		Subd. 7.Documentation. A certified center must document the date of a completed 
595.26 	training required by this section in the personnel record of each staff person.

595.27 	EFFECTIVE DATE. This section is effective August 1, 2017.

595.28 	Sec. 56. [245G.15] EMERGENCY PREPAREDNESS.
595.29 		Subdivision 1.Written emergency plan. (a) A certified center must have a written 
595.30 	emergency plan for emergencies that require evacuation, sheltering, or other protection of 
595.31 	children, such as fire, natural disaster, intruder, or other threatening situation that may pose 
595.32 	a health or safety hazard to children. The plan must be written on a form developed by the 
596.1 	commissioner and reviewed and updated at least once each calendar year. The annual review 
596.2 	of the emergency plan must be documented.
596.3 	(b) The plan must include:
596.4 	(1) procedures for an evacuation, relocation, shelter-in-place, or lockdown;
596.5 	(2) a designated relocation site and evacuation route;
596.6 	(3) procedures for notifying a child's parent or legal guardian of the relocation and 
596.7 	reunification with families;
596.8 	(4) accommodations for a child with a disability or a chronic medical condition;
596.9 	(5) procedures for storing a child's medically necessary medicine that facilitates easy 
596.10 	removal during an evacuation or relocation;
596.11 	(6) procedures for continuing operations in the period during and after a crisis; and
596.12 	(7) procedures for communicating with local emergency management officials, law 
596.13 	enforcement officials, or other appropriate state or local authorities.
596.14 	(c) The certification holder must have an emergency plan available for review upon 
596.15 	request by the child's parent or legal guardian.
596.16 		Subd. 2.Staff person training. The certification holder must train a staff person at 
596.17 	orientation and at least once each calendar year on the emergency plan and document training 
596.18 	in each personnel file. The certified center must conduct at least quarterly one evacuation 
596.19 	drill and one shelter-in-place drill. The date and time of the drills must be documented.

596.20 	EFFECTIVE DATE. This section is effective August 1, 2017.

596.21 	Sec. 57. [245G.16] PERSONNEL RECORD.
596.22 	The certification holder must maintain a personnel record for each staff person at the 
596.23 	program that must contain:
596.24 	(1) the staff person's name, home address, telephone number, and date of birth;
596.25 	(2) documentation that the staff person completed training required by section 245G.14;
596.26 	(3) documentation of the date the program initiated a background study for the staff 
596.27 	person; and
596.28 	(4) documentation of the date the staff person first had direct contact and access to a 
596.29 	child while supervised, and the date the staff person first had direct contact and access to a 
596.30 	child while unsupervised.

597.1 	EFFECTIVE DATE. This section is effective August 1, 2017.

597.2 	Sec. 58. [245G.17] CERTIFICATION STANDARDS.
597.3 	The commissioner shall regularly consult with stakeholders for input related to 
597.4 	implementing the standards in this chapter.

597.5 	EFFECTIVE DATE. This section is effective August 1, 2017.

597.6 	Sec. 59. [245G.18] PARENTAL ACCESS.
597.7 	An enrolled child's parent or legal guardian must be allowed access to the parent's or 
597.8 	legal guardian's child at any time while the child is in care.

597.9 	EFFECTIVE DATE. This section is effective August 1, 2017.

597.10 	Sec. 60. Minnesota Statutes 2016, section 626.556, subdivision 2, is amended to read:
597.11 		Subd. 2.Definitions. As used in this section, the following terms have the meanings 
597.12 	given them unless the specific content indicates otherwise:
597.13 	(a) "Accidental" means a sudden, not reasonably foreseeable, and unexpected occurrence 
597.14 	or event which:
597.15 	(1) is not likely to occur and could not have been prevented by exercise of due care; and
597.16 	(2) if occurring while a child is receiving services from a facility, happens when the 
597.17 	facility and the employee or person providing services in the facility are in compliance with 
597.18 	the laws and rules relevant to the occurrence or event.
597.19 	(b) "Commissioner" means the commissioner of human services.
597.20 	(c) "Facility" means:
597.21 	(1) a licensed or unlicensed day care facility, certified license-exempt child care center,
597.22 	residential facility, agency, hospital, sanitarium, or other facility or institution required to 
597.23 	be licensed under sections 144.50 to 144.58, 241.021, or 245A.01 to 245A.16, or chapter 
597.24 	245D or 245G;
597.25 	(2) a school as defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E; 
597.26 	or
597.27 	(3) a nonlicensed personal care provider organization as defined in section 256B.0625, 
597.28 	subdivision 19a.
598.1 	(d) "Family assessment" means a comprehensive assessment of child safety, risk of 
598.2 	subsequent child maltreatment, and family strengths and needs that is applied to a child 
598.3 	maltreatment report that does not allege sexual abuse or substantial child endangerment. 
598.4 	Family assessment does not include a determination as to whether child maltreatment 
598.5 	occurred but does determine the need for services to address the safety of family members 
598.6 	and the risk of subsequent maltreatment.
598.7 	(e) "Investigation" means fact gathering related to the current safety of a child and the 
598.8 	risk of subsequent maltreatment that determines whether child maltreatment occurred and 
598.9 	whether child protective services are needed. An investigation must be used when reports 
598.10 	involve sexual abuse or substantial child endangerment, and for reports of maltreatment in 
598.11 	facilities required to be licensed or certified under chapter 245A or, 245D, or 245G; under 
598.12 	sections 144.50 to 144.58 and 241.021; in a school as defined in section 120A.05, 
598.13 	subdivisions 9, 11, and 13, and chapter 124E; or in a nonlicensed personal care provider 
598.14 	association as defined in section 256B.0625, subdivision 19a.
598.15 	(f) "Mental injury" means an injury to the psychological capacity or emotional stability 
598.16 	of a child as evidenced by an observable or substantial impairment in the child's ability to 
598.17 	function within a normal range of performance and behavior with due regard to the child's 
598.18 	culture.
598.19 	(g) "Neglect" means the commission or omission of any of the acts specified under 
598.20 	clauses (1) to (9), other than by accidental means:
598.21 	(1) failure by a person responsible for a child's care to supply a child with necessary 
598.22 	food, clothing, shelter, health, medical, or other care required for the child's physical or 
598.23 	mental health when reasonably able to do so;
598.24 	(2) failure to protect a child from conditions or actions that seriously endanger the child's 
598.25 	physical or mental health when reasonably able to do so, including a growth delay, which 
598.26 	may be referred to as a failure to thrive, that has been diagnosed by a physician and is due 
598.27 	to parental neglect;
598.28 	(3) failure to provide for necessary supervision or child care arrangements appropriate 
598.29 	for a child after considering factors as the child's age, mental ability, physical condition, 
598.30 	length of absence, or environment, when the child is unable to care for the child's own basic 
598.31 	needs or safety, or the basic needs or safety of another child in their care;
598.32 	(4) failure to ensure that the child is educated as defined in sections 120A.22 and 
598.33 	260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's 
599.1 	child with sympathomimetic medications, consistent with section 125A.091, subdivision 
599.2 	5;
599.3 	(5) nothing in this section shall be construed to mean that a child is neglected solely 
599.4 	because the child's parent, guardian, or other person responsible for the child's care in good 
599.5 	faith selects and depends upon spiritual means or prayer for treatment or care of disease or 
599.6 	remedial care of the child in lieu of medical care; except that a parent, guardian, or caretaker, 
599.7 	or a person mandated to report pursuant to subdivision 3, has a duty to report if a lack of 
599.8 	medical care may cause serious danger to the child's health. This section does not impose 
599.9 	upon persons, not otherwise legally responsible for providing a child with necessary food, 
599.10 	clothing, shelter, education, or medical care, a duty to provide that care;
599.11 	(6) prenatal exposure to a controlled substance, as defined in section 253B.02, subdivision 
599.12 	2, used by the mother for a nonmedical purpose, as evidenced by withdrawal symptoms in 
599.13 	the child at birth, results of a toxicology test performed on the mother at delivery or the 
599.14 	child at birth, medical effects or developmental delays during the child's first year of life 
599.15 	that medically indicate prenatal exposure to a controlled substance, or the presence of a 
599.16 	fetal alcohol spectrum disorder;
599.17 	(7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
599.18 	(8) chronic and severe use of alcohol or a controlled substance by a parent or person 
599.19 	responsible for the care of the child that adversely affects the child's basic needs and safety; 
599.20 	or
599.21 	(9) emotional harm from a pattern of behavior which contributes to impaired emotional 
599.22 	functioning of the child which may be demonstrated by a substantial and observable effect 
599.23 	in the child's behavior, emotional response, or cognition that is not within the normal range 
599.24 	for the child's age and stage of development, with due regard to the child's culture.
599.25 	(h) "Nonmaltreatment mistake" means:
599.26 	(1) at the time of the incident, the individual was performing duties identified in the 
599.27 	center's child care program plan required under Minnesota Rules, part 9503.0045;
599.28 	(2) the individual has not been determined responsible for a similar incident that resulted 
599.29 	in a finding of maltreatment for at least seven years;
599.30 	(3) the individual has not been determined to have committed a similar nonmaltreatment 
599.31 	mistake under this paragraph for at least four years;
600.1 	(4) any injury to a child resulting from the incident, if treated, is treated only with 
600.2 	remedies that are available over the counter, whether ordered by a medical professional or 
600.3 	not; and
600.4 	(5) except for the period when the incident occurred, the facility and the individual 
600.5 	providing services were both in compliance with all licensing requirements relevant to the 
600.6 	incident.
600.7 	This definition only applies to child care centers licensed under Minnesota Rules, chapter 
600.8 	9503. If clauses (1) to (5) apply, rather than making a determination of substantiated 
600.9 	maltreatment by the individual, the commissioner of human services shall determine that a 
600.10 	nonmaltreatment mistake was made by the individual.
600.11 	(i) "Operator" means an operator or agency as defined in section 245A.02.
600.12 	(j) "Person responsible for the child's care" means (1) an individual functioning within 
600.13 	the family unit and having responsibilities for the care of the child such as a parent, guardian, 
600.14 	or other person having similar care responsibilities, or (2) an individual functioning outside 
600.15 	the family unit and having responsibilities for the care of the child such as a teacher, school 
600.16 	administrator, other school employees or agents, or other lawful custodian of a child having 
600.17 	either full-time or short-term care responsibilities including, but not limited to, day care, 
600.18 	babysitting whether paid or unpaid, counseling, teaching, and coaching.
600.19 	(k) "Physical abuse" means any physical injury, mental injury, or threatened injury, 
600.20 	inflicted by a person responsible for the child's care on a child other than by accidental 
600.21 	means, or any physical or mental injury that cannot reasonably be explained by the child's 
600.22 	history of injuries, or any aversive or deprivation procedures, or regulated interventions, 
600.23 	that have not been authorized under section 125A.0942 or 245.825.
600.24 	Abuse does not include reasonable and moderate physical discipline of a child 
600.25 	administered by a parent or legal guardian which does not result in an injury. Abuse does 
600.26 	not include the use of reasonable force by a teacher, principal, or school employee as allowed 
600.27 	by section 121A.582. Actions which are not reasonable and moderate include, but are not 
600.28 	limited to, any of the following:
600.29 	(1) throwing, kicking, burning, biting, or cutting a child;
600.30 	(2) striking a child with a closed fist;
600.31 	(3) shaking a child under age three;
600.32 	(4) striking or other actions which result in any nonaccidental injury to a child under 18 
600.33 	months of age;
601.1 	(5) unreasonable interference with a child's breathing;
601.2 	(6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
601.3 	(7) striking a child under age one on the face or head;
601.4 	(8) striking a child who is at least age one but under age four on the face or head, which 
601.5 	results in an injury;
601.6 	(9) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled 
601.7 	substances which were not prescribed for the child by a practitioner, in order to control or 
601.8 	punish the child; or other substances that substantially affect the child's behavior, motor 
601.9 	coordination, or judgment or that results in sickness or internal injury, or subjects the child 
601.10 	to medical procedures that would be unnecessary if the child were not exposed to the 
601.11 	substances;
601.12 	(10) unreasonable physical confinement or restraint not permitted under section 609.379, 
601.13 	including but not limited to tying, caging, or chaining; or
601.14 	(11) in a school facility or school zone, an act by a person responsible for the child's 
601.15 	care that is a violation under section 121A.58.
601.16 	(l) "Practice of social services," for the purposes of subdivision 3, includes but is not 
601.17 	limited to employee assistance counseling and the provision of guardian ad litem and 
601.18 	parenting time expeditor services.
601.19 	(m) "Report" means any communication received by the local welfare agency, police 
601.20 	department, county sheriff, or agency responsible for child protection pursuant to this section 
601.21 	that describes neglect or physical or sexual abuse of a child and contains sufficient content 
601.22 	to identify the child and any person believed to be responsible for the neglect or abuse, if 
601.23 	known.
601.24 	(n) "Sexual abuse" means the subjection of a child by a person responsible for the child's 
601.25 	care, by a person who has a significant relationship to the child, as defined in section 609.341, 
601.26 	or by a person in a position of authority, as defined in section 609.341, subdivision 10, to 
601.27 	any act which constitutes a violation of section 609.342 (criminal sexual conduct in the first 
601.28 	degree), 609.343 (criminal sexual conduct in the second degree), 609.344 (criminal sexual 
601.29 	conduct in the third degree), 609.345 (criminal sexual conduct in the fourth degree), or 
601.30 	609.3451 (criminal sexual conduct in the fifth degree). Sexual abuse also includes any act 
601.31 	which involves a minor which constitutes a violation of prostitution offenses under sections 
601.32 	609.321 to 609.324 or 617.246. Effective May 29, 2017, sexual abuse includes all reports 
601.33 	of known or suspected child sex trafficking involving a child who is identified as a victim 
602.1 	of sex trafficking. Sexual abuse includes child sex trafficking as defined in section 609.321, 
602.2 	subdivisions 7a and 7b. Sexual abuse includes threatened sexual abuse which includes the 
602.3 	status of a parent or household member who has committed a violation which requires 
602.4 	registration as an offender under section 243.166, subdivision 1b, paragraph (a) or (b), or 
602.5 	required registration under section 243.166, subdivision 1b, paragraph (a) or (b).
602.6 	(o) "Substantial child endangerment" means a person responsible for a child's care, by 
602.7 	act or omission, commits or attempts to commit an act against a child under their care that 
602.8 	constitutes any of the following:
602.9 	(1) egregious harm as defined in section 260C.007, subdivision 14;
602.10 	(2) abandonment under section 260C.301, subdivision 2;
602.11 	(3) neglect as defined in paragraph (g), clause (2), that substantially endangers the child's 
602.12 	physical or mental health, including a growth delay, which may be referred to as failure to 
602.13 	thrive, that has been diagnosed by a physician and is due to parental neglect;
602.14 	(4) murder in the first, second, or third degree under section 609.185, 609.19, or 609.195;
602.15 	(5) manslaughter in the first or second degree under section 609.20 or 609.205;
602.16 	(6) assault in the first, second, or third degree under section 609.221, 609.222, or 609.223;
602.17 	(7) solicitation, inducement, and promotion of prostitution under section 609.322;
602.18 	(8) criminal sexual conduct under sections 609.342 to 609.3451;
602.19 	(9) solicitation of children to engage in sexual conduct under section 609.352;
602.20 	(10) malicious punishment or neglect or endangerment of a child under section 609.377
602.21 	or 609.378;
602.22 	(11) use of a minor in sexual performance under section 617.246; or
602.23 	(12) parental behavior, status, or condition which mandates that the county attorney file 
602.24 	a termination of parental rights petition under section 260C.503, subdivision 2.
602.25 	(p) "Threatened injury" means a statement, overt act, condition, or status that represents 
602.26 	a substantial risk of physical or sexual abuse or mental injury. Threatened injury includes, 
602.27 	but is not limited to, exposing a child to a person responsible for the child's care, as defined 
602.28 	in paragraph (j), clause (1), who has:
602.29 	(1) subjected a child to, or failed to protect a child from, an overt act or condition that 
602.30 	constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a similar law 
602.31 	of another jurisdiction;
603.1 	(2) been found to be palpably unfit under section 260C.301, subdivision 1, paragraph 
603.2 	(b), clause (4), or a similar law of another jurisdiction;
603.3 	(3) committed an act that has resulted in an involuntary termination of parental rights 
603.4 	under section 260C.301, or a similar law of another jurisdiction; or
603.5 	(4) committed an act that has resulted in the involuntary transfer of permanent legal and 
603.6 	physical custody of a child to a relative under Minnesota Statutes 2010, section 260C.201, 
603.7 	subdivision 11, paragraph (d), clause (1), section 260C.515, subdivision 4, or a similar law 
603.8 	of another jurisdiction.
603.9 	A child is the subject of a report of threatened injury when the responsible social services 
603.10 	agency receives birth match data under paragraph (q) from the Department of Human 
603.11 	Services.
603.12 	(q) Upon receiving data under section 144.225, subdivision 2b, contained in a birth 
603.13 	record or recognition of parentage identifying a child who is subject to threatened injury 
603.14 	under paragraph (p), the Department of Human Services shall send the data to the responsible 
603.15 	social services agency. The data is known as "birth match" data. Unless the responsible 
603.16 	social services agency has already begun an investigation or assessment of the report due 
603.17 	to the birth of the child or execution of the recognition of parentage and the parent's previous 
603.18 	history with child protection, the agency shall accept the birth match data as a report under 
603.19 	this section. The agency may use either a family assessment or investigation to determine 
603.20 	whether the child is safe. All of the provisions of this section apply. If the child is determined 
603.21 	to be safe, the agency shall consult with the county attorney to determine the appropriateness 
603.22 	of filing a petition alleging the child is in need of protection or services under section 
603.23 	260C.007, subdivision 6, clause (16), in order to deliver needed services. If the child is 
603.24 	determined not to be safe, the agency and the county attorney shall take appropriate action 
603.25 	as required under section 260C.503, subdivision 2.
603.26 	(r) Persons who conduct assessments or investigations under this section shall take into 
603.27 	account accepted child-rearing practices of the culture in which a child participates and 
603.28 	accepted teacher discipline practices, which are not injurious to the child's health, welfare, 
603.29 	and safety.

603.30 	EFFECTIVE DATE. This section is effective August 1, 2017.

603.31 	Sec. 61. Minnesota Statutes 2016, section 626.556, subdivision 3, is amended to read:
603.32 		Subd. 3.Persons mandated to report; persons voluntarily reporting. (a) A person 
603.33 	who knows or has reason to believe a child is being neglected or physically or sexually 
604.1 	abused, as defined in subdivision 2, or has been neglected or physically or sexually abused 
604.2 	within the preceding three years, shall immediately report the information to the local welfare 
604.3 	agency, agency responsible for assessing or investigating the report, police department, 
604.4 	county sheriff, tribal social services agency, or tribal police department if the person is:
604.5 	(1) a professional or professional's delegate who is engaged in the practice of the healing 
604.6 	arts, social services, hospital administration, psychological or psychiatric treatment, child 
604.7 	care, education, correctional supervision, probation and correctional services, or law 
604.8 	enforcement; or
604.9 	(2) employed as a member of the clergy and received the information while engaged in 
604.10 	ministerial duties, provided that a member of the clergy is not required by this subdivision 
604.11 	to report information that is otherwise privileged under section 595.02, subdivision 1, 
604.12 	paragraph (c).
604.13 	(b) Any person may voluntarily report to the local welfare agency, agency responsible 
604.14 	for assessing or investigating the report, police department, county sheriff, tribal social 
604.15 	services agency, or tribal police department if the person knows, has reason to believe, or 
604.16 	suspects a child is being or has been neglected or subjected to physical or sexual abuse.
604.17 	(c) A person mandated to report physical or sexual child abuse or neglect occurring 
604.18 	within a licensed facility shall report the information to the agency responsible for licensing
604.19 	or certifying the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; 
604.20 	or chapter 245D or 245G; or a nonlicensed personal care provider organization as defined 
604.21 	in section 256B.0625, subdivision 19. A health or corrections agency receiving a report 
604.22 	may request the local welfare agency to provide assistance pursuant to subdivisions 10, 10a, 
604.23 	and 10b. A board or other entity whose licensees perform work within a school facility, 
604.24 	upon receiving a complaint of alleged maltreatment, shall provide information about the 
604.25 	circumstances of the alleged maltreatment to the commissioner of education. Section 13.03, 
604.26 	subdivision 4, applies to data received by the commissioner of education from a licensing 
604.27 	entity.
604.28 	(d) Notification requirements under subdivision 10 apply to all reports received under 
604.29 	this section.
604.30 	(e) For purposes of this section, "immediately" means as soon as possible but in no event 
604.31 	longer than 24 hours.

604.32 	EFFECTIVE DATE. This section is effective August 1, 2017.

605.1 	Sec. 62. Minnesota Statutes 2016, section 626.556, subdivision 3c, is amended to read:
605.2 		Subd. 3c.Local welfare agency, Department of Human Services or Department of 
605.3 	Health responsible for assessing or investigating reports of maltreatment. (a) The county
605.4 	local welfare agency is the agency responsible for assessing or investigating allegations of 
605.5 	maltreatment in child foster care, family child care, legally unlicensed nonlicensed child 
605.6 	care, juvenile correctional facilities licensed under section 241.021 located in the local 
605.7 	welfare agency's county, and reports involving children served by an unlicensed personal 
605.8 	care provider organization under section 256B.0659. Copies of findings related to personal 
605.9 	care provider organizations under section 256B.0659 must be forwarded to the Department 
605.10 	of Human Services provider enrollment.
605.11 	(b) The Department of Human Services is the agency responsible for assessing or 
605.12 	investigating allegations of maltreatment in juvenile correctional facilities listed under 
605.13 	section 241.021 located in the local welfare agency's county and in facilities licensed or 
605.14 	certified under chapters 245A and, 245D, and 245G, except for child foster care and family 
605.15 	child care.
605.16 	(c) The Department of Health is the agency responsible for assessing or investigating 
605.17 	allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58 and 
605.18 	144A.43 to 144A.482.

605.19 	Sec. 63. Minnesota Statutes 2016, section 626.556, subdivision 4, is amended to read:
605.20 		Subd. 4.Immunity from liability. (a) The following persons are immune from any civil 
605.21 	or criminal liability that otherwise might result from their actions, if they are acting in good 
605.22 	faith:
605.23 	(1) any person making a voluntary or mandated report under subdivision 3 or under 
605.24 	section 626.5561 or assisting in an assessment under this section or under section 626.5561;
605.25 	(2) any person with responsibility for performing duties under this section or supervisor 
605.26 	employed by a local welfare agency, the commissioner of an agency responsible for operating 
605.27 	or supervising a licensed or unlicensed day care facility, residential facility, agency, hospital, 
605.28 	sanitarium, or other facility or institution required to be licensed or certified under sections 
605.29 	144.50 to 144.58; 241.021; 245A.01 to 245A.16; or chapter 245B, or 245G; or a school as 
605.30 	defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E; or a nonlicensed 
605.31 	personal care provider organization as defined in section 256B.0625, subdivision 19a, 
605.32 	complying with subdivision 10d; and
606.1 	(3) any public or private school, facility as defined in subdivision 2, or the employee of 
606.2 	any public or private school or facility who permits access by a local welfare agency, the 
606.3 	Department of Education, or a local law enforcement agency and assists in an investigation 
606.4 	or assessment pursuant to subdivision 10 or under section 626.5561.
606.5 	(b) A person who is a supervisor or person with responsibility for performing duties 
606.6 	under this section employed by a local welfare agency, the commissioner of human services, 
606.7 	or the commissioner of education complying with subdivisions 10 and 11 or section 626.5561
606.8 	or any related rule or provision of law is immune from any civil or criminal liability that 
606.9 	might otherwise result from the person's actions, if the person is (1) acting in good faith 
606.10 	and exercising due care, or (2) acting in good faith and following the information collection 
606.11 	procedures established under subdivision 10, paragraphs (h), (i), and (j).
606.12 	(c) This subdivision does not provide immunity to any person for failure to make a 
606.13 	required report or for committing neglect, physical abuse, or sexual abuse of a child.
606.14 	(d) If a person who makes a voluntary or mandatory report under subdivision 3 prevails 
606.15 	in a civil action from which the person has been granted immunity under this subdivision, 
606.16 	the court may award the person attorney fees and costs.

606.17 	EFFECTIVE DATE. This section is effective August 1, 2017.

606.18 	Sec. 64. Minnesota Statutes 2016, section 626.556, subdivision 10d, is amended to read:
606.19 		Subd. 10d.Notification of neglect or abuse in facility. (a) When a report is received 
606.20 	that alleges neglect, physical abuse, sexual abuse, or maltreatment of a child while in the 
606.21 	care of a licensed or unlicensed day care facility, residential facility, agency, hospital, 
606.22 	sanitarium, or other facility or institution required to be licensed or certified according to 
606.23 	sections 144.50 to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 245D or 245G, or 
606.24 	a school as defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E; or a 
606.25 	nonlicensed personal care provider organization as defined in section 256B.0625, subdivision 
606.26 	19a, the commissioner of the agency responsible for assessing or investigating the report 
606.27 	or local welfare agency investigating the report shall provide the following information to 
606.28 	the parent, guardian, or legal custodian of a child alleged to have been neglected, physically 
606.29 	abused, sexually abused, or the victim of maltreatment of a child in the facility: the name 
606.30 	of the facility; the fact that a report alleging neglect, physical abuse, sexual abuse, or 
606.31 	maltreatment of a child in the facility has been received; the nature of the alleged neglect, 
606.32 	physical abuse, sexual abuse, or maltreatment of a child in the facility; that the agency is 
606.33 	conducting an assessment or investigation; any protective or corrective measures being 
607.1 	taken pending the outcome of the investigation; and that a written memorandum will be 
607.2 	provided when the investigation is completed.
607.3 	(b) The commissioner of the agency responsible for assessing or investigating the report 
607.4 	or local welfare agency may also provide the information in paragraph (a) to the parent, 
607.5 	guardian, or legal custodian of any other child in the facility if the investigative agency 
607.6 	knows or has reason to believe the alleged neglect, physical abuse, sexual abuse, or 
607.7 	maltreatment of a child in the facility has occurred. In determining whether to exercise this 
607.8 	authority, the commissioner of the agency responsible for assessing or investigating the 
607.9 	report or local welfare agency shall consider the seriousness of the alleged neglect, physical 
607.10 	abuse, sexual abuse, or maltreatment of a child in the facility; the number of children 
607.11 	allegedly neglected, physically abused, sexually abused, or victims of maltreatment of a 
607.12 	child in the facility; the number of alleged perpetrators; and the length of the investigation. 
607.13 	The facility shall be notified whenever this discretion is exercised.
607.14 	(c) When the commissioner of the agency responsible for assessing or investigating the 
607.15 	report or local welfare agency has completed its investigation, every parent, guardian, or 
607.16 	legal custodian previously notified of the investigation by the commissioner or local welfare 
607.17 	agency shall be provided with the following information in a written memorandum: the 
607.18 	name of the facility investigated; the nature of the alleged neglect, physical abuse, sexual 
607.19 	abuse, or maltreatment of a child in the facility; the investigator's name; a summary of the 
607.20 	investigation findings; a statement whether maltreatment was found; and the protective or 
607.21 	corrective measures that are being or will be taken. The memorandum shall be written in a 
607.22 	manner that protects the identity of the reporter and the child and shall not contain the name, 
607.23 	or to the extent possible, reveal the identity of the alleged perpetrator or of those interviewed 
607.24 	during the investigation. If maltreatment is determined to exist, the commissioner or local 
607.25 	welfare agency shall also provide the written memorandum to the parent, guardian, or legal 
607.26 	custodian of each child in the facility who had contact with the individual responsible for 
607.27 	the maltreatment. When the facility is the responsible party for maltreatment, the 
607.28 	commissioner or local welfare agency shall also provide the written memorandum to the 
607.29 	parent, guardian, or legal custodian of each child who received services in the population 
607.30 	of the facility where the maltreatment occurred. This notification must be provided to the 
607.31 	parent, guardian, or legal custodian of each child receiving services from the time the 
607.32 	maltreatment occurred until either the individual responsible for maltreatment is no longer 
607.33 	in contact with a child or children in the facility or the conclusion of the investigation. In 
607.34 	the case of maltreatment within a school facility, as defined in section 120A.05, subdivisions 
607.35 	9, 11, and 13, and chapter 124E, the commissioner of education need not provide notification 
608.1 	to parents, guardians, or legal custodians of each child in the facility, but shall, within ten 
608.2 	days after the investigation is completed, provide written notification to the parent, guardian, 
608.3 	or legal custodian of any student alleged to have been maltreated. The commissioner of 
608.4 	education may notify the parent, guardian, or legal custodian of any student involved as a 
608.5 	witness to alleged maltreatment.

608.6 	EFFECTIVE DATE. This section is effective August 1, 2017.

608.7 	Sec. 65. Minnesota Statutes 2016, section 626.556, subdivision 10e, is amended to read:
608.8 		Subd. 10e.Determinations. (a) The local welfare agency shall conclude the family 
608.9 	assessment or the investigation within 45 days of the receipt of a report. The conclusion of 
608.10 	the assessment or investigation may be extended to permit the completion of a criminal 
608.11 	investigation or the receipt of expert information requested within 45 days of the receipt of 
608.12 	the report.
608.13 	(b) After conducting a family assessment, the local welfare agency shall determine 
608.14 	whether services are needed to address the safety of the child and other family members 
608.15 	and the risk of subsequent maltreatment.
608.16 	(c) After conducting an investigation, the local welfare agency shall make two 
608.17 	determinations: first, whether maltreatment has occurred; and second, whether child 
608.18 	protective services are needed. No determination of maltreatment shall be made when the 
608.19 	alleged perpetrator is a child under the age of ten.
608.20 	(d) If the commissioner of education conducts an assessment or investigation, the 
608.21 	commissioner shall determine whether maltreatment occurred and what corrective or 
608.22 	protective action was taken by the school facility. If a determination is made that 
608.23 	maltreatment has occurred, the commissioner shall report to the employer, the school board, 
608.24 	and any appropriate licensing entity the determination that maltreatment occurred and what 
608.25 	corrective or protective action was taken by the school facility. In all other cases, the 
608.26 	commissioner shall inform the school board or employer that a report was received, the 
608.27 	subject of the report, the date of the initial report, the category of maltreatment alleged as 
608.28 	defined in paragraph (f), the fact that maltreatment was not determined, and a summary of 
608.29 	the specific reasons for the determination.
608.30 	(e) When maltreatment is determined in an investigation involving a facility, the 
608.31 	investigating agency shall also determine whether the facility or individual was responsible, 
608.32 	or whether both the facility and the individual were responsible for the maltreatment using 
608.33 	the mitigating factors in paragraph (i). Determinations under this subdivision must be made 
609.1 	based on a preponderance of the evidence and are private data on individuals or nonpublic 
609.2 	data as maintained by the commissioner of education.
609.3 	(f) For the purposes of this subdivision, "maltreatment" means any of the following acts 
609.4 	or omissions:
609.5 	(1) physical abuse as defined in subdivision 2, paragraph (k);
609.6 	(2) neglect as defined in subdivision 2, paragraph (g);
609.7 	(3) sexual abuse as defined in subdivision 2, paragraph (n);
609.8 	(4) mental injury as defined in subdivision 2, paragraph (f); or
609.9 	(5) maltreatment of a child in a facility as defined in subdivision 2, paragraph (c).
609.10 	(g) For the purposes of this subdivision, a determination that child protective services 
609.11 	are needed means that the local welfare agency has documented conditions during the 
609.12 	assessment or investigation sufficient to cause a child protection worker, as defined in 
609.13 	section 626.559, subdivision 1, to conclude that a child is at significant risk of maltreatment 
609.14 	if protective intervention is not provided and that the individuals responsible for the child's 
609.15 	care have not taken or are not likely to take actions to protect the child from maltreatment 
609.16 	or risk of maltreatment.
609.17 	(h) This subdivision does not mean that maltreatment has occurred solely because the 
609.18 	child's parent, guardian, or other person responsible for the child's care in good faith selects 
609.19 	and depends upon spiritual means or prayer for treatment or care of disease or remedial care 
609.20 	of the child, in lieu of medical care. However, if lack of medical care may result in serious 
609.21 	danger to the child's health, the local welfare agency may ensure that necessary medical 
609.22 	services are provided to the child.
609.23 	(i) When determining whether the facility or individual is the responsible party, or 
609.24 	whether both the facility and the individual are responsible for determined maltreatment in 
609.25 	a facility, the investigating agency shall consider at least the following mitigating factors:
609.26 	(1) whether the actions of the facility or the individual caregivers were according to, 
609.27 	and followed the terms of, an erroneous physician order, prescription, individual care plan, 
609.28 	or directive; however, this is not a mitigating factor when the facility or caregiver was 
609.29 	responsible for the issuance of the erroneous order, prescription, individual care plan, or 
609.30 	directive or knew or should have known of the errors and took no reasonable measures to 
609.31 	correct the defect before administering care;
610.1 	(2) comparative responsibility between the facility, other caregivers, and requirements 
610.2 	placed upon an employee, including the facility's compliance with related regulatory standards 
610.3 	and the adequacy of facility policies and procedures, facility training, an individual's 
610.4 	participation in the training, the caregiver's supervision, and facility staffing levels and the 
610.5 	scope of the individual employee's authority and discretion; and
610.6 	(3) whether the facility or individual followed professional standards in exercising 
610.7 	professional judgment.
610.8 	The evaluation of the facility's responsibility under clause (2) must not be based on the 
610.9 	completeness of the risk assessment or risk reduction plan required under section 245A.66, 
610.10 	but must be based on the facility's compliance with the regulatory standards for policies 
610.11 	and procedures, training, and supervision as cited in Minnesota Statutes and Minnesota 
610.12 	Rules.
610.13 	(j) Notwithstanding paragraph (i), when maltreatment is determined to have been 
610.14 	committed by an individual who is also the facility license or certification holder, both the 
610.15 	individual and the facility must be determined responsible for the maltreatment, and both 
610.16 	the background study disqualification standards under section 245C.15, subdivision 4, and 
610.17 	the licensing or certification actions under sections section245A.06or,245A.07, 245G.06, 
610.18 	or 245G.07 apply.

610.19 	EFFECTIVE DATE. This section is effective August 1, 2017.

610.20 	Sec. 66. Minnesota Statutes 2016, section 626.556, subdivision 10f, is amended to read:
610.21 		Subd. 10f.Notice of determinations. Within ten working days of the conclusion of a 
610.22 	family assessment, the local welfare agency shall notify the parent or guardian of the child 
610.23 	of the need for services to address child safety concerns or significant risk of subsequent 
610.24 	child maltreatment. The local welfare agency and the family may also jointly agree that 
610.25 	family support and family preservation services are needed. Within ten working days of the 
610.26 	conclusion of an investigation, the local welfare agency or agency responsible for 
610.27 	investigating the report shall notify the parent or guardian of the child, the person determined 
610.28 	to be maltreating the child, and, if applicable, the director of the facility, of the determination 
610.29 	and a summary of the specific reasons for the determination. When the investigation involves 
610.30 	a child foster care setting that is monitored by a private licensing agency under section 
610.31 	245A.16, the local welfare agency responsible for investigating the report shall notify the 
610.32 	private licensing agency of the determination and shall provide a summary of the specific 
610.33 	reasons for the determination. The notice to the private licensing agency must include 
610.34 	identifying private data, but not the identity of the reporter of maltreatment. The notice must 
611.1 	also include a certification that the information collection procedures under subdivision 10, 
611.2 	paragraphs (h), (i), and (j), were followed and a notice of the right of a data subject to obtain 
611.3 	access to other private data on the subject collected, created, or maintained under this section. 
611.4 	In addition, the notice shall include the length of time that the records will be kept under 
611.5 	subdivision 11c. The investigating agency shall notify the parent or guardian of the child 
611.6 	who is the subject of the report, and any person or facility determined to have maltreated a 
611.7 	child, of their appeal or review rights under this section. The notice must also state that a 
611.8 	finding of maltreatment may result in denial of a license or certification application or 
611.9 	background study disqualification under chapter 245C related to employment or services 
611.10 	that are licensed or certified by the Department of Human Services under chapter 245A or 
611.11 	245G, the Department of Health under chapter 144 or 144A, the Department of Corrections 
611.12 	under section 241.021, and from providing services related to an unlicensed personal care 
611.13 	provider organization under chapter 256B.

611.14 	EFFECTIVE DATE. This section is effective August 1, 2017.

611.15 	Sec. 67. Minnesota Statutes 2016, section 626.556, subdivision 10i, is amended to read:
611.16 		Subd. 10i.Administrative reconsideration; review panel. (a) Administrative 
611.17 	reconsideration is not applicable in family assessments since no determination concerning 
611.18 	maltreatment is made. For investigations, except as provided under paragraph (e), an 
611.19 	individual or facility that the commissioner of human services, a local social service agency, 
611.20 	or the commissioner of education determines has maltreated a child, an interested person 
611.21 	acting on behalf of the child, regardless of the determination, who contests the investigating 
611.22 	agency's final determination regarding maltreatment, may request the investigating agency 
611.23 	to reconsider its final determination regarding maltreatment. The request for reconsideration 
611.24 	must be submitted in writing to the investigating agency within 15 calendar days after receipt 
611.25 	of notice of the final determination regarding maltreatment or, if the request is made by an 
611.26 	interested person who is not entitled to notice, within 15 days after receipt of the notice by 
611.27 	the parent or guardian of the child. If mailed, the request for reconsideration must be 
611.28 	postmarked and sent to the investigating agency within 15 calendar days of the individual's 
611.29 	or facility's receipt of the final determination. If the request for reconsideration is made by 
611.30 	personal service, it must be received by the investigating agency within 15 calendar days 
611.31 	after the individual's or facility's receipt of the final determination. Effective January 1, 
611.32 	2002, an individual who was determined to have maltreated a child under this section and 
611.33 	who was disqualified on the basis of serious or recurring maltreatment under sections 
611.34 	245C.14 and 245C.15, may request reconsideration of the maltreatment determination and 
611.35 	the disqualification. The request for reconsideration of the maltreatment determination and 
612.1 	the disqualification must be submitted within 30 calendar days of the individual's receipt 
612.2 	of the notice of disqualification under sections 245C.16 and 245C.17. If mailed, the request 
612.3 	for reconsideration of the maltreatment determination and the disqualification must be 
612.4 	postmarked and sent to the investigating agency within 30 calendar days of the individual's 
612.5 	receipt of the maltreatment determination and notice of disqualification. If the request for 
612.6 	reconsideration is made by personal service, it must be received by the investigating agency 
612.7 	within 30 calendar days after the individual's receipt of the notice of disqualification.
612.8 	(b) Except as provided under paragraphs (e) and (f), if the investigating agency denies 
612.9 	the request or fails to act upon the request within 15 working days after receiving the request 
612.10 	for reconsideration, the person or facility entitled to a fair hearing under section 256.045
612.11 	may submit to the commissioner of human services or the commissioner of education a 
612.12 	written request for a hearing under that section. Section 256.045 also governs hearings 
612.13 	requested to contest a final determination of the commissioner of education. The investigating 
612.14 	agency shall notify persons who request reconsideration of their rights under this paragraph. 
612.15 	The hearings specified under this section are the only administrative appeal of a decision 
612.16 	issued under paragraph (a). Determinations under this section are not subject to accuracy 
612.17 	and completeness challenges under section 13.04.
612.18 	(c) If, as a result of a reconsideration or review, the investigating agency changes the 
612.19 	final determination of maltreatment, that agency shall notify the parties specified in 
612.20 	subdivisions 10b, 10d, and 10f.
612.21 	(d) Except as provided under paragraph (f), if an individual or facility contests the 
612.22 	investigating agency's final determination regarding maltreatment by requesting a fair 
612.23 	hearing under section 256.045, the commissioner of human services shall assure that the 
612.24 	hearing is conducted and a decision is reached within 90 days of receipt of the request for 
612.25 	a hearing. The time for action on the decision may be extended for as many days as the 
612.26 	hearing is postponed or the record is held open for the benefit of either party.
612.27 	(e) If an individual was disqualified under sections 245C.14 and 245C.15, on the basis 
612.28 	of a determination of maltreatment, which was serious or recurring, and the individual has 
612.29 	requested reconsideration of the maltreatment determination under paragraph (a) and 
612.30 	requested reconsideration of the disqualification under sections 245C.21 to 245C.27, 
612.31 	reconsideration of the maltreatment determination and reconsideration of the disqualification 
612.32 	shall be consolidated into a single reconsideration. If reconsideration of the maltreatment 
612.33 	determination is denied and the individual remains disqualified following a reconsideration 
612.34 	decision, the individual may request a fair hearing under section 256.045. If an individual 
613.1 	requests a fair hearing on the maltreatment determination and the disqualification, the scope 
613.2 	of the fair hearing shall include both the maltreatment determination and the disqualification.
613.3 	(f) If a maltreatment determination or a disqualification based on serious or recurring 
613.4 	maltreatment is the basis for a denial of a license under section 245A.05 or a licensing 
613.5 	sanction under section 245A.07, the license holder has the right to a contested case hearing 
613.6 	under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. As provided for 
613.7 	under section 245A.08, subdivision 2a, the scope of the contested case hearing shall include 
613.8 	the maltreatment determination, disqualification, and licensing sanction or denial of a license. 
613.9 	In such cases, a fair hearing regarding the maltreatment determination and disqualification 
613.10 	shall not be conducted under section 256.045. Except for family child care and child foster 
613.11 	care, reconsideration of a maltreatment determination as provided under this subdivision, 
613.12 	and reconsideration of a disqualification as provided under section 245C.22, shall also not 
613.13 	be conducted when:
613.14 	(1) a denial of a license under section 245A.05 or a licensing sanction under section 
613.15 	245A.07, is based on a determination that the license holder is responsible for maltreatment 
613.16 	or the disqualification of a license holder based on serious or recurring maltreatment;
613.17 	(2) the denial of a license or licensing sanction is issued at the same time as the 
613.18 	maltreatment determination or disqualification; and
613.19 	(3) the license holder appeals the maltreatment determination or disqualification, and 
613.20 	denial of a license or licensing sanction.
613.21 	Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment 
613.22 	determination or disqualification, but does not appeal the denial of a license or a licensing 
613.23 	sanction, reconsideration of the maltreatment determination shall be conducted under sections 
613.24 	626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the 
613.25 	disqualification shall be conducted under section 245C.22. In such cases, a fair hearing shall 
613.26 	also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and 
613.27 	626.557, subdivision 9d.
613.28 	If the disqualified subject is an individual other than the license holder and upon whom 
613.29 	a background study must be conducted under chapter 245C, the hearings of all parties may 
613.30 	be consolidated into a single contested case hearing upon consent of all parties and the 
613.31 	administrative law judge.
613.32 	(g) For purposes of this subdivision, "interested person acting on behalf of the child" 
613.33 	means a parent or legal guardian; stepparent; grandparent; guardian ad litem; adult 
614.1 	stepbrother, stepsister, or sibling; or adult aunt or uncle; unless the person has been 
614.2 	determined to be the perpetrator of the maltreatment.
614.3 	(h) If a maltreatment determination is the basis for a correction order under section 
614.4 	245G.06 or decertification under section 245G.07, the certification holder has the right to 
614.5 	request reconsideration under sections 245G.06 and 245G.07. If the certification holder 
614.6 	appeals the maltreatment determination or disqualification, but does not appeal the correction 
614.7 	order or decertification, reconsideration of the maltreatment determination shall be conducted 
614.8 	under section 626.556, subdivision 10i, and reconsideration of the disqualification shall be 
614.9 	conducted under section 245C.22.

614.10 	EFFECTIVE DATE. This section is effective August 1, 2017.

614.11 	Sec. 68. REVISOR'S INSTRUCTION.
 614.12 	The revisor of statutes shall change all Minnesota Statutes, chapter 245G, references in 
614.13 	this article to chapter 245H.

614.14 	ARTICLE 17
614.15 	HUMAN SERVICES FORECAST ADJUSTMENTS

614.16	Section 1. DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.
 	
614.17 	The dollar amounts shown are added to or, if shown in parentheses, are subtracted from 
614.18 	the appropriations in Laws 2015, chapter 71, article 14, as amended by Laws 2016, chapter 
614.19 	189, articles 22 and 23, from the general fund, or any other fund named, to the Department 
614.20 	of Human Services for the purposes specified in this article, to be available for the fiscal 
614.21 	years indicated for each purpose. The figure "2017" used in this article means that the 
614.22 	appropriations listed are available for the fiscal year ending June 30, 2017.

614.23				APPROPRIATIONS
	
614.24				Available for the Year
	
614.25				Ending June 30
	
614.26					2017

614.27
614.28	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

614.29	Subdivision 1.Total Appropriation
 	$
	(342,045,000)

614.30	Appropriations by Fund
	
614.31		2017
		
614.32	General Fund
	(198,450,000)
		
615.1	Health Care Access
	(146,590,000)
		
615.2	TANF
	2,995,000

615.3	Subd. 2.Forecasted Programs
 					
615.4	(a) MFIP/DWP Grants

615.5	Appropriations by Fund
	
615.6	General Fund
	(2,111,000)
		
615.7	TANF
	2,579,000

615.8	(b) MFIP Child Care Assistance Grants
		(6,513,000)

615.9	(c) General Assistance Grants
		(4,219,000)

615.10	(d) Minnesota Supplemental Aid Grants
		(581,000)

615.11	(e) Group Residential Housing Grants
		(533,000)

615.12	(f) Northstar Care for Children
		2,613,000

615.13	(g) MinnesotaCare Grants
		(145,883,000)
			
615.14 	This appropriation is from the health care 
615.15 	access fund.

615.16	(h) Medical Assistance Grants

615.17	Appropriations by Fund
	
615.18	General Fund
	(192,744,000)
		
615.19	Health Care Access
	(707,000)

615.20	(i) Alternative Care Grants
		-0-

615.21	(j) CD Entitlement Grants
		5,638,000

615.22	Subd. 3.Technical Activities
 		416,000
			
615.23 	This appropriation is from the TANF fund.

615.24 	Sec. 3. EFFECTIVE DATE.
 615.25 	Sections 1 and 2 are effective the day following final enactment.

615.26 	ARTICLE 18
615.27 	APPROPRIATIONS

615.28	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 	
615.29 	The sums shown in the columns marked "Appropriations" are appropriated to the agencies 
615.30 	and for the purposes specified in this article. The appropriations are from the general fund, 
616.1 	or another named fund, and are available for the fiscal years indicated for each purpose. 
616.2 	The figures "2018" and "2019" used in this article mean that the appropriations listed under 
616.3 	them are available for the fiscal year ending June 30, 2018, or June 30, 2019, respectively. 
616.4 	"The first year" is fiscal year 2018. "The second year" is fiscal year 2019. "The biennium" 
616.5 	is fiscal years 2018 and 2019.

616.6				APPROPRIATIONS
	
616.7				Available for the Year
	
616.8				Ending June 30
	
616.9					2018
		2019

616.10
616.11	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

616.12	Subdivision 1.Total Appropriation
 	$
	7,548,395,000
	$
	7,654,331,000

616.13	Appropriations by Fund
	
616.14		2018
	2019
	
616.15	General
	6,819,523,000
	6,880,153,000
	
616.16
616.17	State Government 
Special Revenue
	4,274,000
	4,274,000
	
616.18	Health Care Access
	446,453,000
	501,104,000
	
616.19	Federal TANF
	276,249,000
	266,904,000
	
616.20	Lottery Prize
	1,896,000
	1,896,000
	
616.21 	The amounts that may be spent for each 
616.22 	purpose are specified in the following 
616.23 	subdivisions.

616.24	Subd. 2.TANF Maintenance of Effort
 					
616.25 	(a) The commissioner shall ensure that 
616.26 	sufficient qualified nonfederal expenditures 
616.27 	are made each year to meet the state's 
616.28 	maintenance of effort (MOE) requirements of 
616.29 	the TANF block grant specified under Code 
616.30 	of Federal Regulations, title 45, section 263.1. 
616.31 	In order to meet these basic TANF/MOE 
616.32 	requirements, the commissioner may report 
616.33 	as TANF/MOE expenditures only nonfederal 
617.1 	money expended for allowable activities listed 
617.2 	in the following clauses:
617.3 	(1) MFIP cash, diversionary work program, 
617.4 	and food assistance benefits under Minnesota 
617.5 	Statutes, chapter 256J;
617.6 	(2) the child care assistance programs under 
617.7 	Minnesota Statutes, sections 119B.03 and 
617.8 	119B.05, and county child care administrative 
617.9 	costs under Minnesota Statutes, section 
617.10 	119B.15;
617.11 	(3) state and county MFIP administrative costs 
617.12 	under Minnesota Statutes, chapters 256J and 
617.13 	256K;
617.14 	(4) state, county, and tribal MFIP employment 
617.15 	services under Minnesota Statutes, chapters 
617.16 	256J and 256K;
617.17 	(5) expenditures made on behalf of legal 
617.18 	noncitizen MFIP recipients who qualify for 
617.19 	the MinnesotaCare program under Minnesota 
617.20 	Statutes, chapter 256L;
617.21 	(6) qualifying working family credit 
617.22 	expenditures under Minnesota Statutes, section 
617.23 	290.0671;
617.24 	(7) qualifying Minnesota education credit 
617.25 	expenditures under Minnesota Statutes, section 
617.26 	290.0674; and
617.27 	(8) qualifying Head Start expenditures under 
617.28 	Minnesota Statutes, section 119A.50.
617.29 	(b) For the activities listed in paragraph (a), 
617.30 	clauses (2) to (8), the commissioner may 
617.31 	report only expenditures that are excluded 
617.32 	from the definition of assistance under Code 
618.1 	of Federal Regulations, title 45, section 
618.2 	260.31.
618.3 	(c) The commissioner shall ensure that the 
618.4 	MOE used by the commissioner of 
618.5 	management and budget for the February and 
618.6 	November forecasts required under Minnesota 
618.7 	Statutes, section 16A.103, contains 
618.8 	expenditures under paragraph (a), clause (1), 
618.9 	equal to at least 16 percent of the total required 
618.10 	under Code of Federal Regulations, title 45, 
618.11 	section 263.1.
618.12 	(d) The commissioner may not claim an 
618.13 	amount of TANF/MOE in excess of the 75 
618.14 	percent standard in Code of Federal 
618.15 	Regulations, title 45, section 263.1(a)(2), 
618.16 	except:
618.17 	(1) to the extent necessary to meet the 80 
618.18 	percent standard under Code of Federal 
618.19 	Regulations, title 45, section 263.1(a)(1), if it 
618.20 	is determined by the commissioner that the 
618.21 	state will not meet the TANF work 
618.22 	participation target rate for the current year;
618.23 	(2) to provide any additional amounts under 
618.24 	Code of Federal Regulations, title 45, section 
618.25 	264.5, that relate to replacement of TANF 
618.26 	funds due to the operation of TANF penalties; 
618.27 	and
618.28 	(3) to provide any additional amounts that may 
618.29 	contribute to avoiding or reducing TANF work 
618.30 	participation penalties through the operation 
618.31 	of the excess MOE provisions of Code of 
618.32 	Federal Regulations, title 45, section 261.43 
618.33 	(a)(2).
619.1 	(e) For the purposes of paragraph (d), the 
619.2 	commissioner may supplement the MOE claim 
619.3 	with working family credit expenditures or 
619.4 	other qualified expenditures to the extent such 
619.5 	expenditures are otherwise available after 
619.6 	considering the expenditures allowed in this 
619.7 	subdivision.
619.8 	(f) The requirement in Minnesota Statutes, 
619.9 	section 256.011, subdivision 3, that federal 
619.10 	grants or aids secured or obtained under that 
619.11 	subdivision be used to reduce any direct 
619.12 	appropriations provided by law, does not apply 
619.13 	if the grants or aids are federal TANF funds.
619.14 	(g) IT Appropriations Generally. This 
619.15 	appropriation includes funds for information 
619.16 	technology projects, services, and support. 
619.17 	Notwithstanding Minnesota Statutes, section 
619.18 	16E.0466, funding for information technology 
619.19 	project costs shall be incorporated into the 
619.20 	service level agreement and paid to the Office 
619.21 	of MN.IT Services by the Department of 
619.22 	Human Services under the rates and 
619.23 	mechanism specified in that agreement.
619.24 	(h) Receipts for Systems Project.
619.25 	Appropriations and federal receipts for 
619.26 	information systems projects for MAXIS, 
619.27 	PRISM, MMIS, ISDS, METS, and SSIS must 
619.28 	be deposited in the state systems account 
619.29 	authorized in Minnesota Statutes, section 
619.30 	256.014. Money appropriated for computer 
619.31 	projects approved by the commissioner of the 
619.32 	Office of MN.IT Services, funded by the 
619.33 	legislature, and approved by the commissioner 
619.34 	of management and budget may be transferred 
619.35 	from one project to another and from 
620.1 	development to operations as the 
620.2 	commissioner of human services considers 
620.3 	necessary. Any unexpended balance in the 
620.4 	appropriation for these projects does not 
620.5 	cancel and is available for ongoing 
620.6 	development and operations.
620.7 	(i) Federal SNAP Education and Training 
620.8 	Grants. Federal funds available during fiscal 
620.9 	years 2017, 2018, and 2019 for Supplemental 
620.10 	Nutrition Assistance Program Education and 
620.11 	Training and SNAP Quality Control 
620.12 	Performance Bonus grants are appropriated 
620.13 	to the commissioner of human services for the 
620.14 	purposes allowable under the terms of the 
620.15 	federal award. This paragraph is effective the 
620.16 	day following final enactment.

620.17	Subd. 3.Central Office; Operations

620.18	Appropriations by Fund
	
620.19	General
	136,778,000
	121,009,000
	
620.20
620.21	State Government 
Special Revenue
	4,149,000
	4,149,000
	
620.22	Health Care Access
	21,019,000
	21,019,000
	
620.23	Federal TANF
	100,000
	100,000
	
620.24 	(a) Administrative Recovery; Set-Aside. The 
620.25 	commissioner may invoice local entities 
620.26 	through the SWIFT accounting system as an 
620.27 	alternative means to recover the actual cost of 
620.28 	administering the following provisions:
620.29 	(1) Minnesota Statutes, section 125A.744, 
620.30 	subdivision 3;
620.31 	(2) Minnesota Statutes, section 245.495, 
620.32 	paragraph (b);
620.33 	(3) Minnesota Statutes, section 256B.0625, 
620.34 	subdivision 20, paragraph (k);
621.1 	(4) Minnesota Statutes, section 256B.0924, 
621.2 	subdivision 6, paragraph (g);
621.3 	(5) Minnesota Statutes, section 256B.0945, 
621.4 	subdivision 4, paragraph (d); and
621.5 	(6) Minnesota Statutes, section 256F.10, 
621.6 	subdivision 6, paragraph (b).
621.7 	(b) Transfer to Office of Legislative 
621.8 	Auditor. $600,000 in fiscal year 2018 and 
621.9 	$600,000 in fiscal year 2019 are for transfer 
621.10 	to the Office of the Legislative Auditor for 
621.11 	audit activities under Minnesota Statutes, 
621.12 	section 3.972, subdivision 2b.
621.13 	(c) Base Level Adjustment. The general fund 
621.14 	base is $133,378,000 in fiscal year 2020 and 
621.15 	$133,418,000 in fiscal year 2021.

621.16	Subd. 4.Central Office; Children and Families

621.17	Appropriations by Fund
	
621.18	General
	10,438,000
	10,431,000
	
621.19	Federal TANF
	2,582,000
	2,582,000
	
621.20 	Financial Institution Data Match and 
621.21 	Payment of Fees. The commissioner is 
621.22 	authorized to allocate up to $310,000 each 
621.23 	year in fiscal year 2018 and fiscal year 2019 
621.24 	from the systems special revenue account to 
621.25 	make payments to financial institutions in 
621.26 	exchange for performing data matches 
621.27 	between account information held by financial 
621.28 	institutions and the public authority's database 
621.29 	of child support obligors as authorized by 
621.30 	Minnesota Statutes, section 13B.06, 
621.31 	subdivision 7.

621.32	Subd. 5.Central Office; Health Care

621.33	Appropriations by Fund
	
621.34	General
	20,719,000
	21,249,000
	
622.1	Health Care Access
	23,697,000
	23,804,000
	
622.2 	(a) Integrated Health Partnership Health 
622.3 	Information Exchange. $125,000 in fiscal 
622.4 	year 2018 and $250,000 in fiscal year 2019 
622.5 	are from the general fund to contract with 
622.6 	state-certified health information exchange 
622.7 	vendors to support providers participating in 
622.8 	an integrated health partnership under 
622.9 	Minnesota Statutes, section 256B.0755, to 
622.10 	connect enrollees with community supports 
622.11 	and social services and improve collaboration 
622.12 	among participating and authorized providers.
622.13 	(b) Transfer to Legislative Auditor. 153,000 
622.14 	in fiscal year 2018 and $153,000 in fiscal year 
622.15 	2019 are from the general fund for transfer to 
622.16 	the Office of the Legislative Auditor for the 
622.17 	auditor to establish and maintain a team of 
622.18 	auditors with the training and experience 
622.19 	necessary to fulfill the requirements in 
622.20 	Minnesota Statutes, section 3.972, subdivision 
622.21 	2a.
622.22 	(c) Base Level Adjustment. The general fund 
622.23 	base is $21,257,000 in fiscal year 2020 and 
622.24 	$21,302,000 in fiscal year 2021.

622.25
622.26	Subd. 6.Central Office; Continuing Care for 
Older Adults

622.27	Appropriations by Fund
	
622.28	General
	15,359,000
	15,113,000
	
622.29
622.30	State Government 
Special Revenue
	125,000
	125,000
	
622.31 	(a) Alzheimer's Disease Working Group.
622.32 	$127,000 in fiscal year 2018 and $110,000 in 
622.33 	fiscal year 2019 are from the general fund for 
622.34 	the Alzheimer's disease working group. This 
622.35 	is a onetime appropriation.
623.1 	(b) Base Level Adjustment. The general fund 
623.2 	base is $15,053,000 in fiscal year 2020 and 
623.3 	$15,053,000 in fiscal year 2021.

623.4	Subd. 7.Central Office; Community Supports

623.5	Appropriations by Fund
	
623.6	General
	29,546,000
	29,381,000
	
623.7	Lottery Prize
	163,000
	163,000
	
623.8 	(a) Transportation Study. $250,000 in fiscal 
623.9 	year 2018 and $250,000 in fiscal year 2019 
623.10 	are for a study to identify opportunities to 
623.11 	increase access to transportation services for 
623.12 	individuals who receive home and 
623.13 	community-based services. This is a onetime 
623.14 	appropriation.
623.15 	(b) Deaf and Hard-of-Hearing Services.
623.16 	$438,000 in fiscal year 2018 and $395,000 in 
623.17 	fiscal year 2019 are from the general fund for 
623.18 	the Deaf and Hard-of-Hearing Services 
623.19 	Division under Minnesota Statutes, section 
623.20 	256C.233. Starting in fiscal year 2019, 20 
623.21 	percent of this appropriation each year must 
623.22 	be used for technology improvements, 
623.23 	technology support, and training for staff on 
623.24 	the use of technology for external facing 
623.25 	services to implement Minnesota Statutes, 
623.26 	section 256C.24, subdivision 2, clause (12).
623.27 	(c) Consumer-Directed Community 
623.28 	Supports Revised Budget Methodology 
623.29 	Report. $435,000 in fiscal year 2018 and 
623.30 	$65,000 in fiscal year 2019 are from the 
623.31 	general fund to study and develop an 
623.32 	individual budgeting model for disability 
623.33 	waiver recipients and those accessing services 
623.34 	through consumer-directed community 
623.35 	supports. The commissioner shall submit 
624.1 	recommendations to the chairs and ranking 
624.2 	minority members of the legislative 
624.3 	committees with jurisdiction over these 
624.4 	programs by December 15, 2018. This is a 
624.5 	onetime appropriation.
624.6 	(d) Substance Use Disorder System Study. 
624.7 	$150,000 in fiscal year 2018 and $150,000 in 
624.8 	fiscal year 2019 are for a substance use 
624.9 	disorder system study. This is a onetime 
624.10 	appropriation.
624.11 	(e) Children's Mental Health Report and 
624.12 	Recommendations. $125,000 in fiscal year 
624.13 	2018 and $125,000 in fiscal year 2019 are for 
624.14 	a comprehensive analysis of Minnesota's 
624.15 	continuum of intensive mental health services 
624.16 	for children with serious mental health needs. 
624.17 	This is a onetime appropriation.
624.18 	(f) Self-Directed Workforce Collective 
624.19 	Bargaining Agreement. $1,206,000 in fiscal 
624.20 	year 2018 and $1,206,000 in fiscal year 2019 
624.21 	may be used for administration, training, 
624.22 	grants, and reimbursement to implement a 
624.23 	collective bargaining agreement between the 
624.24 	state and the Service Employees International 
624.25 	Union Healthcare Minnesota (SEIU). This 
624.26 	appropriation is not available until the 
624.27 	collective bargaining agreement between the 
624.28 	state and SEIU under Minnesota Statutes, 
624.29 	section 179A.54, is approved under 
624.30 	subdivision 15, paragraph (b), clause (3). The 
624.31 	commissioner may transfer funds between 
624.32 	budget activities with the approval of the 
624.33 	commissioner of management and budget. The 
624.34 	base for this purpose is $293,000 in fiscal year 
624.35 	2020 and $293,000 in fiscal year 2021.
625.1 	(g) Implementation and Operation of an 
625.2 	Electronic Service Delivery Documentation 
625.3 	System. $170,000 in fiscal year 2018 and 
625.4 	$105,000 in fiscal year 2019 are from the 
625.5 	general fund for the development and 
625.6 	implementation of an electronic service 
625.7 	delivery documentation system. This is a 
625.8 	onetime appropriation.
625.9 	(h) Waiver Consolidation Study. $110,000 
625.10 	in fiscal year 2018 and $140,000 in fiscal year 
625.11 	2019 are to conduct a study on consolidating 
625.12 	the four disability home and community-based 
625.13 	services waivers into one program. The 
625.14 	commissioner of human services shall submit 
625.15 	recommendations to the chairs and ranking 
625.16 	minority members of the legislative 
625.17 	committees with oversight over health and 
625.18 	human services by January 15, 2019. This is 
625.19 	a onetime appropriation.
625.20 	(i) Base Level Adjustment. The general fund 
625.21 	base is $27,504,000 in fiscal year 2020 and 
625.22 	$27,328,000 in fiscal year 2021.

625.23	Subd. 8.Forecasted Programs; MFIP/DWP

625.24	Appropriations by Fund
	
625.25	General
	88,930,000
	98,251,000
	
625.26	Federal TANF
	92,732,000
	83,513,000

625.27
625.28	Subd. 9.Forecasted Programs; MFIP Child Care 
Assistance
 		101,293,000
		112,078,000

625.29
625.30	Subd. 10.Forecasted Programs; General 
Assistance
 		55,536,000
		57,221,000
	
625.31 	(a) General Assistance Standard. The 
625.32 	commissioner shall set the monthly standard 
625.33 	of assistance for general assistance units 
625.34 	consisting of an adult recipient who is 
625.35 	childless and unmarried or living apart from 
626.1 	parents or a legal guardian at $203. The 
626.2 	commissioner may reduce this amount 
626.3 	according to Laws 1997, chapter 85, article 3, 
626.4 	section 54.
626.5 	(b) Emergency General Assistance Limit.
626.6 	The amount appropriated for emergency 
626.7 	general assistance is limited to no more than 
626.8 	$6,729,812 in fiscal year 2018 and $6,729,812 
626.9 	in fiscal year 2019. Funds to counties shall be 
626.10 	allocated by the commissioner using the 
626.11 	allocation method under Minnesota Statutes, 
626.12 	section 256D.06.

626.13
626.14	Subd. 11.Forecasted Programs; Minnesota 
Supplemental Aid
 		40,484,000
		41,634,000

626.15
626.16	Subd. 12.Forecasted Programs; Group 
Residential Housing
 		169,312,000
		179,643,000
	
626.17 	Eliminate Group Residential Housing 
626.18 	Grant. The forecasted base funding for the 
626.19 	group residential housing program shall be 
626.20 	reduced by $460,000 in fiscal year 2018 and 
626.21 	$460,000 in fiscal year 2019 to reflect the 
626.22 	elimination of grant funding for facilities 
626.23 	under Minnesota Statutes, section 256I.05, 
626.24 	subdivision 1m. The ongoing base funding 
626.25 	shall be adjusted to reflect the elimination of 
626.26 	this grant.

626.27
626.28	Subd. 13.Forecasted Programs; Northstar Care 
for Children
 		80,542,000
		96,433,000

626.29	Subd. 14.Forecasted Programs; MinnesotaCare
 		12,363,000
		13,218,000
	
626.30 	This appropriation is from the health care 
626.31 	access fund.

626.32
626.33	Subd. 15.Forecasted Programs; Medical 
Assistance

626.34	Appropriations by Fund
	
626.35	General
	5,174,139,000
	5,172,292,000
	
626.36	Health Care Access
	385,159,000
	438,848,000
	
627.1 	(a) Behavioral Health Services. $1,000,000 
627.2 	in fiscal year 2018 and $1,000,000 in fiscal 
627.3 	year 2019 are for behavioral health services 
627.4 	provided by hospitals identified under 
627.5 	Minnesota Statutes, section 256.969, 
627.6 	subdivision 2b, paragraph (a), clause (4). The 
627.7 	increase in payments shall be made by 
627.8 	increasing the adjustment under Minnesota 
627.9 	Statutes, section 256.969, subdivision 2b, 
627.10 	paragraph (e), clause (2).
627.11 	(b) Self-Directed Workforce Collective 
627.12 	Bargaining Agreement. (1) This 
627.13 	appropriation includes money to implement a 
627.14 	collective bargaining agreement between the 
627.15 	state and the Service Employees International 
627.16 	Union Healthcare Minnesota (SEIU). This 
627.17 	appropriation is not available until the 
627.18 	collective bargaining agreement between the 
627.19 	state of Minnesota and the Service Employees 
627.20 	International Union Healthcare Minnesota 
627.21 	under Minnesota Statutes, section 179A.54, 
627.22 	is approved as provided in clause (3).
627.23 	(2) The commissioner of management and 
627.24 	budget is authorized to negotiate and enter 
627.25 	into a collective bargaining agreement with 
627.26 	SEIU under Minnesota Statutes, section 
627.27 	179A.54, subject to clause (1), and subdivision 
627.28 	7, paragraph (f). The economic terms of the 
627.29 	collective bargaining agreement may include 
627.30 	wage floor increases for direct support 
627.31 	workers, paid time off, holiday pay, wage 
627.32 	increases for workers serving people with 
627.33 	complex needs, training stipends, and training 
627.34 	for direct support workers and for 
628.1 	implementation of the registry as outlined in 
628.2 	the collective bargaining agreement.
628.3 	(3) Notwithstanding Minnesota Statutes, 
628.4 	sections 3.855, 179A.22, subdivision 4, and 
628.5 	179A.54, subdivision 5, upon approval of a 
628.6 	negotiated collective bargaining agreement by 
628.7 	the SEIU and the commissioner of 
628.8 	management and budget, the commissioner 
628.9 	of human services is authorized to implement 
628.10 	the negotiated collective bargaining 
628.11 	agreement.

628.12
628.13	Subd. 16.Forecasted Programs; Alternative 
Care
 		44,258,000
		44,976,000
	
628.14 	Alternative Care Transfer. Any money 
628.15 	allocated to the alternative care program that 
628.16 	is not spent for the purposes indicated does 
628.17 	not cancel but must be transferred to the 
628.18 	medical assistance account.

628.19
628.20	Subd. 17.Forecasted Programs; Chemical 
Dependency Treatment Fund
 		117,226,000
		136,493,000

628.21
628.22	Subd. 18.Grant Programs; Support Services 
Grants

628.23	Appropriations by Fund
	
628.24	General
	8,715,000
	8,715,000
	
628.25	Federal TANF
	96,311,000
	96,311,000

628.26
628.27	Subd. 19.Grant Programs; Basic Sliding Fee 
Child Care Assistance Grants
 		44,690,000
		53,413,000
	
628.28 	(a) Maximum Rate for Certain Child Care 
628.29 	Providers. Notwithstanding Minnesota 
628.30 	Statutes, section 119B.03, subdivisions 6 and 
628.31 	6a, $25,000 in fiscal year 2019 is to modify 
628.32 	maximum rates for child care providers in a 
628.33 	city with boundaries located in two or more 
628.34 	of the counties of Benton, Sherburne, and 
628.35 	Stearns. $12,000 of the funding for the 
628.36 	calendar year 2018 allocation and $29,000 of 
629.1 	the funding for the calendar year 2019 
629.2 	allocation shall be allocated proportionally to 
629.3 	the three counties based on county 
629.4 	expenditures in the most recent calendar year. 
629.5 	Allocations in calendar year 2020 and beyond 
629.6 	shall be calculated using the allocation formula 
629.7 	in Minnesota Statutes, section 119B.03, 
629.8 	subdivision 6.
629.9 	(b) Base Level Adjustment. The general fund 
629.10 	base is $53,583,000 in fiscal year 2020 and 
629.11 	$53,639,000 in fiscal year 2021.

629.12
629.13	Subd. 20.Grant Programs; Child Care 
Development Grants
 		1,737,000
		1,737,000

629.14
629.15	Subd. 21.Grant Programs; Child Support 
Enforcement Grants
 		50,000
		50,000

629.16
629.17	Subd. 22.Grant Programs; Children's Services 
Grants

629.18	Appropriations by Fund
	
629.19	General
	39,240,000
	39,165,000
	
629.20	Federal TANF
	140,000
	140,000
	
629.21 	(a) Title IV-E Adoption Assistance. (1) The 
629.22 	commissioner shall allocate funds from the 
629.23 	Title IV-E reimbursement to the state from 
629.24 	the Fostering Connections to Success and 
629.25 	Increasing Adoptions Act for adoptive, foster, 
629.26 	and kinship families as required in Minnesota 
629.27 	Statutes, section 256N.261.
629.28 	(2) Additional federal reimbursement to the 
629.29 	state as a result of the Fostering Connections 
629.30 	to Success and Increasing Adoptions Act's 
629.31 	expanded eligibility for title IV-E adoption 
629.32 	assistance is for postadoption, foster care, 
629.33 	adoption, and kinship services, including a 
629.34 	parent-to-parent support network.
630.1 	(b) Adoption Assistance Incentive Grants.
630.2 	(1) The commissioner shall allocate federal 
630.3 	funds available for adoption and guardianship 
630.4 	assistance incentive grants for postadoption 
630.5 	services to support adoptive, foster, and 
630.6 	kinship families as required in Minnesota 
630.7 	Statutes, section 256N.261.
630.8 	(2) Federal funds available during fiscal year 
630.9 	2019 for adoption incentive grants must be 
630.10 	used for foster care, adoption, and kinship 
630.11 	services, including a parent-to-parent support 
630.12 	network.
630.13 	(c) Adoption Support Services. The 
630.14 	commissioner shall allocate 20 percent of 
630.15 	federal funds from title IV-B, subpart 2, of the 
630.16 	Social Security Act, Promoting Safe and 
630.17 	Stable Families, for adoption support services 
630.18 	under Minnesota Statutes, section 256N.261.
630.19 	(d) Anoka County Family Foster Care.
630.20 	$75,000 in fiscal year 2018 is from the general 
630.21 	fund for a grant to Anoka County to establish 
630.22 	and promote family foster care recruitment 
630.23 	models. The county shall use the grant funds 
630.24 	for the purpose of increasing foster care 
630.25 	providers through administrative 
630.26 	simplification, nontraditional recruitment 
630.27 	models, and family incentive options, and 
630.28 	develop a strategic planning model to recruit 
630.29 	family foster care providers. This is a onetime 
630.30 	appropriation.
630.31 	(e) White Earth Band of Ojibwe Child 
630.32 	Welfare Services. $500,000 in fiscal year 
630.33 	2018 and $500,000 in fiscal year 2019 are 
630.34 	from the general fund for a grant to the White 
631.1 	Earth Band of Ojibwe to deliver child welfare 
631.2 	services.

631.3
631.4	Subd. 23.Grant Programs; Children and 
Community Service Grants
 		58,201,000
		58,201,000

631.5
631.6	Subd. 24.Grant Programs; Children and 
Economic Support Grants
 		32,930,000
		32,940,000
	
631.7 	(a) Minnesota Food Assistance Program. 
631.8 	Unexpended funds for the Minnesota food 
631.9 	assistance program for fiscal year 2018 do not 
631.10 	cancel but are available for this purpose in 
631.11 	fiscal year 2019.
631.12 	(b) Long-term Homeless Supportive 
631.13 	Services. $375,000 in fiscal year 2018 and 
631.14 	$375,000 in fiscal year 2019 are for the 
631.15 	long-term homeless supportive services fund 
631.16 	under Minnesota Statutes, section 256K.26. 
631.17 	This is a onetime appropriation.
631.18 	(c) Community Action Grants. $750,000 in 
631.19 	fiscal year 2018 and $750,000 in fiscal year 
631.20 	2019 are for community action grants under 
631.21 	Minnesota Statutes, sections 256E.30 to 
631.22 	256E.32. This is a onetime appropriation.
631.23 	(d) Transitional Housing. $200,000 in fiscal 
631.24 	year 2018 and $200,000 in fiscal year 2019 
631.25 	are for the transitional housing program under 
631.26 	Minnesota Statutes, section 256E.33. This is 
631.27 	a onetime appropriation.
631.28 	(e) Family Assets for Independence.
631.29 	$250,000 in fiscal year 2018 and $250,000 in 
631.30 	fiscal year 2019 are for the family assets for 
631.31 	independence program under Minnesota 
631.32 	Statutes, section 256E.35. This is a onetime 
631.33 	appropriation.
632.1 	(f) Safe Harbor for Sexually Exploited 
632.2 	Youth. (1) $400,000 in fiscal year 2018 and 
632.3 	$400,000 in fiscal year 2019 are for 
632.4 	emergency shelter and transitional and 
632.5 	long-term housing beds for sexually exploited 
632.6 	youth and youth at risk of sexual exploitation.
632.7 	(2) $100,000 in fiscal year 2018 and $100,000 
632.8 	in fiscal year 2019 are for statewide youth 
632.9 	outreach workers connecting sexually 
632.10 	exploited youth and youth at risk of sexual 
632.11 	exploitation with shelter and services.
632.12 	(3) Youth 24 years of age or younger are 
632.13 	eligible for shelter, housing beds, and services 
632.14 	under this paragraph. In funding shelter, 
632.15 	housing beds, and outreach workers under this 
632.16 	paragraph, the commissioner shall emphasize 
632.17 	activities that promote capacity-building and 
632.18 	development of resources in greater 
632.19 	Minnesota.
632.20 	(g) Emergency Services Program. $100,000 
632.21 	in fiscal year 2018 and $100,000 in fiscal year 
632.22 	2019 are for the emergency services program, 
632.23 	which provides services and emergency shelter 
632.24 	for homeless Minnesotans under Minnesota 
632.25 	Statutes, section 256E.36. This is a onetime 
632.26 	appropriation.
632.27 	(h) Dakota County Child Data Tracking.
632.28 	$200,000 in fiscal year 2018 is for the 
632.29 	Minnesota Birth to Eight pilot project for the 
632.30 	development of the information technology 
632.31 	solution that will track the established 
632.32 	developmental milestone progress of each 
632.33 	child participating in the pilot up to age eight.
633.1 	(i) Food Shelf Programs. $375,000 in fiscal 
633.2 	year 2018 and $375,000 in fiscal year 2019 
633.3 	are for food shelf programs under Minnesota 
633.4 	Statutes, section 256E.34. This appropriation 
633.5 	may be used to purchase proteins, fruits, 
633.6 	vegetables, and diapers. This is a onetime 
633.7 	appropriation.
633.8 	(j) Community Living Infrastructure. 
633.9 	$1,400,000 in fiscal year 2018 and $1,400,000 
633.10 	in fiscal year 2019 are for community living 
633.11 	infrastructure grants under article 2, section 
633.12 	17.
633.13 	(k) Housing Web Site Grant. $150,000 in 
633.14 	fiscal year 2018 and $150,000 in fiscal year 
633.15 	2019 are for a grant to a public or private 
633.16 	entity to create and maintain a Web site and 
633.17 	application to track real-time housing openings 
633.18 	for people with disabilities.
633.19 	(l) Housing Benefit Web Site. $130,000 in 
633.20 	fiscal year 2018 and $130,000 in fiscal year 
633.21 	2019 are to operate the housing benefit 101 
633.22 	Web site to help people who need affordable 
633.23 	housing, and supports to maintain that 
633.24 	housing, understand the range of housing 
633.25 	options and support services available.
633.26 	(m) Coparenting Education. $150,000 in 
633.27 	fiscal year 2018 and $150,000 in fiscal year 
633.28 	2019 are for a grant to a health and wellness 
633.29 	center located in North Minneapolis that is a 
633.30 	federally qualified health center. This is a 
633.31 	onetime appropriation. The center must use 
633.32 	the grant money to offer coparent services to 
633.33 	unmarried parents. The center must develop 
633.34 	a process to inform and educate unmarried 
633.35 	parents about the center's coparent services. 
634.1 	The coparent services must include the 
634.2 	following:
634.3 	(1) coparenting workshops for the unmarried 
634.4 	parents;
634.5 	(2) assistance to the unmarried parents in 
634.6 	developing a parenting plan that specifies a 
634.7 	schedule of the time each parent spends with 
634.8 	the child, child support obligations, and a 
634.9 	designation of decision-making responsibilities 
634.10 	regarding the child's education, medical needs, 
634.11 	and religious upbringing;
634.12 	(3) an assessment of social services needs for 
634.13 	each parent; and
634.14 	(4) additional social services support, 
634.15 	including support related to employment, 
634.16 	education, and housing.
634.17 	The parenting plan assistance must include 
634.18 	the option of using private mediation.
634.19 	The coparent workshops must focus at a 
634.20 	minimum on (i) the benefits to the child of 
634.21 	having both parents involved in a child's life, 
634.22 	(ii) promoting both parents' participation in a 
634.23 	child's life, (iii) building coparenting and 
634.24 	communication skills, (iv) information on 
634.25 	establishing paternity, (v) assisting parents in 
634.26 	developing a parenting plan, and (vi) educating 
634.27 	participants on how to foster a nonresident 
634.28 	parent's continued involvement in a child's 
634.29 	life.
634.30 	(n) Base Level Adjustments. The general 
634.31 	fund base is $30,840,000 in fiscal year 2020 
634.32 	and $31,940,000 in fiscal year 2021. The 
634.33 	general fund base includes $453,000 in fiscal 
634.34 	year 2020 and $453,000 in fiscal year 2021 
635.1 	for community living infrastructure grant 
635.2 	allocations under Minnesota Statutes, section 
635.3 	256I.09.

635.4	Subd. 25.Grant Programs; Health Care Grants

635.5	Appropriations by Fund
	
635.6	General
	5,519,000
	4,111,000
	
635.7	Health Care Access
	3,465,000
	3,465,000
	
635.8 	(a) Chronic Pain Rehabilitation Therapy 
635.9 	Demonstration Project. $1,000,000 in fiscal 
635.10 	year 2018 is from the general fund for a 
635.11 	chronic pain rehabilitation therapy 
635.12 	demonstration project with a rehabilitation 
635.13 	institute. The commissioner may use up to 
635.14 	three percent of this appropriation for 
635.15 	administrative costs for the project. This is a 
635.16 	onetime appropriation.
635.17 	(b) Health Care Grants. $400,000 in fiscal 
635.18 	year 2018 and $400,000 in fiscal year 2019 
635.19 	are for the substance use disorder and provider 
635.20 	capacity grant program. This is a onetime 
635.21 	appropriation.
635.22 	(c) Base Level Adjustment. The general fund 
635.23 	base is $3,711,000 in fiscal year 2020 and 
635.24 	$3,711,000 in fiscal year 2021.

635.25
635.26	Subd. 26.Grant Programs; Other Long-Term 
Care Grants
 		2,500,000
		2,925,000
	
635.27 	(a) Home and Community-Based Incentive 
635.28 	Pool. $1,000,000 in fiscal year 2018 and 
635.29 	$1,000,000 in fiscal year 2019 are for 
635.30 	incentive payments under Minnesota Statutes, 
635.31 	section 256B.0921. This is a onetime 
635.32 	appropriation.
636.1 	(b) Base Level Adjustment. The general fund 
636.2 	base is $1,925,000 in fiscal year 2020 and 
636.3 	$1,925,000 in fiscal year 2021.

636.4
636.5	Subd. 27.Grant Programs; Aging and Adult 
Services Grants
 		30,786,000
		32,437,000
	
636.6 	(a) Gap Analysis. $217,000 in fiscal year 
636.7 	2018 and $218,000 in fiscal year 2019 are for 
636.8 	analysis of gaps in long-term care services 
636.9 	under Minnesota Statutes, section 144A.351.
636.10 	(b) Advanced In-Home Activity-Monitoring 
636.11 	Systems. $40,000 in fiscal year 2018 is for a 
636.12 	grant to a local research organization with 
636.13 	expertise in identifying current and potential 
636.14 	support systems and examining the capacity 
636.15 	of those systems to meet the needs of the 
636.16 	growing population of elderly persons to 
636.17 	conduct a comprehensive assessment of 
636.18 	current literature, past research, and an 
636.19 	environmental scan of the field related to 
636.20 	advanced in-home activity-monitoring systems 
636.21 	for elderly persons. The commissioner must 
636.22 	report the results of the assessment by January 
636.23 	15, 2018, to the legislative committees and 
636.24 	divisions with jurisdiction over health and 
636.25 	human services policy and finance. This is a 
636.26 	onetime appropriation.
636.27 	(c) Base Level Adjustments. The general 
636.28 	fund base is $32,811,000 in fiscal year 2020 
636.29 	and $32,995,000 in fiscal year 2021. The 
636.30 	general fund base includes $334,000 in fiscal 
636.31 	year 2020 and $477,000 in fiscal year 2021 
636.32 	for the Minnesota Board on Aging for 
636.33 	self-directed caregiver grants under Minnesota 
636.34 	Statutes, section 256.975, subdivision 12.

636.35
636.36	Subd. 28.Grant Programs; Deaf and 
Hard-of-Hearing Grants
 		2,675,000
		2,675,000
	
637.1 	Expanded Services Grants. $800,000 in 
637.2 	fiscal year 2018 and $800,000 in fiscal year 
637.3 	2019 are for deaf and hard-of-hearing grants.
637.4 	The funds must be used to provide:
637.5 	(1) services to Minnesotans who are deafblind 
637.6 	under Minnesota Statutes, section 256C.261;
637.7 	(2) linguistically and culturally appropriate 
637.8 	mental health services to children who are 
637.9 	deaf, children who are deafblind, and children 
637.10 	who are hard-of-hearing;
637.11 	(3) an increase in the fiscal year 2017 base 
637.12 	level grant amount to provide mentors who 
637.13 	have hearing loss to parents of infants and 
637.14 	children with newly identified hearing loss; 
637.15 	and
637.16 	(4) training each year in ProTactile American 
637.17 	Sign Language or other communication 
637.18 	systems used by people who are deafblind. 
637.19 	Training shall be provided to persons who are 
637.20 	deafblind and to interpreters, support service 
637.21 	providers, and intervenors who work with 
637.22 	persons who are deafblind.
637.23 	The funds may be used to provide culturally 
637.24 	affirmative psychiatric services.

637.25	Subd. 29.Grant Programs; Disabilities Grants
 		21,175,000
		21,176,000
	
637.26 	(a) Disability Waiver Rate System 
637.27 	Transition Grants. $30,000 in fiscal year 
637.28 	2018 and $31,000 in fiscal year 2019 are for 
637.29 	grants to home and community-based 
637.30 	disability waiver services providers that are 
637.31 	projected to receive at least a ten percent 
637.32 	decrease in revenues due to transition to rates 
637.33 	calculated under Minnesota Statutes, section 
637.34 	256B.4914.The commissioner shall award 
638.1 	grants to ensure ongoing access for individuals 
638.2 	currently receiving these services and provide 
638.3 	stability to providers as they transition to new 
638.4 	service delivery models. The general fund base 
638.5 	for the grants under this paragraph is $287,000 
638.6 	in fiscal year 2020 and $288,000 in fiscal year 
638.7 	2021.
638.8 	(b) Self-Advocacy Grants. $133,000 in fiscal 
638.9 	year 2018 and $133,000 in fiscal year 2019 
638.10 	are for grants under Minnesota Statutes, 
638.11 	section 256.477, paragraph (a).
638.12 	(c) Services for Persons with Intellectual 
638.13 	and Developmental Disabilities. $143,000 
638.14 	in fiscal year 2018 and $143,000 in fiscal year 
638.15 	2019 are for a grant to an organization 
638.16 	described under Minnesota Statutes, section 
638.17 	256.477. This is a onetime appropriation. 
638.18 	Grant funds must be used for the following 
638.19 	purposes:
638.20 	(1) to maintain the infrastructure needed to 
638.21 	train and support the activities of a statewide 
638.22 	network of peer-to-peer mentors for persons 
638.23 	with developmental disabilities, focused on 
638.24 	building awareness of service options and 
638.25 	advocacy skills necessary to move toward full 
638.26 	inclusion in community life, including the 
638.27 	development and delivery of the curriculum 
638.28 	to support the peer-to-peer network;
638.29 	(2) to provide outreach activities, including 
638.30 	statewide conferences and disability 
638.31 	networking opportunities focused on 
638.32 	self-advocacy, informed choice, and 
638.33 	community engagement skills;
639.1 	(3) to provide an annual leadership program 
639.2 	for persons with intellectual and 
639.3 	developmental disabilities; and
639.4 	(4) to provide for administrative and general 
639.5 	operating costs associated with managing and 
639.6 	maintaining facilities, program delivery, 
639.7 	evaluation, staff, and technology.
639.8 	(d) Outreach to Persons in Institutional 
639.9 	Settings. $105,000 in fiscal year 2018 and 
639.10 	$105,000 in fiscal year 2019 are for a grant to 
639.11 	an organization described under Minnesota 
639.12 	Statutes, section 256.477, to be used for 
639.13 	subgrants to organizations in Minnesota to 
639.14 	conduct outreach to persons working and 
639.15 	living in institutional settings to provide 
639.16 	education and information about community 
639.17 	options. This is a onetime appropriation. Grant 
639.18 	funds must be used to deliver peer-led skill 
639.19 	training sessions in six regions of the state to 
639.20 	help persons with intellectual and 
639.21 	developmental disabilities understand 
639.22 	community service options related to:
639.23 	(1) housing;
639.24 	(2) employment;
639.25 	(3) education;
639.26 	(4) transportation;
639.27 	(5) emerging service reform initiatives 
639.28 	contained in the state's Olmstead plan; the 
639.29 	Workforce Innovation and Opportunity Act, 
639.30 	Public Law 113-128; and federal home and 
639.31 	community-based services regulations; and
639.32 	(6) connecting with individuals who can help 
639.33 	persons with intellectual and developmental 
640.1 	disabilities make an informed choice and plan 
640.2 	for a transition in services.
640.3 	(e) Community Living Grants. To the extent 
640.4 	funding is available, the commissioner may 
640.5 	transfer funds from the semi-independent 
640.6 	living services grant to new community living 
640.7 	grants to pay for transitional costs and 
640.8 	facilitate the transition of individuals from 
640.9 	corporate foster care to community living.
640.10 	(f) Life Skills Training for Individuals with 
640.11 	Autism Spectrum Disorder. $125,000 in 
640.12 	fiscal year 2018 and $125,000 in fiscal year 
640.13 	2019 are for a grant to an organization located 
640.14 	in Richfield that provides life skills training 
640.15 	to young adults with learning disabilities to 
640.16 	meet the needs of individuals with autism 
640.17 	spectrum disorder. This is a onetime 
640.18 	appropriation. This appropriation may be used 
640.19 	to:
640.20 	(1) create a best practices curriculum for 
640.21 	serving individuals with autism spectrum 
640.22 	disorder in residential placements with 
640.23 	therapeutic programming; and
640.24 	(2) expand facilities by adding safety features, 
640.25 	living spaces, and academic areas.
640.26 	(g) Base Level Adjustment. The general fund 
640.27 	base is $21,059,000 in fiscal year 2020 and 
640.28 	$21,060,000 in fiscal year 2021.

640.29
640.30	Subd. 30.Grant Programs; Adult Mental Health 
Grants

640.31	Appropriations by Fund
	
640.32	General
	81,577,000
	81,477,000
	
640.33	Health Care Access
	750,000
	750,000
	
641.1 	(a) Peer-Run Respite Services in Wadena 
641.2 	County. $100,000 in fiscal year 2018 is from 
641.3 	the general fund for a grant to Wadena County 
641.4 	for the planning and development of a peer-run 
641.5 	respite center for individuals experiencing 
641.6 	mental health conditions or co-occurring 
641.7 	substance abuse disorder. This is a onetime 
641.8 	appropriation and is available until June 30, 
641.9 	2021. The grant is contingent on Wadena 
641.10 	County providing to the commissioner of 
641.11 	human services a plan to fund, operate, and 
641.12 	sustain the program and services after the 
641.13 	onetime state grant is expended. Wadena 
641.14 	County must outline the proposed funding 
641.15 	stream or mechanism, and any necessary local 
641.16 	funding commitment, which will ensure the 
641.17 	program will result in a sustainable program. 
641.18 	The funding stream may include state funding 
641.19 	for programs and services for which the 
641.20 	individuals served under this paragraph may 
641.21 	be eligible. The commissioner of human 
641.22 	services, in collaboration with Wadena 
641.23 	County, may explore a plan for continued 
641.24 	funding using existing appropriations through 
641.25 	eligibility for group residential housing under 
641.26 	Minnesota Statutes, chapter 256I.
641.27 	The peer-run respite center must:
641.28 	(1) admit individuals who are in need of peer 
641.29 	support and supportive services while 
641.30 	addressing an increase in symptoms or 
641.31 	stressors or exacerbation of their mental health 
641.32 	or substance abuse;
641.33 	(2) admit individuals to reside at the center on 
641.34 	a short-term basis, no longer than five days;
641.35 	(3) be operated by a nonprofit organization;
642.1 	(4) employ individuals who have personal 
642.2 	experience with mental health or co-occurring 
642.3 	substance abuse conditions who meet the 
642.4 	qualifications of a mental health certified peer 
642.5 	specialist under Minnesota Statutes, section 
642.6 	256B.0615, or a recovery peer;
642.7 	(5) provide at least three but no more than six 
642.8 	beds in private rooms; and
642.9 	(6) not provide clinical services.
642.10 	By November 1, 2018, the commissioner of 
642.11 	human services, in consultation with Wadena 
642.12 	County, shall report to the committees in the 
642.13 	senate and house of representatives with 
642.14 	jurisdiction over mental health issues, the 
642.15 	status of planning and development of the 
642.16 	peer-run respite center, and the plan to 
642.17 	financially support the program and services 
642.18 	after the state grant is expended.
642.19 	(b) Housing Options for Persons with 
642.20 	Serious Mental Illness. $575,000 in fiscal 
642.21 	year 2018 and $575,000 in fiscal year 2019 
642.22 	are from the general fund for adult mental 
642.23 	health grants under Minnesota Statutes, section 
642.24 	245.4661, subdivision 9, paragraph (a), clause 
642.25 	(2), to support increased availability of 
642.26 	housing options with supports for persons with 
642.27 	serious mental illness. This is a onetime 
642.28 	appropriation.
642.29 	(c) Assertive Community Treatment.
642.30 	$200,000 in fiscal year 2018 and $200,000 in 
642.31 	fiscal year 2019 are from the general fund for 
642.32 	adult mental health grants under Minnesota 
642.33 	Statutes, section 256B.0622, subdivision 12, 
643.1 	to expand assertive community treatment 
643.2 	services. This is a onetime appropriation.
643.3 	(d) Mental Health Crisis Services. $400,000 
643.4 	in fiscal year 2018 and $400,000 in fiscal year 
643.5 	2019 are from the general fund for adult 
643.6 	mental health grants under Minnesota Statutes, 
643.7 	section 245.4661, and children's mental health 
643.8 	grants under Minnesota Statutes, section 
643.9 	245.4889, to expand mental health crisis 
643.10 	services, including:
643.11 	(1) mobile crisis services;
643.12 	(2) residential crisis services;
643.13 	(3) colocation of mobile crisis services in 
643.14 	urgent care clinics and psychiatric emergency 
643.15 	departments; and
643.16 	(4) development of co-responder mental health 
643.17 	crisis response models.
643.18 	This is a onetime appropriation.
643.19 	(e) Housing with Supports. $500,000 in fiscal 
643.20 	year 2018 and $500,000 in fiscal year 2019 
643.21 	are for the housing with supports for adults 
643.22 	with serious mental illness grant under 
643.23 	Minnesota Statutes, section 245.4661, 
643.24 	subdivision 9, paragraph (a), clause (2). This 
643.25 	is a onetime appropriation.
643.26 	(f) Base Level Adjustment. The general fund 
643.27 	base is $79,802,000 in fiscal year 2020 and 
643.28 	$79,802,000 in fiscal year 2021.

643.29
643.30	Subd. 31.Grant Programs; Child Mental Health 
Grants
 		21,411,000
		21,476,000
	
643.31 	(a) First Psychotic Episode Funding.
643.32 	$500,000 in fiscal year 2018 and $500,000 in 
643.33 	fiscal year 2019 are for grants under 
644.1 	Minnesota Statutes, section 245.4889, 
644.2 	subdivision 1, paragraph (b), clause (15). This 
644.3 	is a onetime appropriation. Funding shall be 
644.4 	used to:
644.5 	(1) provide intensive treatment and supports 
644.6 	to adolescents and adults experiencing or at 
644.7 	risk of a first psychotic episode. Intensive 
644.8 	treatment and support includes medication 
644.9 	management, psychoeducation for the 
644.10 	individual and family, case management, 
644.11 	employment supports, education supports, 
644.12 	cognitive behavioral approaches, social skills 
644.13 	training, peer support, crisis planning, and 
644.14 	stress management. Projects must use all 
644.15 	available funding streams;
644.16 	(2) conduct outreach, training, and guidance 
644.17 	to mental health and health care professionals, 
644.18 	including postsecondary health clinics, on 
644.19 	early psychosis symptoms, screening tools, 
644.20 	and best practices; and
644.21 	(3) ensure access to first psychotic episode 
644.22 	psychosis services under this section, 
644.23 	including ensuring access for individuals who 
644.24 	live in rural areas. Funds may be used to pay 
644.25 	for housing or travel or to address other 
644.26 	barriers to individuals and their families 
644.27 	participating in first psychotic episode 
644.28 	services.
644.29 	(b) Respite Care Services. $150,000 in fiscal 
644.30 	year 2018 and $150,000 in fiscal year 2019 
644.31 	are for children's mental health grants under 
644.32 	Minnesota Statutes, section 245.4889, 
644.33 	subdivision 1, paragraph (b), clause (3), to 
644.34 	provide respite care services to families of 
645.1 	children with serious mental illness. This is a 
645.2 	onetime appropriation.
645.3 	(c) Base Level Adjustment. The general fund 
645.4 	base is $20,826,000 in fiscal year 2020 and 
645.5 	$20,826,000 in fiscal year 2021.

645.6
645.7	Subd. 32.Grant Programs; Chemical 
Dependency Treatment Support Grants

645.8	Appropriations by Fund
	
645.9	General
	2,386,000
	2,386,000
	
645.10	Lottery Prize
	1,733,000
	1,733,000
	
645.11 	(a) Minnesota Transitions Charter School.
645.12 	Notwithstanding any other law to the contrary, 
645.13 	Minnesota Transitions Charter School is 
645.14 	eligible to receive grants under Minnesota 
645.15 	Statutes, section 254A.03, subdivision 1.
645.16 	(b) Problem Gambling. $225,000 in fiscal 
645.17 	year 2018 and $225,000 in fiscal year 2019 
645.18 	are from the lottery prize fund for a grant to 
645.19 	the state affiliate recognized by the National 
645.20 	Council on Problem Gambling. The affiliate 
645.21 	must provide services to increase public 
645.22 	awareness of problem gambling, education, 
645.23 	and training for individuals and organizations 
645.24 	providing effective treatment services to 
645.25 	problem gamblers and their families, and 
645.26 	research related to problem gambling.
645.27 	(c) Minnesota Organization on Fetal 
645.28 	Alcohol Syndrome. $250,000 in fiscal year 
645.29 	2018 and $250,000 in fiscal year 2019 are for 
645.30 	a grant to the Minnesota Organization on Fetal 
645.31 	Alcohol Syndrome (MOFAS). This is a 
645.32 	onetime appropriation. Of this amount, 
645.33 	MOFAS shall make grants to eligible regional 
645.34 	collaboratives that fulfill the requirements in 
645.35 	this paragraph. "Eligible regional 
646.1 	collaboratives" means a partnership between 
646.2 	at least one local government and at least one 
646.3 	community-based organization and, where 
646.4 	available, a family home visiting program. For 
646.5 	purposes of this paragraph, a local government 
646.6 	includes a county or multicounty organization, 
646.7 	a tribal government, a county-based 
646.8 	purchasing entity, or a community health 
646.9 	board. Eligible regional collaboratives must 
646.10 	use grant funds to reduce the incidence of fetal 
646.11 	alcohol syndrome disorders and other prenatal 
646.12 	drug-related effects in children in Minnesota 
646.13 	by identifying and serving pregnant women 
646.14 	suspected of or known to use or abuse alcohol 
646.15 	or other drugs. The eligible regional 
646.16 	collaboratives must provide intensive services 
646.17 	to chemically dependent women to increase 
646.18 	positive birth outcomes. MOFAS must make 
646.19 	grants to eligible regional collaboratives from 
646.20 	both rural and urban areas. A grant recipient 
646.21 	must report to the commissioner of human 
646.22 	services annually by January 15 on the 
646.23 	services and programs funded by the 
646.24 	appropriation. The report must include 
646.25 	measurable outcomes for the previous year, 
646.26 	including the number of pregnant women 
646.27 	served and the number of toxic-free babies 
646.28 	born.
646.29 	(d) Base Level Adjustment. The general fund 
646.30 	base is $2,136,000 in fiscal year 2020 and 
646.31 	$2,136,000 in fiscal year 2021.

646.32	Subd. 33.Direct Care and Treatment - Generally
 					
646.33 	(a) Transfer Authority. Money appropriated 
646.34 	to budget activities under subdivisions 34, 35, 
646.35 	36, 37, and 38 may be transferred between 
647.1 	budget activities and between years of the 
647.2 	biennium with the approval of the 
647.3 	commissioner of management and budget.
647.4 	(b) Dedicated Receipts Available. Of the 
647.5 	revenue received under Minnesota Statutes, 
647.6 	section 246.18, subdivision 8, paragraph (a), 
647.7 	up to $1,000,000 each year is available for the 
647.8 	purposes of Minnesota Statutes, section 
647.9 	246.18, subdivision 8, paragraph (b), clause 
647.10 	(1); and up to $2,713,000 each year is 
647.11 	available for the purposes of Minnesota 
647.12 	Statutes, section 246.18, subdivision 8, 
647.13 	paragraph (b), clause (2).

647.14
647.15	Subd. 34.Direct Care and Treatment - Mental 
Health and Substance Abuse
 		118,545,000
		118,631,000
	
647.16 	(a)  Child and Adolescent Behavioral Health 
647.17 	Services. $405,000 in fiscal year 2018 and 
647.18 	$491,000 in fiscal year 2019 are to continue 
647.19 	to operate the child and adolescent behavioral 
647.20 	health services program under Minnesota 
647.21 	Statutes, section 246.014. This is a onetime 
647.22 	appropriation.
647.23 	(b) DCT Operating Adjustment (CARE). 
647.24 	$447,000 in fiscal year 2018 and $447,000 in 
647.25 	fiscal year 2019 are for Community Addiction 
647.26 	Recovery Enterprise (CARE) operating 
647.27 	adjustments. The commissioner must transfer 
647.28 	$447,000 in fiscal year 2018 and $447,000 in 
647.29 	fiscal year 2019 to the enterprise fund for 
647.30 	CARE.
647.31 	(c) Base Level Adjustment. The general fund 
647.32 	base is $118,140,000 in fiscal year 2020 and 
647.33 	$118,140,000 in fiscal year 2021.

647.34
647.35	Subd. 35.Direct Care and Treatment - 
Community-Based Services
 		25,652,000
		20,543,000
	
648.1 	(a) DCT Operating Adjustment (MSOCS). 
648.2 	$2,393,000 in fiscal year 2018 and $2,393,000 
648.3 	in fiscal year 2019 are for Minnesota State 
648.4 	Operated Community Services (MSOCS) 
648.5 	operating adjustments. The commissioner must 
648.6 	transfer $2,393,000 in fiscal year 2018 and 
648.7 	$2,393,000 in fiscal year 2019 to the enterprise 
648.8 	fund for MSOCS.
648.9 	(b) MSOCS Sustainability. $7,697,000 in 
648.10 	fiscal year 2018 and $2,588,000 in fiscal year 
648.11 	2019 are for the Minnesota State Operated 
648.12 	Community Services program. Of this amount, 
648.13 	the commissioner must transfer $6,697,000 in 
648.14 	fiscal year 2018 and $1,588,000 in fiscal year 
648.15 	2019 to the enterprise fund for Minnesota State 
648.16 	Operated Community Services. $1,000,000 is 
648.17 	available each year of the biennium for 
648.18 	start-up expenses for new residential homes 
648.19 	to be operated by Minnesota State Operated 
648.20 	Community Services.
648.21 	(c) Base Level Adjustment. The general fund 
648.22 	base is $18,955,000 in fiscal year 2021.

648.23
648.24	Subd. 36.Direct Care and Treatment - Forensic 
Services
 		102,806,000
		106,958,000
	
648.25 	Base Level Adjustment. The general fund 
648.26 	base is $109,828,000 in fiscal year 2020 and 
648.27 	$112,437,000 in fiscal year 2021.

648.28
648.29	Subd. 37.Direct Care and Treatment - Sex 
Offender Program
 		89,217,000
		89,225,000
	
648.30 	Transfer Authority. Money appropriated for 
648.31 	the Minnesota sex offender program may be 
648.32 	transferred between fiscal years of the 
648.33 	biennium with the approval of the 
648.34 	commissioner of management and budget.

649.1
649.2	Subd. 38.Direct Care and Treatment - 
Operations
 		45,151,000
		45,708,000
	
649.3 	Base Level Adjustment. The general fund 
649.4 	base is $45,995,000 in fiscal year 2020 and 
649.5 	$46,256,000 in fiscal year 2021.

649.6	Subd. 39.Technical Activities
 		84,384,000
		84,258,000
	
649.7 	(a) This appropriation is from the federal 
649.8 	TANF fund.
649.9 	(b) Base Level Adjustment. The TANF fund 
649.10 	base is $86,346,000 in fiscal year 2020 and 
649.11 	$86,355,000 in fiscal year 2021.

649.12	Sec. 3. COMMISSIONER OF HEALTH

649.13	Subdivision 1.Total Appropriation
 	$
	213,792,000
	$
	207,347,000

649.14	Appropriations by Fund
	
649.15		2018
	2019
	
649.16	General
	111,829,000
	105,274,000
	
649.17
649.18	State Government 
Special Revenue
	53,607,000
	54,102,000
	
649.19	Health Care Access
	36,643,000
	36,258,000
	
649.20	Federal TANF
	11,713,000
	11,713,000
	
649.21 	The amounts that may be spent for each 
649.22 	purpose are specified in the following 
649.23 	subdivisions.

649.24	Subd. 2.Health Improvement

649.25	Appropriations by Fund
	
649.26	General
	81,438,000
	78,100,000
	
649.27
649.28	State Government 
Special Revenue
	6,215,000
	6,182,000
	
649.29	Health Care Access
	36,643,000
	36,258,000
	
649.30	Federal TANF
	11,713,000
	11,713,000
	
649.31 	(a) TANF Appropriations. (1) $3,579,000 
649.32 	of the TANF fund each year is for home 
649.33 	visiting and nutritional services listed under 
649.34 	Minnesota Statutes, section 145.882, 
650.1 	subdivision 7, clauses (6) and (7). Funds must 
650.2 	be distributed to community health boards 
650.3 	according to Minnesota Statutes, section 
650.4 	145A.131, subdivision 1.
650.5 	(2) $2,000,000 of the TANF fund each year 
650.6 	is for decreasing racial and ethnic disparities 
650.7 	in infant mortality rates under Minnesota 
650.8 	Statutes, section 145.928, subdivision 7.
650.9 	(3) $4,978,000 of the TANF fund  each year 
650.10 	is for the family home visiting grant program 
650.11 	according to Minnesota Statutes, section 
650.12 	145A.17. $4,000,000 of the funding must be 
650.13 	distributed to community health boards 
650.14 	according to Minnesota Statutes, section 
650.15 	145A.131, subdivision 1. $978,000 of the 
650.16 	funding must be distributed to tribal 
650.17 	governments according to Minnesota Statutes, 
650.18 	section 145A.14, subdivision 2a.
650.19 	(4) $1,156,000 of the TANF fund each year 
650.20 	is for family planning grants under Minnesota 
650.21 	Statutes, section 145.925.
650.22 	(5) The commissioner may use up to 6.23 
650.23 	percent of the funds appropriated each year to 
650.24 	conduct the ongoing evaluations required 
650.25 	under Minnesota Statutes, section 145A.17, 
650.26 	subdivision 7, and training and technical 
650.27 	assistance as required under Minnesota 
650.28 	Statutes, section 145A.17, subdivisions 4 and 
650.29 	5.
650.30 	(b) TANF Carryforward. Any unexpended 
650.31 	balance of the TANF appropriation in the first 
650.32 	year of the biennium does not cancel but is 
650.33 	available for the second year.
651.1 	(c) Evidence-Based Home Visiting.
651.2 	$6,000,000 in fiscal year 2018 and $6,000,000 
651.3 	in fiscal year 2019 are from the general fund  
651.4 	to start up or expand evidence-based home 
651.5 	visiting programs. The commissioner shall 
651.6 	award grants to community health boards, 
651.7 	nonprofits, or tribal nations in urban and rural 
651.8 	areas of the state. Grant funds must be used 
651.9 	to start up or expand evidence-based home 
651.10 	visiting programs in the county, reservation, 
651.11 	or region to serve families, such as parents 
651.12 	with high risk or high needs, parents with a 
651.13 	history of mental illness, domestic abuse, or 
651.14 	substance abuse, or first-time mothers 
651.15 	prenatally until the child is four years of age, 
651.16 	who are eligible for medical assistance under 
651.17 	Minnesota Statutes, chapter 256B, or the 
651.18 	federal Special Supplemental Nutrition 
651.19 	Program for Women, Infants, and Children. 
651.20 	Priority for grants to rural areas shall be given 
651.21 	to community health boards, nonprofits, and 
651.22 	tribal nations that expand services within 
651.23 	regional partnerships that provide the 
651.24 	evidence-based home visiting programs. This 
651.25 	funding shall only be used to supplement, not 
651.26 	to replace, funds being used for 
651.27 	evidence-based home visiting services as of 
651.28 	June 30, 2017. Up to seven percent of the 
651.29 	appropriation may be used for training, 
651.30 	technical assistance, evaluation, and other 
651.31 	costs to administer the grants. The general 
651.32 	fund base for this program is $16,500,000 in 
651.33 	fiscal year 2020 and $16,500,000 in fiscal year 
651.34 	2021.
651.35 	(d) Safe Harbor for Sexually Exploited 
651.36 	Youth Services. $250,000 in fiscal year 2018 
652.1 	and $250,000 in fiscal year 2019 are from the 
652.2 	general fund for trauma-informed, culturally 
652.3 	specific services for sexually exploited youth. 
652.4 	Youth 24 years of age or younger are eligible 
652.5 	for services under this paragraph.
652.6 	(e) Safe Harbor Program Technical 
652.7 	Assistance and Evaluation. $200,000 in 
652.8 	fiscal year 2018 and $200,000 in fiscal year 
652.9 	2019 are from the general fund for training, 
652.10 	technical assistance, protocol implementation, 
652.11 	and evaluation activities related to the safe 
652.12 	harbor program. Of these amounts:
652.13 	(1) $90,000 each fiscal year is for providing 
652.14 	training and technical assistance to individuals 
652.15 	and organizations that provide safe harbor 
652.16 	services and receive funds for that purpose 
652.17 	from the commissioner of human services or 
652.18 	commissioner of health;
652.19 	(2) $90,000 each fiscal year is for protocol 
652.20 	implementation, which includes providing 
652.21 	technical assistance in establishing best 
652.22 	practices-based systems for effectively 
652.23 	identifying, interacting with, and referring 
652.24 	sexually exploited youth to appropriate 
652.25 	resources; and
652.26 	(3) $20,000 each fiscal year is for program 
652.27 	evaluation activities in compliance with 
652.28 	Minnesota Statutes, section 145.4718.
652.29 	(f) Promoting Safe Harbor Capacity. In 
652.30 	funding services and activities under 
652.31 	paragraphs (d) and (e), the commissioner shall 
652.32 	emphasize activities that promote 
652.33 	capacity-building and development of 
652.34 	resources in greater Minnesota.
653.1 	(g) Administration of Safe Harbor 
653.2 	Program. $60,000 in fiscal year 2018 and 
653.3 	$60,000 in fiscal year 2019 are for 
653.4 	administration of the safe harbor for sexually 
653.5 	exploited youth program.
653.6 	(h) Palliative Care Advisory Council.
653.7 	$44,000 in fiscal year 2018 and $44,000 in 
653.8 	fiscal year 2019 are from the general fund for 
653.9 	the Palliative Care Advisory Council under 
653.10 	Minnesota Statutes, section 144.059. This is 
653.11 	a onetime appropriation.
653.12 	(i) Transfer; Minnesota Biomedicine and 
653.13 	Bioethics Innovation Grants. $2,500,000 in 
653.14 	fiscal year 2018 is from the general fund for 
653.15 	transfer to the Board of Regents of the 
653.16 	University of Minnesota for Minnesota 
653.17 	biomedicine and bioethics innovation grants 
653.18 	under Minnesota Statutes, section 137.67. The 
653.19 	full amount of the appropriation is for grants, 
653.20 	and the University of Minnesota shall not use 
653.21 	any portion for administrative or monitoring 
653.22 	expenses. The steering committee of the 
653.23 	University of Minnesota and Mayo Foundation 
653.24 	partnership must submit a preliminary report 
653.25 	by April 1, 2018, and a final report by April 
653.26 	1, 2019, on all grant activities funded under 
653.27 	Minnesota Statutes, section 137.67, to the 
653.28 	chairs and ranking minority members of the 
653.29 	legislative committees with jurisdiction over 
653.30 	health and human services finance. This is a 
653.31 	onetime appropriation and is available until 
653.32 	June 30, 2021.
653.33 	(j) Statewide Strategic Plan for Victims of 
653.34 	Sex Trafficking. $73,000 in fiscal year 2018 
653.35 	is from the general fund for the development 
654.1 	of a comprehensive statewide strategic plan 
654.2 	and report to address the needs of sex 
654.3 	trafficking victims statewide. This is a onetime 
654.4 	appropriation.
654.5 	(k) Home and Community-Based Services 
654.6 	Employee Scholarship Program. $500,000 
654.7 	in fiscal year 2018 and $500,000 in fiscal year 
654.8 	2019 are from the general fund for the home 
654.9 	and community-based services employee 
654.10 	scholarship program under Minnesota Statutes, 
654.11 	section 144.1503.
654.12 	(l) Comprehensive Advanced Life Support 
654.13 	Educational Program. $100,000 in fiscal 
654.14 	year 2018 and $100,000 in fiscal year 2019 
654.15 	are from the general fund for the 
654.16 	comprehensive advanced life support 
654.17 	educational program under Minnesota Statutes, 
654.18 	section 144.6062. This is a onetime 
654.19 	appropriation.
654.20 	(m) Opioid Abuse Prevention. $1,028,000 
654.21 	in fiscal year 2018 is to establish and evaluate 
654.22 	accountable community for health opioid 
654.23 	abuse prevention pilot projects. $28,000 of 
654.24 	this amount is for administration. This is a 
654.25 	onetime appropriation and is available until 
654.26 	June 30, 2021.
654.27 	(n) Advanced Care Planning. $250,000 in 
654.28 	fiscal year 2018 and $250,000 in fiscal year 
654.29 	2019 are from the general fund for a grant to 
654.30 	a statewide advanced care planning resource 
654.31 	organization that has expertise in convening 
654.32 	and coordinating community-based strategies 
654.33 	to encourage individuals, families, caregivers, 
654.34 	and health care providers to begin 
654.35 	conversations regarding end-of-life care 
655.1 	choices that express an individual's health care 
655.2 	values and preferences and are based on 
655.3 	informed health care decisions. Of this 
655.4 	amount, $9,000 each year is for administration. 
655.5 	This is a onetime appropriation.
655.6 	(o) Health Professionals Clinical Training 
655.7 	Expansion Grant Program. $526,000 in 
655.8 	fiscal year 2018 and $526,000 in fiscal year 
655.9 	2019 are from the general fund for the primary 
655.10 	care and mental health professions clinical 
655.11 	training expansion grant program under 
655.12 	Minnesota Statutes, section 144.1505. Of this 
655.13 	amount, $26,000 each year is for 
655.14 	administration.
655.15 	(p) Federally Qualified Health Centers.
655.16 	$500,000 in fiscal year 2018 and $500,000 in 
655.17 	fiscal year 2019 are from the general fund to 
655.18 	provide subsidies to federally qualified health 
655.19 	centers under Minnesota Statutes, section 
655.20 	145.9269. This is a onetime appropriation.
655.21 	(q) Base Level Adjustments. The general 
655.22 	fund base is $87,656,000 in fiscal year 2020 
655.23 	and $87,706,000 in fiscal year 2021. The 
655.24 	health care access fund base is $36,858,000 
655.25 	in fiscal year 2020 and $36,258,000 in fiscal 
655.26 	year 2021.

655.27	Subd. 3.Health Protection

655.28	Appropriations by Fund
	
655.29	General
	20,928,000
	17,339,000
	
655.30
655.31	State Government 
Special Revenue
	47,392,000
	47,920,000
	
655.32 	(a) Prescribed Pediatric Extended Care 
655.33 	Center Licensure Activities. $64,000 in fiscal 
655.34 	year 2018 and $17,000 in fiscal year 2019 are 
655.35 	from the state government special revenue 
656.1 	fund for licensure of prescribed pediatric 
656.2 	extended care centers under Minnesota 
656.3 	Statutes, chapter 144H.
656.4 	(b) Vulnerable Adults in Health Care 
656.5 	Settings. $1,162,000 in fiscal year 2018 and 
656.6 	$2,030,000 in fiscal year 2019 are from the 
656.7 	general fund for regulating health care and 
656.8 	home care settings. The general fund base for 
656.9 	this purpose is $2,401,000 in fiscal year 2020 
656.10 	and $3,405,000 in fiscal year 2021.
656.11 	(c) Transfer; Public Health Response 
656.12 	Contingency Account. The commissioner 
656.13 	shall transfer $5,000,000 in fiscal year 2018 
656.14 	from the general fund to the public health 
656.15 	response contingency account established in 
656.16 	Minnesota Statutes, section 144.4199.
656.17 	(d) Base Level Adjustment. The general fund 
656.18 	base is $17,710,000 in fiscal year 2020 and 
656.19 	$18,714,000 in fiscal year 2021. The state 
656.20 	government special revenue fund base is 
656.21 	$47,958,000 in fiscal year 2020 and 
656.22 	$48,295,000 in fiscal year 2021.

656.23	Subd. 4.Health Operations
 		9,463,000
		9,835,000

656.24	Sec. 4. HEALTH-RELATED BOARDS

656.25	Subdivision 1.Total Appropriation
 	$
	24,996,000
	$
	23,189,000
	
656.26 	This appropriation is from the state 
656.27 	government special revenue fund. The 
656.28 	amounts that may be spent for each purpose 
656.29 	are specified in the following subdivisions.

656.30	Subd. 2.Board of Chiropractic Examiners
 		565,000
		571,000
	
656.31 	Base Level Adjustment. The base is $576,000 
656.32 	in fiscal year 2020 and $576,000 in fiscal year 
656.33 	2021.

657.1	Subd. 3.Board of Dentistry
 		1,396,000
		1,408,000

657.2
657.3	Subd. 4.Board of Dietetics and Nutrition 
Practice
 		130,000
		132,000

657.4	Subd. 5.Board of Marriage and Family Therapy
 		360,000
		357,000
	
657.5 	Base Level Adjustment. The base is $360,000 
657.6 	in fiscal year 2020 and $361,000 in fiscal year 
657.7 	2021.

657.8	Subd. 6.Board of Medical Practice
 		5,207,000
		5,243,000
	
657.9 	(a) Health Professional Services Program.
657.10 	This appropriation includes $955,000 in fiscal 
657.11 	year 2018 and $964,000 in fiscal year 2019 
657.12 	for the health professional services program. 
657.13 	The base for this program is $924,000 in fiscal 
657.14 	year 2020 and $924,000 in fiscal year 2021.
657.15 	(b) Base Level Adjustment. The base is 
657.16 	$5,291,000 in fiscal year 2020 and $5,291,000 
657.17 	in fiscal year 2021.

657.18	Subd. 7.Board of Nursing
 		6,380,000
		4,783,000

657.19	Subd. 8.Board of Nursing Home Administrators
 		3,397,000
		3,202,000
	
657.20 	(a) Administrative Services Unit - Operating 
657.21 	Costs. Of this appropriation, $2,260,000 in 
657.22 	fiscal year 2018 and $2,287,000 in fiscal year 
657.23 	2019 are for operating costs of the 
657.24 	administrative services unit. The 
657.25 	administrative services unit may receive and 
657.26 	expend reimbursements for services it 
657.27 	performs for other agencies.
657.28 	(b) Administrative Services Unit - Volunteer 
657.29 	Health Care Provider Program. Of this 
657.30 	appropriation, $150,000 in fiscal year 2018 
657.31 	and $150,000 in fiscal year 2019 are to pay 
657.32 	for medical professional liability coverage 
657.33 	required under Minnesota Statutes, section 
657.34 	214.40.
658.1 	(c) Administrative Services Unit - 
658.2 	Retirement Costs. Of this appropriation, 
658.3 	$378,000 in fiscal year 2018 is a onetime 
658.4 	appropriation to the administrative services 
658.5 	unit to pay for the retirement costs of 
658.6 	health-related board employees. This funding 
658.7 	may be transferred to the health board 
658.8 	incurring retirement costs. Any board that has 
658.9 	an unexpended balance for an amount 
658.10 	transferred under this paragraph shall transfer 
658.11 	the unexpended amount to the administrative 
658.12 	services unit. These funds are available either 
658.13 	year of the biennium.
658.14 	(d) Administrative Services Unit - 
658.15 	Health-Related Licensing Boards Operating 
658.16 	Costs. Of this appropriation, $194,000 in 
658.17 	fiscal year 2018 and $350,000 in fiscal year 
658.18 	2019 shall be transferred to the health-related 
658.19 	boards funded under this section for operating 
658.20 	costs. The administrative services unit shall 
658.21 	determine transfer amounts in consultation 
658.22 	with the health-related boards funded under 
658.23 	this section.
658.24 	(e) Administrative Services Unit - Contested 
658.25 	Cases and Other Legal Proceedings. Of this 
658.26 	appropriation, $200,000 in fiscal year 2018 
658.27 	and $200,000 in fiscal year 2019 are for costs 
658.28 	of contested case hearings and other 
658.29 	unanticipated costs of legal proceedings 
658.30 	involving health-related boards funded under 
658.31 	this section. Upon certification by a 
658.32 	health-related board to the administrative 
658.33 	services unit that costs will be incurred and 
658.34 	that there is insufficient money available to 
658.35 	pay for the costs out of money currently 
659.1 	available to that board, the administrative 
659.2 	services unit is authorized to transfer money 
659.3 	from this appropriation to the board for 
659.4 	payment of those costs with the approval of 
659.5 	the commissioner of management and budget. 
659.6 	The commissioner of management and budget 
659.7 	must require any board that has an unexpended 
659.8 	balance for an amount transferred under this 
659.9 	paragraph to transfer the unexpended amount 
659.10 	to the administrative services unit to be 
659.11 	deposited in the state government special 
659.12 	revenue fund.

659.13	Subd. 9.Board of Optometry
 		173,000
		174,000

659.14	Subd. 10.Board of Pharmacy
 		3,124,000
		3,164,000
	
659.15 	Base Level Adjustment. The base is 
659.16 	$3,189,000 in fiscal year 2020 and $3,226,000 
659.17 	in fiscal year 2021.

659.18	Subd. 11.Board of Physical Therapy
 		507,000
		508,000
	
659.19 	Base Level Adjustment. The base is $524,000 
659.20 	in fiscal year 2020 and $526,000 in fiscal year 
659.21 	2021.

659.22	Subd. 12.Board of Podiatric Medicine
 		198,000
		198,000

659.23	Subd. 13.Board of Psychology
 		1,220,000
		1,240,000
	
659.24 	Base Level Adjustment. The base is 
659.25 	$1,247,000 in fiscal year 2020 and $1,247,000 
659.26 	in fiscal year 2021.

659.27	Subd. 14.Board of Social Work
 		1,254,000
		1,246,000
	
659.28 	Base Level Adjustment. The base is 
659.29 	$1,248,000 in fiscal year 2020 and $1,250,000 
659.30 	in fiscal year 2021.

659.31	Subd. 15.Board of Veterinary Medicine
 		314,000
		320,000
	
660.1 	Base Level Adjustment. The base is $327,000 
660.2 	in fiscal year 2020 and $333,000 in fiscal year 
660.3 	2021.

660.4
660.5	Subd. 16.Board of Behavioral Health and 
Therapy
 		771,000
		643,000

660.6
660.7	Subd. 17.Board of Occupational Therapy 
Practice
 		374,000
		328,000

660.8
660.9	Sec. 5. EMERGENCY MEDICAL SERVICES 
REGULATORY BOARD
 	$
	3,667,000
	$
	3,596,000
	
660.10 	(a) Cooper/Sams Volunteer Ambulance 
660.11 	Program. $950,000 in fiscal year 2018 and 
660.12 	$950,000 in fiscal year 2019 are for the 
660.13 	Cooper/Sams volunteer ambulance program 
660.14 	under Minnesota Statutes, section 144E.40.
660.15 	(1) Of this amount, $861,000 in fiscal year 
660.16 	2018 and $861,000 in fiscal year 2019 are for 
660.17 	the ambulance service personnel longevity 
660.18 	award and incentive program under Minnesota 
660.19 	Statutes, section 144E.40.
660.20 	(2) Of this amount, $89,000 in fiscal year 2018 
660.21 	and $89,000 in fiscal year 2019 are for the 
660.22 	operations of the ambulance service personnel 
660.23 	longevity award and incentive program under 
660.24 	Minnesota Statutes, section 144E.40.
660.25 	(b) EMSRB Operations. $1,771,000 in fiscal 
660.26 	year 2018 and $1,700,000 in fiscal year 2019 
660.27 	are for board operations. The base for this 
660.28 	program is $1,702,000 in fiscal year 2020 and 
660.29 	$1,702,000 in fiscal year 2021.
660.30 	(c) Regional Grants. $585,000 in fiscal year 
660.31 	2018 and $585,000 in fiscal year 2019 are for 
660.32 	regional emergency medical services 
660.33 	programs, to be distributed equally to the eight 
661.1 	emergency medical service regions under 
661.2 	Minnesota Statutes, section 144E.52.
661.3 	(d) Ambulance Training Grant. $361,000 
661.4 	in fiscal year 2018 and $361,000 in fiscal year 
661.5 	2019 are for training grants under Minnesota 
661.6 	Statutes, section 144E.35.
661.7 	(e) Base Level Adjustment. The base is 
661.8 	$3,598,000 in fiscal year 2020 and $3,598,000 
661.9 	in fiscal year 2021.

661.10	Sec. 6. COUNCIL ON DISABILITY
 	$
	893,000
	$
	892,000
	
661.11 	Base Level Adjustment. The base is $856,000 
661.12 	in fiscal year 2020 and $858,000 in fiscal year 
661.13 	2021.

661.14
661.15
661.16	Sec. 7. OMBUDSMAN FOR MENTAL 
HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	2,407,000
	$
	2,427,000
	
661.17 	Department of Psychiatry Monitoring.
661.18 	$100,000 in fiscal year 2018 and $100,000 in 
661.19 	fiscal year 2019 are for monitoring the 
661.20 	Department of Psychiatry at the University of 
661.21 	Minnesota.

661.22	Sec. 8. OMBUDSPERSONS FOR FAMILIES
 	$
	460,000
	$
	465,000

661.23 	Sec. 9. Laws 2009, chapter 101, article 1, section 12, is amended to read:

661.24	Sec. 12. ADMINISTRATION

661.25	Subdivision 1.Total Appropriation
 	$
	19,973,000
	$
	19,617,000

661.26	Appropriations by Fund
	
661.27		2010
	2011
	
661.28	General
	19,723,000
	19,617,000
	
661.29
661.30	Special Revenue 
Fund
	250,000
	0
	
662.1 	The amounts that may be spent for each 
662.2 	purpose are specified in the following 
662.3 	subdivisions.

662.4	Subd. 2.Government and Citizen Services
 		18,097,000
		17,766,000

662.5	Appropriations by Fund
	
662.6	General
	17,847,000
	17,766,000
	
662.7
662.8	Special Revenue 
Fund
	250,000
	0
	
662.9 	(a) $802,000 the first year and $802,000 the 
662.10 	second year are for the Minnesota Geospatial 
662.11 	Information Office. Of the total appropriation, 
662.12 	$10,000 per year is intended for preparation 
662.13 	of township acreage data in Laws 2008, 
662.14 	chapter 366, article 17, section 7, subdivision 
662.15 	3.
662.16 	(b) $74,000 the first year and $74,000 the 
662.17 	second year are for the Council on 
662.18 	Developmental Disabilities.
662.19 	(c) $127,000 the first year and $127,000 the 
662.20 	second year are for transfer to the 
662.21 	commissioner of human services for a grant 
662.22 	to the Council on Developmental Disabilities 
662.23 	for the purpose of establishing a statewide 
662.24 	self-advocacy network for persons with 
662.25 	intellectual and developmental disabilities 
662.26 	(ID/DD). The self-advocacy network shall: 
662.27 	(1) ensure that persons with ID/DD are 
662.28 	informed of their rights in employment, 
662.29 	housing, transportation, voting, government 
662.30 	policy, and other issues pertinent to the ID/DD 
662.31 	community; (2) provide public education and 
662.32 	awareness of the civil and human rights issues 
662.33 	persons with ID/DD face; (3) provide funds, 
662.34 	technical assistance, and other resources for 
662.35 	self-advocacy groups across the state; and (4) 
663.1 	organize systems of communications to 
663.2 	facilitate an exchange of information between 
663.3 	self-advocacy groups. This appropriation must 
663.4 	be included in the base budget for the 
663.5 	commissioner of human services for the 
663.6 	biennium beginning July 1, 2011.
663.7 	(d) $250,000 the first year and $170,000 the 
663.8 	second year are to fund activities to prepare 
663.9 	for and promote the 2010 census.
663.10 	(e) $206,000 the first year and $206,000 the 
663.11 	second year are for the Office of the State 
663.12 	Archaeologist.
663.13 	(f) $8,388,000 the first year and $8,388,000 
663.14 	the second year are for office space costs of 
663.15 	the legislature and veterans organizations, for 
663.16 	ceremonial space, and for statutorily free 
663.17 	space.
663.18 	(g) $3,500,000 of the balance in the facilities 
663.19 	repair and replacement account in the special 
663.20 	revenue fund is canceled to the general fund 
663.21 	on July 1, 2009. This is a onetime cancellation.
663.22 	(h) The requirements imposed on the 
663.23 	commissioner of finance and the commissioner 
663.24 	of administration under Laws 2007, chapter 
663.25 	148, article 1, section 12, subdivision 2, 
663.26 	paragraph (b), relating to the savings 
663.27 	attributable to the real property portfolio 
663.28 	management system are inoperative.
663.29 	(i) $250,000 is appropriated to the 
663.30 	commissioner of administration from the 
663.31 	information and telecommunications account 
663.32 	in the special revenue fund to continue 
663.33 	planning for data center consolidation, 
663.34 	including beginning a predesign study and 
664.1 	lifecycle cost analysis, and exploring 
664.2 	technologies to reduce energy consumption 
664.3 	and operating costs.

664.4	Subd. 3.Administrative Management Support
 		1,876,000
		1,851,000
	
664.5 	$125,000 each year is for the Office of Grant 
664.6 	Management. During the biennium ending 
664.7 	June 30, 2011, the commissioner must recover 
664.8 	this amount through deductions in state grants 
664.9 	subject to the jurisdiction of the office. The 
664.10 	commissioner may not deduct more than 2.5 
664.11 	percent from the amount of any grant. The 
664.12 	amount deducted from appropriations for these 
664.13 	grants must be deposited in the general fund.
664.14 	$25,000 the first year is for the Office of 
664.15 	Grants Management to study and make 
664.16 	recommendations on improving collaborative 
664.17 	activities between the state, nonprofit entities, 
664.18 	and the private sector, including: (1) 
664.19 	recommendations for expanding successful 
664.20 	initiatives involving not-for-profit 
664.21 	organizations that have demonstrated 
664.22 	measurable, positive results in addressing 
664.23 	high-priority community issues; and (2) 
664.24 	recommendations on grant requirements and 
664.25 	design to encourage programs receiving grants 
664.26 	to become self-sufficient. The office may 
664.27 	appoint an advisory group to assist in the study 
664.28 	and recommendations. The office must report 
664.29 	its recommendations to the legislature by 
664.30 	January 15, 2010.

664.31 	Sec. 10. Laws 2012, chapter 247, article 6, section 2, subdivision 2, is amended to read:

664.32	Subd. 2.Central Office Operations

664.33	(a) Operations
		118,000
		356,000
	
665.1 	Base Level Adjustment. The general fund 
665.2 	base is increased by $91,000 in fiscal year 
665.3 	2014 and $44,000 in fiscal year 2015.

665.4	(b) Health Care
		24,000
		346,000
	
665.5 	This is a onetime appropriation.
665.6 	Managed Care Audit Activities. In fiscal 
665.7 	year 2014, and in each even-numbered year 
665.8 	thereafter, the commissioner shall transfer 
665.9 	from the health care access fund $1,740,000 
665.10 	to the legislative auditor for managed care 
665.11 	audit services under Minnesota Statutes, 
665.12 	section 256B.69, subdivision 9d. This is a 
665.13 	biennial appropriation. The health care access 
665.14 	fund base is increased by $1,842,000 in fiscal 
665.15 	year 2014. Notwithstanding any contrary 
665.16 	provision in this article, this paragraph does 
665.17 	not expire.

665.18	(c) Continuing Care
		19,000
		375,000
	
665.19 	Base Level Adjustment. The general fund 
665.20 	base is decreased by $159,000 in fiscal years 
665.21 	2014 and 2015.

665.22 	EFFECTIVE DATE. This section is effective the day following final enactment.

665.23 	Sec. 11. Laws 2013, chapter 108, article 15, section 2, subdivision 2, is amended to read:

665.24	Subd. 2.Central Office
 					
665.25 	The amounts that may be spent from this 
665.26 	appropriation for each purpose are as follows:

665.27	(a) Operations
		2,909,000
		8,957,000
	
665.28 	Base Adjustment. The general fund base is 
665.29 	decreased by $8,916,000 in fiscal year 2016 
665.30 	and $8,916,000 in fiscal year 2017.

665.31	(b) Children and Families
		109,000
		206,000

665.32	(c) Continuing Care
		2,849,000
		3,574,000
	
666.1 	Base Adjustment. The general fund base is 
666.2 	decreased by $2,000 in fiscal year 2016 and 
666.3 	by $27,000 in fiscal year 2017.

666.4	(d) Group Residential Housing
		(1,166,000)
		(8,602,000)

666.5	(e) Medical Assistance
		(3,950,000)
		(6,420,000)

666.6	(f) Alternative Care
		(7,386,000)
		(6,851,000)

666.7	(g) Child and Community Service Grants
		3,000,000
		3,000,000

666.8	(h) Aging and Adult Services Grants
		5,365,000
		5,936,000
	
666.9 	Gaps Analysis. In fiscal year 2014, and in 
666.10 	each even-numbered year thereafter, $435,000 
666.11 	is appropriated to conduct an analysis of gaps 
666.12 	in long-term care services under Minnesota 
666.13 	Statutes, section 144A.351. This is a biennial 
666.14 	appropriation. The base is increased by 
666.15 	$435,000 in fiscal year 2016. Notwithstanding 
666.16 	any contrary provisions in this article, this 
666.17 	provision does not expire.
666.18 	Base Adjustment. The general fund base is 
666.19 	increased by $498,000 in fiscal year 2016, and 
666.20 	decreased by $124,000 in fiscal year 2017.

666.21	(i) Disabilities Grants
		414,000
		414,000

666.22 	Sec. 12. Laws 2015, chapter 71, article 14, section 3, subdivision 2, as amended by Laws 
666.23 	2015, First Special Session chapter 6, section 2, is amended to read:

666.24	Subd. 2.Health Improvement

666.25	Appropriations by Fund
	
666.26	General
	68,653,000
	68,984,000
	
666.27
666.28	State Government 
Special Revenue
	6,264,000
	6,182,000
	
666.29	Health Care Access
	33,987,000
	33,421,000
	
666.30	Federal TANF
	11,713,000
	11,713,000
	
666.31 	Violence Against Asian Women Working 
666.32 	Group. $200,000 in fiscal year 2016 from the 
667.1 	general fund is for the working group on 
667.2 	violence against Asian women and children.
667.3 	MERC Program. $1,000,000 in fiscal year 
667.4 	2016 and $1,000,000 in fiscal year 2017 are 
667.5 	from the general fund for the MERC program 
667.6 	under Minnesota Statutes, section 62J.692, 
667.7 	subdivision 4.
667.8 	Poison Information Center Grants. 
667.9 	$750,000 in fiscal year 2016 and $750,000 in 
667.10 	fiscal year 2017 are from the general fund for 
667.11 	regional poison information center grants 
667.12 	under Minnesota Statutes, section 145.93.
667.13 	Advanced Care Planning. $250,000 in fiscal 
667.14 	year 2016 is from the general fund to award 
667.15 	a grant to a statewide advance care planning 
667.16 	resource organization that has expertise in 
667.17 	convening and coordinating community-based 
667.18 	strategies to encourage individuals, families, 
667.19 	caregivers, and health care providers to begin 
667.20 	conversations regarding end-of-life care 
667.21 	choices that express an individual's health care 
667.22 	values and preferences and are based on 
667.23 	informed health care decisions. This is a 
667.24 	onetime appropriation.
667.25 	Early Dental Prevention Initiatives. 
667.26 	$172,000 in fiscal year 2016 and $140,000 in 
667.27 	fiscal year 2017 are for the development and 
667.28 	distribution of the early dental prevention 
667.29 	initiative under Minnesota Statutes, section 
667.30 	144.3875.
667.31 	International Medical Graduate Assistance 
667.32 	Program. (a) $500,000 in fiscal year 2016 
667.33 	and $500,000 in fiscal year 2017 are from the 
667.34 	health care access fund for the grant programs 
668.1 	and necessary contracts under Minnesota 
668.2 	Statutes, section 144.1911, subdivisions 3, 
668.3 	paragraph (a), clause (4), and 4 and 5. The 
668.4 	commissioner may use up to $133,000 per 
668.5 	year of the appropriation for international 
668.6 	medical graduate assistance program 
668.7 	administration duties in Minnesota Statutes, 
668.8 	section 144.1911, subdivisions 3, 9, and 10, 
668.9 	and for administering the grant programs 
668.10 	under Minnesota Statutes, section 144.1911, 
668.11 	subdivisions 4, 5, and 6. The commissioner 
668.12 	shall develop recommendations for any 
668.13 	additional funding required for initiatives 
668.14 	needed to achieve the objectives of Minnesota 
668.15 	Statutes, section 144.1911. The commissioner 
668.16 	shall report the funding recommendations to 
668.17 	the legislature by January 15, 2016, in the 
668.18 	report required under Minnesota Statutes, 
668.19 	section 144.1911, subdivision 10. The base 
668.20 	for this purpose is $1,000,000 in fiscal years 
668.21 	2018 and 2019.
668.22 	(b) $500,000 in fiscal year 2016 and $500,000 
668.23 	in fiscal year 2017 are from the health care 
668.24 	access fund for transfer to the revolving 
668.25 	international medical graduate residency 
668.26 	account established in Minnesota Statutes, 
668.27 	section 144.1911, subdivision 6. This is a 
668.28 	onetime appropriation.
668.29 	Federally Qualified Health Centers. 
668.30 	$1,000,000 in fiscal year 2016 and $1,000,000 
668.31 	in fiscal year 2017 are from the general fund 
668.32 	to provide subsidies to federally qualified 
668.33 	health centers under Minnesota Statutes, 
668.34 	section 145.9269. This is a onetime 
668.35 	appropriation.
669.1 	Organ Donation. $200,000 in fiscal year 2016 
669.2 	is from the general fund to establish a grant 
669.3 	program to develop and create culturally 
669.4 	appropriate outreach programs that provide 
669.5 	education about the importance of organ 
669.6 	donation. Grants shall be awarded to a 
669.7 	federally designated organ procurement 
669.8 	organization and hospital system that performs 
669.9 	transplants. This is a onetime appropriation.
669.10 	Primary Care Residency. $1,500,000 in 
669.11 	fiscal year 2016 and $1,500,000 in fiscal year 
669.12 	2017 are from the general fund for the 
669.13 	purposes of the primary care residency 
669.14 	expansion grant program under Minnesota 
669.15 	Statutes, section 144.1506.
669.16 	Somali Women's Health Pilot Autism
669.17 	Program. (a) The commissioner of health 
669.18 	shall establish a pilot program between one or 
669.19 	more federally qualified health centers, as 
669.20 	defined under Minnesota Statutes, section 
669.21 	145.9269, a nonprofit organization that helps 
669.22 	Somali women, and the Minnesota Evaluation 
669.23 	Studies Institute, to develop a promising 
669.24 	strategy to address the preventative and 
669.25 	primary health care needs of, and address 
669.26 	health inequities experienced by, first 
669.27 	generation Somali women. The pilot program 
669.28 	must collaboratively develop a patient flow 
669.29 	process for first generation Somali women by:
669.30 	(1) addressing and identifying clinical and 
669.31 	cultural barriers to Somali women accessing 
669.32 	preventative and primary care, including, but 
669.33 	not limited to, cervical and breast cancer 
669.34 	screenings;
670.1 	(2) developing a culturally appropriate health 
670.2 	curriculum for Somali women based on the 
670.3 	outcomes from the community-based 
670.4 	participatory research report "Cultural 
670.5 	Traditions and the Reproductive Health of 
670.6 	Somali Refugees and Immigrants" to increase 
670.7 	the health literacy of Somali women and 
670.8 	develop culturally specific health care 
670.9 	information; and
670.10 	(3) training the federally qualified health 
670.11 	center's providers and staff to enhance 
670.12 	provider and staff cultural competence 
670.13 	regarding the cultural barriers, including 
670.14 	female genital cutting.
670.15 	(b) The pilot program must develop a process 
670.16 	that results in increased screening rates for 
670.17 	cervical and breast cancer and can be 
670.18 	replicated by other providers serving ethnic 
670.19 	minorities. The pilot program must conduct 
670.20 	an evaluation of the new patient flow process 
670.21 	used by Somali women to access federally 
670.22 	qualified health centers services award a grant 
670.23 	to Dakota County to partner with a 
670.24 	community-based organization with expertise 
670.25 	in serving Somali children with autism. The 
670.26 	grant must address barriers to accessing health 
670.27 	care and other resources by providing outreach 
670.28 	to Somali families on available support and 
670.29 	training to providers on Somali culture.
670.30 	(c) The pilot program must report the 
670.31 	outcomes to the commissioner by June 30, 
670.32 	2017. The grantee shall report to the 
670.33 	commissioner and the chairs and ranking 
670.34 	minority members of the legislative 
670.35 	committees with jurisdiction over health care 
671.1 	policy and finance on the grant funds used and 
671.2 	any notable outcomes achieved by January 15, 
671.3 	2019.
671.4 	(d) $110,000 in fiscal year 2016 is for the 
671.5 	Somali women's health pilot program grant to 
671.6 	Dakota County. Of this appropriation, the 
671.7 	commissioner may use up to $10,000 to 
671.8 	administer the program grant to Dakota 
671.9 	County. This appropriation is available until 
671.10 	June 30, 2017. This is a onetime appropriation.
671.11 	Menthol Cigarette Usage in 
671.12 	African-American Community Intervention 
671.13 	Grants. Of the health care access fund 
671.14 	appropriation for the statewide health 
671.15 	improvement program, $200,000 in fiscal year 
671.16 	2016 is for at least one grant that must be 
671.17 	awarded by the commissioner to implement 
671.18 	strategies and interventions to reduce the 
671.19 	disproportionately high usage of cigarettes by 
671.20 	African-Americans, especially the use of 
671.21 	menthol-flavored cigarettes, as well as the 
671.22 	disproportionate harm tobacco causes in that 
671.23 	community. The grantee shall engage 
671.24 	members of the African-American community 
671.25 	and community-based organizations. This 
671.26 	grant shall be awarded as part of the statewide 
671.27 	health improvement program grants awarded 
671.28 	on November 1, 2015, and must meet the 
671.29 	requirements of Minnesota Statutes, section 
671.30 	145.986.
671.31 	Targeted Home Visiting System. (a) $75,000 
671.32 	in fiscal year 2016 is for the commissioner of 
671.33 	health, in consultation with the commissioners 
671.34 	of human services and education, community 
671.35 	health boards, tribal nations, and other home 
672.1 	visiting stakeholders, to design baseline 
672.2 	training for new home visitors to ensure 
672.3 	statewide coordination across home visiting 
672.4 	programs.
672.5 	(b) $575,000 in fiscal year 2016 and 
672.6 	$2,000,000 fiscal year 2017 are to provide 
672.7 	grants to community health boards and tribal 
672.8 	nations for start-up grants for new 
672.9 	nurse-family partnership programs and for 
672.10 	grants to expand existing programs to serve 
672.11 	first-time mothers, prenatally by 28 weeks 
672.12 	gestation until the child is two years of age, 
672.13 	who are eligible for medical assistance under 
672.14 	Minnesota Statutes, chapter 256B, or the 
672.15 	federal Special Supplemental Nutrition 
672.16 	Program for Women, Infants, and Children. 
672.17 	The commissioner shall award grants to 
672.18 	community health boards or tribal nations in 
672.19 	metropolitan and rural areas of the state. 
672.20 	Priority for all grants shall be given to 
672.21 	nurse-family partnership programs that 
672.22 	provide services through a Minnesota health 
672.23 	care program-enrolled provider that accepts 
672.24 	medical assistance. Additionally, priority for 
672.25 	grants to rural areas shall be given to 
672.26 	community health boards and tribal nations 
672.27 	that expand services within regional 
672.28 	partnerships that provide the nurse-family 
672.29 	partnership program. Funding available under 
672.30 	this paragraph may only be used to 
672.31 	supplement, not to replace, funds being used 
672.32 	for nurse-family partnership home visiting 
672.33 	services as of June 30, 2015.
672.34 	Opiate Antagonists. $270,000 in fiscal year 
672.35 	2016 and $20,000 in fiscal year 2017 are from 
673.1 	the general fund for grants to the eight regional 
673.2 	emergency medical services programs to 
673.3 	purchase opiate antagonists and educate and 
673.4 	train emergency medical services persons, as 
673.5 	defined in Minnesota Statutes, section 
673.6 	144.7401, subdivision 4, clauses (1) and (2), 
673.7 	in the use of these antagonists in the event of 
673.8 	an opioid or heroin overdose. For the purposes 
673.9 	of this paragraph, "opiate antagonist" means 
673.10 	naloxone hydrochloride or any similarly acting 
673.11 	drug approved by the federal Food and Drug 
673.12 	Administration for the treatment of drug 
673.13 	overdose. Grants under this paragraph must 
673.14 	be distributed to all eight regional emergency 
673.15 	medical services programs. This is a onetime 
673.16 	appropriation and is available until June 30, 
673.17 	2017. The commissioner may use up to 
673.18 	$20,000 of the amount for opiate antagonists 
673.19 	for administration.
673.20 	Local and Tribal Public Health Grants. (a) 
673.21 	$894,000 in fiscal year 2016 and $894,000 in 
673.22 	fiscal year 2017 are for an increase in local 
673.23 	public health grants for community health 
673.24 	boards under Minnesota Statutes, section 
673.25 	145A.131, subdivision 1, paragraph (e).
673.26 	(b) $106,000 in fiscal year 2016 and $106,000 
673.27 	in fiscal year 2017 are for an increase in 
673.28 	special grants to tribal governments under 
673.29 	Minnesota Statutes, section 145A.14, 
673.30 	subdivision 2a.
673.31 	HCBS Employee Scholarships. $1,000,000 
673.32 	in fiscal year 2016 and $1,000,000 in fiscal 
673.33 	year 2017 are from the general fund for the 
673.34 	home and community-based services 
673.35 	employee scholarship program under 
674.1 	Minnesota Statutes, section 144.1503. The 
674.2 	commissioner may use up to $50,000 of the 
674.3 	amount for the HCBS employee scholarships 
674.4 	for administration.
674.5 	Family Planning Special Projects. 
674.6 	$1,000,000 in fiscal year 2016 and $1,000,000 
674.7 	in fiscal year 2017 are from the general fund 
674.8 	for family planning special project grants 
674.9 	under Minnesota Statutes, section 145.925.
674.10 	Positive Alternatives. $1,000,000 in fiscal 
674.11 	year 2016 and $1,000,000 in fiscal year 2017 
674.12 	are from the general fund for positive abortion 
674.13 	alternatives under Minnesota Statutes, section 
674.14 	145.4235.
674.15 	Safe Harbor for Sexually Exploited Youth. 
674.16 	$700,000 in fiscal year 2016 and $700,000 in 
674.17 	fiscal year 2017 are from the general fund for 
674.18 	the safe harbor program under Minnesota 
674.19 	Statutes, sections 145.4716 to 145.4718. Funds 
674.20 	shall be used for grants to increase the number 
674.21 	of regional navigators; training for 
674.22 	professionals who engage with exploited or 
674.23 	at-risk youth; implementing statewide 
674.24 	protocols and best practices for effectively 
674.25 	identifying, interacting with, and referring 
674.26 	sexually exploited youth to appropriate 
674.27 	resources; and program operating costs.
674.28 	Health Care Grants for Uninsured 
674.29 	Individuals. (a) $62,500 in fiscal year 2016 
674.30 	and $62,500 in fiscal year 2017 are from the 
674.31 	health care access fund for dental provider 
674.32 	grants in Minnesota Statutes, section 145.929, 
674.33 	subdivision 1.
675.1 	(b) $218,750 in fiscal year 2016 and $218,750 
675.2 	in fiscal year 2017 are from the health care 
675.3 	access fund for community mental health 
675.4 	program grants in Minnesota Statutes, section 
675.5 	145.929, subdivision 2.
675.6 	(c) $750,000 in fiscal year 2016 and $750,000 
675.7 	in fiscal year 2017 are from the health care 
675.8 	access fund for the emergency medical 
675.9 	assistance outlier grant program in Minnesota 
675.10 	Statutes, section 145.929, subdivision 3.
675.11 	(d) $218,750 of the health care access fund 
675.12 	appropriation in fiscal year 2016 and $218,750 
675.13 	in fiscal year 2017 are for community health 
675.14 	center grants under Minnesota Statutes, section 
675.15 	145.9269. A community health center that 
675.16 	receives a grant from this appropriation is not 
675.17 	eligible for a grant under paragraph (b).
675.18 	(e) The commissioner may use up to $25,000 
675.19 	of the appropriations for health care grants for 
675.20 	uninsured individuals in fiscal years 2016 and 
675.21 	2017 for grant administration.
675.22 	TANF Appropriations. (a) $1,156,000 of the 
675.23 	TANF funds is appropriated each year of the 
675.24 	biennium to the commissioner for family 
675.25 	planning grants under Minnesota Statutes, 
675.26 	section 145.925.
675.27 	(b) $3,579,000 of the TANF funds is 
675.28 	appropriated each year of the biennium to the 
675.29 	commissioner for home visiting and nutritional 
675.30 	services listed under Minnesota Statutes, 
675.31 	section 145.882, subdivision 7, clauses (6) and 
675.32 	(7). Funds must be distributed to community 
675.33 	health boards according to Minnesota Statutes, 
675.34 	section 145A.131, subdivision 1.
676.1 	(c) $2,000,000 of the TANF funds is 
676.2 	appropriated each year of the biennium to the 
676.3 	commissioner for decreasing racial and ethnic 
676.4 	disparities in infant mortality rates under 
676.5 	Minnesota Statutes, section 145.928, 
676.6 	subdivision 7.
676.7 	(d) $4,978,000 of the TANF funds is 
676.8 	appropriated each year of the biennium to the 
676.9 	commissioner for the family home visiting 
676.10 	grant program according to Minnesota 
676.11 	Statutes, section 145A.17. $4,000,000 of the 
676.12 	funding must be distributed to community 
676.13 	health boards according to Minnesota Statutes, 
676.14 	section 145A.131, subdivision 1. $978,000 of 
676.15 	the funding must be distributed to tribal 
676.16 	governments as provided in Minnesota 
676.17 	Statutes, section 145A.14, subdivision 2a.
676.18 	(e) The commissioner may use up to 6.23 
676.19 	percent of the funds appropriated each fiscal 
676.20 	year to conduct the ongoing evaluations 
676.21 	required under Minnesota Statutes, section 
676.22 	145A.17, subdivision 7, and training and 
676.23 	technical assistance as required under 
676.24 	Minnesota Statutes, section 145A.17, 
676.25 	subdivisions 4 and 5.
676.26 	TANF Carryforward. Any unexpended 
676.27 	balance of the TANF appropriation in the first 
676.28 	year of the biennium does not cancel but is 
676.29 	available for the second year.
676.30 	Health Professional Loan Forgiveness. 
676.31 	$2,631,000 in fiscal year 2016 and $2,631,000 
676.32 	in fiscal year 2017 are from the health care 
676.33 	access fund for the purposes of Minnesota 
676.34 	Statutes, section 144.1501. Of this 
676.35 	appropriation, the commissioner may use up 
677.1 	to $131,000 each year to administer the 
677.2 	program.
677.3 	Minnesota Stroke System. $350,000 in fiscal 
677.4 	year 2016 and $350,000 in fiscal year 2017 
677.5 	are from the general fund for the Minnesota 
677.6 	stroke system.
677.7 	Prevention of Violence in Health Care. 
677.8 	$50,000 in fiscal year 2016 is to continue the 
677.9 	prevention of violence in health care program 
677.10 	and creating violence prevention resources for 
677.11 	hospitals and other health care providers to 
677.12 	use in training their staff on violence 
677.13 	prevention. This is a onetime appropriation 
677.14 	and is available until June 30, 2017.
677.15 	Health Care Savings Determinations. (a) 
677.16 	The health care access fund base for the state 
677.17 	health improvement program is decreased by 
677.18 	$261,000 in fiscal year 2016 and decreased 
677.19 	by $110,000 in fiscal year 2017.
677.20 	(b) $261,000 in fiscal year 2016 and $110,000 
677.21 	in fiscal year 2017 are from the health care 
677.22 	access fund for the forecasting, cost reporting, 
677.23 	and analysis required by Minnesota Statutes, 
677.24 	section 62U.10, subdivisions 6 and 7.
677.25 	Base Level Adjustments. The general fund 
677.26 	base is decreased by $1,070,000 in fiscal year 
677.27 	2018 and by $1,020,000 in fiscal year 2019. 
677.28 	The state government special revenue fund 
677.29 	base is increased by $33,000 in fiscal year 
677.30 	2018. The health care access fund base is 
677.31 	increased by $610,000 in fiscal year 2018 and 
677.32 	by $23,000 in fiscal year 2019.

678.1 	Sec. 13. Laws 2017, chapter 2, article 1, section 2, subdivision 3, is amended to read:
678.2 		Subd. 3.Payments to health carriers. (a) The commissioner shall make payments to 
678.3 	health carriers on behalf of eligible individuals effectuating coverage for calendar year 2017, 
678.4 	for the months in that year for which the individual has paid the net premium amount to the 
678.5 	health carrier. Payments to health carriers shall be based on the premium subsidy available 
678.6 	to eligible individuals in the individual market, regardless of the cost of coverage purchased. 
678.7 	The commissioner shall not withhold payments because a health carrier cannot prove an 
678.8 	enrollee is an eligible individual.
678.9 	(b) Health carriers seeking reimbursement from the commissioner must submit an invoice 
678.10 	and supporting information to the commissioner, using a form developed by the 
678.11 	commissioner, in order to be eligible for payment. The commissioner shall finalize the form 
678.12 	by March 1, 2017.
678.13 	(c) Total state payments to health carriers must be made within the limits of the available 
678.14 	appropriation. The commissioner shall reimburse health carriers at the full requested amount 
678.15 	up to the level of the appropriation. The commissioner, by July 15, 2017, shall determine 
678.16 	whether the available appropriation will be sufficient to provide premium subsidies equal 
678.17 	to 25 percent of the gross premium for the period September 1, 2017, through December 
678.18 	31, 2017. If the commissioner determines that the available appropriation is not sufficient, 
678.19 	the commissioner shall reduce the premium subsidy percentage, beginning September 1, 
678.20 	2017, through the remainder of the calendar year, by an amount sufficient to ensure that the 
678.21 	total amount of premium subsidies provided for the calendar year does not exceed the 
678.22 	available appropriation. The commissioner shall notify health carriers of any reduced 
678.23 	premium subsidy percentage within five days of making a determination. Health carriers 
678.24 	shall provide enrollees with at least 30 days' notice of any reduction in the premium subsidy 
678.25 	percentage.
678.26 	(d) The commissioner shall consider health carriers as vendors under Minnesota Statutes, 
678.27 	section 16A.124, subdivision 3, and each monthly invoice shall represent the completed 
678.28 	delivery of the service.
678.29 	(e) The commissioner, with the November 2017 forecast, shall certify the extent to which 
678.30 	appropriations exceed forecast obligations under this subdivision. Notwithstanding Laws 
678.31 	2017, chapter 2, article 1, section 7, the estimated value of available funds, up to $98,779,000, 
678.32 	shall be canceled to the general fund. The cancellation in this paragraph shall be reduced 
678.33 	by any difference in medical assistance expenditures estimated in the trend calculation under 
678.34 	section 15.

679.1 	Sec. 14. IMPLEMENTATION OF CONTINGENT APPROPRIATIONS.
 679.2 	Notwithstanding Laws 2017, chapter 2, article 1, section 7, and upon certification of 
679.3 	excess funds in accordance with Laws 2017, chapter 2, article 1, section 2, subdivision 3, 
679.4 	up to $1,388,000 in fiscal year 2018 and up to $15,102,000 in fiscal year 2019 are 
679.5 	appropriated to the commissioner of human services for central office operations in fiscal 
679.6 	year 2019. This appropriation is onetime.

679.7 	Sec. 15. TREND LIMIT; CALCULATION.
 679.8 	Beginning January 1, 2019, and ending June 30, 2021, the commissioner may limit the 
679.9 	trend increase in rates paid to managed care plans and county-based purchasing plans under 
679.10 	Minnesota Statutes, sections 256B.69 and 256B.692, by an amount equal to the value of a 
679.11 	0.5 percent reduction in trend in medical assistance. Managed care rates must meet actuarial 
679.12 	soundness and rate development requirements under Code of Federal Regulations, title 42, 
679.13 	part 438, subpart A.
679.14 	In the November 2017 forecast, the commissioner of human services, in consultation 
679.15 	with the commissioner of management and budget, shall determine the extent to which the 
679.16 	limits in managed care trend growth are forecasted to reduce medical assistance expenditures 
679.17 	in fiscal years 2019 through 2021. Any reduction estimated shall reduce the cancellation in 
679.18 	Laws 2017, chapter 2, article 1, section 2, subdivision 3, paragraph (e), by up to $82,289,000.

679.19 	Sec. 16. TRANSFERS.
 679.20 		Subdivision 1.Grants. The commissioner of human services, with the approval of the 
679.21 	commissioner of management and budget, may transfer unencumbered appropriation balances 
679.22 	for the biennium ending June 30, 2019, within fiscal years among the MFIP, general 
679.23 	assistance, medical assistance, MinnesotaCare, MFIP child care assistance under Minnesota 
679.24 	Statutes, section 119B.05, Minnesota supplemental aid, and group residential housing 
679.25 	programs, the entitlement portion of Northstar Care for Children under Minnesota Statutes, 
679.26 	chapter 256N, and the entitlement portion of the chemical dependency consolidated treatment 
679.27 	fund, and between fiscal years of the biennium. The commissioner shall inform the chairs 
679.28 	and ranking minority members of the senate Health and Human Services Finance and Policy 
679.29 	Committee, the senate Human Services Reform Finance and Policy Committee, and the 
679.30 	house of representatives Health and Human Services Finance Committee quarterly about 
679.31 	transfers made under this subdivision.
679.32 		Subd. 2.Administration. Positions, salary money, and nonsalary administrative money 
679.33 	may be transferred within the Departments of Health and Human Services as the 
680.1 	commissioners consider necessary, with the advance approval of the commissioner of 
680.2 	management and budget. The commissioner shall inform the chairs and ranking minority 
680.3 	members of the senate Health and Human Services Finance and Policy Committee, the 
680.4 	senate Human Services Reform Finance and Policy Committee, and the house of 
680.5 	representatives Health and Human Services Finance Committee quarterly about transfers 
680.6 	made under this subdivision.

680.7 	Sec. 17. INDIRECT COSTS NOT TO FUND PROGRAMS.
 680.8 	The commissioners of health and human services shall not use indirect cost allocations 
680.9 	to pay for the operational costs of any program for which they are responsible.

680.10 	Sec. 18. EXPIRATION OF UNCODIFIED LANGUAGE.
 680.11 	All uncodified language contained in this article expires on June 30, 2019, unless a 
680.12 	different expiration date is explicit.

680.13 	Sec. 19. EFFECTIVE DATE.
 680.14 	This article is effective July 1, 2017, unless a different effective date is specified.

APPENDIX 

Repealed Minnesota Statutes: 171-S0002-1 

13.468 DATA SHARING WITHIN COUNTIES.
County welfare, human services, corrections, public health, and veterans service units within a county may inform each other as to whether an individual or family currently is being served by the county unit, without the consent of the subject of the data. Data that may be shared are limited to the following: the name, telephone number, and last known address of the data subject; and the identification and contact information regarding personnel of the county unit responsible for working with the individual or family. If further information is necessary for the county unit to carry out its duties, each county unit may share additional data if the unit is authorized by state statute or federal law to do so or the individual gives written, informed consent. 

103I.005 DEFINITIONS.Subd. 8.Environmental bore hole. 
"Environmental bore hole" means a hole or excavation in the ground that penetrates a confining layer or is greater than 25 feet in depth and enters or goes through a water bearing layer and is used to monitor or measure physical, chemical, radiological, or biological parameters without extracting water. An environmental bore hole also includes bore holes constructed for vapor recovery or venting systems. An environmental bore hole does not include a well, elevator shaft, exploratory boring, or monitoring well. 

Subd. 14.Monitoring well. 
"Monitoring well" means an excavation that is drilled, cored, bored, washed, driven, dug, jetted, or otherwise constructed to extract groundwater for physical, chemical, or biological testing. "Monitoring well" includes a groundwater quality sampling well. 

Subd. 15.Monitoring well contractor. 
"Monitoring well contractor" means a person who is registered by the commissioner to construct monitoring wells. 

103I.451 ENVIRONMENTAL BORE HOLES.
An environmental bore hole must be constructed, sealed, and reported as prescribed by rule of the commissioner by a well contractor or a monitoring well contractor. 

119B.07 USE OF MONEY.
(a) Money for persons listed in sections 119B.03, subdivision 3, and 119B.05, subdivision 1, shall be used to reduce the costs of child care for students, including the costs of child care for students while employed if enrolled in an eligible education program at the same time and making satisfactory progress towards completion of the program. Counties may not limit the duration of child care subsidies for a person in an employment or educational program, except when the person is found to be ineligible under the child care fund eligibility standards. Any limitation must be based on a person's employment plan in the case of an MFIP participant, and county policies included in the child care fund plan. The maximum length of time a student is eligible for child care assistance under the child care fund for education and training is no more than the time necessary to complete the credit requirements for an associate or baccalaureate degree as determined by the educational institution, excluding basic or remedial education programs needed to prepare for postsecondary education or employment. 

(b) To be eligible, the student must be in good standing and be making satisfactory progress toward the degree. Time limitations for child care assistance do not apply to basic or remedial educational programs needed to prepare for postsecondary education or employment. These programs include: high school, general equivalency diploma, and English as a second language. Programs exempt from this time limit must not run concurrently with a postsecondary program. If an MFIP participant who is receiving MFIP child care assistance under this chapter moves to another county, continues to participate in educational or training programs authorized in their employment plans, and continues to be eligible for MFIP child care assistance under this chapter, the MFIP participant must receive continued child care assistance from the county responsible for their current employment plan, under section 256G.07. 

144.0571 INCLUSION OF OTHER HEALTH-RELATED OCCUPATIONS TO CRIMINAL BACKGROUND CHECKS.
(a) If the Department of Health is not reviewed by the Sunset Advisory Commission according to the schedule in section 3D.21, the commissioner of health, as the regulator for occupational therapy practitioners, speech-language pathologists, audiologists, and hearing instrument dispensers, shall require applicants for licensure or renewal to submit to a criminal history records check as required under section 214.075 for other health-related licensed occupations regulated by the health-related licensing boards. 

(b) Any statutory changes necessary to include the commissioner of health to section 214.075 shall be included in the plan required in section 214.075, subdivision 8. 

144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS: REPORT AND STUDY REQUIRED.Subd. 2.Critical access study. 
The commissioner of human services shall conduct a onetime study to assess local capacity and availability of home and community-based services for older adults, people with disabilities, and people with mental illnesses. The study must assess critical access at the community level and identify potential strategies to build home and community-based service capacity in critical access areas. The report shall be submitted to the legislature no later than August 15, 2015. 

147A.21 RULEMAKING AUTHORITY.
The board shall adopt rules: 

(1) setting license fees; 

(2) setting renewal fees; 

(3) setting fees for temporary licenses; and 

(4) establishing renewal dates. 

147B.08 FEES.Subdivision 1.Annual registration fee. 
The board shall establish the fee of $150 for initial licensure and $150 annual licensure renewal. The board may prorate the initial licensure fee. 

Subd. 2.Penalty fee for late renewals. 
The penalty fee for late submission for renewal application is $50. 

Subd. 3.Deposit. 
Fees collected by the board under this section must be deposited in the state government special revenue fund. 

147C.40 FEES.Subdivision 1.Fees. 
The board shall adopt rules setting: 

(1) licensure fees; 

(2) renewal fees; 

(3) late fees; 

(4) inactive status fees; and 

(5) fees for temporary permits. 

Subd. 2.Proration of fees. 
The board may prorate the initial annual license fee. All licensees are required to pay the full fee upon license renewal. 

Subd. 3.Penalty fee for late renewals. 
An application for license renewal submitted after the deadline must be accompanied by a late fee in addition to the required fees. 

Subd. 4.Nonrefundable fees. 
All of the fees in subdivision 1 are nonrefundable. 

148.6402 DEFINITIONS.Subd. 2.Advisory council. 
"Advisory council" means the Occupational Therapy Practitioners Advisory Council in section 148.6450. 

148.6450 OCCUPATIONAL THERAPY PRACTITIONERS ADVISORY COUNCIL.Subdivision 1.Membership. 
The commissioner shall appoint seven persons to an Occupational Therapy Practitioners Advisory Council consisting of the following: 

(1) two public members, as defined in section 214.02. The public members shall be either persons who have received occupational therapy services or family members of or caregivers to such persons; 

(2) two members who are occupational therapists and two occupational therapy assistants licensed under sections 148.6401 to 148.6450, each of whom is employed in a different practice area including, but not limited to, long-term care, school therapy, early intervention, administration, gerontology, industrial rehabilitation, cardiac rehabilitation, physical disability, pediatrics, mental health, home health, and hand therapy. Three of the four occupational therapy practitioners who serve on the advisory council must be currently, and for the three years preceding the appointment, engaged in the practice of occupational therapy or employed as an administrator or an instructor of an occupational therapy program. At least one of the four occupational therapy practitioners who serves on the advisory council must be employed in a rural area; and 

(3) one member who is a licensed or registered health care practitioner, or other credentialed practitioner, who works collaboratively with occupational therapy practitioners. 

Subd. 2.Duties. 
At the commissioner's request, the advisory council shall: 

(1) advise the commissioner regarding the occupational therapy practitioner licensure standards; 

(2) advise the commissioner on enforcement of sections 148.6401 to 148.6450; 

(3) provide for distribution of information regarding occupational therapy practitioners licensure standards; 

(4) review applications and make recommendations to the commissioner on granting or denying licensure or licensure renewal; 

(5) review reports of investigations relating to individuals and make recommendations to the commissioner as to whether licensure should be denied or disciplinary action taken against the person; and 

(6) perform other duties authorized for advisory councils by chapter 214, as directed by the commissioner. 

148.906 LEVELS OF PRACTICE.
The board may grant licenses for levels of psychological practice to be known as (1) licensed psychologist and (2) licensed psychological practitioner. 

148.907 LICENSED PSYCHOLOGIST.Subd. 5.Converting from licensed psychological practitioner to licensed psychologist. 
Notwithstanding subdivision 3, to convert from licensure as a licensed psychological practitioner to licensure as a licensed psychologist, a licensed psychological practitioner shall have: 

(1) completed an application provided by the board for conversion from licensure as a licensed psychological practitioner to licensure as a licensed psychologist; 

(2) paid a nonrefundable fee of $500; 

(3) documented successful completion of two full years, or the equivalent, of supervised postlicensure employment meeting the requirements of section 148.925, subdivision 5, as it relates to preparation for licensure as a licensed psychologist as follows: 

(i) for individuals licensed as licensed psychological practitioners on or before December 31, 2006, the supervised practice must be completed by December 31, 2010; and 

(ii) for individuals licensed as licensed psychological practitioners after December 31, 2006, the supervised practice must be completed within four years from the date of licensure; and 

(4) no unresolved disciplinary action or complaints pending, or incomplete disciplinary orders or corrective action agreements in Minnesota or any other jurisdiction. 

148.908 LICENSED PSYCHOLOGICAL PRACTITIONER.Subdivision 1.Scope of practice. 
A licensed psychological practitioner shall practice only under supervision that satisfies the requirements of section 148.925 and while employed by either a licensed psychologist or a health care or social service agency which employs or contracts with a supervising licensed psychologist who shares clinical responsibility for the care provided by the licensed psychological practitioner. 

Subd. 2.Requirements for licensure as licensed psychological practitioner. 
To become licensed by the board as a licensed psychological practitioner, an applicant shall comply with the following requirements: 

(1) have earned a doctoral or master's degree or the equivalent of a master's degree in a doctoral program with a major in psychology from a regionally accredited educational institution meeting the standards the board has established by rule. The degree requirements must be completed by December 31, 2005; 

(2) complete an application for admission to the examination for professional practice in psychology and pay the nonrefundable application fee by December 31, 2005; 

(3) complete an application for admission to the professional responsibility examination and pay the nonrefundable application fee by December 31, 2005; 

(4) pass the examination for professional practice in psychology by December 31, 2006; 

(5) pass the professional responsibility examination by December 31, 2006; 

(6) complete an application for licensure as a licensed psychological practitioner and pay the nonrefundable application fee by March 1, 2007; and 

(7) have attained the age of majority, be of good moral character, and have no unresolved disciplinary action or complaints pending in the state of Minnesota or any other jurisdiction. 

Subd. 3.Termination of licensure. 
Effective December 31, 2011, the licensure of all licensed psychological practitioners shall be terminated without further notice and licensure as a licensed psychological practitioner in Minnesota shall be eliminated. 

148.909 LICENSURE FOR VOLUNTEER PRACTICE.Subd. 7.Continuing education requirements. 
A provider licensed under this section is subject to the same continuing education requirements as a licensed psychologist under section 148.911. 

148.96 PRESENTATION TO PUBLIC.Subd. 4.Persons or techniques not regulated by this board. 
(a) Nothing in sections 148.88 to 148.98 shall be construed to limit the occupational pursuits consistent with their training and codes of ethics of professionals such as teachers in recognized public and private schools, members of the clergy, physicians, social workers, school psychologists, alcohol or drug counselors, optometrists, or attorneys. However, in such performance any title used shall be in accordance with section 148.96. 

(b) Use of psychological techniques by business and industrial organizations for their own personnel purposes or by employment agencies or state vocational rehabilitation agencies for the evaluation of their own clients prior to recommendation for employment is also specifically allowed. However, no representative of an industrial or business firm or corporation may sell, offer, or provide any psychological services as specified in section 148.89 unless such services are performed or supervised by individuals licensed under sections 148.88 to 148.98. 

Subd. 5.Other professions not authorized. 
Nothing in sections 148.88 to 148.98 shall be construed to authorize a person licensed under sections 148.88 to 148.98 to engage in the practice of any profession regulated under Minnesota law unless the person is duly licensed or registered in that profession. 

245A.1915 OPIOID ADDICTION TREATMENT EDUCATION REQUIREMENT FOR PROVIDERS LICENSED TO PROVIDE CHEMICAL DEPENDENCY TREATMENT SERVICES.
All programs serving persons with substance use issues licensed by the commissioner must provide educational information concerning: treatment options for opioid addiction, including the use of a medication for the use of opioid addiction; and recognition of and response to opioid overdose and the use and administration of naloxone, to clients identified as having or seeking treatment for opioid addiction. The commissioner shall develop educational materials that are supported by research and updated periodically that must be used by programs to comply with this requirement. 

245A.192 PROVIDERS LICENSED TO PROVIDE TREATMENT OF OPIOID ADDICTION.Subdivision 1.Scope. 
(a) This section applies to services licensed under this chapter to provide treatment for opioid addiction. In addition to the requirements under Minnesota Rules, parts 9530.6405 to 9530.6505, a program licensed to provide treatment of opioid addiction must meet the requirements in this section. 

(b) Where a standard in this section differs from a standard in an otherwise applicable administrative rule, the standards of this section apply. 

(c) When federal guidance or interpretations have been issued on federal standards or requirements also required under this section, the federal guidance or interpretations shall apply. 

Subd. 2.Definitions. 
(a) For purposes of this section, the terms defined in this subdivision have the meanings given them. 

(b) "Diversion" means the use of a medication for the treatment of opioid addiction being diverted from its intended use. 

(c) "Guest dose or dosing" means the practice of administering a medication used for the treatment of opioid addiction to a person who is not a client of the program that is administering or dispensing the medication. 

(d) "Medical director" means a physician, licensed to practice medicine in the jurisdiction in which the opioid treatment program is located, who assumes responsibility for administering all medical services performed by the program, either by performing them directly or by delegating specific responsibility to authorized program physicians and health care professionals functioning under the medical director's direct supervision. 

(e) "Medication used for the treatment of opioid addiction" means a medication approved by the Food and Drug Administration for the treatment of opioid addiction. 

(f) "Opioid treatment program" has the meaning given in Code of Federal Regulations, title 42, section 8.12, and includes programs licensed under Minnesota Rules, part 9530.6500. 

(g) "Program" means an entity that is licensed under Minnesota Rules, part 9530.6500. 

(h) "Unsupervised use" means the use of a medication for the treatment of opioid addiction dispensed for use by a client outside of the program setting. This is also referred to as a "take-home" dose. 

(i) "Placing authority" has the meaning given in Minnesota Rules, part 9530.6605, subpart 21a. 

(j) "Minnesota health care programs" has the meaning given in section 256B.0636. 

Subd. 3.Medication orders. 
Prior to the program administering or dispensing a medication used for the treatment of opioid addiction: 

(1) a client-specific order must be received from an appropriately credentialed physician who is enrolled as a Minnesota health care programs provider and meets all applicable provider standards; 

(2) the signed order must be documented in the client's record; and 

(3) if the physician that issued the order is not able to sign the order when issued, the unsigned order must be entered in the client record at the time it was received, and the physician must review the documentation and sign the order in the client's record within 72 hours of the medication being ordered. The license holder must report to the commissioner any medication error that endangers a patient's health, as determined by the medical director. 

Subd. 3a.High dose requirements. 
A client being administered or dispensed a dose beyond that set forth in subdivision 5, paragraph (a), clause (1), that exceeds 150 milligrams of methadone or 24 milligrams of buprenorphine daily, and for each subsequent increase, must meet face-to-face with a prescribing physician. The meeting must occur before the administering or dispensing of the increased dose. 

Subd. 4.Drug testing. 
Each client enrolled in the program must receive a minimum of eight random drug abuse tests per 12 months of treatment. These tests must be reasonably disbursed over the 12-month period. A license holder may elect to conduct more drug abuse tests. 

Subd. 5.Criteria for unsupervised use. 
(a) To limit the potential for diversion of medication used for the treatment of opioid addiction to the illicit market, any such medications dispensed to patients for unsupervised use shall be subject to the following requirements: 

(1) any patient in an opioid treatment program may receive a single take-home dose for a day that the clinic is closed for business, including Sundays and state and federal holidays; and 

(2) treatment program decisions on dispensing medications used to treat opioid addiction to patients for unsupervised use beyond that set forth in clause (1) shall be determined by the medical director. 

(b) A physician with authority to prescribe must consider the criteria in this subdivision in determining whether a client may be permitted unsupervised or take-home use of such medications. The criteria must also be considered when determining whether dispensing medication for a client's unsupervised use is appropriate to increase or to extend the amount of time between visits to the program. The criteria include: 

(1) absence of recent abuse of drugs including but not limited to opioids, nonnarcotics, and alcohol; 

(2) regularity of program attendance; 

(3) absence of serious behavioral problems at the program; 

(4) absence of known recent criminal activity such as drug dealing; 

(5) stability of the client's home environment and social relationships; 

(6) length of time in comprehensive maintenance treatment; 

(7) reasonable assurance that take-home medication will be safely stored within the client's home; and 

(8) whether the rehabilitative benefit the client derived from decreasing the frequency of program attendance outweighs the potential risks of diversion or unsupervised use. 

(c) The determination, including the basis of the determination, must be consistent with the criteria in this subdivision and must be documented in the client's medical record. 

Subd. 6.Restrictions for unsupervised or take-home use of methadone hydrochloride. 
(a) In cases where it is determined that a client meets the criteria in subdivision 5 and may be dispensed a medication used for the treatment of opioid addiction, the restrictions in paragraphs (b) to (g) must be followed when the medication to be dispensed is methadone hydrochloride. 

(b) During the first 90 days of treatment, the take-home supply must be limited to a maximum of a single dose each week and the client shall ingest all other doses under direct supervision. 

(c) In the second 90 days of treatment, the take-home supply must be limited to two doses per week. 

(d) In the third 90 days of treatment, the take-home supply must not exceed three doses per week. 

(e) In the remaining months of the first year, a client may be given a maximum six-day supply of take-home medication. 

(f) After one year of continuous treatment, a client may be given a maximum two-week supply of take-home medication. 

(g) After two years of continuous treatment, a client may be given a maximum one-month supply of take-home medication, but must make monthly visits. 

Subd. 7.Restriction exceptions. 
When a license holder has reason to accelerate the number of unsupervised or take-home doses of methadone hydrochloride, the license holder must comply with the requirements of Code of Federal Regulations, title 42, section 8.12, the criteria for unsupervised use in subdivision 5, and must use the exception process provided by the federal Center for Substance Abuse Treatment Division of Pharmacologic Therapies. For the purposes of enforcement of this subdivision, the commissioner has the authority to monitor for compliance with these federal regulations and may issue licensing actions according to sections 245A.05, 245A.06, and 245A.07 based on the commissioner's determination of noncompliance. 

Subd. 8.Guest dosing. 
In order to receive a guest dose, the client must be enrolled in an opioid treatment program elsewhere in the state or country and be receiving the medication on a temporary basis because the client is not able to receive the medication at the program in which the client is enrolled. Such arrangements shall not exceed 30 consecutive days in any one program and must not be for the convenience or benefit of either program. Guest dosing may also occur when the client's primary clinic is not open and the client is not receiving take-home doses. 

Subd. 9.Data and reporting. 
The license holder must submit data concerning medication used for the treatment of opioid addiction to a central registry. The data must be submitted in a method determined by the commissioner and must be submitted for each client at the time of admission and discharge. The program must document the date the information was submitted. This requirement is effective upon implementation of changes to the Drug and Alcohol Abuse Normative Evaluation System (DAANES) or development of an electronic system by which to submit the data. 

Subd. 10.Nonmedication treatment services; documentation. 
(a) The program must offer at least 50 consecutive minutes of individual or group therapy treatment services as defined in Minnesota Rules, part 9530.6430, subpart 1, item A, subitem (1), per week, for the first ten weeks following admission, and at least 50 consecutive minutes per month thereafter. As clinically appropriate, the program may offer these services cumulatively and not consecutively in increments of no less than 15 minutes over the required time period, and for a total of 60 minutes of treatment services over the time period, and must document the reason for providing services cumulatively in the client's record. The program may offer additional levels of service when deemed clinically necessary. 

(b) Notwithstanding the requirements of comprehensive assessments in Minnesota Rules, part 9530.6422, the assessment must be completed within 21 days of service initiation. 

(c) Notwithstanding the requirements of individual treatment plans set forth in Minnesota Rules, part 9530.6425: 

(1) treatment plan contents for maintenance clients are not required to include goals the client must reach to complete treatment and have services terminated; 

(2) treatment plans for clients in a taper or detox status must include goals the client must reach to complete treatment and have services terminated; 

(3) for the initial ten weeks after admission for all new admissions, readmissions, and transfers, progress notes must be entered in a client's file at least weekly and be recorded in each of the six dimensions upon the development of the treatment plan and thereafter. Subsequently, the counselor must document progress no less than one time monthly, recorded in the six dimensions or when clinical need warrants more frequent notations; and 

(4) upon the development of the treatment plan and thereafter, treatment plan reviews must occur weekly, or after each treatment service, whichever is less frequent, for the first ten weeks after the treatment plan is developed. Following the first ten weeks of treatment plan reviews, reviews may occur monthly, unless the client has needs that warrant more frequent revisions or documentation. 

Subd. 11.Prescription monitoring program. 
(a) The program must develop and maintain a policy and procedure that requires the ongoing monitoring of the data from the prescription monitoring program for each client. The policy and procedure must include how the program will meet the requirements in paragraph (b). 

(b) If a medication used for the treatment of opioid addiction is administered or dispensed to a client, the license holder shall be subject to the following requirements: 

(1) upon admission to a methadone clinic outpatient treatment program, clients must be notified in writing that the commissioner of human services and the medical director will monitor the prescription monitoring program to review the prescribed controlled drugs the clients have received; 

(2) the medical director or the medical director's delegate must review the data from the Minnesota Board of Pharmacy prescription monitoring program (PMP) established under section 152.126 prior to the client being ordered any controlled substance, as defined under section 152.126, subdivision 1, paragraph (c), including medications used for the treatment of opioid addiction, and subsequent reviews of the PMP data must occur at least every 90 days; 

(3) a copy of the PMP data reviewed must be maintained in the client file; 

(4) when the PMP data contains a recent history of multiple prescribers or multiple prescriptions for controlled substances, the physician's review of the data and subsequent actions must be documented in the client's individual file within 72 hours and must contain the medical director's determination of whether or not the prescriptions place the client at risk of harm and the actions to be taken in response to the PMP findings. In addition, the provider must conduct subsequent reviews of the PMP on a monthly basis; and 

(5) if at any time the medical director believes the use of the controlled substances places the client at risk of harm, the program must seek the client's consent to discuss the client's opioid treatment with other prescribers and must seek consent for the other prescriber to disclose to the opioid treatment program's medical director the client's condition that formed the basis of the other prescriptions. If the information is not obtained within seven days, the medical director must document whether or not changes to the client's medication dose or number of take-home doses are necessary until the information is obtained. 

(c) The commissioner shall collaborate with the Minnesota Board of Pharmacy to develop and implement an electronic system through which the commissioner shall routinely access the data from the Minnesota Board of Pharmacy prescription monitoring program established under section 152.126 for the purpose of determining whether any client enrolled in an opioid addiction treatment program licensed according to this section has also been prescribed or dispensed a controlled substance in addition to that administered or dispensed by the opioid addiction treatment program. When the commissioner determines there have been multiple prescribers or multiple prescriptions of controlled substances, the commissioner shall: 

(1) inform the medical director of the opioid treatment program only that the commissioner determined the existence of multiple prescribers or multiple prescriptions of controlled substances; and 

(2) direct the medical director of the opioid treatment program to access the data directly, review the effect of the multiple prescribers or multiple prescriptions, and document the review. 

(d) If determined necessary, the commissioner shall seek a federal waiver of, or exception to, any applicable provision of Code of Federal Regulations, title 42, section 2.34(c), prior to implementing this subdivision. 

Subd. 12.Policies and procedures. 
(a) License holders must develop and maintain the policies and procedures required in this subdivision. 

(b) For programs that are not open every day of the year, the license holder must maintain a policy and procedure that permits clients to receive a single unsupervised use of medication used for the treatment of opioid addiction for days that the program is closed for business, including, but not limited to, Sundays and state and federal holidays as required under subdivision 5, paragraph (a), clause (1). 

(c) The license holder must maintain a policy and procedure that includes specific measures to reduce the possibility of medication used for the treatment of opioid addiction being diverted from its intended treatment use. The policy and procedure must: 

(1) specifically identify and define the responsibilities of the medical and administrative staff for carrying out diversion control measures; and 

(2) include a process for contacting no less than five percent of clients who have unsupervised use of medication used for the treatment of opioid addiction, excluding those approved solely under subdivision 5, paragraph (a), clause (1), to require them to physically return to the program each month. The system must require clients to return to the program within a stipulated time frame and turn in all unused medication containers related to opioid addiction treatment. The license holder must document all related contacts on a central log and the outcome of the contact for each client in the individual client's record. 

(d) Medications used for the treatment of opioid addictions must be ordered, administered, and dispensed according to applicable state and federal regulations and the standards set by applicable accreditation entities. In addition, when an order requires assessment by the person administering or dispensing the medication to determine the amount to be administered or dispensed, the assessment must be completed by an individual whose professional scope of practice permits such assessment. For the purposes of enforcement of this paragraph, the commissioner has the authority to monitor for compliance with these state and federal regulations and the relevant standards of the license holder's accreditation agency and may issue licensing actions according to sections 245A.05, 245A.06, and 245A.07 based on the commissioner's determination of noncompliance. 

Subd. 13.Quality improvement plan. 
The license holder must develop and maintain a quality improvement process and plan. The plan must: 

(1) include evaluation of the services provided to clients with the goal of identifying issues that may improve service delivery and client outcomes; 

(2) include goals for the program to accomplish based on the evaluation; 

(3) be reviewed annually by the management of the program to determine whether the goals were met and, if not, whether additional action is required; 

(4) be updated at least annually to include new or continued goals based on an updated evaluation of services; and 

(5) identify two specific goal areas, in addition to others identified by the program, including: 

(i) a goal concerning oversight and monitoring of the premises around and near the exterior of the program to reduce the possibility of medication used for the treatment of opioid addiction being inappropriately used by clients, including but not limited to the sale or transfer of the medication to others; and 

(ii) a goal concerning community outreach, including but not limited to communications with local law enforcement and county human services agencies, with the goal of increasing coordination of services and identification of areas of concern to be addressed in the plan. 

Subd. 14.Placing authorities. 
Programs must provide certain notification and client-specific updates to placing authorities for clients who are enrolled in Minnesota health care programs. At the request of the placing authority, the program must provide client-specific updates, including but not limited to informing the placing authority of positive drug screenings and changes in medications used for the treatment of opioid addiction ordered for the client. 

Subd. 15.A program's duty to report suspected drug diversion. 
(a) To the fullest extent permitted under Code of Federal Regulations, title 42, sections 2.1 to 2.67, a program shall report to law enforcement any credible evidence that the program or its personnel knows, or reasonably should know, that is directly related to a diversion crime on the premises of the program, or a threat to commit a diversion crime. 

(b) "Diversion crime," for the purposes of this section, means diverting, attempting to divert, or conspiring to divert Schedule I, II, III, or IV drugs, as defined in section 152.02, on the program's premises. 

(c) The program must document its compliance with the requirement in paragraph (a) in either a client's record or an incident report. 

(d) Failure to comply with the duty in paragraph (a) may result in sanctions as provided in sections 245A.06 and 245A.07. 

Subd. 16.Variance. 
The commissioner may grant a variance to the requirements of this section. 

254A.02 DEFINITIONS.Subd. 4.Drug abuse or abuse of drugs. 
"Drug abuse or abuse of drugs" is the use of any psychoactive or mood altering chemical substance, without compelling medical reason, in such a manner as to induce mental, emotional or physical impairment and cause socially dysfunctional or socially disordering behavior and which results in psychological or physiological dependency as a function of continued use. 

256B.19 DIVISION OF COST.Subd. 1c.Additional portion of nonfederal share. 
(a) Hennepin County shall be responsible for a monthly transfer payment of $1,500,000, due before noon on the 15th of each month and the University of Minnesota shall be responsible for a monthly transfer payment of $500,000 due before noon on the 15th of each month, beginning July 15, 1995. These sums shall be part of the designated governmental unit's portion of the nonfederal share of medical assistance costs. 

(b) Beginning July 1, 2001, Hennepin County's payment under paragraph (a) shall be $2,066,000 each month. 

(c) Beginning July 1, 2001, the commissioner shall increase annual capitation payments to a demonstration provider serving eligible individuals in Hennepin County under section 256B.69 for the prepaid medical assistance program by approximately $6,800,000 to recognize higher than average medical education costs. 

(d) Effective August 1, 2005, Hennepin County's payment under paragraphs (a) and (b) shall be reduced to $566,000, and the University of Minnesota's payment under paragraph (a) shall be reduced to zero. Effective October 1, 2008, to December 31, 2010, Hennepin County's payment under paragraphs (a) and (b) shall be $434,688. Effective January 1, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be $566,000. 

(e) Notwithstanding paragraph (d), upon federal enactment of an extension to June 30, 2011, of the enhanced federal medical assistance percentage (FMAP) originally provided under Public Law 111-5, for the six-month period from January 1, 2011, to June 30, 2011, Hennepin County's payment under paragraphs (a) and (b) shall be $434,688. 

256B.4914 HOME AND COMMUNITY-BASED SERVICES WAIVERS; RATE SETTING.Subd. 16.Budget neutrality adjustments. 
(a) The commissioner shall use the following adjustments to the rate generated by the framework to assure budget neutrality until the rate information is available to implement paragraph (b). The rate generated by the framework shall be multiplied by the appropriate factor, as designated below: 

(1) for residential services: 1.003; 

(2) for day services: 1.000; 

(3) for unit-based services with programming: 0.941; and 

(4) for unit-based services without programming: 0.796. 

(b) Within 12 months of January 1, 2014, the commissioner shall compare estimated spending for all home and community-based waiver services under the new payment rates defined in subdivisions 6 to 9 with estimated spending for the same recipients and services under the rates in effect on July 1, 2013. This comparison must distinguish spending under each of subdivisions 6, 7, 8, and 9. The comparison must be based on actual recipients and services for one or more service months after the new rates have gone into effect. The commissioner shall consult with the commissioner of management and budget on this analysis to ensure budget neutrality. If estimated spending under the new rates for services under one or more subdivisions differs in this comparison by 0.3 percent or more, the commissioner shall assure aggregate budget neutrality across all service areas by adjusting the budget neutrality factor in paragraph (a) in each subdivision so that total estimated spending for each subdivision under the new rates matches estimated spending under the rates in effect on July 1, 2013. 

256B.64 ATTENDANTS TO VENTILATOR-DEPENDENT RECIPIENTS.
A ventilator-dependent recipient of medical assistance who has been receiving the services of a home care nurse or personal care assistant in the recipient's home may continue to have a home care nurse or personal care assistant present upon admission to a hospital licensed under chapter 144. The personal care assistant or home care nurse shall perform only the services of communicator or interpreter for the ventilator-dependent patient during a transition period of up to 120 hours to assure adequate training of the hospital staff to communicate with the patient and to understand the unique comfort, safety, and personal care needs of the patient. The personal care assistant or home care nurse may offer nonbinding advice to the health care professionals in charge of the ventilator-dependent patient's care and treatment on matters pertaining to the comfort and safety of the patient. Within 36 hours of the end of the 120-hour transition period, an assessment may be made by the ventilator-dependent recipient, the attending physician, and the hospital staff caring for the recipient. If the persons making the assessment determine that additional communicator or interpreter services are medically necessary, the hospital must contact the commissioner 24 hours prior to the end of the 120-hour transition period and submit the assessment information to the commissioner. The commissioner shall review the request and determine if it is medically necessary to continue the interpreter services or if the hospital staff has had sufficient opportunity to adequately determine the needs of the patient. The commissioner shall determine if continued service is necessary and appropriate and whether or not payments shall continue. The commissioner may not authorize services beyond the limits of the available appropriations for this section. The commissioner may adopt rules necessary to implement this section. Reimbursement under this section must be at the payment rate and in a manner consistent with the payment rate and manner used in reimbursing these providers for home care services for the ventilator-dependent recipient under the medical assistance program. 

256B.7631 CHEMICAL DEPENDENCY PROVIDER RATE INCREASE.
For the chemical dependency services listed in section 254B.05, subdivision 5, and provided on or after July 1, 2015, payment rates shall be increased by two percent over the rates in effect on January 1, 2014, for vendors who meet the requirements of section 254B.05. 

256C.23 DEFINITIONS.Subd. 3.Regional service center. 
"Regional service center" means a facility designed to provide an entry point for deaf, deafblind, and hard-of-hearing persons of that region in need of education, employment, social, human, or other services. 

256C.233 DUTIES OF STATE AGENCIES.Subd. 4.State commissioners. 
The commissioners of all state agencies shall consult with the Deaf and Hard-of-Hearing Services Division concerning the promulgation of public policies, regulations, and programs necessary to address the needs of deaf, deafblind, and hard-of-hearing Minnesotans. Each state agency shall consult with the Deaf and Hard-of-Hearing Services Division concerning the need to forward legislative initiatives to the governor to address the concerns of deaf, deafblind, and hard-of-hearing Minnesotans. 

256C.25 INTERPRETER SERVICES.Subdivision 1.Establishment. 
The Deaf and Hard-of-Hearing Services Division shall maintain and coordinate statewide interpreting or interpreter referral services for use by any public or private agency or individual in the state. The division shall directly coordinate these services but may contract with an appropriate agency to provide this service. The division may collect a $3 fee per referral for interpreter referral services and the actual costs of interpreter services provided by department staff. Fees and payments collected shall be deposited in the general fund. The $3 referral fee shall not be collected from state agencies or local units of government or deaf or hard-of-hearing consumers or interpreters. 

Subd. 2.Duties. 
Interpreting or interpreter referral services must include: 

(1) statewide access to interpreter referral and direct interpreting services, coordinated with the regional service centers; 

(2) maintenance of a statewide directory of qualified interpreters; 

(3) assessment of the present and projected supply and demand for interpreter services statewide; and 

(4) coordination with the regional service centers on projects to train interpreters and advocate for and evaluate interpreter services. 

5600.2500FEES. 
The fees charged by the board are fixed at the following rates: 

A.
 physician application fee, $200; 

B.
 physician annual license, $192; 

C.
 physician endorsement to other states, $40; 

D.
 physician emeritus license, $50; 

E.
 physician temporary licenses, $60; 

F.
 physician late fee, $60; 

G.
 physician assistant application fee, $120; 

H.
 physician assistant annual registration (prescribing), $135; 

I.
 physician assistant annual registration (nonprescribing), $115; 

J.
 physician assistant temporary registration, $115; 

K.
 physician assistant temporary permit, $60; 

L.
 physician assistant locum tenens permit, $25; 

M.
 physician assistant late fee, $50; 

N.
 acupuncture temporary permit, $60; 

O.
 acupuncture inactive status fee, $50; 

P.
 respiratory care annual registration, $90; 

Q.
 respiratory care application fee, $100; 

R.
 respiratory care late fee, $50; 

S.
 respiratory care inactive status, $50; 

T.
 respiratory care temporary permit, $60; 

U.
 respiratory care temporary registration, $90; 

V.
 duplicate license or registration fee, $20; 

W.
 certification letter, $25; 

X.
 verification of status, $10; 

Y.
 education or training program approval fee, $100; 

Z.
 report creation and generation, $60 per hour billed in quarter-hour increments with a quarter-hour minimum; and 

AA.
 examination administrative fee: 

(1)
 half day, $50; and 

(2)
 full day, $80. 

The renewal cycle for physician assistants under items H and I begins July 1. The duration of the permit issued under item L is one year. 

9500.1140APPEALS.   Subp. 3.Case mix appeals.  
A hospital may appeal a payment change that results from a difference in case mix between the base year and rate year. The appeal must be received by the commissioner or postmarked no later than 120 days after the end of the appealed rate year. A case mix appeal will apply to all medical assistance patients who received inpatient hospital services from the hospital for which the hospital received medical assistance payment excluding Medicare crossovers and the appeal is effective for the entire rate year. A case mix appeal excludes medical assistance admissions whose payments have been made according to part 9500.1130, subpart 1b, item E. A case mix appeal excludes medical assistance admissions that have a relative value of zero for its DRG. The results of case mix appeals do not automatically carry forward into later rate years. Separate case mix appeals must be submitted for each rate year based on the change in the mix of cases for that particular rate year. An adjustment will be made only to the extent that the need is attributable to circumstances that are separately identified by the hospital. The hospital must demonstrate that the average acuity or length of stay of patients in each rate year appealed has increased or services have been added or discontinued according to items A to J. 

A.
 The change must be measured by use of case mix indices derived using all DRG's. Relative values for each DRG will be determined according to part 9500.1110, subpart 1, by substituting DRG terms and data for diagnostic category terms and data. DRG relative values will be determined based on all programs and the rehabilitation distinct part specialty group. Separate DRG relative values will be determined for transfers to the neonatal intensive care unit specialty group. For each program and specialty group, make the determinations in subitems (1) to (6). 

(1)
 Multiply the hospital's number of rate year admissions within each DRG by the relative value of that DRG. 

(2)
 Add together each of the products determined in subitem (1). 

(3)
 Divide the total from subitem (2) by the hospital's number of rate year admissions and round the quotient to five decimal places. 

(4)
 Complete the functions in subitems (1) to (3) for the hospital's base year admissions determined in part 9500.1110, subpart 1, item C. 

(5)
 Divide the quotient determined in subitem (3) by the quotient determined in subitem (4). 

(6)
 Multiply subitem (5) by 100 and round the percentage to five decimal places. 

B.
 The percentage change, in whole numbers, between the recalculated case mix indices under item A will be reduced by the change in indices as measured using diagnostic categories in part 9500.1100, subparts 20b to 20g. For each program and specialty group, make the determinations in subitems (1) to (8). 

(1)
 Multiply the hospital's number of rate year admissions within each diagnostic category by the relative value of that diagnostic category as determined in part 9500.1100. 

(2)
 Add together each of the products determined in subitem (1). 

(3)
 Divide the total from subitem (2) by the hospital's number of rate year admissions and round the quotient to five decimal places. 

(4)
 Complete the functions in subitems (1) to (3) for the hospital's base year admissions determined in part 9500.1110, subpart 1, item C. 

(5)
 Divide the quotient determined in subitem (3) by the quotient determined in subitem (4). 

(6)
 Multiply subitem (5) by 100 and round the percentage to five decimal places. 

(7)
 Divide item A, subitem (6), by subitem (6). 

(8)
 Multiply subitem (7) by 100 and round the percentage change to whole numbers. 

C.
 Determine the payments made for admissions occurring during the appealed rate year under part 9500.1128 reduced by property payments made under parts 9500.1121, 9500.1122, 9500.1123, and 9500.1124 for each program and specialty group. 

D.
 Multiply item B, subitem (8), by item C for each program and specialty group. 

E.
 Subtract item C from item D for each program and specialty group. 

F.
 Add the differences in item E. 

G.
 Add the differences in item C. 

H.
 Divide item F by item G. If the quotient is less than positive 0.05 and more than negative 0.05, there can be no payment adjustment for a change in case mix. 

I.
 Subtract 0.05 from the quotient in item H if the quotient is positive or add 0.05 if the quotient is negative. 

J.
 Multiply item G by item I. If the product is positive, there is an underpayment with that amount due the hospital. If the product is negative, there is an overpayment with that amount due the department. 

9500.1140APPEALS.   Subp. 4.Medicare adjustment appeals.  
To appeal a payment rate or payment change that results from Medicare adjustments of base year information, the appeal must be received by the commissioner or postmarked not later than 60 days after the date the medical assistance determination was mailed to the hospital by the department or within 60 days of the date the Medicare determination was mailed to the hospital by Medicare, whichever is later. 

9500.1140APPEALS.   Subp. 5.Rate and payment appeals.  
To appeal a payment rate or payment determination that is not a case mix or Medicare adjustment appeal, the appeal must be received by the commissioner within 60 days of the date the determination was mailed to the hospital. 

9500.1140APPEALS.   Subp. 6.Resolution of appeals.  
The appeal will be heard by an administrative law judge according to parts 1400.5100 to 1400.8401 and Minnesota Statutes, sections 14.57to 14.62, and according to the requirements of items A to D. 

A.
 The hospital must demonstrate by a preponderance of the evidence that the commissioner's determination is incorrect or not according to law. 

B.
 Both overpayments and underpayments that result from the submission of appeals will be implemented. 

C.
 Facts to be considered in any appeal of base year information are limited to those in existence at the time the payment rates of the first rate year were established from the base year information. 

D.
 Relative values and rates that are based on averages will not be recalculated to reflect the appeal outcome. 

9530.6405DEFINITIONS.   Subpart 1.Scope.  
As used in parts 9530.6405 to 9530.6505, the following terms have the meanings given to them. 

9530.6405DEFINITIONS.   Subp. 1a.Administration of medications.  
"Administration of medications" means performing a task to provide medications to a client, and includes the following tasks, performed in the following order: 

A.
 checking the client's medication record; 

B.
 preparing the medication for administration; 

C.
 administering the medication to the client; 

D.
 documenting the administration, or the reason for not administering medications as prescribed; and 

E.
 reporting information to a licensed practitioner or a nurse regarding problems with the administration of the medication or the client's refusal to take the medication. 

9530.6405DEFINITIONS.   Subp. 2.Adolescent.  
"Adolescent" means an individual under 18 years of age. 

9530.6405DEFINITIONS.   Subp. 3.Alcohol and drug counselor.  
"Alcohol and drug counselor" has the meaning given in Minnesota Statutes, section 148C.01, subdivision 2. 

9530.6405DEFINITIONS.   Subp. 4.Applicant.  
"Applicant" means an individual, corporation, partnership, voluntary association, controlling individual, or other organization that has applied for licensure under this chapter. 

9530.6405DEFINITIONS.   Subp. 5.Capacity management system.  
"Capacity management system" means a database operated by the Department of Human Services to compile and make information available to the public about the waiting list status and current admission capability of each program serving intravenous drug abusers. 

9530.6405DEFINITIONS.   Subp. 6.Central registry.  
"Central registry" means a database maintained by the department that collects identifying information from two or more programs about individuals applying for maintenance treatment or detoxification treatment for addiction to opiates for the purpose of avoiding an individual's concurrent enrollment in more than one program. 

9530.6405DEFINITIONS.   Subp. 7.Chemical.  
"Chemical" means alcohol, solvents, controlled substances as defined by Minnesota Statutes, section 152.01, subdivision 4, and other mood altering substances. 

9530.6405DEFINITIONS.   Subp. 7a.Chemical dependency treatment.  
"Chemical dependency treatment" means treatment of a substance use disorder, including the process of assessment of a client's needs, development of planned interventions or services to address those needs, provision of services, facilitation of services provided by other service providers, and reassessment by a qualified professional. The goal of treatment is to assist or support the client's efforts to recover from substance use disorder. 

9530.6405DEFINITIONS.   Subp. 8.Client.  
"Client" means an individual accepted by a license holder for assessment or treatment of a substance use disorder. An individual remains a client until the license holder no longer provides or plans to provide the individual with treatment services. 

9530.6405DEFINITIONS.   Subp. 9.Commissioner.  
"Commissioner" means the commissioner of the Department of Human Services or the commissioner's designee. 

9530.6405DEFINITIONS.   Subp. 10.Co-occurring or co-occurring client.  
"Co-occurring" or "co-occurring client" means a diagnosis that indicates a client suffers from a substance use disorder and a mental health problem. 

9530.6405DEFINITIONS.   Subp. 11.Department.  
"Department" means the Department of Human Services. 

9530.6405DEFINITIONS.   Subp. 12.Direct client contact.  
"Direct client contact" has the meaning given for "direct contact" in Minnesota Statutes, section 245C.02, subdivision 11. 

9530.6405DEFINITIONS.   Subp. 13.License.  
"License" means a certificate issued by the commissioner authorizing the license holder to provide a specific program for a specified period of time in accordance with the terms of the license and the rules of the commissioner. 

9530.6405DEFINITIONS.   Subp. 14.License holder.  
"License holder" means an individual, corporation, partnership, voluntary organization, or other organization that is legally responsible for the operation of the program, has been granted a license by the commissioner under this chapter, and is a controlling individual. 

9530.6405DEFINITIONS.   Subp. 14a.Licensed practitioner.  
"Licensed practitioner" means a person who is authorized to prescribe as defined in Minnesota Statutes, section 151.01, subdivision 23. 

9530.6405DEFINITIONS.   Subp. 15.Licensed professional in private practice.  
"Licensed professional in private practice" means an individual who meets the following criteria: 

A.
 is licensed under Minnesota Statutes, chapter 148C, or is exempt from licensure under that chapter but is otherwise licensed to provide alcohol and drug counseling services; 

B.
 practices solely within the permissible scope of the individual's license as defined in the law authorizing licensure; and 

C.
 does not affiliate with other licensed or unlicensed professionals for the purpose of providing alcohol and drug counseling services. Affiliation does not include conferring with other professionals or making client referrals. 

9530.6405DEFINITIONS.   Subp. 15a.Nurse.  
"Nurse" means a person licensed and currently registered to practice professional or practical nursing as defined in Minnesota Statutes, section 148.171, subdivisions 14 and 15. 

9530.6405DEFINITIONS.   Subp. 16.Paraprofessional.  
"Paraprofessional" means an employee, agent, or independent contractor of the license holder who performs tasks in support of the provision of treatment services. Paraprofessionals may be referred to by a variety of titles including technician, case aide, or counselor assistant. An individual may not be a paraprofessional employed by the license holder if the individual is a client of the license holder. 

9530.6405DEFINITIONS.   Subp. 17.Program serving intravenous drug abusers.  
"Program serving intravenous drug abusers" means a program whose primary purpose is providing agonist medication-assisted therapy to clients who are narcotic dependent, regardless of whether the client's narcotic use was intravenous or by other means. 

9530.6405DEFINITIONS.   Subp. 17a.Student intern.  
"Student intern" means a person who is enrolled in an alcohol and drug counselor education program at an accredited school or educational program and is earning a minimum of nine semester credits per calendar year toward the completion of an associate's, bachelor's, master's, or doctorate degree requirements. Degree requirements must include an additional 18 semester credits or 270 hours of alcohol and drug counseling related course work and 440 hours of practicum. 

9530.6405DEFINITIONS.   Subp. 17b.Substance.  
"Substance" means a "chemical" as defined in subpart 7. 

9530.6405DEFINITIONS.   Subp.  17c.Substance use disorder.  
"Substance use disorder" means a pattern of substance use as defined in the Diagnostic and Statistical Manual of Mental Disorders-IV-TR (DSM), et seq. The DSM-IV-TR is incorporated by reference. The DSM was published by the American Psychiatric Association in 1994, in Washington D.C., and is not subject to frequent change. The DSM-IV-TR is available through the Minitex interlibrary loan system. 

9530.6405DEFINITIONS.   Subp. 18.Target population.  
"Target population" means individuals experiencing problems with a substance use disorder having the specified characteristics that a license holder proposes to serve. 

9530.6405DEFINITIONS.   Subp. 20.Treatment director.  
"Treatment director" means an individual who meets the qualifications specified under part 9530.6450, subparts 1 and 3, and is designated by the license holder to be responsible for all aspects of the delivery of treatment services. 

9530.6405DEFINITIONS.   Subp. 21.Treatment service.  
"Treatment service" means a therapeutic intervention or series of interventions. 

9530.6410APPLICABILITY. Subpart 1.Applicability.  
Except as provided in subparts 2 and 3, no person, corporation, partnership, voluntary association, controlling individual, or other organization may provide chemical dependency treatment services to an individual who has a substance use disorder unless licensed by the commissioner. 

Subp. 2.Activities exempt from license requirement.  
Parts 9530.6405 to 9530.6505 do not apply to organizations whose primary functions are information, referral, diagnosis, case management, and assessment for the purposes of placement, education, support group services, or self-help programs. Parts 9530.6405 to 9530.6505do not apply to the activities of licensed professionals in private practice which are not paid for by the consolidated chemical dependency treatment fund. 

Subp. 3.Certain hospitals excluded from license requirement.  
Parts 9530.6405 to 9530.6505 do not apply to chemical dependency treatment provided by hospitals licensed under Minnesota Statutes, chapter 62J, or under Minnesota Statutes, sections 144.50 to 144.56, unless the hospital accepts funds for chemical dependency treatment under the consolidated chemical dependency treatment fund under Minnesota Statutes, chapter 254B, medical assistance under Minnesota Statutes, chapter 256B, MinnesotaCare or health care cost containment under Minnesota Statutes, chapter 256L, or general assistance medical care under Minnesota Statutes, chapter 256D. 

Subp. 4.Applicability of chapter 2960.  
Beginning July 1, 2005, residential adolescent chemical dependency treatment programs must be licensed according to chapter 2960. 

9530.6415LICENSING REQUIREMENTS. Subpart 1.General application and license requirements.  
An applicant for a license to provide treatment must comply with the general requirements in Minnesota Statutes, chapters 245A and 245C, and Minnesota Statutes, sections 626.556 and 626.557. 

Subp. 2.Contents of application.  
Prior to issuance of a license, an applicant must submit, on forms provided by the commissioner, any documents the commissioner requires to demonstrate the following: 

A.
 compliance with parts 9530.6405 to 9530.6505; 

B.
 compliance with applicable building, fire and safety codes, health rules, zoning ordinances, and other applicable rules and regulations or documentation that a waiver has been granted. The granting of a waiver does not constitute modification of any requirement of parts 9530.6405 to 9530.6505; 

C.
 completion of an assessment of need for a new or expanded program according to part 9530.6800; and 

D.
 insurance coverage, including bonding, sufficient to cover all client funds, property, and interests. 

Subp. 3.Changes in license terms. A.
 A license holder must notify the commissioner before one of the following occurs and the commissioner must determine the need for a new license: 

(1)
 a change in the Department of Health's licensure of the program; 

(2)
 a change in whether the license holder provides services specified in parts 9530.6485 to 9530.6505; 

(3)
 a change in location; or 

(4)
 a change in capacity if the license holder meets the requirements of part 9530.6505. 

B.
 A license holder must notify the commissioner and must apply for a new license if there is a change in program ownership. 

9530.6420INITIAL SERVICES PLAN. 
The license holder must complete an initial services plan during or immediately following the intake interview. The plan must address the client's immediate health and safety concerns, identify the issues to be addressed in the first treatment sessions, and make treatment suggestions for the client during the time between intake and completion of the treatment plan. The initial services plan must include a determination whether a client is a vulnerable adult as defined in Minnesota Statutes, section 626.5572, subdivision 21. All adult clients of a residential program are vulnerable adults. An individual abuse prevention plan, according to Minnesota Statutes, sections 245A.65, subdivision 2, paragraph (b), and 626.557, subdivision 14, paragraph (b), is required for all clients who meet the definition of "vulnerable adult." 

9530.6422COMPREHENSIVE ASSESSMENT. Subpart 1.Comprehensive assessment of substance use disorder.  
A comprehensive assessment of the client's substance use disorder must be coordinated by an alcohol and drug counselor and completed within three calendar days after service initiation for a residential program or three sessions of the client's initiation to services for all other programs. The alcohol and drug counselor may rely on current information provided by a referring agency or other sources as a supplement when information is available. Information gathered more than 45 days before the date of admission is not current. If the comprehensive assessment cannot be completed in the time specified, the treatment plan must indicate how and when it will be completed. The assessment must include sufficient information to complete the assessment summary according to subpart 2 and part 9530.6425. The comprehensive assessment must include information about the client's problems that relate to chemical use and personal strengths that support recovery, including: 

A.
 age, sex, cultural background, sexual orientation, living situation, economic status, and level of education; 

B.
 circumstances of service initiation; 

C.
 previous attempts at treatment for chemical use or dependency, compulsive gambling, or mental illness; 

D.
 chemical use history including amounts and types of chemicals used, frequency and duration of use, periods of abstinence, and circumstances of relapse, if any. For each chemical used within the previous 30 days, the information must include the date and time of the most recent use and any previous experience with withdrawal; 

E.
 specific problem behaviors exhibited by the client when under the influence of chemicals; 

F.
 current family status, family history, including history or presence of physical or sexual abuse, level of family support, and chemical use, abuse, or dependency among family members and significant others; 

G. 
 physical concerns or diagnoses, the severity of the concerns, and whether or not the concerns are being addressed by a health care professional; 

H.
 mental health history and current psychiatric status, including symptoms, disability, current treatment supports, and psychotropic medication needed to maintain stability; 

I.
 arrests and legal interventions related to chemical use; 

J.
 ability to function appropriately in work and educational settings; 

K.
 ability to understand written treatment materials, including rules and client rights; 

L.
 risk-taking behavior, including behavior that puts the client at risk of exposure to blood borne or sexually transmitted diseases; 

M.
 social network in relation to expected support for recovery and leisure time activities that have been associated with chemical use;  

N.
 whether the client is pregnant and if so, the health of the unborn child and current involvement in prenatal care; and 

O.
 whether the client recognizes problems related to substance use and is willing to follow treatment recommendations. 

Subp. 2.Assessment summary.  
An alcohol and drug counselor must prepare an assessment summary within three calendar days for a residential program or within three treatment sessions of service initiation. The narrative summary of the comprehensive assessment results must meet the requirements of items A and B: 

A.
 An assessment summary must be prepared by an alcohol and drug counselor and include: 

(1)
 a risk description according to part 9530.6622 for each dimension listed in item B; 

(2)
 narrative supporting the risk descriptions; and 

(3)
 a determination of whether the client meets the DSM criteria for a person with a substance use disorder. 

B.
 Contain information relevant to treatment planning and recorded in the dimensions in subitems (1) to (6): 

(1)
 Dimension 1, acute intoxication/withdrawal potential. The license holder must consider the client's ability to cope with withdrawal symptoms and current state of intoxication. 

(2)
 Dimension 2, biomedical conditions and complications. The license holder must consider the degree to which any physical disorder would interfere with treatment for substance abuse, and the client's ability to tolerate any related discomfort. The license holder must determine the impact of continued chemical use on the unborn child if the client is pregnant. 

(3)
 Dimension 3, emotional, behavioral, and cognitive conditions and complications. The license holder must determine the degree to which any condition or complications are likely to interfere with treatment for substance abuse or with functioning in significant life areas and the likelihood of risk of harm to self or others. 

(4)
 Dimension 4, readiness for change. The license holder must also consider the amount of support and encouragement necessary to keep the client involved in treatment. 

(5)
 Dimension 5, relapse, continued use, and continued problem potential. The license holder must consider the degree to which the client recognizes relapse issues and has the skills to prevent relapse of either substance use or mental health problems. 

(6)
 Dimension 6, recovery environment. The license holder must consider the degree to which key areas of the client's life are supportive of or antagonistic to treatment participation and recovery. 

9530.6425INDIVIDUAL TREATMENT PLANS. Subpart 1.General.  
Individual treatment plans for clients in treatment must be completed within seven calendar days of completion of the assessment summary. Treatment plans must continually be updated, based on new information gathered about the client's condition and on whether planned treatment interventions have had the intended effect. Treatment planning must include ongoing assessment in each of the six dimensions according to part 9530.6422, subpart 2. The plan must provide for the involvement of the client's family and those people selected by the client as being important to the success of the treatment experience at the earliest opportunity, consistent with the client's treatment needs and written consent. The plan must be developed after completion of the comprehensive assessment and is subject to amendment until services to the client are terminated. The client must have an opportunity to have active, direct involvement in selecting the anticipated outcomes of the treatment process and in developing the individual treatment plan. The individual treatment plan must be signed by the client and the alcohol and drug counselor. The individual treatment plan may be a continuation of the initial services plan required in part 9530.6420. 

Subp. 2.Plan contents.  
An individual treatment plan must be recorded in the six dimensions listed in part 9530.6422, subpart 2, item B, and address each problem identified in the assessment summary, and include: 

A.
 specific methods to be used to address identified problems, including amount, frequency, and anticipated duration of treatment service. The methods must be appropriate to the client's language, reading skills, cultural background, and strengths; 

B.
 resources to which the client is being referred for problems when problems are to be addressed concurrently by another provider; and 

C.
 goals the client must reach to complete treatment and have services terminated. 

Subp. 3.Progress notes and plan review. A.
 Progress notes must be entered in a client's file weekly or after each treatment service, whichever is less frequent, by the staff person providing the service. The note must reference the treatment plan. Progress notes must be recorded and address each of the six dimensions listed in part 9530.6422, subpart 2, item B. Progress notes must: 

(1)
 be entered immediately following any significant event. Significant events include those events which have an impact on the client's relationship with other clients, staff, the client's family, or the client's treatment plan; 

(2)
 indicate the type and amount of each treatment service the client has received; 

(3)
 include monitoring of any physical and mental health problems and the participation of others in the treatment plan; 

(4)
 document the participation of others; and 

(5)
 document that the client has been notified of each treatment plan change and that the client either does or does not agree with the change. 

B.
 Treatment plan review must: 

(1)
 occur weekly or after each treatment service, whichever is less frequent; 

(2)
 address each goal in the treatment plan that has been worked on since the last review; 

(3)
 address whether the strategies to address the goals are effective, and if not, must include changes to the treatment plan; and 

(4)
 include a review and evaluation of the individual abuse prevention plan according to Minnesota Statutes, section 245A.65. 

C.
 All entries in a client's record must be legible, signed, and dated. Late entries must be clearly labeled "late entry." Corrections to an entry must be made in a way in which the original entry can still be read. 

Subp. 3a.Documentation.  
Progress notes and plan review do not require separate documentation if the information in the client file meets the requirements of subpart 3, items A and B. 

Subp. 4.Summary at termination of services.  
An alcohol and drug counselor must write a discharge summary for each client. The summary must be completed within five days of the client's service termination or within five days from the client's or program's decision to terminate services, whichever is earlier. 

A.
 The summary at termination of services must be recorded in the six dimensions listed in part 9530.6422, subpart 2, item B, and include the following information: 

(1)
 client's problems, strengths, and needs while participating in treatment, including services provided; 

(2)
 client's progress toward achieving each of the goals identified in the individual treatment plan; 

(3)
 reasons for and circumstances of service termination; and 

(4)
 risk description according to part 9530.6622. 

B.
 For clients who successfully complete treatment, the summary must also include: 

(1)
 living arrangements upon discharge; 

(2)
 continuing care recommendations, including referrals made with specific attention to continuity of care for mental health problems, as needed; 

(3)
 service termination diagnosis; and 

(4)
 client's prognosis. 

9530.6430TREATMENT SERVICES. Subpart 1.Treatment services offered by license holder. A.
 A license holder must offer the following treatment services unless clinically inappropriate and the justifying clinical rationale is documented: 

(1)
 individual and group counseling to help the client identify and address problems related to chemical use and develop strategies to avoid inappropriate chemical use after discharge; 

(2)
 client education strategies to avoid inappropriate chemical use and health problems related to chemical use and the necessary changes in lifestyle to regain and maintain health. Client education must include information concerning the human immunodeficiency virus, according to Minnesota Statutes, section 245A.19, other sexually transmitted diseases, drug and alcohol use during pregnancy, hepatitis, and tuberculosis; 

(3)
 transition services to help the client integrate gains made during treatment into daily living and to reduce reliance on the license holder's staff for support; 

(4)
 services to address issues related to co-occurring mental illness, including education for clients on basic symptoms of mental illness, the possibility of comorbidity, and the need for continued medication compliance while working on recovery from substance use disorder. Groups must address co-occurring mental illness issues, as needed. When treatment for mental health problems is indicated, it is integrated into the client's treatment plan; and 

(5)
 service coordination to help the client obtain the services and to support the client's need to establish a lifestyle free of the harmful effects of substance use disorder. 

B.
 Treatment services provided to individual clients must be provided according to the individual treatment plan and must address cultural differences and special needs of all clients. 

Subp. 2.Additional treatment services.  
A license holder may provide or arrange the following additional treatment services as a part of the individual treatment plan: 

A.
 relationship counseling provided by a qualified professional to help the client identify the impact of the client's substance use disorder on others and to help the client and persons in the client's support structure identify and change behaviors that contribute to the client's substance use disorder; 

B.
 therapeutic recreation to provide the client with an opportunity to participate in recreational activities without the use of mood-altering chemicals and to learn to plan and select leisure activities that do not involve the inappropriate use of chemicals; 

C.
 stress management and physical well-being to help the client reach and maintain an acceptable level of health, physical fitness, and well-being; 

D.
 living skills development to help the client learn basic skills necessary for independent living; 

E.
 employment or educational services to help the client become financially independent; 

F.
 socialization skills development to help the client live and interact with others in a positive and productive manner; and 

G.
 room, board, and supervision provided at the treatment site to give the client a safe and appropriate environment in which to gain and practice new skills. 

Subp. 3.Counselors to provide treatment services.  
Treatment services, including therapeutic recreation, must be provided by alcohol and drug counselors qualified according to part 9530.6450, unless the individual providing the service is specifically qualified according to the accepted standards of that profession. Therapeutic recreation does not include planned leisure activities. 

Subp. 4.Location of service provision.  
A client of a license holder may only receive services at any of the license holder's licensed locations or at the client's home, except that services under subpart 1, item A, subitems (3) and (5), and subpart 2, items B and E, may be provided in another suitable location. 

9530.6435MEDICAL SERVICES. Subpart 1.Health care services description.  
An applicant or license holder must maintain a complete description of the health care services, nursing services, dietary services, and emergency physician services offered by the license holder. 

Subp. 1a.Procedures.  
The applicant or license holder must have written procedures for obtaining medical interventions when needed for a client, that are approved in writing by a physician who is licensed under Minnesota Statutes, chapter 147, unless: 

A.
 the license holder does not provide services under part 9530.6505; and 

B. 
 all medical interventions are referred to 911, the emergency telephone number, or the client's physician. 

Subp. 2.Consultation services.  
The license holder must have access to and document the availability of a licensed mental health professional to provide diagnostic assessment and treatment planning assistance. 

Subp. 3.Administration of medications and assistance with self-medication.  
A license holder must meet the requirements in items A and B if services include medication administration. 

A.
 A staff member, other than a licensed practitioner or nurse, who is delegated by a licensed practitioner or a registered nurse the task of administration of medication or assistance with self-medication must: 

(1)
 document that the staff member has successfully completed a medication administration training program for unlicensed personnel through an accredited Minnesota postsecondary educational institution. Completion of the course must be documented in writing and placed in the staff member's personnel file; or 

(2)
 be trained according to a formalized training program which is taught by a registered nurse and offered by the license holder. Completion of the course must be documented in writing and placed in the staff member's personnel records; or 

(3)
 demonstrate to a registered nurse competency to perform the delegated activity. 

B.
 A registered nurse must be employed or contracted to develop the policies and procedures for medication administration or assistance with self-administration of medication or both. A registered nurse must provide supervision as defined in part 6321.0100. The registered nurse supervision must include monthly on-site supervision or more often as warranted by client health needs. The policies and procedures must include: 

(1)
 a provision that delegations of administration of medication are limited to administration of those medications which are oral, suppository, eye drops, ear drops, inhalant, or topical; 

(2)
 a provision that each client's file must include documentation indicating whether staff will be administering medication or the client will be doing self-administration or a combination of both; 

(3)
 a provision that clients may carry emergency medication such as nitroglycerin as instructed by their physician; 

(4)
 a provision for medication to be self-administered when a client is scheduled not to be at the facility; 

(5)
 a provision that if medication is to be self-administered at a time when the client is present in the facility, medication will be self-administered under observation of a trained staff person; 

(6)
 a provision that when a license holder serves clients who are parents with children, the parent may only administer medication to the child under staff supervision; 

(7)
 requirements for recording the client's use of medication, including staff signatures with date and time; 

(8)
 guidelines for when to inform a registered nurse of problems with self-administration, including failure to administer, client refusal of a medication, adverse reactions, or errors; and 

(9)
 procedures for acceptance, documentation, and implementation of prescriptions, whether written, verbal, telephonic, or electronic. 

Subp. 4.Control of drugs.  
A license holder must have in place and implement written policies and procedures developed by a registered nurse that contains the following provisions: 

A.
 a requirement that all drugs must be stored in a locked compartment. Schedule II drugs, as defined by Minnesota Statutes, section 152.02, must be stored in a separately locked compartment, permanently affixed to the physical plant or medication cart; 

B.
 a system which accounts for all scheduled drugs each shift; 

C.
 a procedure for recording the client's use of medication, including the signature of the administrator of the medication with the time and date; 

D.
 a procedure for destruction of discontinued, outdated, or deteriorated medications; 

E.
 a statement that only authorized personnel are permitted to have access to the keys to the locked drug compartments; and 

F.
 a statement that no legend drug supply for one client will be given to another client. 

9530.6440CLIENT RECORDS. Subpart 1.Client records required.  
A license holder must maintain a file of current client records on the premises where the treatment services are provided or coordinated. The content and format of client records must be uniform and entries in each case must be signed and dated by the staff member making the entry. Client records must be protected against loss, tampering, or unauthorized disclosure in compliance with Minnesota Statutes, section 254A.09, Code of Federal Regulations, title 42, chapter 1, part 2, subpart B, sections 2.1 to 2.67, and Code of Federal Regulations, title 45, parts 160 to 164, and, if applicable, Minnesota Statutes, chapter 13. 

Subp. 2.Records retention.  
Records of discharged clients must be retained by a license holder for seven years. License holders that cease to provide treatment services must retain client records for seven years from the date of facility closure and must notify the commissioner of the location of the records and the name of a person responsible for maintaining the records. 

Subp. 3.Client records, contents.  
Client records must contain the following: 

A.
 documentation that the client was given information on client rights, responsibilities, grievance procedures, tuberculosis, and HIV, and that the client was provided an orientation to the program abuse prevention plan as required under Minnesota Statutes, section 245A.65, subdivision 2, paragraph (a), clause (4); 

B.
 an initial services plan completed according to part 9530.6420; 

C.
 a comprehensive assessment completed according to part 9530.6422; 

D. 
 an assessment summary completed according to part 9530.6422, subpart 2; 

E. 
 an individual abuse prevention plan that complies with Minnesota Statutes, sections 245A.65, subdivision 2, and 626.557, subdivision 14, when applicable; 

F. 
 an individual treatment plan, as required under part 9530.6425, subparts 1 and 2; 

G. 
 progress notes, as required in part 9530.6425, subpart 3; and  

H. 
 a summary of termination of services, written according to part 9530.6425, subpart 4. 

Subp. 4.Electronic records.  
A license holder who intends to use electronic record keeping or electronic signatures to comply with parts 9530.6405 to 9530.6505 must first obtain written permission from the commissioner. The commissioner must grant permission after the license holder provides documentation demonstrating the license holder's use of a system for ensuring security of electronic records. Use of electronic record keeping or electronic signatures does not alter the license holder's obligations under state or federal law, regulation, or rule. 

9530.6445STAFFING REQUIREMENTS. Subpart 1.Treatment director required.  
A license holder must have a treatment director. 

Subp. 2.Alcohol and drug counselor supervisor requirements.  
A license holder must employ an alcohol and drug counselor supervisor who meets the requirements under part 9530.6450, subpart 4. An individual may be simultaneously employed as a treatment director, alcohol and drug counselor supervisor, and an alcohol and drug counselor if the individual meets the qualifications for each position. If an alcohol and drug counselor is simultaneously an alcohol and drug counselor supervisor or treatment director, that individual must be considered a 0.5 full-time equivalent alcohol and drug counselor for purposes of meeting the staffing requirements under subpart 4. 

Subp. 3.Responsible staff person.  
A treatment director must designate a staff member who, when present in the facility, is responsible for the delivery of treatment services. A license holder must have a designated staff person during all hours of operation. A license holder providing room and board and treatment at the same site must have a responsible staff person on duty 24 hours a day. The designated staff person must know and understand the implications of parts 9530.6405 to 9530.6505 and Minnesota Statutes, sections 245A.65, 626.556, 626.557, and 626.5572. 

Subp. 4.Staffing requirements.  
At least 25 percent of a counselor's scheduled work hours must be allocated to indirect services, including documentation of client services, coordination of services with others, treatment team meetings, and other duties. A counseling group shall not exceed an average of 16 clients during any 30 consecutive calendar days. It is the responsibility of the license holder to determine an acceptable group size based on the client's needs. A counselor in a program treating intravenous drug abusers must not supervise more than 50 clients. The license holder must maintain a record that documents compliance with this subpart. 

Subp. 5.Medical emergencies.  
When clients are present, a license holder must have at least one staff person on the premises who has a current American Red Cross standard first aid certificate or an equivalent certificate and at least one staff person on the premises who has a current American Red Cross community, American Heart Association, or equivalent CPR certificate. A single staff person with both certifications satisfies this requirement. 

9530.6450STAFF QUALIFICATIONS. Subpart 1.Qualifications of all staff members with direct client contact.  
All staff members who have direct client contact must be at least 18 years of age. At the time of hiring, all staff members must meet the qualifications in item A or B. A chemical use problem for purposes of this subpart is a problem listed by the license holder in the personnel policies and procedures according to part 9530.6460, subpart 1, item E. 

A.
 Treatment directors, supervisors, nurses, counselors, and other professionals must be free of chemical use problems for at least the two years immediately preceding their hiring and must sign a statement attesting to that fact. 

B.
 Paraprofessionals and all other staff members with direct client contact must be free of chemical use problems for at least one year immediately preceding their hiring and must sign a statement attesting to that fact. 

Subp. 2.Employment; prohibition on chemical use problems.  
Staff members with direct client contact must be free from chemical use problems as a condition of employment, but are not required to sign additional statements. Staff members with direct client contact who are not free from chemical use problems must be removed from any responsibilities that include direct client contact for the time period specified in subpart 1. The time period begins to run on the date the employee begins receiving treatment services or the date of the last incident as described in the list developed according to part 9530.6460, subpart 1, item E. 

Subp. 3.Treatment director qualifications.  
In addition to meeting the requirements of subpart 1, a treatment director must know and understand the implications of parts 9530.6405 to 9530.6505 and Minnesota Statutes, chapter 245A, and sections 626.556, 626.557, and 626.5572. A treatment director must: 

A.
 have at least one year of work experience in direct service to individuals with chemical use problems or one year of work experience in the management or administration of direct service to individuals with chemical use problems; and 

B.
 have a baccalaureate degree or three years of work experience in administration or personnel supervision in human services. 

Subp. 4.Alcohol and drug counselor supervisor qualifications.  
In addition to meeting the requirements of subpart 1, an alcohol and drug counselor supervisor must meet the following qualifications: 

A.
 the individual is competent in the areas specified in subpart 5; 

B.
 the individual has three or more years of experience providing individual and group counseling to chemically dependent clients except that, prior to January 1, 2005, an individual employed in a program formerly licensed under parts 9530.5000 to 9530.6400is required to have one or more years experience; and 

C.
 the individual knows and understands the implications of parts 9530.6405 to 9530.6505 and Minnesota Statutes, sections 245A.65, 626.556, 626.557, and 626.5572. 

Subp. 5.Alcohol and drug counselor qualifications.  
In addition to meeting the requirements of subpart 1, an alcohol and drug counselor must be either licensed or exempt from licensure under Minnesota Statutes, chapter 148C. An alcohol and drug counselor must document competence in screening for and working with clients with mental health problems, through education, training, and experience. 

A.
 Alcohol and drug counselors licensed under Minnesota Statutes, chapter 148C, must comply with rules adopted under Minnesota Statutes, chapter 148C. 

B.
 Counselors exempt under Minnesota Statutes, chapter 148C, must be competent, as evidenced by one of the following: 

(1)
 completion of at least a baccalaureate degree with a major or concentration in social work, nursing, sociology, human services, or psychology, or licensure as a registered nurse; successful completion of a minimum of 120 hours of classroom instruction in which each of the core functions listed in Minnesota Statutes, chapter 148C, is covered; and successful completion of 440 hours of supervised experience as an alcohol and drug counselor, either as a student or as a staff member; 

(2)
 completion of 270 hours of alcohol and drug counselor training in which each of the core functions listed in Minnesota Statutes, chapter 148C, is covered, and successful completion of 880 hours of supervised experience as an alcohol and drug counselor, either as a student, or as a staff member; 

(3)
 current certification as an alcohol and drug counselor or alcohol and drug counselor reciprocal, through the evaluation process established by the International Certification and Reciprocity Consortium Alcohol and Other Drug Abuse, Inc., and published in the Case Presentation Method Trainer's Manual, copyright 1993. The manual is incorporated by reference. It is available at the State Law Library, Judicial Center, 25 Reverend Dr. Martin Luther King Jr. Blvd., St. Paul, Minnesota 55155; 

(4)
 completion of a bachelor's degree including 480 hours of alcohol and drug counseling education from an accredited school or educational program and 880 hours of alcohol and drug counseling practicum; or 

(5)
 employment in a program formerly licensed under parts 9530.5000 to 9530.6400 and successful completion of 6,000 hours of supervised work experience in a licensed program as an alcohol and drug counselor prior to January 1, 2005. 

Subp. 6.Paraprofessional qualifications and duties.  
A paraprofessional must comply with subpart 1 and have knowledge of client rights, outlined in Minnesota Statutes, section 148F.165, and of staff responsibilities. A paraprofessional may not admit, transfer, or discharge clients but may be the person responsible for the delivery of treatment services as required in part 9530.6445, subpart 3. 

Subp. 7.Volunteers.  
Volunteers may provide treatment services when they are supervised and can be seen or heard by a staff member meeting the criteria in subpart 4 or 5, but may not practice alcohol and drug counseling unless qualified under subpart 5. 

Subp. 8.Student interns.  
A qualified staff person must supervise and be responsible for all treatment services performed by student interns and must review and sign all assessments, progress notes, and treatment plans prepared by the intern. Student interns must meet the requirements in subpart 1, item A, and receive the orientation and training required in part 9530.6460, subpart 1, item G, and subpart 2. 

Subp. 9.Individuals with temporary permit.  
Individuals with a temporary permit from the Board of Behavioral Health and Therapy may provide chemical dependency treatment services under the conditions in either item A or B. 

A.
 The individual is supervised by a licensed alcohol and drug counselor assigned by the license holder. The licensed alcohol and drug counselor must document the amount and type of supervision at least weekly. The supervision must relate to clinical practices. One licensed alcohol and drug counselor may not supervise more than three individuals with temporary permits, according to Minnesota Statutes, section 148C.01, subdivision 12a. 

B.
 The individual is supervised by a clinical supervisor approved by the Board of Behavioral Health and Therapy. The supervision must be documented and meet the requirements of Minnesota Statutes, section 148C.044, subdivision 4. 

9530.6455PROVIDER POLICIES AND PROCEDURES. 
License holders must develop a written policy and procedures manual indexed according to Minnesota Statutes, section 245A.04, subdivision 14, paragraph (c), so that staff may have immediate access to all policies and procedures and so that consumers of the services and other authorized parties may have access to all policies and procedures. The manual must contain the following materials: 

A.
 assessment and treatment planning policies, which include screening for mental health concerns, and the inclusion of treatment objectives related to identified mental health concerns in the client's treatment plan; 

B.
 policies and procedures regarding HIV that comply with Minnesota Statutes, section 245A.19; 

C.
 the methods and resources used by the license holder to provide information on tuberculosis and tuberculosis screening to all clients and to report known cases of tuberculosis infection according to Minnesota Statutes, section 144.4804; 

D.
 personnel policies that comply with part 9530.6460; 

E.
 policies and procedures that protect client rights as required under part 9530.6470; 

F.
 a medical services plan that complies with part 9530.6435; 

G.
 emergency procedures that comply with part 9530.6475; 

H.
 policies and procedures for maintaining client records under part 9530.6440; 

I.
 procedures for reporting the maltreatment of minors under Minnesota Statutes, section 626.556, and vulnerable adults under Minnesota Statutes, sections 245A.65, 626.557, and 626.5572; 

J.
 a description of treatment services including the amount and type of client services provided; 

K.
 the methods used to achieve desired client outcomes; and 

L.
 the hours of operation and target population served. 

9530.6460PERSONNEL POLICIES AND PROCEDURES. Subpart 1.Policy requirements.  
License holders must have written personnel policies and must make them available to each staff member. The policies must: 

A.
 assure that staff member retention, promotion, job assignment, or pay are not affected by a good faith communication between a staff member and the Department of Health, the Department of Human Services, the ombudsman for mental health and developmental disabilities, law enforcement, or local agencies for the investigation of complaints regarding a client's rights, health, or safety; 

B.
 contain job descriptions for each position specifying responsibilities, degree of authority to execute job responsibilities, and qualifications; 

C.
 provide for job performance evaluations based on standards of job performance to be conducted on a regular and continuing basis, including a written annual review; 

D.
 describe behavior that constitutes grounds for disciplinary action, suspension or dismissal, including policies that address chemical use problems and meet the requirements of part 9530.6450, subpart 1, policies prohibiting personal involvement with clients in violation of Minnesota Statutes, chapter 604, and policies prohibiting client abuse as specified under Minnesota Statutes, sections 245A.65, 626.556, 626.557, and 626.5572; 

E.
 list behaviors or incidents that are considered chemical use problems. The list must include: 

(1)
 receiving treatment for chemical use within the period specified for the position in the staff qualification requirements; 

(2)
 chemical use that has a negative impact on the staff member's job performance; 

(3)
 chemical use that affects the credibility of treatment services with clients, referral sources, or other members of the community; and 

(4)
 symptoms of intoxication or withdrawal on the job; 

F.
 include a chart or description of the organizational structure indicating lines of authority and responsibilities; 

G.
 include orientation within 24 working hours of starting for all new staff based on a written plan that, at a minimum, must provide for training related to the specific job functions for which the staff member was hired, policies and procedures, client confidentiality, the human immunodeficiency virus minimum standards, and client needs; and 

H.
 policies outlining the license holder's response to staff members with behavior problems that interfere with the provision of treatment services. 

Subp. 2.Staff development.  
A license holder must ensure that each staff person has the training required in items A to E.  

A.
 All staff must be trained every two years in client confidentiality rules and regulations and client ethical boundaries. 

B.
 All staff must be trained every two years in emergency procedures and client rights as specified in Minnesota Statutes, sections 144.651, 148F.165, and 253B.03. 

C.
 All staff with direct client contact must be trained every year on mandatory reporting as specified under Minnesota Statutes, sections 245A.65, 626.556, 626.5561, 626.5563, 626.557, and 626.5572, including specific training covering the facility's policies concerning obtaining client releases of information. 

D.
 All staff with direct client contact must receive training upon hiring and annually thereafter on the human immunodeficiency virus minimum standards according to Minnesota Statutes, section 245A.19. 

E.
 Treatment directors, supervisors, nurses, and counselors must obtain 12 hours of training in co-occurring mental health problems and substance use disorder that includes competencies related to philosophy, screening, assessment, diagnosis and treatment planning, documentation, programming, medication, collaboration, mental health consultation, and discharge planning. Staff employed by a license holder on the date this rule is adopted must obtain the training within 12 months of the date of adoption. New staff who have not obtained such training must obtain it within 12 months of the date this rule is adopted or within six months of hire, whichever is later. Staff may request, and the license holder may grant credit for, relevant training obtained prior to January 1, 2005. 

Subp. 3.Personnel files.  
The license holder must maintain a separate personnel file for each staff member. At a minimum, the personnel file must be maintained to meet the requirements under parts 9530.6405 to 9530.6505 and contain the following: 

A.
 a completed application for employment signed by the staff member and containing the staff member's qualifications for employment; 

B.
 documentation related to the applicant's background study data, as defined in Minnesota Statutes, chapter 245C; 

C.
 for staff members who will be providing psychotherapy services, employer names and addresses for the past five years for which the staff member provided psychotherapy services, and documentation of an inquiry made to these former employers regarding substantiated sexual contact with a client as required by Minnesota Statutes, chapter 604; 

D.
 documentation of completed orientation and training; 

E.
 documentation demonstrating compliance with parts 9530.6450 and 9530.6485, subpart 2; and 

F.
 documentation demonstrating compliance with part 9530.6435, subpart 3, for staff members who administer medications. 

9530.6465SERVICE INITIATION AND TERMINATION POLICIES. Subpart 1.Service initiation policy.  
A license holder must have a written service initiation policy containing service initiation preferences which comply with this rule and Code of Federal Regulations, title 45, part 96.131, and specific service initiation criteria. The license holder must not initiate services for individuals who do not meet the service initiation criteria. The service initiation criteria must be either posted in the area of the facility where services for clients are initiated, or given to all interested persons upon request. Titles of all staff members authorized to initiate services for clients must be listed in the services initiation and termination policies. A license holder that serves intravenous drug abusers must have a written policy that provides service initiation preference as required by Code of Federal Regulations, title 45, part 96.131. 

Subp. 2.License holder responsibilities; terminating or denying services.  
A license holder has specific responsibilities when terminating services or denying treatment service initiation to clients for reasons of health, behavior, or criminal activity. 

A.
 The license holder must have and comply with a written protocol for assisting clients in need of care not provided by the license holder, and for clients who pose a substantial likelihood of harm to themselves or others, if the behavior is beyond the behavior management capabilities of the staff. All service terminations and denials of service initiation which pose an immediate threat to the health of any individual or require immediate medical intervention must be referred to a medical facility capable of admitting the individual. 

B.
 All service termination policies and denials of service initiation that involve the commission of a crime against a license holder's staff member or on a license holder's property, as provided under Code of Federal Regulations, title 42, section 2.12(c)(5), and Code of Federal Regulations, title 45, parts 160 to 164, must be reported to a law enforcement agency with proper jurisdiction. 

Subp. 3.Service termination and transfer policies.  
A license holder must have a written policy specifying the conditions under which clients must be discharged. The policy must include: 

A.
 procedures for individuals whose services have been terminated under subpart 2; 

B.
 a description of client behavior that constitutes reason for a staff-requested service termination and a process for providing this information to clients; 

C.
 procedures consistent with Minnesota Statutes, section 253B.16, subdivision 2, that staff must follow when a client admitted under Minnesota Statutes, chapter 253B, is to have services terminated; 

D.
 procedures staff must follow when a client leaves against staff or medical advice and when the client may be dangerous to self or others; 

E.
 procedures for communicating staff-approved service termination criteria to clients, including the expectations in the client's individual treatment plan according to part 9530.6425; and 

F.
 titles of staff members authorized to terminate client services must be listed in the service initiation and termination policies. 

9530.6470POLICIES AND PROCEDURES THAT PROTECT CLIENT RIGHTS. Subpart 1.Client rights; explanation.  
Clients have the rights identified in Minnesota Statutes, sections 144.651, 148F.165, and 253B.03, as applicable. The license holder must give each client upon service initiation a written statement of client's rights and responsibilities. Staff must review the statement with clients at that time. 

Subp. 2.Grievance procedure.  
Upon service initiation, the license holder must explain the grievance procedure to the client or their representative. The grievance procedure must be posted in a place visible to clients, and made available upon a client's request. The grievance procedure must also be made available to former clients upon request. The grievance procedure must require that: 

A.
 staff help the client develop and process a grievance; 

B.
 telephone numbers and addresses of the Department of Human Services, licensing division; the Office of Ombudsman for Mental Health and Developmental Disabilities; the Minnesota Department of Health, Office of Alcohol and Drug Counselor Licensing Program, and Office of Health Facilities Complaints; when applicable, be made available to clients; and 

C.
 a license holder be obligated to respond to the client's grievance within three days of a staff member's receipt of the grievance, and the client be permitted to bring the grievance to the highest level of authority in the program if not resolved by other staff members. 

Subp. 3.Photographs of client.  
All photographs, video tapes, and motion pictures of clients taken in the provision of treatment services are considered client records. Photographs for identification and recordings by video and audio tape for the purpose of enhancing either therapy or staff supervision may be required of clients, but may only be available for use as communications within a program. Clients must be informed when their actions are being recorded by camera or tape, and have the right to deny any taping or photography, except as authorized by this subpart. 

9530.6475BEHAVIORAL EMERGENCY PROCEDURES. A.
 A license holder or applicant must have written procedures that staff must follow when responding to a client who exhibits behavior that is threatening to the safety of the client or others. The procedures must include: 

(1)
 a plan designed to prevent the client from hurting themselves or others; 

(2)
 contact information for emergency resources that staff must consult when a client's behavior cannot be controlled by the procedures established in the plan; 

(3)
 types of procedures that may be used; 

(4)
 circumstances under which emergency procedures may be used; and 

(5)
 staff members authorized to implement emergency procedures. 

B.
 Behavioral emergency procedures must not be used to enforce facility rules or for the convenience of staff. Behavioral emergency procedures must not be part of any client's treatment plan, or used at any time for any reason except in response to specific current behaviors that threaten the safety of the client or others. Behavioral emergency procedures may not include the use of seclusion or restraint. 

9530.6480EVALUATION. Subpart 1.Participation in drug and alcohol abuse normative evaluation system.  
License holders must participate in the drug and alcohol abuse normative evaluation system by submitting information about each client to the commissioner in a format specified by the commissioner. 

Subp. 2.Commissioner requests.  
A license holder must submit additional information requested by the commissioner that is necessary to meet statutory or federal funding requirements. 

9530.6485LICENSE HOLDERS SERVING ADOLESCENTS. Subpart 1.License holders serving adolescents.  
A residential treatment program that serves persons under 18 years of age must be licensed as a residential program for children in out-of-home placement by the department unless the license holder is exempt under Minnesota Statutes, section 245A.03, subdivision 2. 

Subp. 2.Alcohol and drug counselor qualifications.  
In addition to the requirements specified in part 9530.6450, subparts 1 and 5, an alcohol and drug counselor providing treatment services to adolescents must have: 

A.
 an additional 30 hours of classroom instruction or one three-credit semester college course in adolescent development. This training need only be completed one time; and 

B.
 at least 150 hours of supervised experience as an adolescent counselor, either as a student or as a staff member. 

Subp. 3.Staffing ratios.  
At least 25 percent of a counselor's scheduled work hours must be allocated to indirect services, including documentation of client services, coordination of services with others, treatment team meetings, and other duties. A counseling group consisting entirely of adolescents must not exceed 16 clients. It is the responsibility of the license holder to determine an acceptable group size based on the needs of the clients. 

Subp. 4.Academic program requirements.  
Clients who are required to attend school must be enrolled and attending an educational program that has been approved by the Minnesota Department of Education. 

Subp. 5.Program requirements.  
In addition to the requirements specified in the client's treatment plan under part 9530.6425, programs serving adolescents must include the following: 

A.
 coordination with the school system to address the client's academic needs; 

B.
 when appropriate, a plan that addresses the client's leisure activities without chemical use; and 

C.
 a plan that addresses family involvement in the adolescent's treatment. 

9530.6490LICENSE HOLDERS SERVING CLIENTS WITH CHILDREN. Subpart 1.Health license requirements.  
In addition to the requirements of parts 9530.6405 to 9530.6480, all license holders that offer supervision of children of clients are subject to the requirements of this part. License holders providing room and board for clients and their children must have an appropriate facility license from the Minnesota Department of Health. 

Subp. 2.Supervision of children defined.  
"Supervision of children" means a caregiver is within sight or hearing of an infant, toddler, or preschooler at all times so that the caregiver can intervene to protect the health and safety of the child. For the school age child it means a caregiver is available to help and care for the child so that the child's health and safety is protected. 

Subp. 3.Policy and schedule required.  
License holders must meet the following requirements: 

A.
 license holders must have a policy and schedule delineating the times and circumstances under which the license holder is responsible for supervision of children in the program and when the child's parents are responsible for child supervision. The policy must explain how the program will communicate its policy about child supervision responsibility to the parents; and 

B.
 license holders must have written procedures addressing the actions to be taken by staff if children are neglected or abused including while the children are under the supervision of their parents. 

Subp. 4.Additional licensing requirements.  
During the times the license holder is responsible for the supervision of children, the license holder must meet the following standards: 

A.
 child and adult ratios in part 9502.0367; 

B.
 day care training in Minnesota Statutes, section 245A.50; 

C.
 behavior guidance in part 9502.0395; 

D.
 activities and equipment in part 9502.0415; 

E.
 physical environment in part 9502.0425; and 

F.
 water, food, and nutrition in part 9502.0445, unless the license holder has a license from the Minnesota Department of Health. 

9530.6495LICENSE HOLDERS SERVING PERSONS WITH SUBSTANCE USE AND MENTAL HEALTH DISORDERS. 
In addition to meeting the requirements of parts 9530.6405 to 9530.6490, license holders specializing in the treatment of persons with substance use disorder and mental health problems must: 

A.
 demonstrate that staffing levels are appropriate for treating clients with substance use disorder and mental health problems, and that there is adequate staff with mental health training; 

B.
 have continuing access to a medical provider with appropriate expertise in prescribing psychotropic medications; 

C.
 have a mental health professional available for staff supervision and consultation; 

D.
 determine group size, structure, and content with consideration for the special needs of those with substance use disorder and mental health disorders; 

E.
 have documentation of active interventions to stabilize mental health symptoms present in treatment plans and progress notes; 

F.
 have continuing documentation of collaboration with continuing care mental health providers, and involvement of those providers in treatment planning meetings; 

G.
 have available program materials adapted to individuals with mental health problems; 

H.
 have policies that provide flexibility for clients who may lapse in treatment or may have difficulty adhering to established treatment rules as a result of a mental illness, with the goal of helping clients successfully complete treatment; and 

I.
 have individual psychotherapy and case management available during the treatment process. 

9530.6500PROGRAMS SERVING INTRAVENOUS DRUG ABUSERS. Subpart 1.Additional requirements.  
In addition to the requirements of parts 9530.6405 to 9530.6505, programs serving intravenous drug abusers must comply with the requirements of this part. 

Subp. 2.Capacity management and waiting list system compliance.  
A program serving intravenous drug abusers must notify the department within seven days of when the program reaches both 90 and 100 percent of the program's capacity to care for clients. Each week, the program must report its capacity, current enrolled dosing clients, and any waiting list. A program reporting 90 percent of capacity must also notify the department when its census has increased or decreased from the 90 percent level. 

Subp. 3.Waiting list.  
A program serving intravenous drug abusers must have a waiting list system. Each person seeking admission must be placed on the waiting list if the person cannot be admitted within 14 days of the date of application, unless the applicant is assessed by the program and found not to be eligible for admission according to parts 9530.6405 to 9530.6505, and Code of Federal Regulations, title 42, part 1, subchapter A, section 8.12(e), and Code of Federal Regulations, title 45, parts 160 to 164. The waiting list must assign a unique patient identifier for each intravenous drug abuser seeking treatment while awaiting admission. An applicant on a waiting list who receives no services under part 9530.6430, subpart 1, must not be considered a "client" as defined in part 9530.6405, subpart 8. 

Subp. 4.Client referral.  
Programs serving intravenous drug abusers must consult the capacity management system so that persons on waiting lists are admitted at the earliest time to a program providing appropriate treatment within a reasonable geographic area. If the patient has been referred through a public payment system and if the program is not able to serve the client within 14 days of the date of application for admission, the program must contact and inform the referring agency of any available treatment capacity listed in the state capacity management system. 

Subp. 5.Outreach.  
Programs serving intravenous drug abusers must carry out activities to encourage individuals in need of treatment to undergo treatment. The program's outreach model must: 

A.
 select, train, and supervise outreach workers; 

B.
 contact, communicate, and follow up with high risk substance abusers, their associates, and neighborhood residents within the constraints of federal and state confidentiality requirements, including Code of Federal Regulations, title 42, sections 2.1 to 2.67, and Code of Federal Regulations, title 45, parts 160 to 164; 

C.
 promote awareness among injecting drug abusers about the relationship between injecting drug abuse and communicable diseases such as HIV; and 

D.
 recommend steps that can be taken to ensure that HIV transmission does not occur. 

Subp. 6.Central registry.  
Programs serving intravenous drug abusers must comply with requirements to submit information and necessary consents to the state central registry for each client admitted, as specified by the commissioner. The client's failure to provide the information will prohibit involvement in an opiate treatment program. The information submitted must include the client's: 

A.
 full name and all aliases; 

B.
 date of admission; 

C.
 date of birth; 

D.
 Social Security number or INS number, if any; 

E.
 enrollment status in other current or last known opiate treatment programs; 

F.
 government-issued photo-identification card number; and 

G.
 driver's license number, if any. 

The information in items A to G must be submitted in a format prescribed by the commissioner, with the original kept in the client's chart, whenever a client is accepted for treatment, the client's type or dosage of a drug is changed, or the client's treatment is interrupted, resumed, or terminated. 

9530.6505REQUIREMENTS FOR LICENSED RESIDENTIAL TREATMENT. Subpart 1.Applicability.  
A license holder who provides supervised room and board at the licensed program site as a treatment component is defined as a residential program according to Minnesota Statutes, section 245A.02, subdivision 14, and is subject to this part. 

Subp. 2.Visitors.  
Clients must be allowed to receive visitors at times prescribed by the license holder. The license holder must set and post a notice of visiting rules and hours, including both day and evening times. A client's right to receive visitors other than a personal physician, religious advisor, county case manager, parole or probation officer, or attorney may be subject to visiting hours established by the license holder for all clients. The treatment director or designee may impose limitations as necessary for the welfare of a client provided that limitations and the reasons for them are documented in the client's file. Clients must be allowed to receive visits at all reasonable times from their personal physicians, religious advisors, county case managers, parole or probation officers, and attorneys. 

Subp. 3.Client property management.  
A license holder who provides room and board and treatment services to clients in the same facility, and any license holder that accepts client property must meet the requirements in Minnesota Statutes, section 245A.04, subdivision 13, for handling resident funds and property. In the course of client property management, license holders: 

A.
 may establish policies regarding the use of personal property to assure that treatment activities and the rights of other patients are not infringed; 

B.
 may take temporary custody of property for violation of facility policies; 

C.
 must retain the client's property for a minimum of seven days after discharge if the client does not reclaim property upon service termination, or for a minimum of 30 days if the client does not reclaim property upon service termination and has received room and board services from the license holder; and 

D.
 must return all property held in trust to the client upon service termination regardless of the client's service termination status, except: 

(1)
 drugs, drug paraphernalia, and drug containers that are forfeited under Minnesota Statutes, section 609.5316, must be destroyed by staff or given over to the custody of a local law enforcement agency, according to Code of Federal Regulations, title 42, chapter 1, part 2, subpart B, sections 2.1 to 2.67, and Code of Federal Regulations, title 45, parts 160 to 164; 

(2)
 weapons, explosives, and other property which can cause serious harm to self or others must be given over to the custody of a local law enforcement agency, and the client must be notified of the transfer and of the right to reclaim any lawful property transferred; and 

(3)
 medications that have been determined by a physician to be harmful after examining the client, except when the client's personal physician approves the medication for continued use. 

Subp. 4.Health facility license.  
A license holder who provides room and board and treatment services in the same facility must have the appropriate license from the Department of Health. 

Subp. 5.Facility abuse prevention plan.  
A license holder must establish and enforce an ongoing facility abuse prevention plan consistent with Minnesota Statutes, sections 245A.65 and 626.557, subdivision 14. 

Subp. 6.Individual abuse prevention plan.  
A license holder must prepare an individual abuse prevention plan for each client as specified under Minnesota Statutes, sections 245A.65, subdivision 2, and 626.557, subdivision 14. 

Subp. 7.Health services.  
License holders must have written procedures for assessing and monitoring client health, including a standardized data collection tool for collecting health-related information about each client. The policies and procedures must be approved and signed by a registered nurse. 

Subp. 8.Administration of medications.  
License holders must meet the administration of medications requirements of part 9530.6435, subpart 3.